Friday Edition

My scratched cornea is still a mess and painful, and I'm having trouble reading and writing. So here's a quick update -- I'm not sure it's 100 percent complete, but it's the best I can do for you this morning.

Now that there's a 2 week extension of the budget, negotiations are under way for a longer term solution. The White House has proposed more cuts, but not enough for the GOP. The House GOP continues to search for ways to defund health reform.

And the parties are in a game of "chicken" over Medicare and other entitlement reform -- who will propose cuts first and take the political blame? Well, House GOP speaker John Boehner says cuts to Medicare and Social Security will be in the GOP budget proposal. More here. Interestingly, Boehner is quoted today as having told President Obama that entitlement reform can be bipartisan, so neither party takes the hit. Meanwhile, groups are already starting to mount opposition to GOP plans to privatize Medicare using a voucher system.

Again, the judge in Florida stayed his own decision, so health reform implementation can proceed.

The GOP is now going after the head of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, writing to the President to ask him to withdraw his nomination. It appears they have the votes to block the nomination. This is disastrous, both because Dr. Berwick is truly an amazing visionary, and because he's already played such a key role in health reform implementation. This makes me think the motivation here is to do whatever they can to undermine that implementation.

Congress is still trying to figure out how to work out the differences in the 1099 reporting requirement repeal. They all agree it needs to go, but they don't agree on how to pay for it. The GOP wants it to come out of middle class subsidies. The Dems and the White House disagree. Stay tuned.

The marvelous Dr. Pauline Chen writes about what the ethical thing to do is when a patient's optimism is unrealistic.

That's it for now. Jennifer