Deadly Spin on Health Care Repeal

Advocates of health care reform who are fearful -- or hopeful,
as the case may be -- that Republicans will be able to repeal the
Patient Protection and Affordable Care Act (aka Obamacare) need to
understand that the GOP has no real intention of repealing it.

The rhetoric of repeal is just a smoke screen to obscure the
real objective of the "repeal and replace" caucus: to preserve the
sections of the law that big insurance and its business allies like
and strip out the regulations and consumer protections they don't
like.

The rhetoric is necessary, of course, to keep fooling the people
they fooled in the first place (with a corporate-funded campaign of
lies and deception) into thinking that repeal would be in their
best interests. For the same reason, it will be necessary for the
Republican-controlled House to pass the two-page bill their PR
consultants drafted to repeal the law. (Calling it the "Repealing
the Job-Killing Health Care Law Act" is a tactic that comes
straight out of the playbook I describe in my book "Deadly
Spin.")

By now, lobbyists for the insurance industry undoubtedly have
met behind closed doors with every one of their new members of
Congress to make it clear what insurers really want. Those meetings
were necessary because it's likely that some of the newly elected
representatives of the insurance industry, who told us that the law
was a "government takeover of health care," had actually begun to
believe their own talking points. You know the old adage: Tell a
lie often enough and you'll begin to believe it.

The real concern for advocates of reform should not be repeal.
What we will wind up with, if the insurers' demands are met, is
much worse.

Insurers got what they needed out of the reform debate: a
requirement that all of us who are not eligible for a
government-run program like Medicare will have to buy their
increasingly inadequate products. That was job one. Job two was to
get the public option, which they knew would be a formidable
competitor, excised from the bill. The insurers were desperate to
have the individual mandate included in the bill because their
current business models are not sustainable. They cannot continue
raising premiums and shifting more costs to their customers through
ever-increasing deductibles and expect employers and regular folks
to buy what they're selling.

Shifting costs is now the only way the for-profit insurers can
ensure Wall Street of the expected return on investment. The
problem, of course, is that you can't keep shifting costs to
consumers indefinitely and expect them to buy your products --
unless, of course, the government forces them to.

Insurers helped finance the "government takeover" fear-mongering
campaign not because they wanted the law repealed but because they
hoped it would enable the GOP to regain at least one chamber of
Congress. They fare much better when Republicans are in control.
They also are not too worried about the challenges to the law's
constitutionality because insurers had a hand in writing the
individual mandate provision to ensure that it could ultimately
withstand a court challenge.

What insurers don't like are the provisions of the law that
restrict their ability to shift costs to us and that require them
to spend at least 80 percent of premiums on our medical care. They
also don't like being told they can't charge women and older people
a lot more than men and younger people. And they are not at all
happy that Congress finally outlawed some of their most
anti-consumer practices, like dumping sick enrollees and refusing
to sell insurance to people with pre-existing conditions.

So the GOP's real agenda is to restore those "freedoms" to
insurers and keep the individual mandate in place. We can only hope
that reform advocates figure how to counter the lies -- the deadly
spin -- and that Democrats in Congress will protect our best
interests.