Flight to Mars Day Edition

Of course, I couldn't get on a plane and head to Seattle without first giving you today's news. So here goes.

No deal on the budget yet, but they say they're still talking and making progress. They are about $5 billion apart, so that can be handled. But they are stuck on the policy issues -- gutting the EPA regulatory authority and further tightening restrictions on abortion (how much tighter can they get than no federal funding ever under any circumstances?). Once again, it appears the issue isn't really about money. At least some of the policy issues are deal breakers, though. They issues are environmental regulation, allowing abortions in the District of Columbia with non-federal dollars, and defunding Planned Parenthood, which is a poison pill for Dems. But some Dems say they'd accept a short-term extension like the GOP proposes, but without the policy riders that the GOP attached to their latest proposal. The Wall St. Journal calls it dickering and they blame President Obama, suggesting that he wants a shutdown. But HuffPo blames the GOP for threatening a shut-down over defunding Planned Parenthood. Harry Reid says it's all about GOP culture wars. Sen. Schumer says there will be a shutdown unless the GOP drops the policy riders.

A shut down would have wide implications. Federal workers don't take a shut down lightly at all. Some would like members of Congress to forgo paychecks along with the 800,000 workers who would be furloughed. And both parties could be blamed -- although my opinion is that the blame will go to the Tea Party if there's a shutdown, as at least one poll shows. There are comparisons to 1995, when we last had a shutdown when Newt Gingrich and Bill Clinton locked horns. A shutdown could slow mortgage relief, harming a housing market that is struggling to recover. There's surely enough blame to go around -- one Tea Party Senator says the President planned this all along. Sen. DeMint says the Dems are choreographing the shutdown. Sen. Schumer blames it on Speaker Boehner's refusal to lead.

And remember the scary 2012 budget that ends Medicare and Medicaid as we know them? Well, some conservative GOPers have drafted an alternative -- that cuts way more spending. It would cut $9.1 trillion over the next decade, and like the Ryan proposal, it does not raise taxes.

Amidst all the budget turmoil comes the clear and unwavering voice of Dr. Pauline Chen, this month talking about the changes in hours that residents are working, and asking whether this is a positive change for patients.

And in other news, two Senators push to open the Medicare database as the best way to find fraud in the system.

Congresswoman Gabrielle Giffords's office is proposing ways to expand insurance coverage of traumatic brain injury.

Express Scripts -- a mail order pharmacy that provides prescription drugs through many insurance plans -- says we need to use mail order pharmacies to bring down the cost of drugs. Setting aside their blatant self-interest for a moment, I can report that I tried mail order pharmacy years ago, and they were so bad at getting refills on time and asking doctors for new prescriptions when refills ran out that I gave up on them. So maybe instead of criticizing patients, they should try doing their job a little better.

And Arielle Levin Becker of the Connecticut Mirror writes today about the fate of small physician practices -- are they a thing of the past, like house calls?

Here's an interesting interview with Aetna's CEO, Mark Bertolini. He's had some first-hand experience with health care issues, so he's somewhat more thoughtful than most large insurer CEOs.

Babies traveling abroad should have the measles vaccine first.

I hope, by the time I get home, that the budget will have been resolved. In the meantime, I plan to enjoy some great music and even greater friends. Have a great day and a great week-end! Jennifer