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The hospitals want a deal? Let’s make it a law. |
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After voluntary deals with the health insurers and the drug companies, Senators and the administration reportedly has a deal with hospitals:
With health care legislation at a crossroads, the nation’s hospitals are near agreement with a key lawmaker and the White House to pick up part of the cost of President Barack Obama’s plan for expanded coverage, officials said Monday.
The precise size of any deal was not available, although several days ago, talks were focused in the area $155 billion over a decade. These officials said under the emerging agreement, hospitals would accept lower-than-anticipated payments under Medicare and Medicaid, the federal health care programs for seniors and the poor.
To which I say, like I’ve said before, great! Now let’s just write all those deals into law to make sure we’re not hanging our hopes on voluntary measures that never come to pass.
But there’s more at work here than just the policy. Obama has clearly decided that he wants to keep these large industry players at the table, and he’s keeping them there by making these kinds of deals. It’s a high-stakes strategy, because these players would just as soon keep the status-quo if they could, but so far it seems to be paying off, seeing as they understand status-quo is dead. Hospitals, drug companies, and insurers are still saying they are pro-reform, and more importantly, they have not poured their huge coffers into paid media advertising against reform. Keeping them at the table means they can’t spend a lot of time or money attacking other elements of reform. That’s a big deal.
Of course, keeping these people at the table carries the risk that the final product will be influenced by their interests, which makes it more likely the final product won’t actually provide quality, affordable health care to everyone. (And indeed, there is an understanding in this deal that the new public option would pay higher than Medicare and Medicaid rates - a win in that hospitals are tacitly agreeing to a public option, but with a caveat.) But, while the industry is spending $1.4 million a day, that money is just barely keeping them in the game. Reform is moving forward, and four of the five committees with control over health care in Congress are supporting a strong public health insurance option, the thing these interests fear most.
I’d agree with Jon Cohn about the big picture:
[Congressional and administration staff] suggested the political upside of these deals was considerable: “The more people are making deals,” one Hill staffer told me, “the greater the sense of inevitability that this will happen and the greater the momentum.” And while these sources understood the groups could simply walk away from the deals anytime–and declare, in effect, that their pledges of support were null and void–these sources noted that reformers, starting with the president, could do the very same thing.
Keep in mind these are deals with Baucus and, via his proxy, the Senate Finance Committee. But whatever comes out of Senate Finance will eventually have to be combined with the Senate Health, Education, Labor, and Pensions Committee bill. The combination, in turn, will have to be reconciled with whatever comes out of the House. That creates quite a few opportunities for modification–and improvement.
Keeping these people at the table makes reform more likely, and if you can keep them at the table while still writing legislation that lowers cost and gives good health care to everyone - something these groups don’t really want to do - more power to you.
(also posted at the NOW! blog)
