That's the cover story from BusinessWeek last week.
As the health reform fight shifts this month from a vacationing Washington to congressional districts and local airwaves around the country, much more of the battle than most people realize is already over. The likely victors are insurance giants such as UnitedHealth Group (UNH), Aetna (AET), and WellPoint (WLP). The carriers have succeeded in redefining the terms of the reform debate to such a degree that no matter what specifics emerge in the voluminous bill Congress may send to President Obama this fall, the insurance industry will emerge more profitable. Health reform could come with a $1 trillion price tag over the next decade, and it may complicate matters for some large employers. But insurance CEOs ought to be smiling....
The industry has already accomplished its main goal of at least curbing, and maybe blocking altogether, any new publicly administered insurance program that could grab market share from the corporations that dominate the business. UnitedHealth has distinguished itself by more deftly and aggressively feeding sophisticated pricing and actuarial data to information-starved congressional staff members. With its rivals, the carrier has also achieved a secondary aim of constraining the new benefits that will become available to tens of millions of people who are currently uninsured. That will make the new customers more lucrative to the industry.
How'd they do it?
Impressing fiscally conservative Democrats like Matheson, a leader of the House of Representatives' Blue Dog Coalition, is at the heart of UnitedHealth's strategy. It boils down to ensuring that whatever overhaul Congress passes this year will help rather than hurt huge insurance companies....
Matheson, whose Blue Dogs command 52 votes in the House, can't offer enough praise for UnitedHealth, the largest company of its kind. "The tried and true message of their advocacy," he says, "is making sure the information they provide is accurate and considered."
Representative Mike Ross, an Arkansas Democrat who leads the Blue Dogs' negotiations on health reform, also welcomes input from UnitedHealth. "If United has something to offer on cutting costs, we should consider it," says Ross, a former small-town pharmacy owner. "We need more examples that work, and everything should be on the table."
That's this Mike Ross, the one boasting about how he "held the [health care] bill hostage in committee for 10 days":
We ensured that if there is a government option, it will be just that -- an option -- and it won't be mandated on anybody. If it had been based on Medicare rates, I can assure you that it would have eventually ended up resulting in a single payer-type system, because Medicare has really good rates, because they're negotiating for every senior in America. Private insurance companies could not have competed with that. And so we would have at the end of the day ended up with single payer. Now we've leveled the playing field, if there is a government option they'll have to go out again and negotiate with providers just like private insurance companies do. That was important to me to insure that we don't end up with some type of single payer system.
They might have won this skirmish, but it doesn't mean they've won the final battle for this bill, or for long-term healthcare reform. It's precisely why we have to have a strong public option in this bill, and not the "compromise" forced out of E&C by the Blue Dogs. A strong public option in this bill is the one thing that can begin to eat away at the monolithic power structure the industry has created both in our healthcare system, and in the halls of Congress. The only other thing that could happen that could check the power of the insurance industry is far less likely than a public option, and that's public financing of campaigns.