The holiday is over and bloggers are bouncing back with health system critiques and ideas to improve it.

Cato’s Tad DeHaven looks at Medicare and Medicaid waste outlined in a GAO report and concludes, “Alas, the Obama administration plans to open another major tributary with its new health care plan. But the administration insists that taxpayers and the economy won’t get swept away by the rising torrent as its plan with actually save money. If this claim sounds ridiculous, it’s because it is ridiculous.”

Health Populi’s Jane Sarasohn-Kahn discusses a Business Roundtable proposal to restructure the health care market through delivery reforms like pay for performance and wellness incentives.

Uwe Reindhardt on the New York Times’ Economix looks at comments by Sen. Kay Bailey Hutchison, R-Texas, that all women should be able to get yearly mammograms. Reinhardt says the senator’s comments illustrate how the United States health care system rations: “But chances are that in a state in which 25 percent of the population is without health insurance, a good many of these Texans are likely to have been forced to choose between spending their own money on these tests or prenatal care and other necessities of life. To paraphrase Senator Hutchison, they were being rationed out of health care.”

Mark Trahant thinks it’s the political system that needs overhaul — he focuses on the senate, saying, “The requirement of fixing health care must be seen in the context of a political system where it’s easier to spend than to save, and easier to borrow than to tax. The current scare over health care rationing makes this point exactly: No one has to give up anything. We can afford the very best, most expensive treatments even when they don’t work.”

The Washington Post’s Ezra Klein posts an analysis from Jonathan Gruber — the MIT economist who keeps popping up during the health reform debate. Gruber estimates that without reform, premiums on the individual market will cost 23% more.

Meanwhile, The New Republic’s Jonathan Cohn, who prefers the House bill, finds more flaws in the Senate version: loopholes would possibly exempt many businesses from lifetime benefit caps.

But Critical Condition’s Jeffrey Anderson thinks a round of recent polls spells trouble for reform efforts, and says “It is time to kill this expensive, intrusive, unpopular monster — once and for all.”

A pre-Thanksgiving buffet today.  This is the last Blog Watch until Monday — have a great Holiday!

Catherine Rampell of the New York Times’ Economix compares a map of obesity rates with a map of Medicare spending (from the Dartmouth Atlas project).  She asks, “How much overlap do you see?”  We’re seeing a lot.

Ezra Klein is on an anti-filibuster kick, devoting three posts yesterday to the topic, including one with a priceless 1964 letter on the Medicare bill.   

Insure Blog’s Mike Feehan looks at polls on health care, including a new one from the Robert Wood Johnson Foundation, and thinks Democratic leaders aren’t listening to the public: “I think these results suggest it’s unlikely that there is in fact some widespread groundswell of public support for the House or Senate health care bills. People just don’t get enthusiastic over nothing or less than nothing. Yet the President, Nancy Pelosi, Harry Reid, and their minions all claim they have overwhelming public support. What voices are they listening to?”

Heritage’s Guinevere Nell says, “It is a well known economic policy rule that if you want less of something you tax it, and if you want more of something you subsidize it,” and grouses that there are taxes in the health overhaul bills on medical device makers, over the counter meds, private health insurance plans and “innovative medical companies.”

TPM DC’s Brian Beutler takes a closer look at GOP lawmakers’ claims that the Senate bill actually costs $2.5 trillion, not $849 billion.  According to Beutler, the estimate comes from moving the time-frame of the bills costs to 2014-2024: “this critique elides the fact that, whatever the federal responsibility for health care becomes as a result of this bill, the total package is projected to dramatically reduce the deficit in both the near and long terms.”  Wonk Room’s Igor Volsky has more.

Elsewhere, Health and Human Services has launched a new blog focused on health information technology.  It’s hosted at the Office of the National Coordinator for Health IT, and Director David Blumethal wrote the first post (a generic welcome.)

And many bloggers are still debating controversial new mammography guidelines.  Phyllis Greenberger of Disruptive Women in Health Care says, “Why are women being targeted? I thought this was all about giving women more access to health care, many of the changes in regulations are definitely positive, but what the government gives with one hand, it seems to take away with the other.”   But Adrian Fugh-Berman writes on the Bioethics Forum that “Vague, fact-free, emotionally charged statements are the language of public relations, not scientific discourse. The striking similarities in word choice among these critics could be entirely coincidental,” and looks at potential conflicts of interest among opponents of the new guidelines.

Politico’s Mike Allen reports this morning that the Obama Administration is labelling a blog post from the Atlantic’s Ron Brownstein “required reading.” Brownstein’s thesis: the Senate bill contains plenty of cost control measures. 

A key passage that probably caught the President’s eye: optimism from MIT economist Jonathan Gruber: “They really make the best effort anyone has ever made. Everything is in here….I can’t think of anything I’d do that they are not doing in the bill. You couldn’t have done better than they are doing.”

The only other item like Brownstein’s said to have circulated the West Wing in recent months was from physician and New Yorker staff writer Atul Gawande, and zeroed in on one particularly high-cost town in Texas. 

The New Republic’s Jonathan Cohn thinks these the buzz surrounding these two pieces “is one more signal from the White House that it considers cost control a priority–a message it has been sending privately, during negotiations with Congress and interest groups, from day one.”

Perhaps Brownstein’s piece also held the administration’s attention because he so clearly articulated possible cost-controls in the bill, which have been under attack for months. 

Opponents aren’t backing down, though.  Take Cato’s Michael Cannon, for instance, who has started tweeting the following everyday:

Cannon’s piece argues that the true cost of the bills are unknown.  He believes, because there is a requirement in the bills that individuals have to buy health insurance, the Congressional Budget Officeshould count the cost of the premiums as part of the cost of the bill.  He says the CBO did that for President Clinton’s bill in 1994 — and it was called “devastating” by then Health and Human Services Secretary Donna Shalala. Cannon says, “So while the CBO estimates that the coverage expansions in the House Democrats’ legislation would trigger about $1 trillion of new federal spending over ten years, the actual cost of those coverage expansions is more like $2.5 trillion.”