Cui Bono?

| Mon May 11, 2009 12:38 PM EDT

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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