Health Care Reform: Keep Your Friends Close and Your Enemies Closer

Posted by Lindsay Beyerstein, Media Consortium at 1:16 PM on May 13, 2009.

This week, the White House teamed up with health care industry giants for a two-day PR blitz on health reform. A coalition of industry leaders sent a letter to president Obama over the weekend, pledging to help contain health care costs. The signatories include PhRMA (drug makers), Advamed (device manufacturers), the AMA (doctors), the AHA (hospitals), AHIP (health insurance), and SEIU’s Health Care project. The corporate signatories are the very same interest groups that have fought U.S. health care reform for generations. AHIP, America’s Health Insurance Plans, helped torpedo the Clinton plan in the 1990s with the infamous “Harry and Louise” TV spots.

Progressive health care writers are divided as to whether Obama’s rapprochement is a good sign. One school of thought is that the interest groups have finally seen the writing on the wall. Arguably, the industry realizes that some kind of health care reform is inevitable and they hope to get the best possible deal by cooperating. Another perspective, not necessarily incompatible with the first, is that this kind of “cooperation” will ultimately co-opt Obama’s reform program.

Mike Madden summarizes the main thrust of the industry charm offensive in Salon:

The letter itself offers few details as to how the industries will actually go about saving money. More to the point, there’s nothing forcing these groups to follow through on anything they’ve pledged to do.

Still, if you parse the platitudes, the industry is diverging slightly from Republican anti-reform rhetoric. The GOP has been crusading against comparative effectiveness research (CER) ever since the stimulus bill set aside a billion dollars to fund it. CER is just research to discover which treatments give the best outcomes for the money, but the GOP would have us believe that it’s a stalking horse for rationing. Whereas, the industry coalition’s letter talks about cutting costs by “aligning quality and efficiency incentives” and “adherence to evidence-based best practices”–basically, big words for “studying the evidence” and “trimming the fat”–the core of the CER agenda.

Steve Benen of the Washington Monthly thinks the new conciliatory posture is encouraging evidence that the Republican opposition to reform is in such disarray that the industry is prepared to make nice with the Obama administration:

Andy Stern, president of the Service Employees International Union (SEIU), also secured a seat at the table. As Ezra Klein suggests in the American Prospect, the fact that Stern is in the room is a testament to his skill as a coalition builder. SEIU represents millions of Americans, including many health care workers. Stern told Klein that the group had set itself a June 1 deadline to put forward concrete proposals that can be assigned dollar figures. The Finance Committee’s first bill drops in June, so the committee will have to work fast if they want to see their suggestions incorporated.

Josh Holland of AlterNet says we should beware of the health care execs’ blandishments. Holland notes that they promise to reduce the growth in costs to “only” 4.7% a year:

In Mother Jones, James Ridgeway agrees that the initiative is a mere publicity stunt, seeing as there’s nothing but the threat of public embarrassment to hold the group to any of its pledges.

Even if we do get health care reform this year, what would the end product look like? In the Nation, Trudy Lieberman, director of the health and medicine reporting program at CUNY, takes a hard look at the messages the president has sent so far. She foresees a package that’s congenial to Obama’s corporate allies:

It’s becoming clearer that reform will include some or all of these options: requiring everyone to carry health insurance (an individual mandate à la Massachusetts); subsidizing a portion of the 85 percent of the uninsured who can’t afford to buy a policy; taxing some of the health benefits workers now get from employers to pay for insurance for the uninsured; letting people keep the coverage they have even though it’s likely to cover less as time goes on; shoving more people onto Medicaid; and trying to get insurers to insure sick people. There may or may not be a public insurance option–maybe like Medicare, or maybe not–that would compete with private insurers and theoretically reduce the cost of insurance.

All this conciliation is not cost-free. In the following video, economist Richard Wolff tells The Real News that Obama risks a grassroots backlash if he caters to corporate interests on health care. People want better health care, not just a choice of bad options. If the result of “reform” is an inferior public plan alongside the private system, employers will have an incentive to push their workers onto the public plan, and we’ll all be worse off.

The president may not support a true national healthcare plan, but don’t count the friends of single payer out yet. Doctors and other advocates for single-payer healthcare crashed a Senate Finance Committee meeting this week to protest their exclusion from a series of roundtable discussions on healthcare policy, as Laura Flanders reports on GRITtv. “Every lobbyist in America is at the table, when are the American people going to be heard?” shouted one activist. A handful of activists were arrested when they refused to come to order.

Lindsay Beyerstein a New York writer blogging at Majikthise.