Earlier this week the AP sent out a story that offered some clues to the future of health reform and the future of the improbable strange bedfellows alliance. The story, by Julie Hirschfeld Davis, gave readers a succinct and clear summary of the troubles plaguing the widely ballyhooed Divided We Fail coalition—yes, its members really do disagree on the fundamental direction of reform after all.
The coalition began two years ago to promote the notion that such disparate groups as the AARP, the Business Roundtable, the National Federation of Independent Business, and the Service Employees International Union were one big happy family. They would work together and maybe, just maybe, lobby in sync to change the health care system. The group’s Web site listed such platitudinous goals as giving all Americans access to affordable health care, making wellness and prevention of illness top national priorities, and letting Americans choose among long-term care services to maintain their independence at home. Who could argue with that? The coalition has been spearheading petition drives, running ads, and holding rallies across the country to drum up popular support for health reform—that’s health reform in a general sense. OK, nothing wrong with that either.
But the AP tells us that the groups who founded the coalition disagree over important details, like how big a role the government should play, and where the private market fits in. That question is, indeed, the Big Kahuna. The AP story summarized where the partners stand. Labor unions and liberal groups want a universal coverage system, with the government providing insurance that would compete with private plans. The business groups want a system based mostly on private insurance, and dislike requirements that would make employers offer health insurance to their workers or force them to pay into a fund to help those who can’t afford coverage.
Right before the stimulus package passed, the Business Roundtable, whose members include CEOs of the major insurance carriers, issued a statement making its position pretty clear. Said the Roundtable:
While health IT’s passage is critical, Business Roundtable is pressing for further reforms to improve our health care system, create a competitive, private health care market and ensure all Americans have access to quality, affordable health care.
That statement seems to foreshadow what the Roundtable will be fighting for. So where does that leave the coalition when the lobbying really counts? Groups may say one thing in public and do quite another thing behind closed doors. “You start off by being congenial and agreeable,” Joseph Antos, a health analyst at the conservative American Enterprise Institute, told the AP. “So you can get into those meetings where you say, ‘This is the way we need to have it work—or else.’”
The AP’s story, which may have been inspired by an earlier piece about the coalition in The Hill, is important because it reaches millions of readers in small towns and cities that don’t read The Hill or any other Beltway publication. It tells them what’s at stake in health reform, and why they might want to take all the warm, fuzzy ads they see on TV with a grain of salt.Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.