Clinton arrives for NATO talks, praises allies

BRUSSELS – U.S. Secretary of State Hillary Rodham Clinton, arriving Friday at NATO headquarters, welcomed an expected series of announcements by allied nations of additional military, civilian and financial support for the war effort in Afghanistan.

Clinton was attending a string of meetings here with allied foreign ministers and with representatives of non-NATO countries that have troops in Afghanistan, plus Russia. She sought to sell President Barack Obama's revamped war strategy, which banks on major new allied contributions, not just to escalate the combat effort but also to bolster civilian functions and provide more development aid.

Gen. Stanley McChrystal, the top American commander in Afghanistan, also was to attend the meeting of NATO's main political council to explain the 43-nation military mission, which he has sought to revise and reinforce since he took over command last June. He has described conditions in the fight against Taliban extremists — now in its ninth year — as serious and deteriorating.

Allied governments need to be able to sell their publics on the idea of enlarging the war, and particularly those countries in which political parties share power have to be sure "the political stars are in alignment" before they announce new commitments, Clinton said.

Clinton made the comments in an interview with reporters traveling with her from Washington. She departed the U.S. capital Thursday shortly after testifying before the Senate Foreign Relations Committee, where she joined Defense Secretary Robert Gates and Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, in defending the president's decision to send 30,000 more troops to Afghanistan.

Clinton told reporters she was pleased that allies have responded positively to the Obama plan.

"We are encouraged that they are going to — beginning (Friday) but not ending (Friday) — have a number of public announcements about additional troop commitments and additional civilian assistance and development aid, as well," she said without naming any countries.

She said she had discussed the matter with her counterparts from 20 to 25 countries over the past week.

NATO Secretary-General Anders Fogh Rasmussen said Wednesday that the allies will contribute at least 5,000 more troops to the war effort "and probably a few thousand more."

The U.S. now has about 71,000 troops in Afghanistan, while 42 other NATO and non-NATO nations have a total of 38,000 troops there. They are fighting a far smaller collection of Taliban militants who enjoy a haven across the border in Pakistan.

European countries have been reluctant to add large numbers of soldiers to a war that often looks unwinnable and to support an Afghan government tainted by corruption and election fraud. Some leaders are waiting for an international conference on Afghanistan in London in late January before promising any more troops.

Asked about the criticism that has focused on Obama's decision to announce a date in 2011 to begin the withdrawal of American troops from Afghanistan, Clinton said that it has been misunderstood by some and that others were simply seeking to create a controversy.

"There have been some misunderstandings about what that date meant," she said, referring to Obama's announcement that beginning in July 2011, the U.S. troop contingent would begin to be withdrawn. The administration has said the pace and scale of the withdrawal will be determined after a further assessment of conditions on the ground, starting with an administration review in December 2010.

"Some people seized on that, for whatever reason or lack of understanding, as a way to try to create a difference where I'm not sure there is one," Clinton said.

She also took a gentle stab at the Bush administration's approach to running the war. She said Afghanistan's defense chief had told her last month that for the first time he felt like a full participant in the NATO military structure, as a result of changes made by McChrystal, who was appointed to the top command by Obama several months after he took office. Referring to the more limited Afghan participation before McChrystal's arrival, she said, "That's a little bit discouraging, when one looks back."

Clinton also was scheduled to meet separately in Brussels Friday with Russian Foreign Minister Sergei Lavrov for eleventh-hour talks on a follow-on to the Strategic Arms Reduction Treaty that expires at midnight Friday. Both sides have said they don't expect to complete a draft agreement — let alone get it ratified by their national legislatures — before the existing treaty expires. But they hope to wrap it up by the end of December and to make arrangements for monitoring each other's nuclear arsenals in the interim.

Upon her arrival in Brussels, Clinton's aides said she had recorded earlier in the week two video messages directed at the people of Afghanistan and Pakistan to "echo the themes and messages" from Obama's West Point speech on his Afghan war plan. The Clinton videos are available via the internet in Arabic, Dari, English, Pashto and Urdu, her aides said.

Health bill survives first big test - on Medicare

WASHINGTON – Unflinching on a critical first test, Senate Democrats closed ranks Thursday behind $460 billion in politically risky Medicare cuts at the heart of health care legislation, thwarting a Republican attempt to doom President Barack Obama's sweeping overhaul.

The bid by the bill's critics to reverse cuts to the popular Medicare program failed on a vote of 58-42, drawing the support of two Democratic defectors. Approval would have stripped out money needed to pay for expanding coverage to tens of millions of uninsured Americans.

The broader legislation aims to extend health coverage to 31 million who now lack it, while barring insurance industry practices such as denying coverage on the basis of pre-existing medical conditions. Though the overhaul is estimated to cost about $1 trillion over a decade, the Congressional Budget Office has said it would cut federal deficits by $130 billion over that period, and probably reduce them further in the 10 years beyond that.

"Our bill does nothing to reduce guaranteed Medicare benefits," said Sen. Max Baucus, D-Mont., as several fellow Democrats accused Republican critics of making false claims of potential harm during three days of debate.

The AARP supported the 10-year package of cuts in projected spending, giving Democrats political cover for their decision to pare back subsidies to private Medicare plans as well as payments to hospitals, hospices, home health agencies and other providers.

Republicans disagreed vigorously. "Medicare is already in trouble. The program needs to be fixed, not raided to create another new government program," said the party's leader, Sen. Mitch McConnell of Kentucky.

The Medicare vote came not long after the Senate backed a guarantee for all insured women age 40 and older to receive mammograms with no out-of-pocket costs. The breast cancer screening test would be included in an array of preventive measures that insurance plans would be required to cover. The proposal cleared on a near party-line vote of 61-39, one more than the 60 needed for passage. It essentially wiped out a federal advisory committee recommendation to defer routine mammograms until women reach the age of 50.

The day's votes were the first since the Senate's health care debate began on Monday, and demonstrated the ability of Democrats to move ahead in the face of implacable Republican opposition.

At the same time, Democrats worked in private meetings to settle controversies within the party that are still standing in the way of the bill's passage. The most contentious of these involves proposals for the government to sell insurance in competition with private companies, an approach supported by liberals but opposed by most Democratic moderates and conservatives.

"Our caucus is now in the process of negotiating with ourselves because we need all 60 of us to get this done," said Sen. Mary Landrieu, D-La., after one closed-door meeting. Senate procedures require 60 votes to overcome Republican delaying tactics designed to kill the bill.

Majority Leader Harry Reid, D-Nev., said he expected all such issues to be worked out soon, but he did not specify precisely when.

For the time being, that left the two parties free to engage in an intensely political debate on health care, an issue that is certain to play a role in next year's midterm elections.

Unwilling to allow Republican charges on Medicare to go unanswered, Democrats responded with an alternative that stated no guaranteed benefits would be cut from the program and its finances would be strengthened.

The lead proponent of that provision was Sen. Michael Bennet of Colorado, who was appointed to his seat earlier in the year and faces a difficult campaign in 2010. "This is a message amendment," his office informed fellow Democrats in an e-mail unintended for publication, indicating its purpose was partially political.

The bill "does not take away any seniors' guaranteed Medicare benefits," Bennet said on the Senate floor. "We know that the bill extends Medicare solvency for five additional years." It passed 100-0.

Sen. John McCain of Arizona, Obama's Republican opponent in last year's presidential race, laid bare the political nature of the debate by making a recording to be telephoned automatically to thousands of voters in states represented by Democrats, urging the deletion of the Medicare cuts. The calls were paid for by the National Republican Senatorial Committee and took aim at Bennet as well as Sens. Blanche Lincoln of Arkansas, who is seeking a new term next year, and Ben Nelson of Nebraska.

In the end, Nelson and Sen. Jim Webb of Virginia were the only Democrats to support McCain's proposal.

On the other side, Republicans would not allow the Democrats to go unchallenged on women's health with a proposal long backed by Sen. Barbara Mikulski requiring the government to develop a list of tests to be covered at no additional cost to the patient.

On Wednesday, Sen. David Vitter, R-La., made it explicit that mammograms would be covered for women at age 40.

More broadly, Sen. Lisa Murkowski, R-Alaska, backed an alternative that gave GOP senators opposed to the Democratic proposal a measure they could support. It urged the insurance industry to consult with medical experts in deciding what preventive tests to provide. But it provided no government guarantee that any would be required, did not rule out copays for patients undergoing the procedures, and would have wiped out a list of free tests for men and women that Democrats wrote into their legislation.

It failed on a vote of 59-41 with Nelson siding with the Republicans.

Political philosophy played a hidden role in the struggle over women's health. Republicans have accused Democrats for months of supporting a federal takeover of health care. Murkowski quietly shelved an earlier draft of her amendment that would have given the government authority to require additional preventive tests and raised the cost of the bill by $30 billion over a decade. One Republican said conservatives objected, forcing the switch.

Overall, the $1 trillion legislation would require most Americans to purchase insurance and provide federal subsidies to lower and middle income individuals and families to defray the cost. Businesses would not be required to provide coverage to their employees, but large firms would face a penalty if they did not and if any of their workers received federal subsidies.

Consumers would be allowed to shop for insurance in a new marketplace in which companies would compete for business by selling policies that provide benefits according to standards established by the federal