Tuesday's Tidbits

It's getting ugly in Washington over the budget. Let's see what's in the papers:

Congress is at an impasse on the budget. They can't decide on the starting point for negotiation -- do we cut from current spending levels, or do we start from the House bill that cut $61 billion and defunded health reform and Planned Parenthood? The Dems say we cut from current spending levels -- and they've already cut $10 billion in the last two temporary budgets. The GOP says discussions have to start from their proposal, which contains the poison pills of defunding, which the Dems are not prepared to consider. Are we heading towards a show-down and/or a shut-down? The Wall St. Journal says a shut-down is likely. Politico says it's really about the "riders" -- defunding health reform and Planned Parenthood -- because the GOP has to please the Tea Partiers. Conservatives are, indeed, challenging the GOP leadership and expecting huge cuts in Medicaid and Medicare for the 2012 budget -- which they haven't started even looking at yet. Dems are trying to force GOP leadership to choose between the Tea Party conservatives or a compromise deal that would alienate the Tea Party -- and it's not clear that the GOP would have the votes in the House without the Tea Partiers. What would a shut-down look like? HuffPo describes it here.

And several religious leaders have gone on a hunger strike to protest the GOP budget cuts to the safety net programs that care for the poor, the sick, the elderly. They say the budget is a moral document.

Meanwhile, the cost of health reform won't really be known for sure until HHS announces the "essential benefits package" -- what has to be covered by the plans offered through the Exchange. The Institute of Medicine is working on proposals. But it's going to be tricky -- being generous enough so people aren't outraged by limitations on benefits, while being limited enough not to break the bank. This is one of the most important pieces of health reform, and we're all sitting on the edge of our seats waiting to see how it plays out.

A new report says Medicaid is wasting money on brand name drugs when it could have used generics.

The federal Office of Policy and Management has asked insurers to provide incentives to federal government employees for wellness programs.

Despite the national debt, although members of Congress may return all or part of their salaries, none of the millionaires in Congress does so.

Michigan -- a state with HUGE unemployment -- has cut unemployment benefits by 6 weeks. Does this make sense to anybody?

Nurses are playing an increasingly greater role in health care -- especially primary care.

A new study shows that roughly half of men don't go to the doctor. Not even for an annual check up. Which means they don't get preventive care. Which means when they get sick, it may be too late.

Some say the way to combat rising health care costs is through innovation. One option is medical homes, where the patient and primary care provider coordinate care, plan care, and oversee the whole patient. Intensive care units are getting a makeover. Mobile technology for medicine is a booming industry, like cell phone-sized portable ultrasound machines. And then there are accountable care organizations -- large groups of providers making one-stop medicine the goal.

Hospitals increasingly use palliative care -- care that makes you feel better by dealing with pain, shortness of breath, fatigue -- and result in better health outcomes.

Most doctors who write clinical guidelines have conflicts of interests, a new study shows. This study was in cardiovascular medicine.

And that's today's news. Jennifer