The president will outline his specific ideas days before the televised congressional talks planned next week. It marks a change in tack from his approach to let congressional leaders take the lead.

The posting would come three days before a televised meeting that Obama plans to convene with congressional Democratic and Republican leaders in hopes of restarting his stalled bid to overhaul the nation's healthcare system.

"There will be one proposal. It is the president's," Secretary of Health and Human Services Kathleen Sebelius said Thursday while unveiling a report highlighting large premium increases by insurance companies nationwide, including California-based Anthem Blue Cross.

"I think the idea is that it will take some of the best of the ideas [from the House and Senate bills] and put them into a framework moving forward," Sebelius said.

Sebelius and other Democratic officials have been stepping up their attacks on the insurance industry as they work to convince Americans of the need for a comprehensive healthcare bill.

Obama, in a letter inviting congressional leaders to next week's meeting, indicated that his legislative proposal would "put a stop to insurance company abuses, extend coverage to millions of Americans, get control of skyrocketing premiums and out-of-pocket costs and reduce the deficit."

His plan will probably offer the most detailed vision yet of where the president stands on a number of contentious healthcare issues that have divided Democrats, including how to pay for a major expansion of medical coverage. Administration officials and congressional Democrats are nearing such a compromise, according to Democratic officials.

It is still unclear what, if any, concessions the president will make to Republicans, who have steadfastly opposed Obama's push for an overhaul.

Obama's proposal may represent the last, best hope for reviving his top domestic priority. After a year during which the president looked to congressional Democrats to develop health legislation, many are now looking to him to push it over the finish line after his party lost its Senate supermajority following last month's special election in Massachusetts.

Obama has challenged congressional Republicans to come forward with their own alternative.

House Republicans have proposed a more limited healthcare bill that the nonpartisan Congressional Budget Office estimated would control premiums, but would do almost nothing to expand coverage over the next decade.

Senate Republican leaders have not developed an alternative. "We will not be offering a comprehensive bill," said Don Stewart, a spokesman for Senate Minority Leader Mitch McConnell (R-Ky.), citing public anxiety about sweeping healthcare legislation.

Michael Franc, who oversees government relations for the conservative Heritage Foundation, said Republicans would be wise to steer clear of any public negotiating over healthcare legislation with the president, suggesting instead that they stick to their demand that the Democratic bills be scrapped.

"The last thing Republican leadership wants is to get drawn into something that upsets their base," Franc said.

House Minority Leader John A. Boehner (R-Ohio) and the minority whip, Rep. Eric Cantor (R-Va.), have asked the White House for an assurance that Obama is prepared to "start over." Administration officials have firmly rejected that.

Instead, senior Democrats plan to outline a proposal that hews closely to the legislation that Democrats developed last year that would expand coverage to about 30 million Americans over the next decade, dramatically increase regulation of the insurance industry and cost about $900 billion.

To get the proposal through Congress, Democrats in the House would probably have to approve the bill that the Senate approved last year on a party-line vote. Then both the House and Senate would vote on a package of changes to the bill using a process known as budget reconciliation that requires only a simple majority in the Senate.

That package of changes, which has been the subject of intense negotiations for more than a month, are almost finalized, according to Democratic officials.

Senior Democrats have largely agreed to eliminate a controversial provision in the Senate bill providing special federal aid to Nebraska to help that state expand its Medicaid program, which had been included to secure the vote of that state's Democratic senator.

They plan to boost federal subsidies to help low- and moderate-income Americans buy health insurance in new insurance exchanges. And they want to close the gap in Medicare's drug coverage for seniors, known as the "doughnut hole."

Discussions about how to scale back a new tax in the Senate bill on high-end "Cadillac" health plans are still underway.

Next week, the White House and senior Democrats could also add more changes to the package to reflect Republican priorities or to satisfy additional requests from rank-and-file Democrats, who will return to Washington after their Presidents Day recess.

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Times staff writer Duke Helfand in Los Angeles contributed to this report.
 

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• Dry
  
  Often, the dry form of macular degeneration initially causes slightly blurred central vision, both close up and far. Central vision may become fuzzy or shadowed, and this shadowy or blurry area grows larger as the disease progresses. Blind spots could develop, and it is more difficult to see color and fine detail.



• Wet
  
  Wet macular degeneration will present the same symptoms as the dry form and may also include straight lines appearing wavy. Also, wet macular degeneration can occur rapidly, sometimes within days or weeks.

Only an ophthalmologist is able to detect early signs of macular degeneration before symptoms appear. This is one of the many reasons why regular eye exams are so important.

Low vision is a visual impairment that interferes with a person’s ability to perform daily activities and it cannot be corrected by standard eyeglasses, contact lenses, medication, or surgery. Low vision affects 1 in 28 American's over the age of 40, nearly 3.3 million Americans. Learn more about living with macular degeneration.

 

Living With Age-Related Macular Degeneration

An Inspirational Story

Although living with low vision can be difficult, many continue to lead fulfilling and productive lives, despite their diagnoses. An example of the kind of fighting spirit that exists in those with blindness or low vision can be seen in Mike Despot, a photographer and an inspiration for those with macular degeneration.

Read Mike's personal story: http://www.ahaf.org/macular/livingwith/mike-despot.html.

Not only has Mike told us about his personal journey with macular degeneration and inspired us with his photos, he has created a personal fundraising page as well. Donations to Mike’s page will go towards research to find a cure for macular degeneration and services for those with macular degeneration.

• Help Mike raise funds to find a cure for macular degeneration.



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TEHRAN (Reuters) - Iran says it will start producing higher-grade nuclear fuel on Tuesday and plans a major expansion of its uranium enrichment program by building 10 new plants in the next year, further stoking tensions with the West.

The statement by Iran's nuclear agency chief Ali Akbar Salehi on Sunday evening came after President Mahmoud Ahmadinejad earlier in the day instructed him to start work on producing atomic fuel for a Tehran research reactor.

Iran's announcement raised the stakes in its dispute with the West, although analysts doubted Iran could launch 10 new plants in the near future since U.N. sanctions imposed on Tehran make it harder for it to obtain sophisticated components.

Analysts believe Tehran's announcement that it will start producing higher-refined uranium may be a negotiating tactic to prod the West into closing a fuel deal largely on Iranian terms.

But the move could also backfire if it only serves to make Western powers increasingly determined to push for more sanctions against Iran, the world's fifth-largest oil producer, over its refusal to suspend enrichment.

"Iran will set up 10 uranium enrichment centers next year," Iran's Arabic-language television station al Alam quoted Salehi as saying. The Iranian year starts on March 21. Iran mooted such a plan late last year but gave no time frame.

Ahmadinejad also said talks could still be revived on a nuclear fuel exchange offer by world powers designed to allay fears the Islamic Republic is trying to develop atomic bombs.

The enrichment would take place at  Salehi said Iran would start to raise the enrichment level from 3.5 percent to 20 percent on Tuesday, in the presence of inspectors from the International Atomic Energy Agency (IAEA).

He said Iran would formally notify the Vienna-based U.N. watchdog about the move in a letter on Monday, al Alam reported. He earlier said production would take place at the Natanz site.

But Salehi also suggested production would be halted if Iran could import fuel enriched to 20 percent, the degree of purity required for conversion into special fuel needed to run a Tehran nuclear medicine reactor, Iran's stated goal for the move.

Tehran has also voiced readiness to send low-enriched uranium (LEU) abroad in a swap for fuel for the reactor, due to run out of it later this year. But amendments Iran has demanded to the U.N.-drafted proposal have been rejected by the United States, France and Russia, the other parties to the plan.

"Iran would halt its enrichment process for the Tehran research reactor any time it receives the necessary fuel for it," Salehi said.

IRAN'S MOVE MAY BACKFIRE, PROVOKE MORE SANCTIONS

Ahmadinejad's contradictory signals over the last week -- first expressing readiness to send low-enriched uranium abroad and then announcing that Iran would start producing 20 percent fuel itself -- may also be a sign of Iran's political turmoil.

Analysts believe Ahmadinejad may want to secure a swap deal with the international community to boost his standing and legitimacy after last year's disputed election, but is hampered by political rivals who oppose any LEU export as a threat to national security.

Iran's move to make 20 percent fuel itself may stoke suspicion that its real aim is higher-enriched uranium for atom bombs, since only France and Argentina -- not Iran -- are known to have the technology to yield fuel for medical isotopes.

A senior diplomat close to the IAEA said enrichment to 20 percent was legal under Iran's non-proliferation accord with the agency. "But what counts is design verification (the inspectors do). Higher enrichment means higher verification requirements."

"Natanz would need less than a few months to start making the 20 percent enriched uranium, (although) Iran will face significant technical hurdles in manufacturing it," said David Albright, head of the Institute for Science and International Security, a think-tank that tracks nuclear proliferation.

"The larger technical issue is whether Iran is planning to make only the small amount of enriched uranium needed for its research reactor, or is it trying to convert most of its 3.5 percent stock of enriched uranium into 20 percent material.

By doing so, it would be going most of the rest of the way to weapon-grade uranium," Albright told Reuters.

Western powers fear Iran's nuclear programme is aimed at developing nuclear weapons capability with high-enriched uranium. Tehran denies the charge, saying it wants only lower-grade nuclear material for electricity generation.

Iran in November declared plans to build 10 new enrichment plants in a vast, defiant expansion of nuclear work after the IAEA rebuked it for erecting a second plant in secret.

(Additional reporting by Hashem Kalantari and Mark Heinrich in Vienna; Editing by Samia Nakhoul)

WASHINGTON — The Joint Strike Fighter was supposed to be the program that broke the mold, proof that the Pentagon could build something affordable, dependable and without much drama.

Navy Secretary Ray Mabus in the cockpit of a Joint Strike Fighter in December during a visit to a Lockheed Martin facility in Fort Worth.

But rather than being the Chevrolet of the skies, as it was once billed, the fighter plane, also called the F-35, has turned into the Pentagon’s biggest budget-buster. And with worries growing that the rise in costs could overwhelm other programs, Defense Secretary Robert M. Gates fired the general in charge this week and said he would withhold $614 million in fees from the prime contractor, Lockheed Martin.

The decision was an embarrassment for Lockheed Martin, the nation’s largest military contractor, which could eventually draw at least a quarter of its sales from the F-35. But Pentagon officials said they wanted to make sure they avoided the kind of death spiral that had caused so many other weapons programs to collapse.

The Air Force, the Navy and the Marines are planning to buy more than 2,400 of the planes. But any delays could force them to spend billions of dollars on less advanced fighters to avoid a shortfall. That, in turn, would reduce their orders for the F-35, driving up the price for each plane and forcing them to cut orders further.

The main problem, some analysts say, is that even with recent improvements in acquisition practices, the military persists in buying new weapons systems before all the kinks are worked out.

At the Pentagon’s behest, Lockheed Martin has already started building production models of the F-35, even though only 2 percent of the flight test program has been completed. “Unless they convert the program to a fly-before-you-buy approach, they will continue to have pain,” said Winslow T. Wheeler, an analyst for the Center for Defense Information in Washington.

But Pentagon officials said that given the rapid changes in technology, they could not afford to take such a gradual approach without systems becoming outdated before they rolled off the line. Lockheed Martin executives said that they had gotten the message about picking up the pace, and that they believed they would be able to start delivering the planes faster than the government now projects.

“They have been very clear that they intend to hold us to more aggressive standards, and we intend to perform to those,” Daniel J. Crowley, one of Lockheed Martin’s project managers, told reporters on Tuesday.

Mr. Crowley acknowledged that the program, which has been adjusted several times, was running six months behind the latest schedule. But he said that after building the first few planes, the company had been able to sharply reduce how much time and money each one required. And that has given it more confidence that it can get back on track.

Yuri Gripas/Reuters;

Maj. Gen. David R. Heinz of the Marine Corps was removed on Monday as head of the Joint Strike Fighter program.

Mr. Gates also said on Monday that he knew of “no insurmountable problems, technological or otherwise, with the F-35.” But he added a year to the development phase of the program, and slowed plans to increase production, to give the company a chance to catch up.

Still, that solution is basically a gamble that the company will do better. The program, which is by far the Pentagon’s largest, is expected to cost nearly $300 billion if all of the 2,456 planes are purchased in the next 25 years. Eight allied nations have also invested in the program and could buy hundreds of additional planes.

Some senators sounded skeptical in questioning Mr. Gates at a hearing on Tuesday. “I’m still concerned about whether the services will get the J.S.F. when they need them,” said Senator John McCain, Republican from Arizona, referring to the plane.

Other senators criticized Mr. Gates, who promoted the coming of the F-35 as a reason to kill the more costly F-22 fighter program last summer, for not having a handle on the problems sooner.

Many of the concerns were outlined in a report by a special Pentagon assessment team in late 2008. Mr. Gates said at the hearing on Tuesday that he did not recall that report. He said he had intervened now to try to head off the dire projections in a similar assessment completed in the fall.

That study found that the development of the plane could be delayed by two and a half years and cost an extra $16.6 billion if no changes were made. Mr. Gates has also said that he replaced the head of the program, Maj. Gen. David R. Heinz of the Marine Corps, to show that officials would be held accountable “when things go wrong.”

When the Pentagon began thinking about the F-35 in the mid-1990s, the Pentagon was building the F-22, the world’s stealthiest fighter, for aerial dogfights, and it expected to buy 650 to 750 of them. The F-35, which also has stealth features to avoid radar, was meant to focus more on attacking ground targets. Creating three versions with a similar core — one each for the Air Force, the Navy and the Marines — was supposed to make it more affordable.

But while delays and overruns pushed the cost of the F-22 so high that only 187 are being built, the projected costs of the F-35 program have also risen to $298.8 billion from an early estimate of about $200 billion.

Counting all the development costs, each F-35 is now projected to cost about $122 million compared with about $350 million for each F-22. Another concern is that additional problems often appear in flight testing. And a recent Navy study concluded that the F-35 could be significantly more expensive to operate than older fighters.

But Mr. Crowley, one of Lockheed Martin’s top managers on the project, said the company had greatly reduced the parts shortages that delayed the first planes. He said the company was talking to the Pentagon about adding another plane to the flight test program, and it was much closer to finishing sensitive systems, like the software that operates the plane and its sensors, than it was at a similar stage on the F-22.

He added that it was “our intent to outperform” projections for the program, enabling the government to buy more planes than it expected to over the next few years.

Other industry officials said they had heard that Mr. Gates was likely to name Vice Adm. David J. Venlet, commander of the Naval Air Systems Command, to succeed General Heinz in overseeing the program. And given that Mr. Gates has had to backtrack from his praise for the program, he now has even more on the line in holding it together.

The Associated Press
Friday, January 29, 2010; 4:16 PM

From left, House Minority Leader John Boehner of Ohio, House Minority Whip Eric Cantor of Va., and Rep. Mike Pence, R-Ind., listen as President Barack Obama speaks to Republican lawmakers at the GOP House Issues Conference in Baltimore, Friday, Jan. 29, 2010. (AP Photo/Charles Dharapak) (Charles Dharapak - AP)

By LAURA MECKLER And JONATHAN WEISMAN

WASHINGTON—President Barack Obama intends to propose a three-year freeze in spending that accounts for one-sixth of the federal budget—a move meant to quell rising concern over the deficit but whose practical impact will be muted.

Getty Images

President Barack Obama and Vice President Joe Biden at a meeting of the Middle Class Task Force on Monday.

To attack the $1.4 trillion deficit, the White House will propose limits on discretionary spending unrelated to the military, veterans, homeland security and international affairs, according to senior administration officials. Also untouched are big entitlement programs such as Social Security and Medicare.

The freeze would affect $447 billion in spending, or 17% of the total federal budget, and would likely be overtaken by growth in the untouched areas of discretionary spending. It's designed to save $250 billion over the coming decade, compared with what would have been spent had this area been allowed to rise along with inflation.

The administration officials said the cap won't be imposed across the board. Some areas would see cuts while others, including education and investments related to job creation, would realize increases.

Among the areas that may be potentially subject to cuts: The departments of Housing and Urban Development, Justice, Energy, Transportation, Agriculture, and Health and Human Services.

"We're not here to tell you we've solved the deficit, but you have to take steps to put spending under control," a senior administration official said.

The spending freeze, which is expected to be included in Wednesday's State of the Union address and the president's Feb. 1 budget proposal, is one of a series of small-scale initiatives the White House is unrolling as the president adjusts to a more hostile political terrain in his second year. On Monday, the president unveiled a set of proposals aimed at making child care, college and elder care more affordable.

"Given Washington Democrats' unprecedented spending binge, this is like announcing you're going on a diet after winning a pie-eating contest," said Michael Steel, spokesman for House Minority Leader John A. Boehner (R., Ohio). "Will the budget still double the debt over five years and triple it over 10? That's the bottom line."

Responding to criticism, administration officials acknowledged the freeze is directed at only a small part of overall spending, but that fiscal discipline has to start somewhere. President Obama had requested a 7.3% increase last year in the areas he now seeks to freeze. White House officials said they had achieved 60% of the $11.5 billion in cuts outlined in the budget for the current fiscal year.

Mr. Obama will also propose the creation of a deficit commission to look for potential solutions for the medium- and long-term deficit—a move to garner bipartisan support for what may be unpopular tax increases and spending cuts. A bipartisan group of senators has been trying to get such a commission passed into law in a way that would give teeth to its recommendations. The recommendations of any presidential panel would require congressional approval.

The budget proposal will be welcomed in some quarters. On Monday, four members of the Democratic Party's Blue Dog caucus, which favors fiscal discipline, wrote to Mr. Obama suggesting he implement a freeze much like the one he plans. "More will need to be done to get our fiscal house in order, but we believe this freeze in non-defense related discretionary spending is a good place to begin," they wrote.

John Makin, an economist at the conservative American Enterprise Institute, called the effort "certainly a step in the right direction." He said the amount saved isn't large, but noted that he preferred this approach over raising taxes. "I'm not going to belittle it because it's not a big cut in spending."

A year after the White House rolled out ambitious initiatives on health care and energy, in addition to a giant economic stimulus plan, the president is in some respects taking smaller steps. That's partly because much of the 2009 agenda remains undone. Also, in an election year, members of Congress are typically reluctant to take on controversial proposals.

But the president said Monday that he remains committed to tackling health care and other big problems. "I'd rather be a really good one-term president than a mediocre two-term president," he told ABC News.

He faces tough dynamics. Mr. Obama and his party are bracing for losses in this fall's election amid fallen approval ratings and after a damaging loss in a Massachusetts special Senate election. The president has already shifted to a more populist tone aimed at convincing independent voters in particular that he is on their side.

"We're going to keep fighting to rebuild our economy so that hard work is once again rewarded, wages and incomes are once again rising, and the middle class is once again growing," Mr. Obama said in unveiling his new proposals Monday.

That message will likely be broadcast on Wednesday, when Mr. Obama delivers his State of the Union address to Congress. Aides say he'll use the domestic-policy section to focus on jobs, the budget deficit and ways to reform the way Washington works.

The big-ticket legislative items from last year may wind up on the back burner. The president has suggested Congress might significantly scale back its health-care legislation after the party lost its 60-vote Senate super-majority.

And on energy, following last year's proposal to fight global warming by requiring companies pay for the right to emit greenhouse gases, Democrats concede it is more likely that Congress will approve a scaled-back bill with subsidies and more modest rules.

White House officials say they will continue to push their 2009 goals. "We are not trimming the sails on the major policy initiatives, but we are at a different stage where the focus is on moving forward [on existing initiatives] not announcing a new policy," said one White House adviser.

Many Republicans argue Mr. Obama tried to do too much. "In my view, the president struggled in his first year not only because his agenda veered too far left, but because he took too many big bites out of too many apples and tried to swallow them all at once," Sen. Lamar Alexander (R., Tenn.) said on the Senate floor Monday.

On Monday, the president and Vice President Joe Biden announced a handful of modest proposals aimed at supporting middle-class families, the result, they said, of a task force led by Mr. Biden. They said the budget will include an additional $1.6 billion for low-income child-care subsidies, and that they would ask Congress to sweeten a child-care tax credit with more generous help for families earning up to $115,000.

Administration officials wouldn't say how much the extra tax breaks would cost, or how they would pay for them. The plan also includes new limits for people repaying student loans, capping repayments at 10% of discretionary income, at a cost of $7.5 billion over 10 years, and $102.5 million for help with elder care.