Tuesday Tidbits

It's hot in here. And I don't think the news is going to be cool, either.

Starting the day with more salt in the wound from Orrin Hatch, who once again says the bottom 51% of Americans are not paying their fair share of taxes? This was his idea of backing off a comment he made last week that the poor should be paying more. Now, he says not the really, really poor who would be doing better if they could -- just the bottom 51% of Americans whom he apparently believes are poor by choice. This requires no further comment, does it?

The President has decided to be mediator-in-chief, depicting himself as the only grown-up willing to make compromises on a debt deal. He's prepared to take heat from his party, he said, if the GOP leadership would do the same. No deal. Speaker Boehner says the GOP's big compromise is increasing the debt limit at all, and he will not consider revenue raisers. It appears that the parties are stuck. WaPo reports that the Speaker offered Medicare cuts in the form of wealthiest seniors paying more and imposing copays on home health care, but the President refuses to burden seniors without also asking the wealthiest Americans to pay more in taxes. Americans are increasingly concerned about the debt limit and defaulting on our debt. Majority Leader Eric Cantor is playing an increasingly large and obstructionist role, prepared to walk out of any negotiations he doesn't like, thereby placing a strain on his relationship with Speaker Boehner. And finally, we hear from business, as the Chamber of Commerce urges the parties to make a deal now. Meanwhile Sen. Kent Conrad says he has the votes in the Senate for a "grand bargain." Um, Senator, that's nice, but it's the House that's totally split.

The federal regulations containing rules about how the new Exchanges (insurance marketplaces) will work came out yesterday. Small business owners like them because they should be able to get less expensive insurance for their employees. The biggest controversy is over whether Exchanges should choose plans to offer to the public, or whether they should let every plan into the Exchange. The regulations allow states to decide. But the regulations also allow insurers to sit on the Board of the Exchange -- never has there been a clearer conflict of interest. I haven't yet read all 244 pages, although you can be sure I will. But the reports are that states have been given latitude to craft arrangements that make sense in their states, while ensuring consumer choice. I'll let you know what I think when I read them. I have a couple of insurance appeals I have to write first. In the meantime, here's a simple guide of health insurance exchanges.

Insurers are beginning to offer a private alternative to Exchanges, setting up all the options and allowing workers to select from among the plans their employees will contribute to. Sort of an interesting, innovative idea.

Interesting issue: should doctors guard the medical privacy of teen-agers? This has always been a huge issue for reproductive health care, and you can imagine that teens don't want their parents to know they're sexually active. But what about mental health issues? Others?

There's a new computer system for catching Medicare fraud -- about time. It raises alerts about suspicious claims, directing investigators where they should look more closely.

Most of us believe it's healthier to live in the country, but the Wall St. Journal says we're wrong. Suburban dwellers are the best off.

And on that note, I leave you to the day. Stay cool and have a great day! Jennifer