Around 5:30 on Friday afternoon I received a robocall paid for by the Democratic National Committee on behalf of Organizing for America. The voice informed me about a rally for health care reform, scheduled for Saturday at 6 pm just west of the state capitol building in Des Moines. Press 1 if you plan to attend.

I didn’t press 1 and stayed on the line to see what would happen. The voice came back, telling me “The president needs you to show support” for reform.

The folks at Organizing for America have some pronoun trouble. It’s not President Obama who needs us. We need him to show support for real reform.  

Although I have a busy day planned, I would have rearranged my schedule to attend this evening’s rally if I saw the president working hard to get the best deal possible on health care reform. Instead, the White House cuts back-room deals with drug companies and encourages industry lobbyists to negotiate with the Senate Finance Committee, the Congressional committee likely to produce the worst bill from the perspective of consumers.

Not only is it ludicrous to let the Finance committee’s “gang of six” (three “centrist” Democrats and three Republicans) write a health care bill in a chamber with a strong Democratic majority, the White House isn’t even trying to add some irrelevant sweeteners to win Republican votes for more controversial health care policies.

Official administration policy on “health insurance reform” is backing away from some of Obama’s campaign promises. The Organizing for America issue page on health care doesn’t even mention a public health insurance option as a goal.

In this context, the insurance industry is understandably confident that they will get the bill of their dreams: a mandate for all Americans to buy health insurance, with no public option to compete with private insurers that dominate most markets.

Tinkering with insurance regulations will not solve our problems, as shown by the Health Insurance Portability and Accountability Act of 1996 (also known as Kennedy-Kassebaum). Bleeding Heartland user ragbrai08 has reminded me that this law was supposed to end abuses such as “rescission,” when insurance companies cancel people’s policies after they become sick. Ragbrai08 blames poor enforcement by state regulators for the failure of this bill and helpfully sent me this link on the problem. Others such as Mike Lux point to loopholes that insurance industry proxies in Congress wrote into the 1996 bill. Regarding HIPAA and the Massachusetts health care reform adopted a few years ago, Lux writes:

These two bills, both passed with great fanfare in the thoroughly bipartisan fashion, are not working because they provide no check on insurance industry power, no competition and no reason for insurers to control their costs- which, by the way, is exactly why they passed so easily with such big bipartisan support.

Remember, insurance companies are granted exemption from anti-trust laws by the McCarran-Ferguson Act. A very small number of them have overwhelmingly market power in huge parts of the country. Their rates are unregulated by the federal government. And they have enormous political power to go along with their massive market power.

What my friends at Third Way don’t mention is that the insurance industry has happily signed off on all the regulatory changes mentioned above, just as they supported Kennedy-Kassebaum and the Massachusetts health bill. They know that with all the market and political power they have, without anti-trust or federal rate regulation to worry about, without competition from a public option, they can raise rates as much as they want and probably write loopholes into the regulations that they agreed to so that they will be easier to slide around.

Requiring Americans to purchase private health insurance would amount to a regressive tax going directly to corporations. And since private insurers have very high administrative expenses, their preferred method of controlling health care costs is limiting people’s access to medical services.

Until the president honors promises he made to those who got him elected and rejects the stupid and politically suicidal path favored by insurance companies, Organizing for America can count me out of their photo-ops.