For months, even as other Democrats fell by the wayside, Nancy Pelosi has been saying she wouldn’t put through health reform without a “robust” public option. Instead, she this week agreed to a provision that would make any public plan weak to the point of meaninglessness.
In announcing the House Democrats’ health reform plan, Pelosi made it clear that she has abandoned any ideas that the public option’s payment rates should be based on Medicare rates, or otherwise standardized and set by the government. Instead, the government-run insurance plan will negotiate rates with doctors and hospitals, just as the private insurers do.
What this means is that plan rates under the public option will be pegged to those of the insurance industry, eliminating any real chance that the public option will bring down health care costs by “competing” with the private companies. There is no waffling here. Just complete capitulation to private industry.
Pelosi apparently gave in under pressure from members of her own party. But the real winner in the health reform debate are not the so-called moderate Democrats, or the Republicans, and certainly not Obama or Pelosi or Harry Reid. It is Karen Ignagni, president and CEO of America’s Health Insurance Plans. She called the politicians’s bluff—and won.
She knew from the very beginning, as did most of Washington, that the profit-making industries who control the American health care system would emerge victorious. Billy Tauzin, mouthpiece for Big Pharma, whined about Obama’s duplicity but sat tight, knowing the drugmakers had in the end gotten a sweet deal. Ignagni, likewise, didn’t make threats. She waited, then executed her own double-cross and amidst liberal yelps ran right through the opposition without a scratch.
Could anyone have blocked Ignagni’s breakaway run? Not in this crew, that’s for sure. LBJ would have stopped her. Liberals scorn Johnson because of Vietnam. But LBJ had a domestic program that he never lost sight of, and that he refused to concede enitrely to the power of corporate America. It was Johnson, after all, who got the bill creating Medicare through Congress, over the objections of the AMA and a lot of other powerful interests. Neither Pelosi nor the oh-so-clever Rahm Emanuel has Johnson’s dealmaking abilities–or his spine.