The Wall Street Journal has published on its website the text of the proposed 10-point checklist for determining whether a Republican candidate is orthodox enough  to benefit from the party's endorsement and fund-raising.

The affirmations issues are quite a mixed bag. Some are perennial and cosmic, such as: "We support the right to keep and bear arms by opposing government restrictions on gun ownership." Others are micro-specific and could be obsolescent by the time they are proposed to the Republican National Committee in January.  Take: "We support market-based health care reform and oppose Obama-style government run healthcare." In January, they  might have to change "oppose" to "opposed."

And, even if you're a true-blue conservative, is legislation opposing "card check" as a way to organize unions as big a deal as abortion or the right to keep and bear arms? Presumably not, but all of the propositions are weighted the same. As George W. Bush said of Al Gore's economic proposals, this is fuzzy math.

-- Michael McGough

The New York Times reports that conservatives  have been drawing up a 10-point checklist -- to be printed on litmus paper? -- against which the Republican National Committee should measure prospective GOP candidates.

There's nothing surprising about the contents of the proposed creed (for example, opposition to government funding of abortion and President Obama's "socialist agenda"). Nor is the idea of a conservative loyalty test. It was implicit in the muscling by true believers of a Republican nominee for a House seat in New York who didn't toe the ideological line.

Never mind that Democrats captured that seat after the withdrawal of the scorned RINO (Republican in Name Only). Conservative Republicans increasingly seem willing to sacrifice electoral success on the altar of philosophical purity, and moderate Republicans are increasingly are an endangered species. That's good news for Democrats, but bad news for those of us who believe that a modicum of diversity in both parties is conducive to compromise and good government.

But back to the surprising thing about the proposed Index of Acceptability: the fact that 70% is a passing grade. Answer seven questions right and you get an endorsement and funding. Get six right and you flunk.  ("Bummer! I messed up that abortion question. Maybe I can do something for extra credit.") If too many candidates fall short, the party may have to start grading on the curve.

-- Michael McGough

Good news today from the backstage maneuverings on the Senate Democrats' healthcare reform bill. As The New Republic reported, Democratic leaders have agreed to give more flexibility to millions of Americans who get their health insurance today through their workplace.

First, a little background. My favorite healthcare reform proposal was the Healthy Americans Act by Sens. Ron Wyden (D-Ore.) and Robert Bennett (R-Utah). In addition to being a genuinely bipartisan approach to the issue, it was smart about bringing market forces to bear on the industry. But it also was the most radical departure from the current system, because it would have decoupled health insurance from employment. Instead of continuing to have employers cut deals with insurers and then pay part of the cost of coverage on their workers' behalf, it would have given employees the subsidies and tax benefits directly, grouped them into statewide risk pools and created new markets for them to shop for policies. In addition to giving workers far more choice of insurer and plan -- most employers have a take-it-or-leave-it approach to health benefits -- it would encourage them to spend their healthcare dollars more wisely. That's because, for the first time, they'd see the total cost of their insurance and all the options for managing it.

Wyden tried in vain add a variation of that plan to the Senate Finance Committee's healthcare bill -- his amendment would have let workers take vouchers from their employers in lieu of health benefits, then use those vouchers to help buy individual policies through new state insurance exchanges. Now, finally, he has persuaded Senate Democratic leaders to give his vision of employee choice a foot in the door. Wyden announced a deal this afternoon with Senate Majority Leader Harry Reid (D-Nev.) and Finance Committee Chairman Max Baucus (D-Mont.) to add a slimmed-down version of his plan to the healthcare reform bill the Senate may take up Saturday.

As with his earlier amendment, the proposal would give workers the option of converting the money their employer spends on health benefits into vouchers they could use to buy policies through the state exchanges. The main difference is that this capability would be available only to certain workers who would be exempt from the bill's requirement to obtain insurance. Specifically, it would apply only to those earning less than four times the federal poverty threshold (e.g., $88,200 for a family of four) whose employer-sponsored insurance premiums would consume 8% to 9.8% of their total income.

It's not much, but it's a start. Now let's see if Reid can get the 60 votes needed to start debate on the bill....

Photo: Sen. Ron Wyden. Credit: Alex Wong / Getty Images

-- Jon Healey

We've seen taxes on death, luxury and sin, and now the Senate is poised to impose one on vanity. To help cover the cost of health insurance subsidies for the working class, the bill cobbled together by Senate Majority Leader Harry Reid (D-Nevada) would create a 5% excise tax on elective cosmetic surgery. "Elective" is the important word here; the new levy wouldn't apply to reconstructive surgery for people who'd been disfigured.

The idea, which some Senate Democrats have been kicking around for months, has already been tried out in New Jersey, where it reportedly brought in a fraction of the expected amount. That's probably true because it's relatively easy to evade a tax levied by only one state; dodging one assessed in all 50 would be a bigger challenge, although hardly an insurmountable one.

If this were a Republican proposal, I'd suspect it was a form of payback to Hollywood liberals. But it's a Democratic idea, a small piece of the party's attempt to make the wealthy pick up as much of the tab for healthcare reform as possible. (Not that cosmetic surgery is only for the rich, but it certainly takes a fair amount of disposable income.)

The biggest problem with this kind of tax is that, as the Tax Foundation points out, it distorts behavior. And unlike smoking or even drinking sugary cola, it's not a behavior that policymakers have a reason to discourage. Elective cosmetic surgeries aren't covered by insurance, and they don't contribute rising healthcare costs or the looming insolvency in Medicare.

No, these procedures are simply an inviting target, as per Russell Long's axiom about taxing the man behind the tree. 

Along the same lines, Reid's bill would hike the Medicare tax on wages above $200,000 by almost 35%. The change is projected to raise 10 times as much as the tax on plastic surgeries -- $54 billion over 10 years vs. $5 billion. But it violates the spirit of Medicare, which is an insurance program, not a savings plan. The benefits it provides are the same regardless of how much you've paid into the system, and they're no more valuable to a retiree who was a big earner than one who was a low-wage worker bee.

By adding those two taxes to the bill, Reid and company were able to reduce the amount collected through a tax on expensive health insurance plans. Such a tax would distort behavior too, but in a good way -- by encouraging people to obtain insurance plans with higher deductibles and co-payments, which would be less likely to promote overconsumption of healthcare services.

Organized labor bitterly opposes this surcharge, however, because it would affect rank-and-file union members who've bargained for rich insurance plans, not just CEOs with gold-plated benefits. That makes it a tough sell for Democrats, even if it's better policy than simply slapping more taxes on the rich.

-- Jon Healey

Photo credit: Mark Boster / Los Angeles Times

It's a combination of issues so hot, an op-ed about reopening King-Harbor hospital doesn't even make the top three! Leading off is a pair of op-eds about best-selling memoirist Sarah Palin -- one friendly, one not so much. Matthew Continetti, associate editor of the right-leaning Weekly Standard and author of "The Persecution of Sarah Palin," tops the page with an analysis of the many reinventions of Alaska's erstwhile governor: first culture warrior, then watchdog, reformer, would-be vice president and, now, celebrity:

But Michael Carey, a columnist for the Anchorage Daily News, retorts that Palin's new book shows her to be more of a whiner than a leader:

(Are you planning to help Palin's publisher recoup its advance? Take our poll!)

Rounding out the op-ed page, Times columnist Tim Rutten urges the University of California Board of Regents to approve a proposed partnership with the county Board of Supervisors to reopen and jointly oversee Martin Luther King Jr.-Harbor Hospital.

On the other side of the Opinion divide, the Times editorial board gives Atty. Gen. Jerry Brown a dash of sympathy being "trapped in a political cage from which there will be no easy escape." The cause? His office just gave a pass to Brown's former communications director for surreptitiously recording interviews with reporters, and now liberals are pushing him to investigate a pair of independent filmmakers who surreptitiously recorded ACORN employees in California advising them how to set up a prostitution ring (or, in the case of ACORN's Felix Harris in Los Angeles, refusing to help after learning the prostitutes would be minors).

The board also urges the District of Columbia Council not to bow to pressure from the Catholic Archdiocese of Washington, which has threatened to stop providing social services if the council approves same-sex marriages in D.C.

(True personal story to illustrate how conservative the Archdiocese of Washington is: I'm a Catholic, and I got engaged to be married while I was living in D.C. But when I asked a priest at my church if I could have the nuptials there in five months, he told me I needed to wait at least a year to receive the church's blessing. And if I didn't receive the church's blessing, my soul would be "lost to perdition." In other words, I'd spend eternity in Hell because I'd gotten married the wrong way. As it happened, my future mother-in-law lived outside Baltimore, and the diocese there accommodated us without hesitation. That was 19 years ago, and we're still happily married. Whether I'm on the road to perdition is a wholly separate issue.)

Finally, the board gives its support, with reservations, to the latest version of a proposed federal "shield law" to help journalists shield the identity of confidential sources.

Illustration: Ken Fallin For The Times

-- Jon Healey

A new Associated Press poll, done by Stanford University and the Robert Wood Johnson Foundation, provides more evidence that the public wants comprehensive healthcare reform but rejects just about everything that implies. Although you should take a moment to look at all the results -- and comment on them below! -- here's a quick summary.

As shown in the screen shot to the right, people are eager for major improvements to the healthcare system. They want someone else to pay for the changes, however.

In particular, they strongly oppose raising income taxes or taxing health insurance benefits, but almost 60% favor dunning the rich. They like the idea of requiring everyone to obtain insurance, but they hate the idea of financial penalties on those who don't. Similarly, they want a mandate on businesses to provide insurance, but are lukewarm about enforcing it. Finally, more than 70% said insurers are too profitable and medicines too expensive, but most opposed raising taxes on them, drug companies or medical device makers.

My interpretation: the survey is yet another indication that the Obama administration and congressional Democrats haven't persuaded Americans, most of whom have health insurance and aren't seriously ill, that the proposed reform will benefit them, too. Not convinced that they have much to gain personally, they're not willing to pay more to achieve it.

About 1,500 randomly selected adults were surveyed, giving the poll a margin of error of  plus/minus 2.5%.

-- Jon Healey

I've encountered a fair amount of confusion about the abortion language the House actually adopted on Saturday. Read it for yourself here -- it's a little more than three pages in large type, much of it spent removing abortion-related provisions in the underlying bill. The amendment by Bart Stupak (D-Mich.) and Joe Pitts (R-Pa.) would restrict only the new insurance marketplace (a.k.a. the "exchange") that the bill would create for uninsured individuals and small businesses. It would have no direct effect on the group insurance policies that cover many American workers and their families. Whether it would have an indirect effect on those policies, however, is an open question. Feel free to offer your speculation in the comment section below.

Specifically, the Stupak amendment would prohibit federal dollars from being used to buy any policy offered through the exchange that covered abortions other than those related to rape, incest or danger to the mother's life. It also would require insurers that offered elective abortion coverage through the exchange to also offer policies "identical in every respect" except that they did not cover such abortions.

The main effects of the amendment would be to stop anyone receiving a federal subsidy from buying a comprehensive health insurance policy that covered elective abortions, and to bar the proposed government-run insurance plan (a.k.a. the "public option") from covering such procedures. The amendment would allow insurers to offer "supplemental" policies that covered abortions, but their customers could not use federal subsidies to buy them.

Prior to the Stupak amendment, the House bill would have required insurers to jump through some accounting hoops to segregate the money collected for coverage that was mandated by the bill -- and eligible for subsidies -- from coverage for elective abortions. But abortion opponents argued that this arrangement didn't go far enough. Money is fungible, after all, and making the mandatory coverage more affordable with subsidies would also make any additional coverage more affordable.

The same argument applies to the Stupak amendment. The Stupak language would require women seeking coverage of elective abortions through the exchange to sign up for a separate policy, potentially (but not necessarily) forcing them to spend more for the two than they would have spent on a single plan that included the coverage. Of course, their ability to afford the supplemental coverage would be greatly enhanced by the federal subsidies that shrink the cost of the main plan.

So why is the pro-life camp so enthusiastic about the amendment? Maybe they expect it to lead insurers to stop offering any kind of coverage for elective abortions through the exchange. That's what Planned Parenthood and its allies fear. These advocates complain that insurers wouldn't offer the supplemental coverage because there wouldn't be enough demand, given that abortions result from unplanned pregnancies. I'm not so sure about that -- no one plans to get sick or break a bone either, and yet everyone who buys health insurance wants to be covered for such things.

It's also worth noting that although many insurance policies cover elective abortions today, a high percentage of them aren't paid for by insurers. In addition, 17 states use their own Medicaid budgets to pay for "medically necessary" abortions for poor women.

So the Stupak amendment may not have much effect on the poorest women in states such as California, women covered by group insurance policies, or women of means. But it's undeniable that the amendment threatens the availability of insurance coverage for elective abortions for the working poor and lower middle class -- the ones who would receive subsidies under the House bill to buy insurance through the exchange. That category includes those making 150% to 400% of the federal poverty line -- up to $43,000 for a single woman.

Updated, Wednesday at 3:27 p.m.: I see from the comments left by Karen, Nate and a few others that I shouldn't have referred to abortions not covered by the so-called Hyde amendment restrictions (i.e., to terminate pregnancies not caused by rape or incest and not needed to save the mother's life) as "elective." My bad. The non-Hyde category includes abortions that would be deemed "medically necessary," which is a very broad classification. In fact, some abortion opponents view "medically necessary" as a loophole so wide, it opens the door to abortions for practically any reason.

-- Jon Healey

Public option, shmublic option. If you really want to get people worked up about healthcare reform, start talking about whether it should cover abortions and illegal immigrants. Today, the editorial board tackles both those issues, saying that abortion opponents are looking to "extend federal prohibitions into private pocketbooks. By restricting coverage offered through the exchange, they hope to make abortion coverage so unattractive that insurers eventually stop offering it in the market for individual and small-group policies." Healthcare reform thus should not restrict those who receive subsidies from buying extra coverage for abortions. And it's an odd healthcare policy that would eliminate all possibility for illegal immigrants to participate in subsidized care, but require them to purchase their own coverage regardless of their personal finances, the board argues.

"Extraordinary rendition" is just a dressed-up word for kidnapping in the editorial board's eyes, and it praises Italy for recognizing that fact, if mainly symbolically, by convicting 23 Americans and two Italians in absentia for grabbing an Egyptian cleric in Milan six years ago.

On the other side of the fold, the author of a book on the Cold War argues that former President  Reagan's seemingly bold words to Mikhail S. Gorbachev --"Mr. Gorbachev, tear down this wall." -- were for the most part a cover intended to build popular support for the president while he worked on effective diplomatic relations with the then-Soviet president.

And writer Joe Mathews raises his hand for the job of lieutenant governor. It's not that he has ambitions to run anything, he says, and that's exactly what qualifies him for the job. Meanwhile, think of all the spare time he'd have for blogging.

-- Karin Klein

Photo: People stroll by the giant dominoes set up at the site of the Berlin Wall, part of a gala celebration of its toppling. Credit: Fabrizio Bensch / Reuters

I had surgery not long ago, and the actual surgery itself didn’t take a fraction as much time as all the insurance wrangling and worrying did.

At one point, when I was trying to negotiate the massive gap between what the out-of-network anesthesiologists charge and what my insurance would pay, I finally said that I’d just bite down on a wooden spoon during the surgery –- and I’d bring my own spoon, so I wouldn't get charged for that, too.

Whatever the doctor thought, I figured I couldn’t get the surgery until I’d figured out how much I’d have to pay, and whether I could afford it –- or whether I should just wait until things got so bad I’d just check into the emergency room, and they’d have to pay for it.

But all of it gave me an idea.

"House" is a rare TV show I’ve watched with pleasure, in part because there’s the splendid Hugh Laurie, and in larger part because it’s so much like my beloved Sherlock Holmes: House/Holmes, aided or on occasion challenged by Wilson/Watson, solves the most mystifying conundrums in the world of medicine/crime.

But the series is starting to get a wee bit stale, and I think I know how to fix it, and fix it in a way that will illuminate the problems of our present healthcare system, too.

Every show involves massive amounts of medical diagnostics and treatment –- MRIs galore, CAT scans, arcane tests I’ve never heard of, as the patient lies expensively tethered to monitors and tubes for weeks at a time.

And I don’t think I’ve ever heard any test the doctors have ordered not being done because of how much it costs.

TV isn’t supposed to be realistic, but even a good drama could use a little more drama. So here’s my idea: a new addition to the regular cast. The head guy in the hospital's insurance office.

What insurance policy would pay for all that treatment and hospital time? What hospital could pick up the tab for all of that platinum care? When the opponents of healthcare reform moan about "rationed care," all I can say is that it’s already rationed: I have a lifetime dollar-figure cap. When I hit that, they unplug me and roll me out the door, unless I can pay the tab myself.

So if "House" is going to treat us to real diseases and diagnoses, it ought to show us some real insurance controversies. The cast-member naysayer and House could mix it up, fight over that third MRI in a week, come to blows, make up over beers -– all about deductibles and out-of-network coverage. And you’re welcome, Fox TV –- you can send the check to me right here.

[While I have the attention of the health-minded, I’d like to quibble with the Centers for Disease Control and Prevention websites exhorting the potentially flu-stricken to "cough or sneeze into your elbow." This, as the good doctors know, is physiologically all but impossible. In a world where eardrops have to come with instructions to users to put the drops in the ear, better they should be telling people to sneeze or cough into the crook of the arm. And, yes, that either arm will do.]

-- Patt Morrison

Columnist Jonah Goldberg foresees clouds ahead for the Democrats -- in fact, a coming storm so severe that it could end Democratic control of Congress. It's building from the Tea Party movement, which Goldberg sees as an heir to the Ross Perot third-party movement of the 1990s. "If the GOP can convincingly align with and exploit the growing Perotista discontent, it very well might ride to victory on a tsunami the Democrats can't even see."

Also on today's Op-Ed page, scholar Giles Dorronsoro explains why U.S. attempts to win hearts and minds in Afghanistan's Pashtun areas in the south and east are probably doomed to fail. And ACLU National Security Project chief Jameel Jaffer decries an attempt by Congress to circumvent the courts by giving the secretary of Defense the power to withhold photographs of combatants "engaged, captured or detained" by the U.S. during the Bush administration.

On the Editorial page, The Times weighs in on Atty. Gen. Eric Holder's policy change on medical marijuana. Though we're happy that federal prosecutors will make marijuana cases a low priority in states like California that have passed laws approving its medicinal use, we think that's the wrong approach. The administration shouldn't be picking and choosing states in which to enforce federal law -- rather, it should de-emphasize medical marijuana cases in all 50.

We also note that the best place for local health departments to conduct swine flu vaccinations is at public schools -- yet that's not where the inoculations will take place in Los Angeles, thanks to a failure by the school district and the county to properly coordinate.

And we muse on the bizarre spectacle presented by Colorado's Heene family, accused of perpetrating the "balloon boy" hoax in an attempt to drum up publicity for a reality show. "As much as some people will do just about anything for a Hollywood contract, a good number of the rest will lap up the juicy story of their wrongdoing. In reality, perhaps we all get what we wanted."

Illustration by Jonathan Twingley / For The Times