All the big players in health insurance and care are lining up, it seems, to pledge future savings as their part of the sacrifice we will all make for better, cheaper, and more available health insurance. A while back, pharmaceutical manufacturers pledged $80 billion; now, it's the hospitals' turn, with promises of $155 billion.
These offers remind me a lot of the offers we get in the mail about once a week: $300 off your next roofing job, $150 off duct cleaning -- I'm sure you're familiar with these. They and the health industry's offers are alike in two ways. First, if you read the fine print on the coupons, most of them say something like "valid only if presented at the time of estimate." So how do you know if you really get your $300 discount? There's no way to tell (but anyone who's visited the famous Cave at Emptor can probably make a pretty accurate guess).
Second, though the amounts of the coupon discounts sound large, they're usually a pretty small percentage of the typical job cost. They're designed to hook the customer. Similarly, the industry group offers sound impressive, but they're a small, small fraction of what's at stake. And the companies are frank in telling us their pledges buy them "a seat at the table," that is, a seat from which they hope to be able to tailor the contract to enhance (or prevent erosion) of profits amd assure a return much greater than the offered savings.
It's encouraging that hospitals, drugmakers, insurance companies, and other sectors are seeking a seat at the table this time around; certainly no workable proposal could be developed without their input. But the savings promised along the way will be difficult to confirm when the bill comes due.
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