No One's Falling for Big Health's Bogus Promise to "Reform"

This week, the health care lobby scored a cunning propaganda victory by feigning interest in fixing the perennial rip-off we call a health care system.

With much fanfare, Big Health trotted out a six-month old "promise" -- a toothless, non-binding pledge lacking any specifics -- to make various nips and tucks that would slow the rate at which health costs grow to "only" 4.7 percent annually. It was hailed by the Obama administration and many observers as a breakthrough in the battle for reform.

Until recently, the health care industry has been dead-set on preserving a disastrous but profitable status quo (The U.S. spends close to twice as much per person on care than other wealthy countries, and gets consistently poorer results; among residents of 30 rich countries polled by Gallup, Americans came in 18th in terms of satisfaction with their care). But now the "disease care" industry is portraying itself as an agent of change. Fearful of a growing movement towards real, substantive reform, it's trying to co-opt the process under the guise of "getting a seat at the table." That they've given up, for now, their oppositional stance is what has so many tongues wagging about the significance of the proposal.

But it's nothing new -- "voluntary" codes  of conduct, self-regulation and industry-driven initiatives for the private sector to address complex policy issues have long been a standard tactic for heading off real regulation and deeper systemic reforms. The Brookings' Institution's Henry Aaron, a former official in the Carter administration told the New York Times that when he heard of the proposal, "I had a Rip van Winkle moment, as if I had fallen asleep in 1977 and woke up again this morning.” According to the Times, Carter's pledge to do something about out-of-control health care costs "prompted the industry to undertake a short-lived 'voluntary effort.'” The growth of health care costs also slowed briefly after Bill Clinton's failed attempt to fix the system.

But while the industry's proposal is light on substance, it is a game-changer to some degree. Instead of simply opposing reform, which is a more dangerous proposition today -- with 47 million uninsured and health care eating up 17 percent of the country's economic output -- than it was when Clinton mounted his fight, Big Health is trying to kill the most important and progressive elements of Obama's promised reforms from the inside -- from its "seat at the table."

But while health lobbyists are trying to maintain the industry's grip on trillions of dollars of business, Health Care for America Now, a broad coalition of groups including ACORN, the AFL-CIO, Campaign for America's Future and MoveOn.org, is fighting for the inclusion of a public-insurance option that would add to the current mix of employer-based insurance and government programs for the needy -- one of the centerpieces of Obama's health care proposals during the campaign. According to The Hill, "Organizers believe their efforts will pressure centrist Democrats and Republicans to line up behind Obama's health care proposal, which calls for all Americans to have the choice of a public insurance plan."  This week, the group launched a series of ads targeting wishy-washy Dems by name.

The Public Option 

The creation of a public health insurance option is what the insurance industry fears most. The idea is to allow businesses and individuals to continue purchasing coverage from private insurance companies if they desire, while also establishing a public insurance program modeled on Medicare as an alternative. The government would subsidize the premiums paid by low-income families, but anyone could buy in. "Choice" is the key word.