U.S. Sen. Joseph I. Lieberman, I-Conn., whose vote could be crucial to breaking an expected GOP filibuster on health care legislation, Thursday said he would consider voting to move the bill forward, even if he ultimately casts his ballot against the reform package. …

Lieberman said he was “inclined to let the motion to proceed” (or cloture) go forward, but “I haven’t decided yet.”

And with that, Democrats appear to be one step closer to 60 votes.

Grassley, on the front lines of the year’s thorny health reform debate, has been impressed by the larger-than-usual public gatherings that have stolen headlines throughout the month, referring to them Thursday as “democracy in action.” Still, the Gang of Six member was quick to point out that the future of health reform hinges on the collective experience of Congress, not his alone.

“You need the judgment of all 535 members of Congress on whether or not the town meetings have changed the direction of health care,” Grassley said during a teleconference with reporters. “I think they probably have changed the direction, but it’s difficult for me to say how much.

“But I believe [the bill] will be a little more scaled down than what we were originally thinking when we left for August summer break.”

[T]here are no “death panels” in the Democratic health-care bills, and to say that there are is to debase the debate.

With his comments, Krauthammer joins an ever-growing list of conservative commentators and health policy experts who’ve blasted the “death panel” claims as inaccurate, malicious or both.

What the Democrats bill does — and what some Republicans have supported in the past — is to have Medicare pay doctors for late-life decision-making services when patients request such counseling. That means it’s exactly 100 percent voluntary.

Krauthammer doesn’t like the idea, arguing that the effect of the “chats” will be “to gently point the patient” toward choosing death over the expensive treatments that might prolong life for just a few months.

[W]hy get Medicare to pay the doctor to do the counseling? Because we know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we’ve nudged you ever so slightly toward letting go.

This is an odd remark, which seems (1) to question the wisdom of the doctors who do this counseling, (2) to toss doctors into the same mythical category of government bureaucrats hell-bent on killing off seniors to save costs, and (3) to doubt the ability of patients to make their own decisions based on the advice they’re given.

Still, Krauthammer, who is a psychiatrist, adds that the proposal is “not an outrage,” and “it’s surely not a death panel.”

It’s safe, at this point, to place those claiming otherwise squarely in the category of folks trying to kill health care reform, rather than debate it.

Although Kennedy, who is battling brain cancer, does not specifically mention his illness or the health care debate raging in Washington, the implication of his letter is clear: He is trying to make sure that the leading cause in his life, better health coverage for all, advances in the event of his death.

The letter is grim acknowledgment that Kennedy, whose surprise appearance on Capitol Hill last summer prevented Republicans from killing a vital Democratic Medicare bill, might not be healthy enough to pull off the same heroics this year.

In an interview with Bloomberg Television airing Friday, DeParle indicates that the White House “would be interested in” an alternative proposal that would create health cooperatives in lieu of the public option — as long as the co-op model is shown to inject additional competition into the insurance market.

Obama has said in the past that he won’t hinge his support for the larger health reform bill on the inclusion of the public option, but DeParle’s openness to the co-op strategy is the most specific indication that the administration won’t insist on a government-backed plan.

Her words appear to align the White House roughly with the sentiments of House Majority Leader Steny Hoyer (D-Md.), who told reporters last week that he’d also be receptive to the creation of co-ops.

“After all,” Hoyer said, “a co-op will be a competitor.”

But that’s bad news for many liberal lawmakers and patient advocates, who argue that the public option is the only way to create a nationwide patient pool large enough to compete with the giants in the private insurance industry, thereby keeping them honest with respect to cost and coverage.

Writing for The New Republic in June, Yale political scientist Jacob Hacker argued that there are three unique advantages to the public option approach: It would (1) be a backup when patients had no other affordable coverage options (for example, when employers don’t offer coverage); It would (2) provide a benchmark to make sure private insurers offer comprehensive coverage; and it would (3) create a backstop preventing doctor and hospital costs from creeping up, as often happens in areas where health care providers consolidate their operations. The co-op approach — being championed by Sen. Kent Conrad (D-N.D.) — wouldn’t accomplish all of these goals, Hacker wrote.

Cooperatives might be able to provide some backup in some parts of the nation, but they are not going to have the ability to be a cost-control backstop, much less a benchmark for private plans, because they are not going to have the reach or authority to implement innovative delivery and payment reforms. And so Conrad’s idea appears to be yet another compromised compromise that cuts the heart out the idea of public plan choice on the alter of political expediency.

It might not matter. Conrad, one of six Finance Committee members in contentious negotiations over how to structure that panel’s overhaul blueprint, told The Washington Post this week that, considering the conservatives’ opposition to the public plan, the inclusion of that option would sink the bill in the Senate, where 60 votes are required to pass almost anything these days.

“The hard reality is . . . that a public option does not have enough support in the Senate to pass,” Conrad said.

He doesn’t mention if he would be among the “no” votes.

[S]trong anti-insurer rhetoric from Democrats struggling to win over a skeptical public could wake the sleeping giant.

Karen Ignagni, the president and CEO of the trade group America’s Health Insurance Plans (AHIP), said the industry would take its case directly to the American public via a television advertising campaign and by dispatching insurance company employees to public events staged by Democratic members of Congress during the August recess. [...]

“A campaign has been launched to demonize health plans and the men and women who work hard every day in their communities to provide health insurance coverage to more than 200 million Americans,” she said on a conference call with reporters.

Famously, the insurance industry helped to kill the Clinton administration’s 1993 health reform push, running a wildly effective ad claiming that the Clinton plan would steal the rights of patients to choose their own health care plans — the same argument the industry is using now to battle the public option proposal.

Ignagni said she’s not trying to cripple the Democrats’ health reform plans, The Hill reported. But if the Democrats come up with a strong public plan option, as many want, you can bet that AHIP’s strategy will quickly change.

Critics claim that needle-exchange programs create a moral hazard by legitimizing drug abuse. But it does not legitimate drug abuse to help people with the clinical disease of addiction avoid other deadly diseases until they are ready for help. Sacrificing the lives of addicts to send an “unmixed” moral message actually sends a troubling moral message: that the unwanted have no worth.

The topic is timely, because House lawmakers have passed legislation repealing a 21-year-old ban on federal funding for needle exchange programs, which have been endorsed by a long list of public health groups and federal health officials. Conservative critics, however, say the programs simply condone drug use and contribute to crime. Bowing to such sentiments, House Democrats were forced to dilute their proposal by prohibiting needle exchanges within 1,000 feet of schools, daycare centers, pools, parks, and basically anywhere else that children gather. In a city setting, that means just about everywhere.

In the eyes of Gerson, the restrictions make no sense.

This restriction might make sense if needle-exchange programs increased the number of addicts. But they don’t. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, has comprehensively reviewed the scientific studies on needle exchange. “It does not,” he says, “result in an increase in drug abuse, and it does decrease the incidence of HIV. . . . The idea that kids are going to walk out of school and start using drugs because clean needles are available is ridiculous.”

Later in the year, House and Senate lawmakers will meet to decide whether the the repeal of the federal ban on needle-exchange funding will remain in the larger bill, which will provide funds for the Department of Health and Human Services. A number of Democrats hope that, not only will that language remain, but the 1,000-foot restriction will be eliminated as well.

The House Education & Labor Committee voted today in favor of an amendment, sponsored by Rep. Dennis Kucinich (D-Ohio), eliminating legal barriers that might prevent states from adopting a Medicare-style system of health coverage.

The vote was 25 to 19, with support coming from an odd mix of liberal Democrats who support single-payer on its merits and conservative Republicans who want to preserve the rights of states to regulate themselves.

The vote is largely symbolic. Cash-strapped states likely won’t be able to rustle up the funding to cover all their residents without federal help, even if they did support the concept politically. Still, some health care groups are cheering the House vote nonetheless. The California Nurses Association, for example, issued a statement calling the vote “a historic moment for patients.”

If the provision were to become law, CNA argues, single-payer supporters could move their lobbying battle from Washington to state capitals.

Kucinich offered his own take on the significance of the push.

“By getting rid of the for-profit insurance companies,” the Ohio liberal said in a statement, “we can save $400 billion per year and provide coverage for all medically necessary services for everyone in the U.S.”

To succeed, Baucus will have to stray decidedly from the HELP committee proposal (i.e., it will have to eliminate the public-plan option). That much is evident not only from the fact that no Republican on the HELP panel voted for the HELP bill, but also from the bitterness that sprung up during that debate — and afterwards. Indeed, Republicans have been doing interviews all morning condemning not only the bill, but the process that pieced it together.

“This partisan bill,” said Sen. Judd Gregg (R-N.H.), “will have a negative impact on the high quality health care and innovation we have become accustomed to in the United States. It moves us closer to a single-payer system where choice of care, treatments, and even a patient’s personal doctor will be mandated by a bureaucrat in Washington D.C.”

Sen. Charles Grassley (Iowa), senior Republican on the Finance Committte, also blasted the HELP bill this morning, arguing in a phone call with reporters that health care reform, because it’s an issue that affects literally everyone, “ought to have a broad base of consensus.”

Grassley also pointed to a more practical reason why he and Baucus are working on a proposal that some Republicans can support: It probably won’t pass otherwise.

“Not much gets done in the Senate that’s not bipartisan,” he said.

After the HELP vote this morning, Baucus issued a statement vowing to work with HELP members to combine the two bills into something everyone can support. But he’ll have to decide shortly whether he wants to prioritize bipartisanship above the Democrats’ wishes to include a public option as part of their strategy.

We’ll know soon enough what Baucus comes up with. The Finance Committee proposal is expected for release as early as Thursday.

Shuster: Why shouldn’t people believe that your decision to say a public option as backup plan — why shouldn’t people believe that it’s been influenced by the money you’ve gotten from the insurance companies and from pharmaceuticals who don’t want a backup plan, who want it as — who don’t want a public option, at all, or a backup plan as a worst-case scenario?

Carper: Well, at the end of the day, I want us to pass a bill. I want us to pass a good bill … At the end of the day, there are more important things in the bill than whether or not we have a public plan or a public option. I think the idea of what we did in the Medicare Part D plan, where we have a fallback plan on the shelf, ready to pull out if we need it, in order to make sure market forces are working, that seems to me to be a perfectly good option.

Shuster: But, Senator, you’re under a lot of pressure, wouldn’t you acknowledge, from the insurance companies, with all the money they’ve given you?

Carper: I don’t feel a lot of pressure at all. The most effective lobbyist for me — I’ve been governor; I’ve been congressman; I’ve been state treasurer; now I’m the senator — the most effective lobbyist, for me, in everything I have ever done, are actually people from Delaware that I know that I trust who talk to me, in all kinds of parades all over my state this last Fourth of July weekend, and people that call my office, mostly from Delaware, that have a view, some for public plans, some against it.

“The best way to do it,” Carper concluded, “is to develop a bipartisan plan.”