The Nation -- Outside Washington, there is still a sense that a serious debate about healthcare reform is going on.

In Washington, there is a good deal of fear among informed and engaged progressives that the debate may be done.

Yes, of course, something called "reform" might be enacted this year by a Congress where Democrats control both the House and Senate by overwhelming majorities and signed into law by a Democratic president who says reworking the healthcare system is a top priority of his administration.

But the measure of whether this "reform" really does amount to the change promised by Barack Obama's 2008 presidential campaign now comes down to a simple question: Will whatever legislation that is enacted create a sufficiently robust government-run "public option" to serve as an alternative to the expensive and restrictive offerings of the for-profit insurance industry?

The answer to that question is taking shape today on the powerful Senate Finance Committee, the last of five House and Senate committees that must advance a health care proposal before the real wrangling begins on Capitol Hill.

Committee chairman Max Baucus, the Montana Democrat who has been accused of doubling as an insurance-industry representative, has proposed a $900 billion plan that would require all Americans to obtain health insurance but that lacks the government-run public health insurance option that is the baseline demand of progressives who would prefer a single-payer "Medicare for All" reform.

Two key Democratic members of the finance committee, West Virginia's Jay Rockefeller and New York's Chuck Schumer, will attempt today to get it to back some form of a public option.

That would bring the finance committee's proposal more in line with proposals already backed by three House committees and the Senate Health, Education, Labor and Pensions Committee.

If they succeed, that will make negotiations to reconcile the differing proposals, which have already begun in the House, a good deal easier. And the public option -- perhaps even in a form similar to Medicare, with lower premium costs and greater flexibility -- would remain a reasonably viable prospect.

If Rockefeller and Schumer fail, the public option will be dealt a serious blow -- and with it the prospects for anything akin to real reform.

To succeed, Rockefeller and Schumer must win broad support from the 13 Democrats on the committee. (The 10 Republicans are expected to vote "no" on the three amendments being offered by Rockefeller and Schumer.)

That won't be easy, as the finance committee's Democratic membership includes a number of senators who have erred on the side of caution when it comes to reform, including North Dakota's Kent Conrad, Arkansas' Blanche Lincoln and, of course, chairman Baucus.

The votes will be close.

The stakes could not be much higher.

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LONDON (Reuters) –
Spending on Internet advertising in Britain grew 4.6 percent in the first half of 2009, outperforming the wider ad sector, which slumped 17 percent, and making it the country's biggest ad medium ahead of TV.

According to the biannual report from the Internet Advertising Bureau (IAB), ad spend on the Internet grew to 1.75 billion pounds, with the medium accounting for 23.5 percent of all spend, ahead of television for the first time.

Guy Phillipson, chief executive of the IAB, told Reuters the jump ahead of TV as the leading medium had come earlier than he expected and that the growth boded well for the rest of the year.

He believes there will be some growth in 2010 for online advertising, and double digit percentage growth by 2011.

"This is a significant milestone," he said. "This is the first major market where online has overtaken television to become the biggest single medium."

Online growth had slowed considerably compared with the 21 percent reported for the first half of 2008, but it still fared far better than television, print and radio, the report by PricewaterhouseCoopers and the World Advertising Research Center said.

"Perhaps surprisingly, a slowing economy has accelerated the migration to digital technology," Eva Berg-Winters of PWC said. "Hence the continuing shift from more traditional forms of advertising to online, which promises return on investment and measurability in a period of instability."

According to the report, the Internet accounted for 23.5 percent of all spend, compared with 18.7 percent in the first half of 2008. Television accounted for 21.9 percent, press display for 18.5 percent and direct mail for 11.5 percent.

The shake-up in market share followed a 16.1 percent fall in television spend, and a more than 20 percent fall in press display, outdoor advertising and directories. Spend on press classified fell 37 percent.

The report confirms the torrid time suffered by commercial media groups of late, such as free-to-air broadcasters, newspapers and radio, which rely on advertising and are now looking for alternative revenue streams.

ITV, Britain's biggest commercial free-to-air broadcaster, said net advertising revenue for the family of ITV channels fell 15 percent in the first half of the year.

The IAB report said the Internet had avoided this slump, due to the strong demand for paid-for search on sites such as Google and resilience shown by classified online ads.

Paid-for search grew 6.8 percent from the first half of 2008 to 2009, with marketers investing 1.05 billion pounds, equating to 60 percent of all online advertising expenditure.

Classified adverts, which are moving from print to online, grew by 10.6 percent to 385 million pounds, while online display adverts fell 5.2 percent.

Britain remains the world leader in terms of market share for online advertising, due to the use of online networks to place advertising, the availability of fast and cheap broadband and the popularity of new formats such as video adverts.

(Reporting by Kate Holton, editing by Will Waterman)

LONDON – British health officials temporarily suspended a vaccination program in an English city Tuesday after a 14-year-old girl died a few hours after being vaccinated against the virus that causes cervical cancer.
The National Health Service in Coventry said it paused the program for two days to give staff administering the vaccine training in how to answer questions from anyone concerned about its safety.
"We fully expect to resume the program in the coming days," the health authority said in a statement.
Natalie Morton died in a hospital Monday, a few hours after being the given the Cervarix vaccine, which protects against two strains of the human papilloma virus that causes cervical cancer. She was vaccinated at her school in Coventry.
Morton appeared to be healthy before being given the shot. An autopsy will be carried out to see if there was any link between Morton's death and the vaccine, said Caron Grainger, director for public health at Coventry City Council. Health officials also said they quarantined the batch of vaccine given at the school.
The school principal, Julie Roberts, said a few other girls also reported being unwell after receiving the vaccine and some were sent home.
The state-run National Health Service began offering the Cervarix vaccine to teenage girls last year, and more than 1.4 million doses of the vaccine have been given out so far under the program. The virus is often transmitted through sexual intercourse and authorities wanted to give the vaccine to girls as young as 13 so they are protected by the time they become sexually active.
The cervical cancer vaccine is routinely administered to millions of young girls across Europe and North America. No safety concerns about the vaccines have been raised elsewhere.
"As with any medical intervention ... one can, on rare occasions, see tragic consequences," said Professor Malcolm McCrae, virologist at the University of Warwick. "But overall this is an extremely well tested vaccine which has been produced in response to a critical health issue — cervical cancer — a disease responsible for almost 1,000 deaths annually in the UK."
Dr. Pim Kon, medical director at GlaxoSmithKline UK which manufactures Cervarix, said in a statement that the company is working with the Health Department and health regulators to investigate the case and that the exact cause of death was not yet known.
The statement added that the majority of suspected adverse reaction to the Ceravix vaccine so far have related "either to the signs and symptoms of recognized side effects listed in the product information or were due to the injection process and not the vaccine itself."
GlaxoSmithKline shares were down 0.16 percent at 1,249.5 pence ($19.90).
The cervical cancer vaccination program sparked controversy in Britain when it was first introduced. Some critics argued it would encourage girls to become sexually active at a younger age.
Morton's death comes as doctors begin to give children a vaccine against swine flu in a clinical trial. Doctors across England have begun administering one of two vaccines to 1,000 children between the ages of six months and 12 years. One of the vaccines is administered by GlaxoSmithKline and the other by Baxter. The trial aims to see which one is most effective on children.

NEW YORK – The New York City medical examiner's office says DJ AM's death was accidental. It blames a lethal cocktail of prescription drugs and cocaine.
The toxicology report released Tuesday shows the 36-year-old had cocaine, OxyContin, Benadryl and another drug used to cut cocaine in his system.
The medical examiner says the death was acute intoxication.
The celebrity, whose real name was Adam Goldstein, was found Aug. 28 in his apartment in New York City's trendy SoHo neighborhood after a friend called 911. Paramedics had to break down the door before they found him, shirtless and wearing sweat pants, in his bed around 5:20 p.m.
A crack pipe and prescription pill bottles were discovered scattered around the apartment.