Yes, Republicans are AWOL on the subject. Yes, lefty netroot types are consumed with rage about the fact that the public option is dead and that health-insurance companies are going to get lots of new customers. Yes, my BNET colleague Ken Terry is correct that there are lots of niggling issues left unaddressed — or dealt with inadequately — by the Senate legislation.

Chief executive officer Michael McDevitt claims the sales growth at Medifast (MED) is due to the successful execution of the company’s diverse multi-channel distribution strategy, through which Medifast brand’s value proposition “continues to be successfully communicated and accepted by its customers.” Detractors allege, however, the company’s growth is attributable to nothing more than a twist of the notorious Ponzi postage stamp con of 1921 — a modern day, multilevel pyramid scheme. Is the company getting a bum rap?

Competitors in the commercial weight loss sector are blaming lower consumer spending and a falloff in new customer traffic on a dearth of discretionary income, a result of the global economic slowdown. Weight Watchers International (WTW), which derives more than 60 percent of its revenue from members paying service fees to attend more than 50,000 weekly support meetings worldwide, reported a nine percent drop in comparable sales to $763.1 million in the first six months of 2009. Nutrisystem (NTRI), a leading provider of dietary food products sold directly to consumers through its e-commerce website, witnessed a 28 percent year-on-year decline to $294.5 million.

So Cigna (CI) has now joined the roll of health-insurance companies that are busy cutting workers as the economy worsens and rising medical costs take their toll on profits and membership. The insurer, which suffered a big loss in a discontinued death-benefit annuity business, said it will cut its workforce by about four percent, or 1,100 jobs, while taking a charge of $30 million to $40 million.

Cigna, whose health-insurance business is largely focused on administering health plans for employers and governments, isn’t saying which jobs it plans to cut. That puts it in good company; for whatever reason, its major rivals have also declined to give many details about the layoffs that are starting to sweep the industry.

So for readers, here are a few of the most notable end-of-year healthcare donnybrooks:

Which all sounds great, at least until you realize this “certification” only reflects on the supposed quality of WellCare’s call center — the vast assemblage of operators who field more than 10 million calls from WellCare members every year. Apparently WellCare’s representatives rated within the top 20 percent of customer-service scores based on “courtesy, knowledge, concern for the customer,” and similar factors. Oddly enough, the insurer’s benefit packages, payment of claims, selection of doctors and concern for the health of its members didn’t come into play in this particular survey.

A few weeks ago, I noted that Aetna (AET) is showing interesting — if still nascent — signs of transforming its business, in part due to its seemingly aggressive embrace of healthcare information technology. My BNET colleague Ken Terry echoed this theme when he recently pointed out Aetna’s sizable lead over its larger rival, UnitedHealth Group, in terms of offering personal-health records and mining medical and claims data to help its members search for useful health information.

All that may well be correct so far as it goes. But I’m a longtime Aetna member myself, and some of my recent experiences with the company demonstrate just how low a bar an IT “leader” in the health-insurance industry has to clear. Let’s just say that it isn’t exactly pretty.