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The president scored a big one last week when he appeared on national TV with representatives of six big stakeholders in the health reform debateâthe AMA; AHIP, the insurers trade group; PhRMA; the SEIU; the American Hospital Association; and AdvaMed, a trade association for the medical technology industry. At the press event, the assembled players announced they had signed a letter agreeing to help the administration reach its goal of âdecreasing by 1.5 percentage points the annual health care spending growth rateâsaving $2 trillion or moreâ over the next decadeâa figure a trade association official told me was a âphony number based on projected rates of growth.â Obama used the words âhistoricâ and âwatershedâ to describe the groupsâ pledge, and Americans got the message that doctors, hospitals, insurers, technology manufacturers, and unions were really going to do something about health care costs.
As the week went on, it was clear that some of these trade groups had made promises with which their members did not agree. The American Hospital Association (AHA) began hearing from member hospitals wondering just what its trade association had committed them to. At first, the AHA appeared to blame the media, saying that âsome early news reports misstated the savings goal as 1.5 percentage points per year over 10 years.â Some letter signers then said they had actually agreed to more gradual spending reductions.
But wait a minute: Wasnât the president saying the same thing as early media reports? AHA executive vice president Richard Pollack wrote to his member hospitals, saying: âThe groups did not support reducing the rate of health spending by 1.5 percentage points annually.â The associationâs senior vice president for communications, Rick Wade, told me âYou could read the [original] letter two ways.â
By the end of the week, the percentage point saga had reached Robert Pear of The New York Times. Pear reported that the industry was now backpedaling on its pledge to reduce spending, and the White House was flip-flopping on what the president actually said. According to Pear, Nancy-Ann DeParle, director of the White House Office of Health Reform, first told him that âthe President misspokeâ during Mondayâs announcement. An hour later she called back and said: âI donât think the president misspoke. His remarks correctly and accurately described the industryâs commitment.â Budget director Peter Orszag weighed in on his blog, reprimanding the Times for making âa mountain out of a molehill.â
Too bad the media didnât pick up Pearâs story the way they jumped on the presidentâs âhistoricâ announcement; they could have used the opportunity to reveal some pretty interesting politics. At its core, the story was a question of whoâs using who: Was the White House using the industry, or was the industry using the White House? One thing is certain: everyone was using the press. This was a story where follow-up was in order, but these days the mediaâs attention span is short. Washingtonâs politicos know that.
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