Reflections at the Intersection of Economy & Society: How Pharma and Insurance Intend to Kill the Public Option

Thursday, June 11, 2009

How Pharma and Insurance Intend to Kill the Public Option

I am cautiously optimistic about the up coming battle for a public healthcare option. I have been scanning the cable news channels, the dominant newspapers, and the blogs. They all point out that there is an intensifying debate in Washington and things are going to get worse. Leading the opposition, ironically, is the American Medical Association. The AMA is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system. Additionally, as Reich points out, the opposition is coming from Big Pharma and Big Insurance. Enjoy the article below and let your representative and senators know you want a public option without conditions.

By Robert Reich--

I'ved poked around Washington today, talking with friends on the Hill who confirm the worst: Big Pharma and Big Insurance are gaining ground in their campaign to kill the public option in the emerging health care bill.

You know why, of course. They don't want a public option that would compete with private insurers and use its bargaining power to negotiate better rates with drug companies. They argue that would be unfair. Unfair? Unfair to give more people better health care at lower cost? To Pharma and Insurance, "unfair" is anything that undermines their profits.

So they're pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers...

This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle. (more)

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Economy & Society Quotes:

"The central characteristic of agents is not that they reason poorly but that they often act intuitively. And the behavior of these agents is not guided by what they are able to compute, but by what they happen to see at a particular moment." -Daniel Kahneman

"The problem is a lot of what is called economics is not economics. It is more ideology or religion." - Joseph Stiglitz

"Formal rules are an important part of the institutional framework but only a part. To work effectively they must be complemented by informal constraints (conventions, norms of behavior) that supplement them and reduce enforcement costs." -Douglas North

"The science called 'economics' is based on an initial act of abstraction that consists in dissociating a particular category of practices, or a particular dimension of all practice, from the social order in which all human practice is immersed." -Pierre Bourdieu

"Rational economic man, in the narrow mainstream sense, is close to being a social moron. The inability to think about other people is not a proof of reason - it's the absence of reason." -Amartya Sen

"It is not the consciousness of men that determines their being, but, on the contrary, their social being that determines their consciousness." -Karl Marx

"Actors do not behave or decide as atoms outside a social context, nor do they adhere slavishly to a script written for them by the particular intersection of social categories that they happen to occupy. Their attempts at purposive action are instead embedded in concrete, ongoing systems of social relations." -Mark Granovetter

"Once a transaction has been made, in which the principal satisfies interests of the agent (for example, through a monetary payment) in return for the agent's using his actions to pursue the principal's interests, a social system has been created." -James Coleman

"Given the fact that economists and sociologists each hold half of the truth, so to speak, when it comes to markets, it seems natural that they should try to coordinate their efforts. Economists need to better understand the role of the social relations in the market, and sociologists need to better understand how prices are formed and what effect these have on the economy." -Richard Swedberg

"My aim is to integrate a focus on social relations and institutions into a modern sociological approach to the study of economic behavior by highlighting the mechanisms that regulate the manner in which formal elements of institutional structures in combination with informal social organization and networks and norms facilitate, motivate, and govern economic action." -Victor Nee

“But this long run is a misleading guide to current affairs. In the long run we are all dead. Economists set themselves too easy, too useless a task if in tempestuous seasons they can only tell us that when the storm is long past the ocean is flat again.” -John Maynard Keynes

"The more people accept the neoclassical paradigm as a guide for their behavior, the more their ability to sustain a market economy is undermined." -Amitai Etzioni

"The great bulk of controls over social behavior are not external but built into the relationships themselves." -George Homans

"While economics is about how people make choice, sociology is about how they don't have any choice to make." -Bertrand Russell

"It is difficult to get a man to understand something, when his salary depends upon his not understanding it." -Upton Sinclair

"It takes centuries of culture to produce a utilitarian such as John Stuart Mill." -Henri Bergson

"The contract is not sufficient by itself, but is only possible because of the regulation of contracts, which is social in origin." -Emile Durkheim

"The care for external goods should only lie on the shoulders of the ’saint like a light cloak, which can be thrown aside at any moment.’ But fate decreed that the cloak should become an iron cage.” -Max Weber

"A hardhitting economic sociology would attempt to draw on the best of sociology and economics, and to unite interests and social relations in one and the same analysis. Interests, in all brevity, are always socially defined, and they can only be realized through social relations." -Richard Swedberg

"As economic sociology moves beyond the earlier embeddedness perspective, the challenge is to specify and explicate the social mechanisms determining the relationship between the informal social organization of close-knit groups and the formal rules of institutional structures monitored and enforced by organizations and states." -Victor Nee

"I had stumbled on one of the fundamental truths of economics that no one in graduate school had ever told me about: If you want markets to expand, you need governments to do the same." -Dani Rodrik

"When the facts change, I change my opinion. What do you do, sir?" -John Maynard Keynes

"The difference between the most dissimilar characters, between a philosopher and a common street porter seems to arise not so much from nature, as from habit, custom, and education." -Adam Smith

“The businessman is only tolerable so long as his gains can be held to bear some relation to what, roughly and in some sense, his activities have contributed to society.” -John Maynard Keynes

"Markets are most developed and most effective in generating wealth when they are backed by solid governmental institutions. Markets and states are complements, not substitutes, as simplistic economic accounts would often have it." -Dani Rodrik

"Social relations, rather than institutional arrangements or generalized morality (e.g. shared beliefs and norms), are mainly responsible for the production of trust in economic life." -Mark Granovetter

"The ideas of economists and political philosophers, both when they are right and when they are wrong, are more powerful than is commonly understood. Indeed the world is ruled by little else. Practical men, who believe themselves to be quite exempt from any intellectual influence, are usually the slaves of some defunct economist." -John Maynard Keynes

Thursday, June 11, 2009

How Pharma and Insurance Intend to Kill the Public Option

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