Industry Interests are Not in Their "Twilight"

The Washington Post's Ezra Klein has an
amazing post
in which he trumpets what he calls the "Twilight
of the Interest Groups
" reflected by likely passage of the
health care bill (h/t). Why are
Interest Groups -- once so powerful in Washington -- now banished to
their "twilight"? Because, says Ezra, "the Obama administration
succeeded at neutral

The Washington Post's Ezra Klein has an
amazing post
in which he trumpets what he calls the "Twilight
of the Interest Groups
" reflected by likely passage of the
health care bill (h/t). Why are
Interest Groups -- once so powerful in Washington -- now banished to
their "twilight"? Because, says Ezra, "the Obama administration
succeeded at neutralizing every single industry." If, by
"neutralizing," Ezra means "bribing and accommodating them to such an
extreme degree that they ended up affirmatively supporting a bill that
lavishes them with massive benefits," then he's absolutely right. He
himself notes what he calls the "remarkable level of industry consensus"
in support of the bill:

Pharma supports the bill. Insurers are incoherent on it, but
there's not a ferocious and united campaign to kill the proposal. The
American Medical Association has endorsed the Senate bill. The hospitals
have endorsed the bill. Labor has endorsed the bill. The business
community is split, with larger employers holding their fire.

Indeed, PhRMA is so in favor of this bill that, over the last week,
they've
spent $6 million
on an ad campaign aimed at undecided House
Democrats to try to pressure them to vote for the bill.
And while the
most hackish Obama loyalists
(echoing
the administration
) have been claiming that the health insurance
industry is vehemently opposed to and working to defeat this bill, Ezra
commendably acknowledges the reality that they have done little in that
regard (Marcia Angell -- Professor at Harvard Medical School and the
former editor of The New England Journal of Medicine -- said a
few weeks ago
of the health insurance industry: "What they're
fighting for is the individual mandate. And if they get that mandate
[which the final bill contains], if everyone does have to buy their
commercial products, then they're going to be extremely happy
with it
").

Now, if someone wants to argue (as Kevin Drum
has
) that sleazily bribing these industry interests with secret
deals was a necessary evil -- a shrewd, pragmatic way to get a health
care bill passed, without which it could not have happened -- that's
one thing. I think that's debatable -- after all, the central promise
of the Obama campaign was that it would circumvent those factions by
appealing directly to the armies of citizen-supporters they had lined up
-- but at least that's an honest, rational argument. Bribing
these industries was ugly and sleazy but necessary
.

But to pretend that this bill represents the "Twilight of the
Interest Groups," that special interests have been "neutralized," that
this bill is some sort of great victory over the health insurance and
drug lobbies, is just hagiography and propaganda. Being able to force
the Government to bribe and accommodate you is not a reflection of your
powerlessness; quite the opposite. Everyone would love to be forced
into a "twilight" like that. It's one thing for the Obama
administration and the DNC to issue self-serving claims like this (we've
stood up to the insurance and drug companies!
), but those who hold
themselves out as independent commentators ought to keep their feet on
their ground.

As for the related
Obama defense
that the way this bill was crafted fulfilled his
campaign promises because he said he would include these industries "at
the table": please. It's true that Obama did say that, and
that this clearly meant he intended to try to accommodate some of their
concerns so that they didn't wage jihad against his bill. That's fair
enough. But it's also true that he repeatedly railed against the
Washington practice of crafting bills by negotiating in secret with
lobbyists and industry interests, and his whole I'll-put-these-negotations-on-C-SPAN
promise
was specifically designed, he said, to prevent a health
care bill from being negotiated based on secret deals with the health
care and pharmaceutical industries.

But that's exactly how he ended up negotiating
this bill -- using the exact secret processes that he railed against and
which he swore he would banish. It was only because The
Huffington Post
's Ryan Grim uncovered
the secret memo-deal the White House had entered into with PhRMA
--
a deal they had
publicly denied until then
and until PhRMA
demanded they publicly affirm it
-- did we know that
the administration had agreed to oppose drug
re-importation and bulk price negotiations, measures Obama (and the
Democrats generally) repeatedly
promised to enact
. Indeed, when it came time to vote on drug
re-importation, the administration concocted
false "safety concerns" about re-importation
in order to whip
against
Byron Dorgan's re-importation amendment, rather than admit
that they really opposed it because they secretly promised they would to
PhRMA, which hates drug re-importation because it lowers prices. And
it was only two days ago that we finally
had confirmed
what (at least to me) was obvious all along: namely,
the White House had agreed in secret with health care industry
representatives that there would be no public option in a final bill,
even as the President publicly feigned support for it and pretended to
be fighting for it.

In other words, this bill was negotiated using the standard,
secret, sleazy Beltway lobbyist/industry practices that candidate Obama
frequently condemned and vowed to defeat. And these industries
extracted such huge benefits as a result of these secret deals -- a bill
shaped to their liking and profit objectives -- that they are
essentially in favor of it.

Again, none of this is proof that the health care bill is a bad
idea -- it's possible that a bill which pleases these industries also
produces, on balance, more good than harm (by expanding coverage and
restricting some industry abuses). But being in favor of the bill is
not a justification for making misleading claims to try to glorify what
it achieves or, worse, claiming that it represents a change in the way
Washington works and a fulfillment of Obama's campaign pledges. The way
this bill has been shaped is the ultimate expression -- and bolstering
-- of how Washington has long worked. One can find reasonable excuses
for why it had to be done that way, but one cannot reasonably deny that
it was. And one can truthfully say many things about the political
power of industry interests in Washington after this is all done; that
they were "neutralized" and are in their "twilight" is most assuredly
not among them.

UPDATE: Matt Yglesias
also says
Ezra Klein's claims about interest groups are "wrong" and
that the reality is the "reverse" of what Klein wrote: "interest
groups were able to get their way on most key points without needing to
seriously attempt to deliver votes in exchange. . . . the interest
groups were able to get 85 percent of what they wanted in
exchange for absolutely nothing
." Does that sound like their
having been "neutralized" and sent to their "twilight"? This highlights
a primary point I'm making here: Yglesias is as enthusiastic a
supporter of this bill as one can find, yet, at least in this regard, is
still able to be realistic about what it actually is and is not.

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