07/16/2009 05:12 am ET Updated May 25, 2011

Follow the Money on Health Care Reform

"What Happened to Single Payer?," asks the Washington Independent in a recent article.

One answer, the Independent suggests, comes from Sen. Bernie Sanders and Rep. John Conyers, authors of the single payer bills in the Senate, S 703, and House, HR 676:

Both lawmakers argue that private insurers, who have a fiduciary duty to shareholders, are the wrong folks to dictate who receives what care when. "The function of a private health insurance company is not to provide health care; it is to deny health care," Sanders said last week. "Every dollar of premium that a health insurance company does not spend on health care needs is a dollar more in profits."

If the policy provisions that seem to be deemed politically expendable seem to be those that most accommodate the health care industry, perhaps it's time, as the adage says, to follow the money.

USA Today released data showing that the biggest drug and insurance giants have amped up their lobbying spending by 41 percent this year to make sure that reform gets done right -- for them anyway.

20 of the largest health insurance and drug companies and their trade groups spent nearly $35 million in the first quarter of 2009, up more than $10 million from the same period last year

And you have to love these quotes from two of the pharmaceutical behemoths:

"We believe that the private health care marketplace fosters competition, innovation and consumer choice," read a Merck statement.

Somehow competition, innovation, and consumer choice are not the words we'd use to describe what the health care industry has done to our health care system. Profiteering, care denials, and 37th in the World Health Organization rankings would be better descriptions.

Yes, there's tons of choice: the choice of which care services to self-ration because of the high co-pays and deductibles, the choice of which outrageously priced drug to avoid because big pharma prevents access to generic drugs or importing drugs from Canada or other countries where the government can actually use its bulk purchasing power to force lower drug costs, the choice of which doctors, hospitals, or clinics and medications are off limits because they are out of your insurance network or not on the approved drug formulary.

Yet somehow, the far right policy wonks and far too many politicians want us to believe it is the private market, not public plans like single payer, under which you would have one medical card and could go anywhere you want, which guarantee choice in health care.

Then there's this comment from Pfizer about the money they are devoting to lobbying.

A Pfizer statement read, "We are committed to making our voice heard and to be constructively engaged" in the debate.

To that, we can say Mission Accomplished.

Here"s the scorecard from USA Today. You'll find that Pfizer's lobbying monies have risen 119 percent in 2009, and Health Net's 106 percent.

Is it any wonder that single payer is considered to be politically out of bounds, but forcing people to buy private insurance is a central part of all the other proposals, to name just one of many industry-friendly provisions likely to be in the final bill?

And, of course, this is just what they spend on lobbying. It doesn't include the millions the same companies spend in campaign contributions to those writing the health care legislation, as the Washington Post reported in March:

Health insurers and their employees contributed $2.2 million to the top 10 recipients in the House and Senate since 2005, while drug makers and their employees gave more than $3.3 million to top lawmakers during that period, according to an analysis of federal elections data by Consumer Watchdog, a California-based advocacy group.

All in all, it seems a safe bet that in the final analysis, we may yet end up with the best healthcare reform money can buy.

And the reason that plan is likely to end up preserving a key component of the status quo, defined by Geri Jenkins, RN, co-president of the California Nurses Association/National Nurses Organizing Committee in her testimony Wednesday, in the one Congressional hearing at which single payer has been on the table:

"Right now we are the only nation on earth that barters human life for money."