D0-or-Die - Rendezvous with History- The Final Obamacare Sprint

January 7, Thursday,2010 - Today begins the final sprint for Obamacare. House and Senate leaders will meet with the President , Chief of Staff Rahm Emanuel and Office of Health Reform Director, Nancy-Ann DeParle, to negotiate a bill behind closed White House doors.

President Obama says the bill will be “historic. “ He claims it will rank right up there with the passage of Social Security in the 1930s and Medicare in the 1960s. It will be, in short, Obama's rendezvous with history. It may, also, if not passed in a timely way, a rendezvous with political defeat.

As Democrats begin their final sprint, we know,

• The legislative clock is ticking - fast. President Obama wants a bill passed before his State of the Union address in late January or early February. Because an open process, namely televising proceedings on C-Span would slow things up, negotiations for the final bill, will be conducted in secrecy.

• The Democrats’ political position is perilous. With the retirement of two Democrat Senators, Chris Dodd of Connecticut and Byron Dorgan of North Dakota, and the party switch of Parker Griffith of Alabama in the House, their 60 votes in the Senate and their majority in the House are imperiled and may evaporate come November. Thus, for Democrats, it is now or never.

• The main issues to be reconciled between the House and Senate are how to pay for the $ 1 trillion bill, who to tax and how much, the fate of the public option, federal coverage for abortion , and extent of subsidies to help lower earners buy health insurance. One concession by the Senate may be accepting the House proposal to repeal antitrust exemption of insurance companies, and the concession by the House may be dropping the public option.

Among Americans, a sluggish economy, rising deficits, persistent unemployment, and a sense the country is headed in the wrong direction are fueling anger, angst, hopelessness, skepticism , and populist movement to throw the incumbents out.

Some realists are asking, why overhaul the health care industry when it produced 381,000 new jobs in 2007, 372,000 jobs in 2008, and 600,000 in 2009? And why do it in secrecy behind closed doors when transparency was promised?

Meanwhile, The nation’s doctors, slated to deliver care to 30 million more newly insured promised by the bill, sit helplessly on the sidelines. There is not much in the final bill for them. Indeed, to assure the bill comes under budget, now and over the next 10 years, Congress will shave $500 million Medicare money, partly by reducing reimbursement for doctors and procedures they perform in hospitals, One glimmer of hope. The House bill contains $57 billion more for primary care doctors who will be needed to care for those in vastly expanded Medicaid programs.