Right now, Obamacare is at war with itself. Political efforts to buy off Big Pharma, private insurers, and the American Medical Association are all pushing up long-term costs -- one reason why Douglas Elmendorf, head of the Congressional Budget Office, told Congress late last week that "the cost curve is being raised." But this is setting off alarms among Blue Dog Democrats worried about future deficits -- and their votes are critical.
Big Pharma, for example, is in line to get just what it wants. The Senate health panel's bill protects bio-tech companies from generic competition for 12 years after their drugs go to market, which is guaranteed to keep prices sky high. Meanwhile, legislation expected from the Senate Finance committee won't allow cheaper drugs to be imported from Canada and won't give the federal government the right to negotiate Medicare drug prices directly with pharmaceutical companies. Last month, Big Pharma agreed to what the White House touted as $80 billion in givebacks to help pay for expanded health insurance, but so far there's been no mechanism to force the industry to keep its promise. No wonder Big Pharma is now running "Harry and Louise" ads -- the same couple who 15 years ago scared Americans into thinking the Clinton plan would take away their choice of doctor -- now supportive of Obamacare.
More after the jump.
--Robert Reich