THE BLOG
09/10/2009 05:12 am ET | Updated May 25, 2011

Is Health Care Reform About to Go the Way of No Child Left Behind?

The White House is in full scramble mode, trying to walk back last week's reports that the administration had struck a deal with Big Pharma promising to remove from its health care overhaul the ability of Medicare to negotiate for lower drug prices.

But they can't walk back two essential facts: 1) the drug industry has drawn an $80 billion line in the sand -- that's the maximum amount of cost cutting it'll accept before withdrawing its support for health care reform, and 2) during the campaign Obama promised to repeal the ban on negotiating with drug companies, predicting it would result in as much as $310 billion in savings.

So even if the White House didn't explicitly promise to take price negotiations off the table, by agreeing to Big Pharma's $80 billion ceiling they've effectively done just that (the $150 million ad campaign the drug industry has promised to run in support of the president's health care plan only adds to the stench).

And if the right to negotiate drug prices is dead, so is the chance for meaningful reform.

The White House has now shown itself willing to cave on the two essential elements of real health care reform -- drug price negotiations and having a public option.

Both are crucial to containing costs. The right to negotiate drug prices is how free markets operate -- taking advantage of economies of scale and the bargaining power that comes with bulk purchasing. To give this up should be abhorrent to anyone who believes in a functioning capitalist system, as opposed to what we are increasingly becoming: an oligarchy of powerful interests. In the same way, having a public option is the only meaningful way to provide competition leading to lower insurance costs.

Giving us health care reform without those key ingredients is like serving a PBJ sandwich without the peanut butter or the jelly.

This white-bread-only reform makes no sense practically -- or politically. Health care reform that doesn't contain costs is destined to fail -- arming the GOP with a powerful "I told you so" cudgel to swing in 2010 and 2012.

Making matters worse, the chance to enact meaningful change doesn't come along often. And when the opportunity is squandered, it is lost for a long, long time. When reform that isn't reform passes, people check it off their list and move on -- and we are left with worse-than-no-reform boondoggles like No Child Left Behind and Bush's Medicare drug plan.

Robert Reich called the White House/Big Pharma deal -- or its wink-wink, no-deal-here equivalent -- "extortion."

For me, it's emblematic of precisely what Obama promised to put an end to: politics as usual where, as Frank Rich put it, "the American game is rigged" and (quoting Obama himself) the system is in hock to "the interests of powerful lobbyists or the wealthiest few" who have "run Washington far too long."

And it's not like the drug industry somehow pulled a fast one on the president. During the 2008 campaign, Obama was unequivocal on the issue. Here are some of the flashback quotes we put together for HuffPost's Obama vs. Obama story:

-- "Congress exempted Medicare from being able to negotiate for the cheapest available price. And that was a profound mistake."

-- "We will break the stranglehold that a few big drug and insurance companies have on the health care market."

-- "We're not going to get change unless we can overcome the resistance the drug companies, the insurance companies, the HMOs, those who are making a major profit from the system currently."

And from his campaign documents:

Allow Medicare to negotiate for cheaper drug prices.... Barack Obama and Joe Biden will repeal the ban on direct negotiation with drug companies and use the resulting savings, which could be as high as $310 billion, to further invest in improving health care coverage and quality.

"We'll tell the pharmaceutical companies 'Thanks but no thanks for overpriced drugs,'" Obama said in October. "We'll let Medicare negotiate for lower prices." From now on shall we just assume that "thanks but no thanks" really means "thanks"?

Obama also promised to hold all negotiations on C-SPAN. He hasn't. Instead we've had a week of White House statements, followed by anonymous White House briefings, followed by contradictory anonymous White House briefings, accompanied by the PhRMA drug lobbyists touting their agreement, followed by the lobbyists issuing "no comment" comments on their agreement, followed by the lobbyists walking back their touting of their agreement.

The health care industry has hired more than 350 former members of Congress and government staffers to lobby their former colleagues, and is spending around $1.4 million a day trying to maintain the status quo. Looks like it will be money well spent. With price control negotiations and the public option circling the drain, their victory is near complete.

The third fundamental element of real cost containment is getting serious about prevention -- shifting the focus of our health care system from treating sickness to preventing illness. As Einstein put it: "Problems cannot be solved by the same level of thinking that created them." That's why HuffPost is committed to pursuing new lines of thinking on the health care debate -- including the importance of making changes to the lifestyle choices that greatly impact our health.

To this end, we are delighted to welcome Dr. Dean Ornish as our Medical Editor. He's a pioneer in promoting lifestyle changes and prevention as a path to better health, and will be writing both about personal health issues and about moving prevention front and center in the ongoing health care debate. See his latest post here. He'll also be recruiting writers with a wide range of perspectives on how to achieve wellness. This is a vital debate to have, because we clearly cannot continue down the current costly and inefficient health care path.

Remember when Obama kept presenting the fact that he hadn't been in Washington very long as a virtue? If real health care reform dies -- and the death of real health care reform is completely consistent with a Rose Garden signing ceremony of a "reform bill" -- I guess it will show that even six months in Washington is too long.