Whether on prime time television or in a Rose Garden news conference, President Barack Obama makes a convincing case for health care reform. The public seems interested in it, too: Polls show a healthy majority of Americans believe greater government involvement is needed to control the feverish rise of medical costs.
But while the White House may be optimistic that such reforms can be achieved this year, there's big money being invested in maintaining the status quo. Insurance companies, physicians and other providers, hospitals, the pharmaceutical industry and others who make a living off the nation's bloated and woefully inefficient health care system are spending hugely where it counts.
A report released Wednesday by Common Cause found that health care interests are spending $1.4 million per day lobbying Congress. About $94 million went to congressional candidates in the last election cycle alone, with much of it going to the members serving on committees and subcommittees that oversee reforms.
With so much money trading hands, it's hard to imagine lawmakers taking the kind of sensible actions needed to both curb spending and reduce the ranks of the uninsured.
Consider these examples. Mr. Obama's proposed public insurance option (favored by 76 percent of the public, according to recent polls) is vigorously opposed by the American Medical Association and may not survive the coming debate on Capitol Hill. A proposal in Congress to require businesses to at least help pay for health insurance for their workers gets a thumbs down from the U.S. Chamber of Commerce as a jobs killer.
Anything that moves the country closer toward single-payer coverage is going to be fought hard by the insurance industry - as will any proposal that might reduce the value of drug patents.
That kind of well-funded opposition can be overcome, of course, but in an issue as complex as health care reform the devil is in the details. The public may want a better health care system, but people don't necessarily have a clear idea of what that might entail.
The industry has a right to make its case in the halls of Congress, of course. That's a right all Americans enjoy. But the country is ill-served when elected officials are so greatly dependent on campaign donations from such deep-pocketed special interests.
Public financing for congressional campaigns offers the best and probably cheapest prescription for genuine health care reform. But that's not something Mr. Obama and the Democratic majority seem particularly interested in - at least not while they hold the fundraising advantage that comes with incumbency.
Until the country's leaders can be elected - or re-elected - without taking exorbitant sums from those whom they are supposed to be regulating, the prospects for meaningful changes in health care seem slight.
