Victoria Colliver at the San Francisco Chronicle collects some of the responses to yesterday’s announcement about the health industry’s commitments, and I express my mix of skepticism on the policy and optimism on the politics.
Some have characterized this as a “voluntary” commitment by the industry–and that is something to be wary about. Health Access California has been correctly skeptical of past industry attempts here in our state of avoiding reform with “voluntary guidelines,” like on the issue of hospitals overcharging the uninsured, or “voluntary discounts” by prescription drug companies. In the latter case, we fought an initiative battle, that the pharmaceutical companies spent $80 million on, on the very issue of a “voluntary” drug discount program, versus one where the discounts were negotiated. In both cases, the industries were trying to stop–or at least delay–legislation.
This time, the industry groups aren’t promising to control costs as an alternative to reform. They’re promising to control costs as part of reform. In fact, some of the efficiency steps they are proposing wouldn’t even be possible without the sorts of changes now under discussion in Washington, because they require changes in legislation.
If the “voluntary commitment” was explicitly posed as an alternative to health reform, or even of key reform elements–like the public health insurance plan, or bulk purchasing of prescription drugs and medical devices–then it would be a concern. But these efforts should not be–and don’t have to be–mutually exclusive. And we should all be very clear about that in the weeks ahead…