One of the traits that people prize most in dogs is loyalty. However, the question then becomes loyalty to whom or what?

In the case of the "Blue Dog Caucus," the group of Congressional Democrats that has emerged as the major player in health care reform, it appears that its loyalty is first and foremost to its big campaign contributors -- the health insurance firms and the drug companies. The general claim that they make is that they are worried about the fiscal consequences of health care reform, but when it comes to specifics, they are most opposed to the very elements of the reform package that are most likely to be successful in driving down the overall cost.

It is easy to figure out why the GOP is united in opposition to the primary plans being debated in Congress. (Some members of the GOP have proposed an alternate plan, but, overall, the party’s bottom line on the plans currently being considered by the Democrats is NO.) The GOP hopes that if the plan fails, so will the Obama presidency. Sen. Jim DeMint of S.C. pretty much came out and said so ("It will be his Waterloo").

What the Blue Dogs are up to is harder to figure out. The main answer I come up with is the campaign contributions. For example, Mike Ross (D-AR), who has emerged as the Blue Dog leader on health care, got more than twice as much campaign money from health care professionals as any other source in the 2008 election campaign. Above all, dogs are loyal.

Probably the most important tool on the table for controlling health care costs is the public option. Essentially, it will let individuals buy into Medicare early. Medicare is a FAR more efficient system than the private health insurance system. For each dollar that is spent on Medicare, more than 98 cents goes to paying for actual medical costs.

At the major health insurance companies like United Health Care ( ), Aetna ( ) and Humana ( ), less than 80% goes to pay for doctors and hospitals. The rest of the money goes to overhead -- principally trying to get lots of people to apply for health care coverage and then to weed out the ones that are more likely to get sick.