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Thursday, May 14, 2009

The Big Bogus

American Scofflaw

This week, the health care lobby scored a cunning propaganda victory by feigning interest in fixing the perennial rip-off we call a health care system.

With much fanfare, Big Health trotted out a six-month old "promise" -- a toothless, non-binding pledge lacking any specifics -- to make various nips and tucks that would slow the rate at which health costs grow to "only" 4.7 percent annually. It was hailed by the Obama administration and many observers as a breakthrough in the battle for reform.

Until recently, the health care industry has been dead-set on preserving a disastrous but profitable status quo (The U.S. spends close to twice as much per person on care than other wealthy countries, and gets consistently poorer results; among residents of 30 rich countries polled by Gallup, Americans came in 18th in terms of satisfaction with their care). But now the "disease care" industry is portraying itself as an agent of change. Fearful of a growing movement towards real, substantive reform, it's trying to co-opt the process under the guise of "getting a seat at the table." That they've given up, for now, their oppositional stance is what has so many tongues wagging about the significance of the proposal.

But it's nothing new -- "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 and deeper systemic reforms. The Brookings' Institution's Henry Aaron, a former official in the Carter administration told the New York Times that when he heard of the proposal, "I had a Rip van Winkle moment, as if I had fallen asleep in 1977 and woke up again this morning.” According to the Times, Carter's pledge to do something about out-of-control health care costs "prompted the industry to undertake a short-lived 'voluntary effort.'” The growth of health care costs also slowed briefly after Bill Clinton's failed attempt to fix the system.

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