The vast healthcare lobby conspiracy

Cigna, Aetna, Blue Cross -- they're allies, not competitors, when it comes to stopping a public plan

Published July 6, 2009 8:15PM (EDT)

President Obama is popular. Healthcare is a mess, and everyone knows it. The president’s proposed public option enjoys massive public support. Even the Republicans, who’ve spent decades studiously avoiding the issue, are playing on Democratic turf by sort of talking about reform. Who could possibly stop the president and his allies now?

Well, the healthcare industry is happy to give it the old college try, with an assist from the Senate Finance Committee. The Washington Post has a major article today showing that the healthcare lobby has kicked into high gear, spending $1.4 million a day on lobbying. The effort involves 350 former government staffers and members of Congress, and while presumably the lobby isn’t monolithic, it’s clear where industry interests lie. Their focus is on the Senate Finance Committee, which has produced the most conservative of three bills moving around Congress, and the only one without a public plan.

In fact, as Robert Reich has pointed out in Salon, an option to buy into a public, government-run insurance plan has become the center of the whole healthcare fight precisely because it’s so threatening to industry -- and the industry complaint is, essentially, that a public plan would work too well at providing cheaper, better coverage. As Sen. Ben Nelson says, “At the end of the day, the public plan wins the game.” (He meant that as criticism.)

A good deal of Republican criticism of the public option has focused on how it would drive practitioners and insurers out of business. That, of course, is another way of making Reich’s point: Either the private members of the industry will lower costs to compete with the public plan, or, yes, they will go out of business. But even if it seems immensely costly to run a large-scale lobbying effort -- $126 million to date, this year -- it’s far cheaper than having to compete with a government plan that could cut into their business.

By Gabriel Winant

Gabriel Winant is a graduate student in American history at Yale.

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