Weekly Pulse: Keep Your Friends Close and Your Enemies Closer

This week, the White House teamed up with healthcare 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 healthcare 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. healthcare 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 healthcare 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 healthcare 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:

Some of the organizations that have fought hardest against changing the system in the past are — for now, at least — saying they’ll work for it this time around. To demonstrate how serious they are, they joined Obama Monday to say they’ll work voluntarily to cut the growth rate of healthcare costs by 1.5 percent each year for the next decade. Unchecked, costs would increase by more than 6 percent a year, so the administration says the country — private employers and the government combined — would save $2 trillion from the effort. An average family of four could save $2,500 a year within five years.

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:

…I’m encouraged anyway, in part because it suggests the right’s opposition is completely falling apart, as the reform push picks up needed momentum, and in part because it brings these heavy-hitters into the tent, where they’re far less likely to start launching vicious attacks.

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 healthcare 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 healthcare execs’ blandishments. Holland notes that they promise to reduce the growth in costs to “only” 4.7% a year:

There’s no news here — “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, real accountability measures, systemic reforms.

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.

“Public embarrassment”? From Big Pharma and the health insurance companies–-two of the most shameless industries in the history of corporate capitalism? In any case, even if the $2 trillion reduction is achieved, it clearly won’t come out of industry profits.

Even if we do get healthcare 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 healthcare. People want better healthcare, 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.

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