All this fuss over one little letter. I've got the full document for download here. And the early reports are true. It's signed by the presidents of Pharma, Advamed (device manufacturers), the American Medical Association (doctors), the American Hospital Association, America's Health Insurance Plans, and SEIU's Health Care project. It promises that "we will do our part to achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more." It says that "we are developing consensus proposals to reduce the rate of increase in future health and insurance costs through changes made in all sectors of the health care system." And it gives some general areas of agreement:

• Implementing proposals in all sectors of the health care system, focusing on administrative simplification, standardization, and transparency that supports effective markets;

• Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency;

• Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies; and,

• Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms.

Devil, details, etc. I'm looking forward to reading those consensus proposals. And one more thing: A source who I generally trust and who has deep knowledge of these conversations says that she is more confident that a public plan will be included now than she was 48 hours ago. So take that for what it's worth.