Houston DWI Attorney Paul B. Kennedy

WASHINGTON (AP) -- In the special interest war over health care, the White House and congressional Democrats have the nation's drug makers and hospitals generally on their side; the insurance industry, not so much.

Now the bill's supporters are making a play to lock in the American Medical Association, the organization that says it represents 250,000 doctors and medical students in every state and congressional district. The principal enticement, a $247 billion measure making its way to the Senate floor, aims to wipe out a scheduled 21 percent rate cut for doctors treating Medicare patients and replace it with a permanent, predictable system for future fee increases.

The AMA, firmly in favor of higher pay for doctors, began airing ads last week saying the increase would "protect seniors' access to quality care." In case lawmakers need any inducement to act, a late 2008 study by the Medicare Payment Advisory Commission, which advises Congress, found that nearly 30 percent of Medicare patients looking for a new primary care doctor had trouble finding one.

Yet the AMA won't yet pledge support for the major health care bill that is the chief objective of the White House and congressional Democrats, despite a request that several officials say was made at a meeting last week with Senate Majority Leader Harry Reid, D-Nev.

Nor does it seem eager to soft-pedal another of its own top priorities, legislation to restrict medical malpractice payments.

"We continue to press for significant medical liability reform because we know that is a very important contributor to unnecessary health care costs," Dr. J. James Rohack, president of the AMA, said in an interview in which he decli! ned repe atedly to say whether the organization had been asked to back off.

Higher payments to doctors and curbs on medical malpractice awards "in my mind are separate issues. I can't speak for how other people are putting this whole thing together," he added.

Evidently not in the minds of Democrats. Several officials say that request, too, was conveyed to the AMA and other doctor groups in last week's session with Reid. Not coincidentally, any limitations in medical malpractice awards are anathema to trial lawyers, whom Democrats count as among their most reliable and generous campaign supporters.

The dance is one of many in the long-running health care debate, the issue that has consumed Congress, the administration and a vast constellation of outside groups for months.

Take the Senate Finance Committee, which last week approved a middle-of-the-road measure that may eventually prove a template for a compromise on an issue that has defied solution for decades. Sen. Olympia Snowe of Maine drew headlines when she became the first Republican to support White House-backed health care legislation.

But according to some of the bill's supporters, a vote that occurred with little fanfare several evenings earlier was crucial to the legislation's survival.

It pitted the drug makers and the White House on one side and most of the committee's Democrats on the other.

At issue was a plan by Sen. Bill Nelson, D-Fla., to sweeten drug benefits for certain Medicare beneficiaries - normally something all lawmakers can favor. In this case, Nelson proposed raising fees on drug companies by $106 billion over a decade to cover the costs. "Did PhRMA come to the table in the agreement with the White House with enough? A number of us feel that is not the case," he said of the industry.

But his approach happened to run afoul of a deal! the ind ustry made months ago with the White House and Sen. Max Baucus, D-Mont., the committee's chairman. Drug makers would cover $80 billion of the cost of the legislation over a decade, and the White House and Baucus would help shield them from attempts by other lawmakers to impose additional fees or taxes.

Left undisclosed for weeks was a critical codicil - that the industry would bankroll an expensive advertising campaign to promote the bill's passage, at a cost of $100 million or more.

Passage of Nelson's proposal "may well undermine our ability to pass comprehensive health care reform in this Congress and I think that would be a great tragedy," Sen. Tom Carper, D-Del., said shortly before the vote.

Baucus, too, spoke against Nelson's recommendation, although he added, "we have to find some other time and some other way to fill the doughnut hole," a reference to a gap in coverage under the Medicare prescription drug program.

Of Nelson, Baucus said, "I frankly wish the senator had decided not to push" for a vote.

Not only Baucus, but also the White House had urged Nelson to drop his amendment, according to Senate sources who spoke on condition of anonymity. On the vote, the chairman, Carper and Sen. Bob Menendez, D-N.J., joined all committee Republicans in opposing the plan, and it failed on a vote of 13-10.

The drug deal was secure, and so, too, the bill.

Special interest politics was also at play for the nation's hospitals. They, too, have a side deal with the White House and Baucus, and they also received a measure of protection in the bill that cleared the committee.

At the last minute, the chairman decided to shield them from any future cuts to be recommended by an independent commission charged with recommending savings in Medicare.

The insurance industry?

Reid made an unusual appearance at a Senate committee hearing recently to support repeal of 60-year-old antitrust laws that benefit insurance companies.

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EDITOR'S NOTE - David Espo is chief congressional correspondent for The Associated Press.

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WASHINGTON (AP) -- Americans seem to be cooling toward global warming.

Just 57 percent think there is solid evidence the world is getting warmer, down 20 points in just three years, a new poll says. And the share of people who believe pollution caused by humans is causing temperatures to rise has also taken a dip, even as the U.S. and world forums gear up for possible action against climate change.

In a poll of 1,500 adults by the Pew Research Center for the People & the Press, released Thursday, the number of people saying there is strong scientific evidence that the Earth has gotten warmer over the past few decades is down from 71 percent in April of last year and from 77 percent when Pew started asking the question in 2006. The number of people who see the situation as a serious problem also has declined.

The steepest drop has occurred during the past year, as Congress and the Obama administration have taken steps to control heat-trapping emissions for the first time and international negotiations for a new treaty to slow global warming have been under way. At the same time, there has been mounting scientific evidence of climate change - from melting ice caps to the world's oceans hitting the highest monthly recorded temperatures this summer.

The poll was released a day after 18 scientific organizations wrote Congress to reaffirm the consensus behind global warming. A federal government report Thursday found that global warming is upsetting the Arctic's thermostat.

Only about a third, or 36 percent of the respondents, feel that human activities - such as pollution from power plants, factories and automobiles - are behind a temperature increase. That's down from! 47 perc ent from 2006 through last year's poll.

"The priority that people give to pollution and environmental concerns and a whole host of other issues is down because of the economy and because of the focus on other things," suggested Andrew Kohut, the director of the research center, which conducted the poll from Sept. 30 to Oct. 4. "When the focus is on other things, people forget and see these issues as less grave."

Andrew Weaver, a professor of climate analysis at the University of Victoria in British Columbia, said politics could be drowning out scientific awareness.

"It's a combination of poor communication by scientists, a lousy summer in the Eastern United States, people mixing up weather and climate and a full-court press by public relations firms and lobby groups trying to instill a sense of uncertainty and confusion in the public," he said.

Political breakdowns in the survey underscore how tough it could be to enact a law limiting pollution emissions blamed for warming. While three-quarters of Democrats believe the evidence of a warming planet is solid, and nearly half believe the problem is serious, far fewer conservative and moderate Democrats see the problem as grave. Fifty-seven percent of Republicans say there is no solid evidence of global warming, up from 31 percent in early 2007.

Though there are exceptions, the vast majority of scientists agree that global warming is occurring and that the primary cause is a buildup of greenhouse gases in the atmosphere from the burning of fossil fuels, such as oil and coal.

Jane Lubchenco, head the National Oceanic and Atmospheric Administration, told a business group meeting at the White House Thursday: "The science is pretty clear that the climate challenge before us is very real. We're already seeing impacts of climate change in our own backyards."

Despite misgivings about th! e scienc e, half the respondents still say they support limits on greenhouse gases, even if they could lead to higher energy prices. And a majority - 56 percent - feel the United States should join other countries in setting standards to address global climate change.

But many of the supporters of reducing pollution have heard little to nothing about cap-and-trade, the main mechanism for reducing greenhouse gases favored by the White House and central to legislation passed by the House and a bill the Senate will take up next week.

Under cap-and-trade, a price is put on each ton of pollution, and businesses can buy and sell permits to meet emissions limits.

"Perhaps the most interesting finding in this poll ... is that the more Americans learn about cap-and-trade, the more they oppose cap-and-trade," said Sen. James Inhofe, R-Okla., who opposes the Senate bill and has questioned global warming science.

Regional as well as political differences were detected in the polling.

People living in the Midwest and mountainous areas of the West are far less likely to view global warming as a serious problem and to support limits on greenhouse gases than those in the Northeast and on the West Coast. Both the House and Senate bills have been drafted by Democratic lawmakers from Massachusetts and California.

One of those lawmakers, Sen. Barbara Boxer of California, told reporters Thursday that she was happy with the results, given the interests and industry groups fighting the bill.

"Today, to get 57 percent saying that the climate is warming is good, because today everybody is grumpy about everything," Boxer said. "Science will win the day in America. Science always wins the day."

Earlier polls, from different organizations, have not detected a growing skepticism about the science behind global warming.

Since 1997, the percentage of Americans that believe the Earth is heating up has remained constant - at around 80 percent - in polling done by Jon Krosnick of Stanford University. Krosnick, who has been conducting surveys on attitudes about global warming since 1993, was surprised by the Pew results.

He described the decline in the Pew results as "implausible," saying there is nothing that could have caused it.

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Associated Press Writers Seth Borenstein and Kevin Freking contributed to this report.

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WASHINGTON (AP) -- The Treasury Department on Thursday ordered seven companies that accustomed billions of dollars in government bailouts to bisect total advantage for their top executives. But the big reductions will not apply to pay becoming before November.

Kenneth Feinberg, the Treasury official arch the pay review, told reporters that boilerplate salaries for the top 25 admiral are being cut 90 percent starting next month.

The action will apply to the top admiral at Bank of America Corp., American International Group Inc., Citigroup Inc., General Motors, GMAC, Chrysler and Chrysler Financial.

Meanwhile, the Federal Reserve unveiled a proposal Thursday that would police banks' pay behavior to ensure they don't animate advisers to take reckless gambles like those that contributed to the banking crisis.

Unlike the Treasury plan, the Fed proposal would awning bags of banks, including abounding that never accustomed a bailout. But the central coffer would not absolutely set compensation. Instead, the Fed would review - and could veto - pay behavior that could cause too abundant risk-taking by executives, traders or accommodation officers.

The government did not appetite to make admiral return advantage already accustomed this year, but the bargain pay levels will be the base for making decisions on salary in 2010, Feinberg said.

The admiral will still be subject to advantage limits as long as their companies are accepting abutment from the government's $700 billion bailout fund. Their total advantage was being cut in half, on average.

Cash salaries will be limited to $500,000 for added than 90 percent of affe! cted emp loyees. Personal costs for such allowances as aggregation autos and corporate jets will be capped at $25,000 without approval from Feinberg's office for college payments.

Feinberg got the job as pay czar earlier this year when Congress, responding to outrage about huge bonuses being paid to AIG, adapted the bailout law to crave that controlling advantage at companies accepting exceptional abetment be curbed.

He has been reviewing advantage bales since August and called abounding of the negotiations "intense."

Speaking earlier at the White House, President Barack Obama welcomed Treasury's decision and said Americans' ethics are offended by boundless paychecks for admiral whose companies were bailed out by taxpayers. He urged Congress to pass legislation to accord shareholders a articulation in controlling pay packages.

"It does affront our ethics when admiral of big banking firms that are struggling pay themselves huge bonuses alike as they await on extraordinary abetment to stay afloat," Obama said.

Treasury Secretary Timothy Geithner additionally praised the outcome of Feinberg's deliberations.

"We gave him the difficult task of cutting boundless pay, striking a balance between advantage and accident taking and keeping able management teams in place to help the economies recover - all in the public interest," Geithner said in a statement.

Smaller companies and those that accept repaid the bailout money, including Goldman Sachs Group Inc. and JPMorgan Chase & Co., are not affected by the plan.

GM said in a statement that it will adopt the advantage changes categorical by Feinberg by alive its pay bales toward non-cash advantage that is tied to aggregation performance.

"Along with restoring GM to profitability, a key antecedence is responsible stewardship of the public ad! vance in our aggregation and accelerated claim of that investment," the automaker said.

Bank of America beneath to comment on Feinberg's plans, but a spokesman said the aggregation was not worried about top admiral leaving. "We're a able aggregation with a highly aggressive platform and we believe people appetite to assignment here," said Scott Silvestri.

Chrysler Group LLC CEO Sergio Marchionne and other Fiat admiral who assignment for both Chrysler and Fiat were exempted from the pay cuts as part of the agreement with the U.S. government for Fiat to take over management control of Chrysler and get a 20 percent pale in the company.

Executives who assignment solely for Chrysler could be affected, but abounding of the top earners under Chrysler's above owner accept left the aggregation including above CEO Robert Nardelli and above Vice Chairman Tom LaSorda. Deputy CEO Jim Press additionally is about to leave the company.

Under the Fed proposal, the 28 better banks would develop their own affairs to make sure advantage doesn't spur disproportionate accident taking. If the Fed approves, the plan would be adopted and coffer admiral would adviser compliance.

At smaller banks - area advantage is about less - Fed admiral will conduct reviews. Those banks don't accept to abide plans.

The Fed refused to analyze the 28 banks that will accept to abide plans. But Citigroup, Bank of America and Wells Fargo & Co. are usually included on such lists. Nearly 6,000 banks regulated by the Fed would be covered.

"The Federal Reserve is working to ensure that advantage bales appropriately tie rewards to longer-term achievement and do not create disproportionate accident for the firm or the banking system," said Fed Chairman Ben Bernanke.

In the AIG trading division, the arm of the aggregation whose risky trades caused its dow! nfall, n o top controlling will receive added than $200,000 in total advantage for 2009. However, the affair of $198 actor in bonuses that are to be paid to advisers of the trading unit in 2010 still must be determined. The government has said it will push to see those bonuses reduced.

The giant insurance aggregation has accustomed taxpayer abetment valued at added than $180 billion. AIG assembly beneath to comment Thursday.

The pay restrictions for all seven companies will crave any controlling gluttonous added than $25,000 in appropriate allowances - things such as country club memberships, clandestine planes and aggregation cars - to get permission for those allowances from the government.

Feinberg's decisions appear days after administration officials voiced aciculate criticism of affairs by some firms, particularly those on Wall Street, to pay huge bonuses alike as the country continues to struggle with rising unemployment and the effects of the recession.

Goldman Sachs, which has paid back its bailout money, has said it appropriate $16.7 billion for advantage so far this year, added than $500,000 per employee. Citigroup is advantageous $5.3 billion in bonuses to its advisers and Bank of America $3.3 billion.

Elsewhere, Freddie Mac is giving its chief banking officer advantage account as abundant as $5.5 million, including a $2 actor signing bonus. The government-controlled mortgage finance aggregation doesn't accept to follow the controlling advantage rules because it is being paid outside the TARP.

Congress passed legislation in February acute Treasury to oversee pay at companies that took bailout money. Treasury created the pay czar's office in June as one agency of implementing that law.

Treasury's rules crave the appropriate master to review pay for the 25 top earners at companies that accustomed "exceptional assistance," ex! amining overall pay structures and recapturing payouts that go adjoin taxpayers' interests.

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Associated Press Writers Jeannine Aversa, Ken Thomas, Jim Kuhnhenn and Marcy Gordon in Washington, Ieva M. Augstums in Charlotte, N.C., and Tom Krisher in Detroit contributed to this report.

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