This, as related by the New York Times, is the kind of thing that sends some progressives screaming into the tormented night:
"Pressed by industry lobbyists," wrote political reporter David Kirkpatrick, "White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal to block any Congressional effort [within its health-care reform measures] to extract cost savings from them beyond an agreed-upon $80 billion."
The background to which is this: Speaker Nancy Pelosi had declared that the House was circumscribed by no outside deals whatsoever -- that is, by either the White House or the Senate -- which was her and the House's perfect prerogative. So when the House confected a means by which "the government [might] negotiate drug prices," lobbyists for drug makers "successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs.... The Obama administration had never spelled out the details of the agreement."
Billy Tauzin, a venal little opportunist who left the smallness of Republican politics for the big time of pharmaceutics lobbying, told the Times, with truly irksome validity (don't you just hate it when they're right?): "We were assured: 'We need somebody to come in first. If you come in first, you will have a rock-solid deal.' "
The White House confirmed Tauzin's story, which he had continued by saying, again with an irritating fidelity to political reality: "Who is ever going to go into a deal with the White House again if they don't keep their word?"
Now on to the Times' characterization of these seemingly dark deeds, which comes in as a strong finalist in my running Understatement of the Year competition: "The new attention to the agreement could prove embarrassing to the White House, which has sought to keep lobbyists at a distance"; not to mention that the confirmed deal undercuts "Congressional allies who have an eye on drug companies' profits as they search for ways to pay for the $1 trillion cost of the health legislation."
Ouch, and double-ouch. Or, as Rep. Raul Grijalva, co-chairman of the House progressive caucus, put it: "disturbing" (and that's at least a semi-finalist).
So, why, especially at this delicate time, would the White House agree to "explicitly acknowledge" its inside deal with the universally detested drug makers?
Because it's engaged in a swirling dance of reciprocal extortion for the higher public good, that's why: "[F]ailing to publicly confirm Mr. Tauzin's descriptions of the deal risked alienating a powerful industry ally currently helping to bankroll millions in television commercials in favor of Mr. Obama's reforms."
Not enough extortion for your taste? Here's some more: The White House's bipartite alliance with drug makers is meant to fiercely isolate the health insurance industry. It's merely a game of Who's willing to play ball. "Drug makers have been elevated to a seat of honor at the negotiating table, while insurers" -- who have "steadfastly vowed to block" a public option -- "have been pushed away."
True, those leviathan drug makers oppose a public option as well. However, and this is key, "its lobbyists acknowledge privately that they have no intention of fighting it, in part because their agreement with the White House provides them other safeguards."
In short, what at first might appear to some progressives as nefarious skulduggery in actuality reveals itself as effective White House neutralization of an immensely powerful and potentially obstructive lobby: The Obama administration not only secures non-resistance to a public option from formidable drug manufacturers, but enlists their advertising dollars in support of broad reform, while leaving itself free to bash the bejesus out of giant insurers, the original target all along.
Pretty smart triangulation.
Yet the smart, politically, is also defined by the essential. And while the essential presidential politics of health-care reform being played out may frustrate many progressives (I know it does me), there are some laws of politics and power relationships that are immutable, and they grew to be that way because of the unacceptability of the regretted alternatives.
Simply and brutally put, Obama has got to have a reform bill; this time around, almost any bill. He must be able to declare victory on this, otherwise his presidency sustains a mortal wound in its infancy, is weakened to '94 Clintonlike status, and is consigned to watching its entire reform agenda -- including additional health-care reforms -- get kicked around by a vastly empowered opposition. But by allowing Congress the responsibility for devising a bill, whatever it devises and Obama signs is by definition a victory.
It is circumstantially critical to keep in mind, however, that responsibility also lies with this Democratic Congress because they insisted on that responsibility. This bill is their baby. They rebelled 15 years ago when handed a perfectly good bill from on-high; they campaigned as a party in 2008 to work in a unified way to finally pass comprehensive reform; and they now owe such reform to the nation.
Yes, Obama is playing it cool, at times perhaps a little too cool. But he wasn't the one who forced this architectural style of reform -- and, bottom line, he's merely trusting the people's representatives to do their damn jobs and actually represent the people, as promised.
All of which should be embraced by progressives. After all, a participatory and representative democracy, not a dictatorship, is what progressives for the last eight years yearned for. Well, they got it, and as one major voice from those previous years observed in a rare, rare moment of lucidity, it's messy as hell.
Hard Work
Raising hell for a couple of months will not get us a single payer system. It will take a lot of hard work over a long time. Say what you will about the corporations, but they are willing to devote the time and resourses for as long as it takes to win.
Healthcare reform has been my number one economic political issue for a long time. So have tracked it closely within the party. It is a policy I use to grade all Democrats. Two years ago, I told my progressive friends that I thought healthcare reform could be achieved in this cycle. They laughed at me, but wished me well. At that time, John Edwards was the only major candidate to propose universal healthcare.
It was another six months before Hillary and Obama really got on board. If you will think back, healthcare reform was not really pushed by Obama during the election. It was in the agenda, but it was not pushed. It certainly was not a rallying point for the Democrats, in the same sense that lower taxes is for Republicans.
If you really want single payer healthcare, then you had better organize, contribute and work for the next ten years.
Or you can hiss at failure.
Fuggeddaboutit!
The public option is as dead as Obama's idol Abe Lincoln. Once the insurance companies get mandatory participation in their over-priced and under-provided policies, they will fight tooth and nail against anything which threatens their bottom line. They will use the government to defend their losses against the public's interest and needs.
As much as I hate to say it, we have reached that symbiosis of the corporate sector and government promoted by Mussolini (the real one) as the inevitable future of all societies and which rules in its own self-interest.
messy politics of reform
Your Pipe Dream
"...we might get somewhere. "
Whatever you're smoking, I could use some!
We're gonna get that
Good Point
We're going to get a bill this time
We are going to get health care "reform" this year. The only thing left to determine is how much more money the insurance and drug companies will make from "reform". There will be a direct correlation between the amount of bribes handed out in August and the rate of guaranteed increase in health and drug company profits.
Single payer was never going to be an option and it looks like the public option will be a joke and limited to a small segment of the population. Co-ops won't be able to effectively compete. Everyone is going to be forced to have coverage and insurance profits will soar. Drug profits have been promised protection by the White House.
Whatever comes out of Congress will be certain to pick our pockets, contain few cost controls and reap huge rewards for Congress' corporate masters. America, prepare to bend over and grab your ankles again.
Ben Dover
I am 56, recently unemployed, have had a heart attack and have had cancer. When my COBRA insurance runs out, I will not be able to buy health insurance as a single buyer. The only current option is to be employed and get group insurance. Of course anyone hiring me will look at me as someone who will drive up their premium unless it is a really big company. Thus making it less likely that I will be hired.
So, as I acknowledged in my previous post, the big increase in efficiency is taking out the insurance company middle men. Yes, they will continue to get their cut. To use your terminology, I might have to bend over to get coverage, and I don't like that.
But there are some things worse than bending over to get coverage, such as no coverage at all.
I wish...
I wish we had an honest Congress that would tell the insurance parasites to bend over so none of us would have to worry about coverage.
I am one of the "lucky" Americans with employer provided health care. Because of many years of double digit increases in the cost of premiums, the company had a choice of dropping health coverage or giving us a stripped down plan. We were faced with keeping health insurance or keeping people, just to break even. We are a small business and private health care is eating us alive.
We now have a huge deductible so most people don't see the doctor unless they absolutely have to go. I, along with some of my co-workers, skip taking prescription doses to make them last longer. The premiums the company pays are pretty much gravy for the insurance company because none of use have gotten past the deductible. At least we have coverage if someone has something major.
We are classed with those that have health insurance but what good is health care if you can't afford to see a doctor or fill a prescription?
Under Insured
Uh-uh - we gonna win - think
Effectiveness Versus Efficiency
As a graying engineer, I long ago learned to distinguish effectiveness from efficiency when analyzing a system. For healthcare, effectiveness comes in the form of universal coverage, affordble coverage, portability (preexisting conditions) and recission (dropped after the fact). My understanding of the negotiations is that there is a consensus on these issues. These are huge steps forward, are ones that would have been deemed impossible two years ago.
Efficiency comes in the form of negotiating drug prices, reucing certain unit costs of services, eliminating unneeded services and medicines and ultimately eliminating the (depending whom you believe) 15-30% overhead costs created by insurance companies. There seems to be something of a consensus on some of these, but not on others. I forget the names of the proposed review boards, but one will provide some comprhensive basis for deciding what drugs and services work well. Another board is proposed to assess the unit billing rates for services. The $80 billion cap on drug reductions is not ideal, but it is a good first step.
It should be noted that all this creates a comprehensive framework for managing costs in the future. Once these control systems are in place, government will not be able to afford to let them go away. They will result in a continual ratcheting down of excessive costs. I believe this is hugely important and underappreciated.
That leaves us with the overhead of the insurance companies. The most effective means of reducing this cost is the single payer system. But that ain't agonna' happen in this cycle - period. If and when it happens, it will happen only after it is explicitly presented as a party platform in a presidential election and the proponent wins the election. It likely will happen after unit cost have been demonstrated to have been squeezed as much as possible, leaving this as the only alternative. Welcome to U.S. domcracy.
With single payer off the table we are left the negotiations over the public option versus a co-op system. If my first choice is single payer, you might guess that my second coice is the public option. I must confess two points about the co-op system. One, it actually can work. There are similar systems in states for auto insurance for drivers with poor driving records. Two, co-ops are susceptible to being manipulated into nothingness by the insurance companies. I think the current status of the negotiations (and let's not forget public opinion) is a 50-50 proposition.
I will continue to press my congressman and senators for the public option. At the same time, I will look for more information regarding how many teeth are in the co-op alternative. I submit that nothing is being reported about that issue. That tells me that it is the real negotiation.
If a co-op system with teeth is added to the consensus items, the reform will be a huge success. Further, all the elements will then be in place to drive towards a public option in 10 years and single payer within 20 years. This is not my ideal scenario, but it is a quantum leap forward from what we have now.
Thank you
Thank you, TennesseeCatfish, for laying out what is realistically achievable in the current political climate. You and I would, in a more perfect reality, prefer a single payer system but, as you rightly point out, it ...ain't agonna' happen in this cycle - period.
Yet there are those whom I term the ideologically pure left who will settle for nothing less than a single payer system. From my prospective they are as much a stumbling block to achieving any type of health care insurance reform as the rabid-dog reactionary right. For exercising my First Amendment right I have been roundly castigated on this and other Internet forums.
ET SpoonGet castigated, that ye may
Push Hard
No Longer Sub Rosa
The corporate ownership of the government has become too blatant to hide anymore. But thanks to the abuse of psychology, corporate-funded Astroturfing sees to it that the righteous anger of the people is directed at the opponents of the very entities which abuse our Constitutional rights and freedoms instead of toward the real perpetrators.
America, we hardly knew ye!
Nationalize the extortionate mofos!