Smelling a Pattern: Is Obama Planning to Make Healthcare Reform Initially "Voluntary"?
What's going on with the administration's healthcare announcement today? Ezra Kline is skeptical that the announcement is much more than symbolics:
What we have, in other words, are promises of future cost containment that exist alongside concrete and continued opposition to the cost containment ideas that are actually on the table. And for good reason. A 1.5 percentage point decrease in health spending is a 1.5 percentage point decrease in medical industry profits. This commitment doesn't contain any examples of concessions that will reduce a participant's revenue streams. Conversely, every time legislators have proposed a reform that will actually cut industry profits -- and thus cut health spending -- the industry has howled in pain and anger. It's hard to sync that with promises to cut spending by $2 trillion over the next 10 years by implementing a set of unspecified reforms.
And the answer is: Not much. As one senior administration official said to me, "this is a commitment, not a plan."
Why would the healthcare industry go on record as setting huge cost savings--and profit shaving--goals? What do they gain? I have my suspicions.
I wonder if the industry representatives involved in today's announcement are offering their support contingent on the abandonment of the public program portion of Obama's healthcare plan. Maybe the Obama administration is (secretly?) planning something for the healthcare industry like he's already done with the banking industry and automobile industries.
Banks had to submit themselves to "stress tests", the failure of which would bring about the requirement to meet goals through private or public measures. It could be a sneaky way to nationalizing some banks by forcing some banks to acknowledge that they are essentially insolvement and therefore converting preferred shares of government-owned stock into private shares.
GM and Chrysler were given government relief contingent upon agreeing to develop comprehensive turnaround plans that met government approval. If they failed, then government would refuse aid, giving the companies the need to go into bankruptcy which could eventually lead to government-run takeovers.
Maybe Obama's actual unannounced goal with respect to healthcare is to let industry try the private option first, and then go to public mandates or public programs only after the private sector has proved incompetent. Maybe Obama will let the industry set "voluntary" cost setting goals and coverage goals for private insurers without mandates or a public option, and then, if they fail to meet those objectives, that would be tantamount to the banks failing their "stress tests". Subsequently, the government could step in with a public plan, price controls, mandates or other measures that could be politically risky if implemented as anything other than a last resort.
I have no psychic insights into what the administration is really thinking, but the pattern in the Obama administration's policy overhauls so far seems to be to build industry and public support for major national interventions by giving the private sector a chance to fail first. Could Obama be thinking of making the first phase of his healthcare reform plan "voluntary"? Just asking.













