Cui Bono?

| Mon May. 11, 2009 8:38 AM PDT

Today a bunch of healthcare industry executives will announce that they plan to go shoulder to shoulder with President Obama in his quest to cut healthcare costs.  Paul Krugman is cautious but supportive.  Jon Cohn is cautious but enthusiastic.  Ezra Klein is just cautious.

Count me in Ezra's camp.  The healthcare folks are promising initiatives that will cut the growth of healthcare spending by 1.5 percentage points a year.  Here's Jon Cohn on that:

That may not sound like a lot of money. But it is. If indeed the industry could produce such savings, according to the White House, it'd be worth around $2,500 a year to the typical family — which, it just so happens, is what Obama promised during his presidential campaign. (Amazing coincidence, no?)

....This doesn't mean the groups are acting out of altruism. The five big industry groups are the Advanced Medical Technology Association (AdvaMed), America's Health Insurance Plans (AHIP), the American Hospital Association (AHA), the American Medical Association (AMA) and Pharmaceutical Manufacturers of America (PhRMA). And they've made no secret of their opposition to proposals for creating a public insurance plan, into which anybody could enroll. Monday's gesture may simply be an effort to cut a deal that leaves out the public plan.

Ya think?  My problem here isn't that the industry folks haven't proposed detailed plans or enforcement mechanisms.  That's to be expected.  My problem is that they're apparently planning to argue that things like streamlined billing and "encouraging" the use of evidence-based guidelines will be enough to entirely meet Obama's cost goals.  Cost effectiveness research?  No need!  A public plan?  No need!  It's just like 1993, when the HMO revolution was going to change medical care so dramatically that there was no need for Bill Clinton's healthcare reform.  That didn't work out so well.

Anyway.  Jon argues that the optics are good even if we should continue to watch these guys like hawks.  Ezra just thinks we should just watch them like hawks.  I'm with Ezra.  Their incentives here are simply too clear to believe they want to genuinely be of help.

UPDATE: Matt Yglesias offers a comment:

Whatever kind of backstabbing these industry groups may or may not do in the future, they won’t be able to take back the fact that once upon a time they stood beside the White House in agreeing that it’s possible to achieve massive cost-savings without compromising patient care. That argument may well prove hugely important, politically, to getting a package through congress.

True enough.

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Kevin Drum is a political blogger for Mother Jones. For more of his stories, click here.

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Comments

Gee, give that alcoholic a drink

tagged as: 
He's reformed, he's on the wagon. On second though, give him the whole bottle, the case. He can be trusted

Best comment on this I have

Best comment on this I have seen (probably at Eschaton): the reason we're in such a mess right now is because we let the bankers write the "regulations". If we let the insurance companies/pharm cos/medical industries write the rules on this one, we are screwed. That seems to be what they are angling for.

It's not what they'll do, it's what this shows

I think there is a reason to view this as good news, namely, that the primary obstructionists are reading the tea leaves and have concluded that they don't have a strong enough position just to say "screw you" (much as they'd like to). Now, maybe you and Ezra are better informed than I was and were already convinced of this, but I wasn't. So, while I ascribe no benign motives, I'm in a good mood today because evidently the powers that run healthcare believe they are in an environment where this is their best opening move.

Trust has to be earned.

It's a good sign they want to help us achieve some big goals. Let them show what they can do and then we can all cheer. But, aside from that promises are easy to make and not always easy to keep. If the Dems write a sensible law it won't hurt the industry too much and a lot of them may thank 'us' for easing their odd relationship with the insurance people. THAT may be an important reason they're willing to stand with Obama. So we move forward and keep working with whomever is willing to help to improve the system.

I'm not buying it

If there's no public option, there's no real reform. One of the most chilling conversations I've ever over heard took place between a couple of people from my hospital financial services office and the brain cancer patient I was sharing a room with. "Sir, your insurance company has abandoned you." And then they spent the next half hour getting him ready to go home and, I assume, die. "abandoned you" Imagine that. There's no room in a decent health care system for private insurance companies who compete for profit. None.

Um, if they had ways to

Um, if they had ways to lower costs all this time, why have they not already applied them? If by costs they mean premiums, they're volunteering to reduce their profits for nothing. If they mean treatment costs to consumers, isn't that what they're already trying to do? Fortunately, my BS meter is set on vibrate.

You bet.

tagged as: 
What the health care industry is actually admitting to is that there's been two trillion dollars worth of fat in the system and that they've been pocketing it. And if you follow the trail of logic from there, they're admitting that all the people who have died uninsured are blood on their hands and the decks of their yachts.

He's reformed, he's on the

He's reformed, he's on the wagon. On second though, give him the whole bottle, the case. He can be trusted

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