This is an amazingly arrogant video in many senses. We're supposed to believe that former Senators Bob Graham and Jim Talent of this WMD Prevention Commission, a government-funded group, put together this snazzy and misleading video about H1N1 vaccines? Or did a Big Pharma lobbying group do it for them? It's hard to say, based on the lack of information as to the actual creator. The basic question is, is there really anything wrong with creating flu vaccine with eggs?

Here's the thing - back in the day, pharmaceuticals making vaccines needed a living medium in which to grow cultures, something that was cheap because they needed to make a lot. Something like... eggs! The FDA not only approved this process for flu vaccines, but also vaccines for measles, mumps, rubella, and rabies. And the thing is, once the FDA approves a particular process and materials for a drug, if you want to update the process and/or materials, you have to start all over with the FDA approval process. That's expensive, especially if you have to pay off the research and development costs accrued.

Today the problem is that no large pharmaceutical firms want to get involved in vaccine production because of the time and cost involved. Many of our vaccines come from overseas plants today. That's part of the reason why the production of H1N1 vaccine was delayed, but to be clear, this is more about an overworked and underappreciated FDA than the need for new production facilities.

So why do these guys want to tell us about H1N1 vaccines? Do they really care about public health vaccines? Or do they really want some attention so that you'll listen to them talk about bioterrorism and their lobby friends can get some business to produce more BW agent vaccines? I'm thinking the latter. And then there's this part of the G-T comedy hour.

The consequences of ignoring these warnings could be dire. For example, one recent study from the intelligence community projected that a one- to two-kilogram release of anthrax spores from a crop duster plane could kill more Americans than died in World War II. Clean-up and other economic costs could exceed $1.8 trillion.

Now in what universe does a small release of anthrax cause more deaths than all those Americans who died in WW2, when bio weapons experts like Bill Patrick have told us that 50 kilos of anthrax would be needed to take out Washington DC? I don't think the intel community endorses this scenario; rather, the G-T team got a powerpoint slide from a certain senior bioterrorism adviser to the former administration that effectively makes an anthrax attack worse than a nuclear weapon.

A source tells me that this study uses a point source generator inside of a city to cause 1.9 to 3.4 million exposed, with 450,000 people becoming ill and 380,000 dead. City-wide decontamination is needed and the projected economic cost is greater than $1.6 trillion. This is just a brilliant case of fiction, designed to get the attention of people who usually wouldn't stop to talk about bioterrorism. I doubt that any intel community expert would give this scenario the time of day - but Senators Graham and Talent don't know that. They just repeat what they've been told.

It's just sad.

This is, to say the least, strange. Crazy enough that Hatch inserted it, odder still that Ted Kennedy and John Kerry supported it. But if passed, this will open the floodgates to every fringe group out there:

Reporting from Washington - Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

The provision was inserted by Sen. Orrin G. Hatch (R-Utah) with the support of Democratic Sens. John F. Kerry and the late Edward M. Kennedy, both of Massachusetts, home to the headquarters of the Church of Christ, Scientist.

The measure would put Christian Science prayer treatments -- which substitute for or supplement medical treatments -- on the same footing as clinical medicine. While not mentioning the church by name, it would prohibit discrimination against "religious and spiritual healthcare."

It would have a minor effect on the overall cost of the bill -- Christian Science is a small church, and the prayer treatments can cost as little as $20 a day. But it has nevertheless stirred an intense controversy over the constitutional separation of church and state, and the possibility that other churches might seek reimbursements for so-called spiritual healing.

Can you say "Scientology"? I knew you could!

Phil Davis, a senior Christian Science Church official, said prayer treatment was an effective alternative to conventional healthcare.

"We are making the case for this, believing there is a connection between healthcare and spirituality," said Davis, who distributed 11,000 letters last week to Senate officials urging support for the measure.

Don't get me wrong, I happen to believe this myself. But I wouldn't dream of asking other people to pay for my spiritual beliefs without their full knowledge and consent.

And since many Christian fundamentalists consider Christian Science to be a cult, I suspect the uproar will get this pulled out of the bill.

It's so predictable, isn't it? Every time there's legislation to help ordinary working people, the Republicans hold it for ransom until they get... tax breaks! Is there any illness for which they don't see tax breaks as the cure?

A $20 billion-plus package of homebuyer and business tax breaks was advanced in the Senate Monday, together with a precedent-setting expansion of unemployment benefits to help carry the jobless through the holiday season.

Ending weeks of delay, all but two Republicans joined Democrats on an 85-2 roll call to cut off debate. Procedural obstacles remain, but passage this week appears all but certain. The House is expected to take up the measure next and send it on to President Barack Obama for his signature.

Concessions to real estate and business interests helped deliver the package, a remarkable political amalgam given the pain so associated with the long-term unemployed.

The homebuyer credit, which remains controversial, will apply to houses worth as much as $800,000; and businesses of all sizes stand to benefit from a tax break first afforded this year just to those with gross receipts of $15 million or less.

But the biggest emotional driver for Democrats is the prospect of hundreds of thousands of workers exhausting their benefits before Thanksgiving and Christmas without some extension.

The bill seeks to fill this gap by adding up to 20 more weeks in aid — establishing a modern record of 99 weeks when state and federal benefits are counted together. With new unemployment numbers due out Friday, the measure testifies to the enduring joblessness problem even as the economy shows signs of new strength and recovery.

As always, the devil is in the details. But it sounds like Congress is punting to the states on more than the public option - and since our states are smaller and our local officials more amenable to bribery contributors, this could be a real disaster. Let's wait and see what's in the final bill, but in the meantime, we'll have to keep a close eye on things:

The debate over whether to let states opt out of any government-run health insurance plan overlooks a key facet of the health-care measures being assembled in Congress: When Washington is done, the shape of any new health-care system is likely to be finalized in Lansing and Boise and Baton Rouge.

Besides the opt-out choice, proposed last week by Senate leaders, health-care legislation being drafted on Capitol Hill would delegate to state officials a multitude of momentous decisions, from what benefits are offered to low-income families to what hurdles to put in front of private insurance companies before they can raise premiums.

"The fact is that state programs are going to look different," said Judith Solomon, a senior fellow at the Center on Budget and Policy Priorities in Washington. "Where some people might be expecting national health reform, we're facing the real possibility that what you get is going to depend heavily on where you live."

The prospect of state control over the new system holds both promise and peril, said Jonathan Gruber, an economist at the Massachusetts Institute of Technology who has advised Democrats on health reform. "The plus side is that states are uniquely positioned to reflect the tastes of their residents and market conditions. Plus, we can really learn from the different approaches states take," he said. The downside "is that states can screw up and not meet . . . minimum standards."

Oy. I'm betting on the downside.

The health-care package unveiled by House leaders Thursday comes closer to national reform, health policy experts said. It would create a national marketplace where those who lack insurance could shop for policies, including a plan designed and administered by federal health officials. States would play a supporting role, helping to design the largest expansion of Medicaid in 40 years and to develop high-risk insurance pools for people in immediate need of coverage.

The package under development in the Senate is a different story. A bill approved by the Finance Committee would leave virtually every major decision to state officials.

Rather than create a central marketplace for insurance, that measure would permit each state to establish its own "exchange" and decide which insurers have access to that market. States could let low-income families shop the exchanges or offer them some other kind of coverage, such as policies already offered to state employees. Under a provision authored by Sen. Ron Wyden (D-Ore.), states could even bypass the exchange mechanism and try to expand coverage in other ways.

The Finance Committee bill did not include a government insurance option; Senate Majority Leader Harry M. Reid (D-Nev.) said last week that he would add one before bringing a package to the Senate floor. But to appease Democratic moderates wary of a big new program, the availability of the public option, too, would be subject to state discretion.

Reid's opt-out plan is opposed by Sen. Olympia J. Snowe (Maine), the only Republican to support the Democratic-led reform effort. Snowe is pushing for a "trigger," which would create a public plan only in states where private insurers failed to offer policies that were broadly affordable.

Given that the Senate presents the larger political hurdle to passing legislation, political analysts expect its state-choice approach to prevail. That means that a White House signing ceremony for a health-reform bill could become a prelude to 50 state legislative battles over how to expand Medicaid, how to set up the exchanges and how to enforce new insurance regulations, as well as whether to give state residents access to a public plan.

Back in September, a study by Harvard Medical School found that over 44,000 Americans die each year due to lack of health insurance. Now, in a complete reversal of both logic and the truth, Senate Minority Leader Mitch McConnell (R-KY) announced that it is the availability of a public insurance option which could prove fatal. Of course, McConnell's announcement that the public option "may cost you your life" should come as no surprise. After all, in July he echoed George W. Bush and Tom Delay in declaring that thanks to the emergency room, Americans "don't go without health care."

Mitch McConnell's latest fear-mongering came during an appearance on Dennis Miller's radio show. Blasting the "opt-out" version of the public option in the Senate bill, the Senator from the state ranked 45th in health care performance insisted access to coverage could be deadly:

MCCONNELL: Well, it doesn't make any difference frankly whether you opt-in or you opt-out, it's still a government plan. You know, Medicaid, the program for the poor now, states can opt-out of that, but none of them have. I think if you have any kind of government insurance program, you're going to be stuck with it and it will lead us in the direction of the European style, you know, sort of British-style, single payer, government run system. And those systems are known for delays, denial of care and, you know, if your particular malady doesn't fit the government regulation, you don't get the medication.

MILLER: Right.

MCCONNELL: And it may cost you your life. I mean, we don't want to go down that path.

While he has generally left the myth-making about "death panels" and "pulling the plug on grandma" to Sarah Palin, Chuck Grassley and other tall tale tellers in the GOP, Senator McConnell has otherwise been fabricator-in-chief when it comes to Republican talking points on health care.

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From the Center for Public Integrity, some very interesting news. This sort of undercuts Obama's "let's make the Blue Dogs happy" strategy, doesn't it?

It’s official. The Blue Dog’s fundraising slowdown was not just a symptom of the dog days of summer. Newly released public disclosure forms indicate that over September, the coalition’s PAC took in its smallest monthly total yet this year.

Our analysis of the fiscally conservative and increasingly influential Blue Dog Coalition and its funding noted that the group’s political action committee had averaged more than $176,000 in receipts from other PACs over the first half of 2009. Their monthly haul dropped to a surprisingly low $27,000 in July, rebounded somewhat in August, and but then dropped again to just $12,500 in September.

That September money came from just three donations — $5,000 from accounting and professional services giant Ernst & Young’s PAC, $2,500 from the Food Marketing Institute PAC, and $5,000 from the National Rifle Association of America Political Victory Fund.

After raising $1.1 million from January to June, the committee raised less than $87,000 between July and September — less than it brought in during any one of the preceding five months. And in just three months, the Blue Dog PAC’s monthly fundraising average dropped by more than $50,000 — probably not the sort of fiscal conservatism the 52-member coalition was hoping for.

Looks like we're going to see a push to open the public option. Get on the phones and let your congress creatures know you're behind it:

Sen. Ron Wyden has doubts about the scope of the public option plan announced Monday.

"I agree with Senator Reid that health reform should give Americans more options. Now, I want to work with him to ensure that all Americans can choose those options," Wyden said. "The bottom line is that the public option can’t really hold private insurers accountable if it is only competing for 10 percent of the insurance market, because private insurance companies aren’t going to change their business practices if 90 percent of their customers can’t take their business elsewhere.

"Real reform means empowering Americans to choose insurance that works well for them and their family, while rejecting plans that don’t. Including a public option is a step in the right direction, now let’s remove the firewalls in this bill that prevent Americans from choosing it," Wyden said in a statement.

[...][Jeff] Merkley, for example, said he would be unhappy if more Americans weren't able to select the so-called public option. As a member of one of the committees that wrote a health care bill, Merkley actively supported a government-option as the best way to maintain costs and provide greater choice. Merkley said in an interview Monday that he would press for any public option to be broadly available along the lines of an amendment he successfully offered in July when the bill was in committee.

Merkley's amendment is designed to give small businesses access to newly created health insurance exchanges that, in theory, breed competition by pooling the number of customers in a specific region. Merkley estimated that his amendment would allow nearly 25,000 more businesses – employing 485,000 workers – to enter the exchanges and 32 million people nationwide.
...

That amendment would increase the size of small businesses eligible for enter the national exchange that includes a public options. He also supports giving states the right expand the size of eligible businesses even more.

"What sense does it make to keep companies from going into the exchange?" he said.

While the Obama White House, Senate Majority Leader Harry Reid and Congressional Democrats debate among themselves whether the so-called "opt out" public health insurance option endorsed by Reid will be included in reform legislation, Minnesota Governor and GOP presidential wannabee Tim Pawlenty has already weighed in. Asked if he would "lead a charge" in his state to opt out, Pawlenty replied, "I think so because I don't like government run health care."

That's easy for him to say. As it turns out, Minnesota is the exception that proves the rule of red state socialism. An increasingly blue state with the 4th best health care system in the nation, the Land of 10,000 Lakes sends far more tax dollars to Washington than it receives in federal spending in return. But for Pawlenty's fellow Republican refuseniks, leaders of red states offering dismal health care and a beneficiaries of a one-way transfer of taxpayer funds from DC, opting out may not be an option.

In recent weeks, Texas secessionists and Georgia legislators have echoed Pawlenty's confused reading of the Tenth Amendment by endorsing a state veto over federal health reform mandates. But just in time for the debate over the merits of a state-by-state "opt out" of a national public health insurance option, the Commonwealth Fund has released its 2009 state health care scorecard. As in 2007, the data reveals the critical condition of red state health care. All of which could present Republican governors and legislatures with a dilemma: Will they refuse to offer lower cost insurance coverage for their residents by rejecting a system funded in part by blue state taxpayers?

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As expected, Dems are pushing hard for something to show the voters. Too bad they didn't just drop the Medicare age, but oh well:

Democrats are pushing Senate leaders and the White House to speed up key benefits in the health reform bill to 2010, eager to give the party something to show taxpayers for their $900 billion investment in an election year.

The most significant changes to the health care system wouldn’t kick in until 2013 — two election cycles away. With Republicans expected to make next year a referendum on health care reform, Democrats are quietly lobbying to push up the effective dates on popular programs, so they'll have something to run on in the congressional midterm elections.

Democrats are anxious to mix the good with the bad since some of the pain would be phased in early, including more than $100 billion in industry fees that critics say could be passed on to consumers.

“We want to be able, within the cost framework and the implementation framework, to have as much start as early as possible, even though we know all of it can’t,” said Sen. Debbie Stabenow (D-Mich.), a Finance Committee member who is working with other senators on the effort. “And the White House wants to have as much as possible to start.”

Under the Democratic wish list, senior citizens would receive discounts on brand-name drugs next year. Small businesses that provide insurance would see tax credits. And a $5 billion high-risk pool would cover people with preexisting conditions.

Democratic strategists expect the 2010 election to present a stark contrast between the parties, particularly if the health care bill receives minimal Republicans support. The front-load strategy could help blunt GOP attacks on the bill as a toxic mix of higher taxes, rising premiums and cuts to Medicare.

So according to this L.A. Times article, the health insurance got everything it wanted in this healthcare "reform" bill - except the death of the public option. So as relatively small a concession as that is unacceptable to them - which tells you who really owns this country. (Not us.) All the more reason to push your congress critter. Call today!

Reporting from Los Angeles and Washington - As President Obama's push for a healthcare overhaul moves toward its final act, the oft-vilified health insurance industry is on the verge of seeing a plan enacted that largely protects its financial interests.

That achievement, should it stand up in the final legislation, would be the capstone of a sophisticated lobbying and strategic campaign that began even before Obama was elected president.

The specifics of the healthcare legislation are still being hashed out on Capitol Hill, and key details will evolve in the days ahead. Even so, there is broad agreement that the final plan will, for the first time, require Americans to buy health coverage, with taxpayer subsidies for millions who cannot afford it.

For the health insurance industry, that means millions of new paying customers. What's more, there are likely to be no limits on what insurers can charge, while at the same time the plan is expected to limit competition from any new national government insurance plan that lawmakers create.

I mean, really. What's not to like?

These anticipated wins -- from an initiative that has at times been portrayed as doomsday for health insurers -- is the result of a strategy developed by one of Washington's savviest lobbyists, Karen Ignagni. Under Ignagni's leadership, the industry group America's Health Insurance Plans adopted the goal of universal coverage while setting out to shape it in a way that benefited insurers -- a crucial move that aligned their interests with those of other groups, including consumers and hospitals.

Insurers poured campaign donations into the coffers of key sympathetic members of the House and Senate, and loaded up on lobbyists. And when Obama and other Democrats began attacking the industry, insurers made a strategic choice not to walk away from the negotiating table.

"While so many in this town have been playing checkers, Karen has been playing chess," said Mark Merritt, a veteran lobbyist who heads the Pharmaceutical Care Management Assn.

[...] In addition to fighting the public option, insurers that offer Medicare health maintenance organizations are battling more than $100 billion in cuts in federal payments to that program. And they are trying to beat back a move by Democrats to go after the industry's decades-old exemption from antitrust law.

But in Washington, many marvel that lawmakers have not wrung more from an industry that, surveys show, is held in low regard by the public.

"The industry is really in no position to be making demands," said Celinda Lake, a longtime Democratic pollster.

And yet, they continue to do so - especially through senators like Olympia Snowe and Kent Conrad. Don't you love it that no matter how much we donate, politicians say they can't support the netroots agenda "because you're not in my district", yet are so very sympathetic to the millions of dollars poured into their states from giant industries like insurance? Looks like our bribes contributions just aren't big enough.

For much of the last three years, industry leaders have been laying the groundwork for this battle. Amid horror stories about insurers dumping sick patients, denying coverage for medical treatment and cherry-picking customers, Ignagni and a few insurance company executives pushed the idea within America's Health Insurance Plans that the industry risked political catastrophe if it did not move proactively.

"They knew they had a very big [public relations] problem, and they knew this day was coming," said Wendell Potter, a Cigna Corp. public relations executive who quit last year. "They knew they had to be perceived as coming to the table with solutions. It was a departure from their previous point of view. But they knew they would be slaughtered if it weren't."

We have a national health emergency, and Senate Republicans are stalling the surgeon general's confirmation. But then, they don't live in the same country as the rest of us:

A GOP stall on all Health and Human Services nominees has left the department without a surgeon general during a period of a global flu pandemic, prompting the HHS secretary to call for Senate action.

Regina Benjamin, the surgeon general nominee, “is ready to be voted on in the Senate, and we would just strongly urge the United States Senate” to act, HHS Secretary Kathleen Sebelius said during an MSNBC interview Friday in which she discused the department's response to the spread of the H1N1 virus.

President Barack Obama on Saturday declared the H1N1 outbreak a national emergency.

“We are facing a major pandemic, we have a well-qualified candidate for surgeon general, she’s been through the committee process. We just need a vote in the Senate,” Sebeilus said. “Please give us a surgeon general.”

Benjamin was unanimously approved by the Health, Education, Labor and Pensions Committee on Oct. 7, but Senate Republicans are holding up all HHS nominees over a so-called gag order on insurance companies that have been critical of Democratic efforts to reform health care.

“We’ve not received any recent calls from the administration about their nominee,” a senior Republican aide said. “There won’t be any time agreements for confirmation of HHS nominees until their actions have been fully reviewed.”

This is infuriating. If there was any doubt in your mind as to whose side the political establishment is on, this should settle it:

An amendment that would prevent the government from working with contractors who denied victims of assault the right to bring their case to court is in danger of being watered down or stripped entirely from a larger defense appropriations bill.

Multiple sources have told the Huffington Post that Sen. Dan Inouye, a longtime Democrat from Hawaii, is considering removing or altering the provision, which was offered by Sen. Al Franken (D-Minn.) and passed by the Senate several weeks ago.

Inouye's office, sources say, has been lobbied by defense contractors adamant that the language of the Franken amendment would leave them overly exposed to lawsuits and at constant risk of having contracts dry up. The Senate is considering taking out a provision known as the Title VII claim, which (if removed) would allow victims of assault or rape to bring suit against the individual perpetrator but not the contractor who employed him or her.

"The defense contractors have been storming his office," said a source with knowledge of the situation. "Inouye either will get the amendment taken out altogether, or water it down significantly. If they water it down, they will take out the Title VII claims. This means that in discrimination cases, they will still force you into a secret forced arbitration on KBR's (or other contractors') own terms -- with your chances of prevailing practically zero. The House seems to be very supportive of the original Franken amendment and all in line, but their hands are tied since it originated in the Senate. And since Inouye runs the show on this bill, he can easily take it out to get Republicans and the defense contractors off his back, which looks increasingly likely."

A Democratic aide on the Hill, also with knowledge of the situation, confirmed the account, as did a source who works on defense contracting matters outside of Congress. "The contractors are putting on a full-court press on this amendment... they are all doing it," said the latter source.

In their fight for a good public option, Health Care for America Now has unleashed a new campaign that addresses the core problem of affordable health insurance coverage - namely, where are you gonna go? There's no competition:

“Health insurance companies are exempt from antitrust regulations, and as a result, a small number of very large companies have almost total control of the health insurance marketplace. These big insurers aren’t competing for our business by lowering costs. Instead, they are driving up prices as high as the market will bear because they know we have nowhere else to turn,” said Richard Kirsch, National Campaign Manager, Health Care for America Now.

“We need the choice of a public health insurance option in the marketplace to inject real competition. Private insurers will have to work a lot harder to get costs under control and put people’s health before their profits if they know consumers have a viable health insurance alternative that’s not beholden to Wall Street.”

In May, Health Care for America Now released a national report (pdf) and state-specific reports detailing the extreme consolidation in the health insurance marketplace, and during a conference call debuting the report, Senator Chuck Schumer said, “This is the starkest evidence yet that the private health care insurance market is in bad need of some healthy competition. A public health insurance option is critical to ensure the greatest amount of choice possible for consumers.”

One of the bloggers on a conference call with Sen. Arlen Specter this week was pressing him on increasing health insurance premiums for overweight Americans. Specter gently corrected her. He said his son, a resident psychiatrist, has explained to him weight is a matter of many complex factors and it wouldn't be fair to financially penalize an entire group based on things they couldn't control.

I was appalled at the question. I've put on 50 pounds in two years of inactivity as a result of my (until recently undiagnosed) ankle injury and the last thing I need is someone charging me more money for it.

As policy, this is an especially uninformed and insensitive position because every study shows that rural and inner-city residents (who have the highest obesity rates) actually have little access to affordable, healthy food. (And that's not even touching the research showing that the chemicals in foods have all kinds of harmful effects on your body that encourage weight retention.)

So if people could educate themselves about these issues, we won't have to waste time on discussing what amount to punitive measures:

Get in shape or pay a price.

That's a message more Americans could hear if health-care reform provisions passed by the Senate finance and health committees become law. By more than doubling the maximum penalties that companies can apply to employees who flunk medical evaluations, the legislation could put workers under intense financial pressure to lose weight, stop smoking or even lower their cholesterol.

The bipartisan initiative, largely eclipsed in the health-care debate, builds on a trend that is in play among some corporations and that more workers will see in the benefits packages they bring home during this fall's open enrollment. Some employers offer lower premiums to workers who complete personal health assessments; others limit coverage for smokers.

The current legislative effort would take the trend a step further. It is backed by major employer groups, including the U.S. Chamber of Commerce and the National Association of Manufacturers. It is opposed by labor unions and organizations devoted to combating serious illnesses, such as the American Heart Association, the American Cancer Society and the American Diabetes Association.

Critics say employers could use the rewards and penalties to drive some workers out of their health plans.

President Obama and members of Congress have said they are trying to create a system in which no one can be denied coverage or charged higher premiums based on their health status. The insurance lobby has said it shares that goal. However, so-called wellness incentives could introduce a colossal loophole. In effect, they would permit insurers and employers to make coverage less affordable for people exhibiting risk factors for problems such as diabetes, heart disease and stroke.

"Everybody said that we're going to be ending discrimination based on preexisting conditions. But this is, in effect, discrimination again based on preexisting conditions," said Ann Kempski of the Service Employees International Union.

The legislation would make exceptions for people who have medical reasons for not meeting targets.

Supporters say economic incentives can prompt workers to make healthier choices, thereby reducing medical expenses. The aim is to "focus on wellness and prevention rather than just disease and treatment," said John J. Castellani, president of the Business Roundtable.

It's nice to hear some people are actually fighting for our interests. I was beginning to wonder if anyone was:

The forces in favor of a public health insurance option roared back Thursday on Capitol Hill after weeks when their cause looked bleak.

House Speaker Nancy Pelosi (D-Calif.) looked closer than ever to including a robust U.S. government-run insurance program in the House bill — saying recent attempts by the health insurance industry to undercut reform prove insurers can’t be trusted.

And in the Senate, a weekly policy lunch turned into a heated debate when liberals went after the Senate Finance Committee bill and made clear they won’t roll over for legislation that doesn’t include a public option.

Reflecting deep divides within the caucus, the Senate luncheon turned tense, with voices elevated and senators venting. “In today’s lunch, it even involved a little performance theater,” Sen. Evan Bayh (D-Ind.) said, describing it as an “emotional catharsis.”

In a week when the Senate Finance Committee passed a bill without a public option — raising questions about whether that would prove the public option’s last gasp — progressives in both houses showed they won’t go down without a fight.

And Thursday proved that if President Barack Obama hoped the public option question would fade of its own accord, he probably won’t get that lucky — but will be forced to referee a compromise between liberals and moderates.

But in the House, moderates stand to suffer the most if Pelosi goes ahead with plans to include the most ambitious public option — forcing them into a tough vote that will surely be used by Republican opponents in 2010.

In the House, Pelosi told her rank and file Thursday that the time has come to “freeze the design,” meaning she wants unveil a completed House bill as early as next week.

Pelosi favors a public-option plan supported by liberals that reimburses doctors at rates that are 5 percent higher than Medicare — one of the strongest versions of the public option on the table.

Pelosi used the reports put out this week by the insurance lobby — which said reform would add thousands to family insurance premiums — to show the public needs some defense against the industry.

“Anyone who had any doubts about the need for such an option need only look at the behavior of the health insurance industry this week,” Pelosi said. “If you are going to mandate that people must buy insurance, why would you throw them into the lion’s den of the insurance industry without some leverage with a public option?”