September 2009

WASHINGTON (Reuters) – Many people who have died of swine flu infections in the United States have also had bacterial infections, health officials reported on Wednesday.

A study of 77 patients who died of the new pandemic H1N1 virus showed 29 percent of them had so-called bacterial co-infections, the U.S. Centers for Disease Control and Prevention reported.

About half of these had Streptococcus pneumoniae, which can be prevented with a vaccine, the CDC said.

The CDC has already reported that H1N1, declared a pandemic in June, has become more active as weather cools and schools return from summer breaks. Cases are reported in all 50 states.

“Our influenza season is off to a fast start and unfortunately there will be more cases of bacterial infections in people suffering from influenza,” CDC epidemiologist Dr. Matthew Moore said in a statement.

“It’s really important for people, especially those at high risk for the serious complications from influenza, to check with their provider when they get their influenza vaccine about being vaccinated against pneumococcus.”

Wyeth’s Prevnar is part of the routine series of immunizations that children should get, and another vaccine against so-called pneumococcal bacteria is available for elderly adults.

The CDC team noted that at first it did not appear that people who were seriously ill with swine flu or who died of it had secondary infections. But doctors may have missed them, the CDC said.

“Routine clinical tests used to identify bacterial infections among patients with pneumonia do not detect many of these infections,” the CDC team reported.

(Editing by Bill Trott)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

By Kate Kelland

LONDON (Reuters) – More than half of the 9.5 million people who need AIDS drugs cannot get them and 33 million people across the world are still infected with the virus that causes it, a United Nations report said on Wednesday.

Access to drugs, counseling and testing for AIDS has increased, but there were still 2.7 million new infections in 2007 and the human immunodeficiency virus (HIV) that causes AIDS remains a major challenge for global health, it said.

Teguest Guerma, an AIDS director at the Geneva-based World Health Organization, noted some progress — particularly in access to HIV testing and counselling, and getting HIV drugs to pregnant women and those in low- and middle-income countries.

But she said an internationally agreed goal of achieving universal access to treatment by 2010 was unlikely to be hit and required more concentrated effort.

“We’re moving toward universal access, but we’re not there yet,” she said in a telephone interview. “We need to sustain the effort and commitment we have now to move forward.”

Since the AIDS pandemic started in the early 1980s, more than 25 million people have died from the virus. There is no cure, but a cocktail of drugs known as highly active antiretroviral therapy can help keep it under control.

According to the UNAIDS report, groups at high risk of infection, including men who have sex with men, sex workers, drug users and prisoners, still have limited access to HIV testing and counseling services.

As a result, only 40 percent of all people estimated to have AIDS are aware that they are infected.

VACCINE PROSPECTS

The report praised an “unprecedented expansion” of drug treatment in low- and middle-income countries, where more than 4 million people were receiving drugs by the end of 2008, up from around 3 million a year earlier.

The greatest gains were seen in sub-Saharan Africa, where around two-thirds of HIV infections occur. Around 2.9 million people there received treatment in 2008, compared with about 2.1 million in 2007.

Pregnant women, who can transmit the AIDS virus to their children, also had better access to tests and drugs. UNAIDS said 21 percent of pregnant women in low- and middle-income countries had an HIV test in 2008, up from 15 percent in 2007, and 45 percent of pregnant women with HIV got medicines.

Companies and non-profit groups, along with governments, have been working to make a vaccine against the virus that causes AIDS, and experts agree a vaccine is the only way to conquer it.

Trial results last week showed that for the first time, an experimental AIDS vaccine protected people from the virus — but it only lowered the infection rate by 30 percent.

“We need to continue the research because there is hope for the discovery of a vaccine,” Guerma said. “But for the time being, a vaccine with a modest efficacy cannot be used by itself.”

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

LOS ANGELES (Reuters) – A U.S. appeals court on Monday reinstated an Alaska lawsuit against Altria Group Inc’s Philip Morris USA by the survivor of a deceased smoker, saying her state product liability claims were not preempted by federal law and should have been tried in state court.

Altria and Philip Morris had argued that the state claims could not go forward against Alaska Commercial Co, a local retailer, because a victory for plaintiffs Dolores Hunter and the estate of Benjamin G. Francis could result in a ban of cigarette sales in the state.

Francis died at 52 of lung cancer in December of 2004. Hunter was his common law wife and was appointed the personal representative of his estate by a state court.

A lower court agreed that the state claims were barred by “congressional intent not to ban the sale of cigarettes” and dismissed the case due to Hunter’s failure to bring a claim under federal law, the opinion by the Ninth U.S. Circuit Court of Appeals said.

But the appeals court ruled that Altria had “failed to establish a clear conflict between Hunter’s claim and federal law” and that U.S. regulatory laws “do not provide strong evidence of a federal policy against more stringent state regulation.”

The court found that the case did not belong in federal court and instructed that it be remanded to Alaska state court for further proceedings.

Representatives for Philip Morris and Alaska Commercial could not be reached immediately for comment. Hunter’s attorney was not available for comment.

In afternoon New York Stock Exchange trading, Altria shares were up 19 cents or 1.1 percent to $17.69.

The case is Dolores Hunter v. Philip Morris et al, Case No. 07-35916, U.S. Court of Appeals for the Ninth Circuit.

(Reporting by Gina Keating, editing by Gerald E. McCormick)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

By Tan Ee Lyn

HONG KONG (Reuters) – An experimental AIDS vaccine that appears to be the first to protect people was mired for years in deep controversy, and credit for its success must go to Thailand where the trial was conducted, experts said.

The trial was criticized by 22 prominent U.S. scientists in 2004 because the vaccine was widely expected to have no effect.

The critics, including Dr. Robert Gallo of the Institute of Human Virology in Baltimore, who helped discover the AIDS virus, signed a letter accusing the U.S. government of wasting more than $100 million by funding it.

But Thailand’s health authorities and their U.S. partners at the National Institutes of Health and the Walter Reed Army Institute of Research pressed on with the trial, which involved 16,000 Thai volunteers.

“It was a tough decision. I am glad we made it,” Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, who defied the criticism and continued the trial, told reporters.

The trial vaccine was made using two failed products — Sanofi-Pasteur’s ALVAC canary pox/HIV vaccine and AIDSVAX, made by a San Francisco company called VaxGen and now owned by the non-profit Global Solutions for Infectious Disease.

“This trial was controversial. In 2004, prominent U.S. scientists wrote a letter to Science magazine saying this shouldn’t be done because the vaccines that had previously been tested were found wanting and didn’t stimulate immunity of the right kind,” said Donald Burke, dean of the University of Pittsburgh’s Graduate School of Public Health.

“But given the importance of the AIDS epidemic, the decision was made to go forward regardless of these criticisms. It was a difficult choice, but a courageous choice,” said Burke, who was head of AIDS research at Walter Reed before retiring in 1997.

Burke isolated the AIDS virus taken from a young HIV-infected Thai soldier in 1989, after Thai army doctors discovered an outbreak of HIV among young recruits in Chiang Mai, in northern Thailand. That virus sample went on to become one of the seed viruses in the experimental vaccine, Burke said.

“If I were to give any single group of people the credit, it would be the Ministry of Public Health of Thailand because it was a trial in Thai people,” he added.

The $105 million trial was sponsored and paid for by the U.S. government and results showed it cut the risk of infection by 31.2 percent among 16,402 volunteers over three years.

“To their credit the Thais did a remarkable job on this,” Dr. Eric Schoomaker, the Surgeon General of the U.S. Army, told reporters. “They did remarkable job of recruiting volunteers and conducting this trial almost flawlessly.”

The surprising results mark another triumph for Thailand, which battled hard against a disease that threatened to spiral out of control some 20 years ago.

HIV prevalence among injecting drug users in Thailand was as high as 30-50 percent in 1991, and 33.2 percent among female sex workers in 1994, according to UNAIDS.

The Thai government responded in the early 1990s by launching a high-profile anti-AIDS campaign, including public education, improving treatment of sexually transmitted diseases, discouraging men from visiting prostitutes, promoting condom use and requiring sex workers to undergo regular health checks.

Infection rates fell and the exercise remains widely cited today as a model in disease prevention among health experts — although numbers have shown signs of creeping up in the last few years among some high risk groups, such as gay and bisexual men. (Additional reporting by Maggie Fox in Washington; Editing by Alex Richardson)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

TORONTO (Reuters) – Canada outperforms the United States in health outcomes but is well behind global leaders like Japan in overall health of its population, a Canadian report released on Monday showed.

The annual report card by the Conference Board of Canada ranked Canada 10th out of 16 developed countries, with a “B” grade. The United States was the worst performer, placing 16th and earning a “D” grade.

“Canada has been at the center of much of the debate on U.S. health care reform. Since Canada ranks ahead of the United States on all but one indicator of health status … it is clear that we are getting better results,” Gabriela Prada, director of health policy at the Conference Board, said in a statement.

“But when we look beyond the narrow Canada-U.S. comparison to the rest of the world, Canadians rank in the middle of the pack in terms of their health status,” Prada said.

Most of the data on which the report card was based is from 2006, the group said.

President Barack Obama has pledged to reform the country’s healthcare system, which is expensive and leaves millions of Americans without coverage. Canada, with its single-payer government-run system, is often held out as an example to be praised or derided by U.S. critics.

The Conference Board, which has been issuing the report card since 1996, ranked the 16 countries according to 11 criteria, including life expectancy, mortality due to cancer, circulatory diseases, respiratory diseases, metal disorders, as well as infant mortality and self-reported health status.

Japan was once again the top-ranking country. Switzerland, Italy, and Norway also earned “A” grades.

“B” grades were given to Sweden, France, Finland, Germany, Australia and Canada, while Netherlands, Austria and Ireland earned a “C” grade, the report showed.

Along with the United States, Denmark and the United Kingdom got “D” grades.

Canada and the United States both earned “A” grades on self-reported health status, ranking first and second, respectively, among the 16 countries.

Canada ranked higher than the United States on all of the mortality measures except for mortality due to cancer, a criteria for which both countries earned a “B” grade.

The Conference Board said top-performing countries achieved better health outcomes on broad actions such as environmental stewardship and health promotion programs that focus on changes in lifestyle, along with education, early childhood development, and income to improve health outcomes.

Rank Country Grade

1 Japan A

2 Switzerland A

3 Italy A

4 Norway A

5 Sweden B

6 France B

7 Finland B

8 Germany B

9 Australia B

10 Canada B

11 Netherlands C

12 Austria C

13 Ireland C

14 United Kingdom D

15 Denmark D

16 United States D

Source: The Conference Board of Canada

(Reporting by Andrea Hopkins; editing by Peter Galloway)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

GENEVA (Reuters) – Early use of antivirals is effective in treating H1N1 flu and health authorities must be vigilant for signs of drug resistance, the World Health Organisation said on Friday.

Drug-resistant pandemic flu viruses have appeared infrequently so far and there is no evidence they are spreading, but further cases are likely, the WHO said on its website.

Growing international experience showed the importance of the early use of oseltamivir, manufactured as Tamiflu by Roche Holding and Gilead Sciences, or zanamivir, an inhaled medicine produced as Relenza by GlaxoSmithKline in swine flu cases,” the WHO said.

“The experience of clinicians, including those who have treated severe cases of pandemic influenza, and national authorities, suggests that prompt administration of these drugs following symptom onset reduces the risk of complications and can also improve clinical outcome in patients with severe disease,” the Geneva-based U.N. agency said.

“This experience further underscores the need to protect the effectiveness of these drugs by minimizing the occurrence and impact of drug resistance,” it said.

Most people who contract pandemic influenza suffer only mild symptoms before recovery without treatment, but children, pregnant women and those with some existing health conditions are vulnerable to a more severe attack or even death.

The WHO, which declared H1N1 a global pandemic in June, says one third of the world’s population of nearly seven billion people could catch it.

The risk of resistance is higher in patients who suffer from weak immune systems and have already been treated with oseltamivir, it said.

It is also high in people who are treated with the antivirals as a prophylactic — as a precaution after exposure to someone with influenza, but nevertheless develop the disease.

In such cases medical staff should investigate whether resistance has developed and take precautions to prevent the spread of a resistant virus, it warned.

Health authorities should also investigate whether a drug-resistant virus is spreading through communities from person to person.

The WHO repeated guidance that it did not recommend taking antivirals as a prophylactic. People exposed to pandemic flu victims should be monitored closely and treated promptly with antivirals if symptoms develop, it said.

Global monitoring has detected 28 resistant viruses so far. In each case the viruses were resistant to treatment with oseltamivir but not zanamivir, which should be used to help patients suffering severe illness from an oseltamivir-resistant virus, it said.

(For the WHO note go to link.reuters.com/cad68d)

(Reporting by Jonathan Lynn; Editing by Janet Lawrence)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) – An experimental AIDS vaccine made from two failed products has protected people for the first time, reducing the rate of infection by about 30 percent, researchers said on Thursday.

Developers said they were now debating how to test the limited amounts of vaccine they have left to find out if there are ways to make it work better.

Scientists said they were unsure how or why the vaccines worked when used together in the trial, which took place in Thailand, and will study the volunteers to find out.

All agreed that a commercial product would be years away but the U.N. World Health Organization said the result created new hope that an effective vaccine would eventually be found.

“The result of the study is a very important step for developing an AIDS vaccine,” Thai health minister Withaya Kaewparadai told a news conference in Bangkok. “It’s the first time in the world that we have found a vaccine that can prevent HIV infection.”

Activists and researchers alike were thrilled. “The outcome is very exciting news and a significant scientific achievement,” said Dr. Seth Berkley, chief executive officer of the International AIDS Vaccine Initiative, which was not involved in this study. “It’s the first demonstration that a candidate AIDS vaccine provides benefit in humans.

The vaccine is a combination of Sanofi-Pasteur’s ALVAC canary pox/HIV vaccine and the failed HIV vaccine AIDSVAX, made by a San Francisco company called VaxGen and now owned by the nonprofit Global Solutions for Infectious Diseases.

The trial was sponsored by the U.S. government and conducted by the Thai Ministry of Public Health. It cut the risk of infection by 31.2 percent among 16,402 volunteers over three years.

“We had 74 infections in the placebo group and 51 in the vaccine group,” Dr. Jerome Kim, a U.S. Army colonel at the Walter Reed Army Institute of Research in Maryland, who helped lead the trial, said by telephone.

The results were a triumph for supporters, who went ahead with the giant trial despite criticism it was unethical or a waste of money because the vaccine was widely expected to have no effect.

The AIDS virus infects an estimated 33 million people globally and has killed 25 million since it was identified in the 1980s. It affects immune cells called T-cells.

Cocktails of drugs can control HIV but there is no cure. In 2007, Merck & Co ended a trial of its vaccine after it was found not to work, and in 2003, AIDSVAX used alone was found to offer no protection, either.

INSTILLING HOPE

The Geneva-based World Health Organization and the Joint United Nations Program on HIV/AIDS, or UNAIDS, stressed the effects of the vaccine in the Thailand test were modest.

“However, these results have instilled new hope in the HIV vaccine research field and promise that a safe and highly effective HIV vaccine may become available for populations throughout the world who are most in need of such a vaccine,” they said.

Sanofi shares rose as much as 1.6 percent in early trade in Paris but closed down slightly at 50 euros.

“We see no commercial vaccine available for some time yet, but the prospect has finally been raised (after 30 years of trying) that an effective vaccine is possible,” said Michael Leacock, an analyst at ABN AMRO research.

“What is needed here is more in-depth analysis,” Sanofi’s Jim Tartaglia told a briefing. Dr. Donald Francis of Global Solutions for Infectious Diseases said the companies had limited amounts of vaccine left to test and would have to make more.

“For me the biggest question is, how do you take what we know of this vaccine and give it greater protective power. Once you know that, then it makes sense to go to other parts of a population,” Sanofi’s Chris Viehbacher told Reuters.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which paid for most of the $105 million trial, said the team was confused because people who got the vaccine and who became infected anyway had just as much virus in their blood and just as much damage to their immune systems as HIV patients who went unvaccinated.

That meant the vaccine helped prevent infection but did nothing to affect the virus once it is in the body.

In addition, the immune responses that were generated by the vaccine should not, in theory, have protected anyone. Fauci said AIDS researchers may have to go back and see if they have been looking at the wrong things when checking the immune response to potential HIV vaccines.

Kim said the vaccine might not work in the people and places where HIV is most common — in Africa, among men who have sex with men and among injecting drug users.

The vaccine was formulated specifically to work against two subtypes of the human immunodeficiency virus — clade E, which circulates in Thailand and Southeast Asia, and clade B, common in the United States and Europe.

The volunteers in the trial got six shots over six months, four with ALVAC and two with AIDSVAX.

ALVAC is a genetically engineered canarypox virus that has spliced into it synthetic versions of three HIV genes. AIDSVAX is made using two versions of one HIV gene, one from the B subtype and one from the E subtype.

(Additional reporting by Caroline Jacobs in Paris, Thin Lei Win in Bangkok and Stephanie Nebehay in Geneva; Editing by David Storey.)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

By John Whitesides and Donna Smith

WASHINGTON (Reuters) – A U.S. Senate panel considering a sweeping healthcare overhaul upheld a requirement on Thursday that individuals purchase health insurance and rejected a proposal that could have scuttled an $80 billion White House deal with drugmakers.

On their third day of debate, members of the Senate Finance Committee made slow progress on hundreds of amendments to the healthcare bill, the last of five measures pending in Congress on President Barack Obama’s top domestic priority.

The Democratic-controlled panel defeated on a largely party-line vote a Republican proposal to let individuals opt out of the bill’s requirement that everyone have health insurance. The plan would offer subsidies on a sliding scale to help people buy it.

Republicans said the issue was a matter of personal freedom and questioned the constitutionality of forcing people to purchase insurance.

“The individual mandate in this bill is un-American. It may even be unconstitutional,” said Republican Senator Jim Bunning, the amendment’s sponsor.

Democrats said the requirement was vital to the success of the overhaul, which aims for a dramatic reduction in the number of uninsured people living in the United States. “The system won’t work if this passes,” Baucus said of the amendment.

The panel’s bill, which committee staff said would cost about $900 billion over 10 years, mirrors Obama’s proposals to rein in costs, increase insurance competition and regulation and expand coverage to the uninsured.

PUBLIC OPTION VOTES PLANNED

The Baucus proposal does not include a government-run insurance plan — the “public option” — that is included in the other four bills in Congress, and two Democratic senators said they would seek votes on the issue on Friday.

Democratic Senators John Rockefeller and Charles Schumer said they would bring up public option amendments in order to kick off a discussion on the approach, which is backed by President Barack Obama as a way to create competition but opposed by critics who fear it will hurt the private insurance industry.

“This is the starting point,” Schumer told reporters about the debate on a public option, which was included in the four other bills in Congress.

He said the public option would have a hard time passing the more conservative Senate Finance Committee but had strong support in the full Senate and House of Representatives.

In one of the few votes this week that was not mostly party-line, the panel backed an agreement the White House and Baucus struck with drugmakers earlier this year that required the industry to contribute $80 billion to the overhaul.

An amendment by Democratic Senator Bill Nelson would have cost the industry an extra $106 billion by forcing drugmakers to pay the government a rebate on prescriptions for low-income people who are eligible for both the Medicaid insurance program for the poor and the Medicare program for the elderly.

The additional money raised under the amendment would have been used in part to close a gap in prescription drug coverage for some Medicare recipients.

“Did the pharmaceutical company come to the table in the agreement with the White House with enough? There are a number of us who feel that is not the case,” Nelson said.

Baucus and two other Democratic senators — Tom Carper and Robert Menendez — joined committee Republicans in voting against the amendment.

“This may well undermine our ability to pass comprehensive healthcare reform through this committee and in this Congress,” Carper said.

Democrats on the panel also defeated two Republican amendments that would have blocked the bill’s cuts in Medicare Advantage, which augments the government’s Medicare insurance program for the elderly with private insurance.

The reform bill would cut $123 billion in government subsidies to the Advantage plan, which Republicans say could force insurance companies out of the market and change or eliminate the benefits for many of the program’s 10 million participants.

Democrats say the changes to Medicare would increase benefits and participation over 10 years and shore up Medicare’s trust fund.

The debate has focused heavily so far on Medicare and other programs for the elderly, who as a group are more likely to vote and who polls show are among the most concerned about Obama’s healthcare plans.

(Editing by Simon Denyer and Chris Wilson)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage 

By John Whitesides and Donna Smith

WASHINGTON (Reuters) – Democrats pushed on Tuesday to make insurance reforms more affordable for workers and Republicans decried what they called a rush to judgment, as a key Senate panel began debate on a sweeping healthcare overhaul.

Democrats on the Senate Finance Committee said they feared many of the changes under Chairman Max Baucus’s plan would hurt low- and middle-class families, and Baucus unveiled a revised bill to ease their concerns.

After the failure of months of negotiations, Republicans on the panel complained they were being pressured into making hasty decisions on an overhaul of the $2.5 trillion healthcare industry, President Barack Obama’s top domestic priority.

“The cry of impatience has won out,” said Senator Charles Grassley, the panel’s senior Republican and a member of the “Gang of Six” negotiators who failed to reach an agreement. “They have put moving quickly over moving correctly.”

Committee members will consider 564 potential amendments to the proposal over the next few days as the raging battle over the reforms enters a new phase in Congress.

The finance panel is the last of five congressional committees to take up a healthcare bill.

Baucus said his “common-sense” plan took the best ideas of lawmakers in both parties with the goal of attracting the 60 votes needed to overcome procedural hurdles in the 100-member Senate.

“This is our opportunity to make history,” Baucus said. “The question is whether we can seize the opportunity and change things for the better.”

Obama has pushed for a sweeping healthcare overhaul that would rein in costs, improve care, regulate insurers and expand coverage to many of the 46 million uninsured people living in the United States.

SLOWED BY BATTLES IN CONGRESS

The healthcare overhaul has been besieged by critics and slowed by battles in Congress. Elements of the insurance and healthcare industries have lobbied hard against parts of it.

A Wall Street Journal/NBC poll showed Obama made modest gains in public support on healthcare this month after intensifying efforts to sell the overhaul, with the public now split on his handling of the issue rather than leaning toward disapproval.

Republican Senator Orrin Hatch delayed committee consideration of amendments during a night session by asking a lengthy series of questions of staff members, drawing rebukes from Democrats and an offer from Baucus to stay all night for his questions if he would allow the meeting to proceed.

“Are we going to be really serious about understanding this bill or are we just going to roll over everybody?” Hatch said. “I do think it’s outrageous we have to do this in two or three days.”

The committee, which hopes to complete work on the bill this week, postponed any roll-call votes on amendments until Wednesday.

To address concerns about affordability, Baucus had incorporated amendments that would expand subsidies to help buy insurance, reduce the penalties for not purchasing insurance and raise the threshold on the tax on high-cost insurance plans for those in high-risk jobs and for retired workers aged 55 and older who are not eligible for Medicare.

He also removed a provision in his original bill placing a fee on clinical laboratories and slightly raised the annual fee paid by health insurers.

Under the plan Baucus unveiled last week, all U.S. citizens and legal residents would be required to obtain health insurance, with subsidies offered on a sliding scale to help people buy it.

The plan would create state-based exchanges where individuals and small businesses could shop for insurance. The proposal also would levy fees on healthcare companies and insurers, tax high-cost insurance plans and expand Medicaid, the healthcare system for the poor.

It does not include a government-run insurance option included in the other four bills in Congress, but substitutes a provision for a nonprofit cooperative as a way to create competition for insurers.

‘WE CAN DO BETTER’

“I think we can do better,” Democratic Senator Ron Wyden said. “This bill does not hold insurance companies accountable.”

The White House released research on Tuesday showing insurance premiums have risen faster than inflation in every U.S. state — by between 90 and 150 percent in the past decade, while consumer prices have risen 28 percent ID:nN21287346.

The debate in Congress has raised passions on both sides, with health insurers accusing the U.S. Medicare agency of political interference for investigating a letter Humana Inc sent enrollees about the overhaul. ID:nN22365760

The agency also sent a warning to other insurers against sending potentially misleading mailings about the reform bill to customers.

Committee Republicans said the overhaul would amount to a government intrusion in the healthcare sector and urged Democrats to slow down. “This bill is a stunning assault on liberty,” Republican Senator Jon Kyl said.

Senator Olympia Snowe, another negotiator and the only panel Republican seen as a possible supporter of the measure, said she regretted what she described as a premature end to the talks but said the bill was “a solid starting point.”

In a long discussion of the Baucus revisions, Republicans said before any final vote they wanted time to evaluate the completed bill and see an analysis from congressional budget experts on what it would cost.

“I need to know and I think others need to know what it is we’re voting on, what’s in the bill and what it costs,” Republican Senator John Cornyn said.

Baucus urged Congressional Budget Office Director Douglas Elmendorf to provide a speedy analysis of the financial implications of the final bill.

Elmendorf said analysts in his office have been working around the clock since the weekend to determine the budgetary implications of the hundreds of amendments.

Republicans have offered 292 amendments, including proposals to eliminate the individual insurance requirement, allow purchase of insurance across state lines and eliminate the fees on healthcare industries.

(Editing by David Alexander and Sandra Maler)

© Thomson Reuters 2009 All rights reserved

Reuters provides an in-depth look at the issues facing Americans as the Obama administration wrestles with healthcare policy.  Full Coverage