Will HIMSS vendors oppose their best customers?
Evidence-based care and comparative effectiveness, concepts pushed heavily by insurers as a replacement for the HMO horrors of a decade ago, are finally ready to start proving their worth. Many doctors, and more politicians, believe in them.
And now some want the government to take the resulting profit.
That's what the political battle over health reform comes down to, according to the insurers.
The sticking point is this. Should government offer citizens a health care plan in competition with the private sector?
The insurance industry and their allies in Congress have made it abundantly clear this is a line reformers dare not cross.
Yet their arguments against it can seem downright schizophrenic:
- Government can't do anything right. A government insurance plan is socialism -- it's Swedish, it's Old Europe, it's French.
- A government plan would drive private insurers under.
How these contradictory arguments can be contained in a single political brain without an explosion occurring is one of the great feats of our time.
If government is inefficient and can't do anything right, there is nothing to fear from government entering the market against private insurers. People will recoil from its offering, it will be seen as second-rate, and government will be left with the worst risks.
So how is it that government would drive private insurers under if it entered their market? Because the same vendors who worked so hard this decade developing solutions for insurers would welcome the chance to sell the finished products to government.
In fact it doesn't matter whether the arguments make sense. What matters is whether those making them can maintain a solid wall of opposition that forces the Obama Administration to back down or which prevents health reform from passing at all.
Right now they are doing a fine job of it. Conservative Democrats are objecting to passage of any plan without allowing a 60-vote cloture vote. Enough are objecting to the idea of a "public option" that the President faces an uphill fight.
But this President has won uphill fights before. That's what the HIMSS customers most fear.