The White House is expected
today to announce a major agreement in which the major
players in the health care industry pledge to reduce the expected
rate of growth of health care by $2 trillion over the next 10
years.
Policywise, there are reasons the be skeptical, as the
Washington Post
reports:
Despite such heady predictions, many aspects of the plan remain
unclear. The groups did not spell out yesterday how they plan
to reach such a target, and in a letter to Obama they offer
only a broad pledge, not an outright commitment.
In addition, White House officials said, there is no mechanism
to ensure that the groups live up to their offer, only the
implicit threat of public embarrassment. And it would be
difficult to track whether they come up with the promised
savings, other than the imprecise measure of comparing current
projections of health-care cost increases with future actual
costs.
Furthermore, it's important to draw a distinction between a
reduction in the rate of growth in overall health care costs and
the reduction in the rate of growth of government
spending on health care. If legislation, as expected,
dramatically expands the role of government, then government
spending will rise even if projected costs decline for the sector
as a whole.
With that said, politically this is a major development, one
which may very well be the "game
changer" the White House is touting it as. I wrote a few
months ago that while conservatives had a lot of allies in the
private sector in 1993 and 1994, that they'd be alone like Gary
Cooper in High Noon this time around, and it's now
coming to pass.
Most Americans who pay attention to the news today won't care
about all the details. All they'll see is the major industry
groups (American Medical Association, the Pharmaceutical Research
and Manufacturers of America, the American Hospital Association,
and America's Health Insurance Plans) and the Service Employees
International Union coming together under the leadership of
President Obama. Remember, in 1993/94, it was the predecessor
group of America's Health Insurance Plans (AHIP) that took out
the famous "Harry and
Louise" ads opposing HillaryCare.
The theatrics of this alone will create a lot of momentum for
health care reform and put pressure on Congress to get something
done this year. Conservatives, and those who advocate a free
market or consumer-driven approach to health care, will be
further marginalized as obstructionists. Say what you want about
Obama, but he continues to find creative ways to out-maneuver his
opposition.
