One of the chief complaints from progressives about the health care law is that the White House cut a deal with the pharmaceutical industry to pass the bill. Basically, the industry's trade group, PhRMA, was guaranteed that the bill would not allow drug re-importation or allow the government to bargain for lower drug prices through Medicare. In exchange, PhRMA said it would offer up to $80 billion over 10 years in cost reductions to consumers and up to $150 million in TV ads supporting the bill. To some progressives, this was a craven sellout and a giveaway to the drug companies.
Maybe it was actually damn good strategy. After having just come through the health care debate, can you imagine if the pharmaceutical industry had been in the thick of the fight and on the other side? Beating the traditional conservative coalition plus a pissed-off health insurance industry was hard enough. Adding a pissed off pharmaceutical industry to the mix might have been trying to tackle too many giants at one time.
Instead, we came out of the fight with a better regulated insurance industry, an expansion of Medicaid, an expansion of public health clinics, and, overall, a patch-work system that for the first time covers nearly everybody. And it's not like the White House gave the pharmaceutical industry any goodies in this deal; they just said that this bill would not take away any of the goodies the industry already has. Remember how Democratic leaders continually used the words health insurance reform instead of health care reform? At the time, I thought that was just because the former sounded to the public less gargantuan and scary than the latter. Now I wonder if they were also meant as soothing words for the drug companies.
But if PhRMA was willing to make a deal at all, it must have meant they thought there would be risk involved in opposing any bill outright and fighting to keep the status quo. I doubt they offered the $80 billion + $150 million out of the goodness of their hearts. They must have thought they stood to lose more by fighting and possibly losing. Not to mention what they stood to gain from the bill: millions of newly insured and government subsidized customers.
I feel like progressives won a fight against the insurance industry and lived to fight another day against the pharmaceutical industry. Maybe I'm missing something, but to me this is no sellout. It's dividing and conquering. I think of it as playing one industry against another to win a strategic victory in a big sector of the economy. I also wonder to what extent the same strategy could be used in other areas. Could we unite with community banks and credit unions to rein in big banks? Could we unite with emerging alternative energy companies and green construction companies to shrink oil and coal companies?
The corporate establishment and the right wing have a long record of dividing ordinary people against one another to conquer democratic forces and progressive movements. Native workers against immigrant workers, straights against gays, middle class against poor, scabs against union workers. And the upper class has almost always been more class-conscious and in solidarity than the working class. But I think if the progressive movement is really doing its job and moving with force, it's possible to make one industry "scab" against another. After all, in 2009 the pharmaceutical industry looked at a popular new Democratic President with large majorities in both chambers of Congress and an activist base hungry for a big victory on its core issue, and they decided to run away from the health insurance industry and to the negotiating table of a so-called socialist White House.
If it's essentially a class war--and, on the biggest issues, it is--I think it's best to welcome deserters and turncoats when it suits us.