The Legacy of Billy Tauzin: The White House-PhRMA Deal


More than a million spectators gathered before the Capitol on a frosty January afternoon to witness the inauguration of Barack Obama, who promised in his campaign to change Washington’s mercenary culture of lobbyists, special interest influence and backroom deals. But within a few months of being sworn in, the President and his top aides were sitting down with leaders from the pharmaceutical industry to hash out a deal that they thought would make health care reform possible.

Over the following months, pharmaceutical industry lobbyists and executives met with top White House aides dozens of times to hammer out a deal that would secure industry support for the administration’s health care reform agenda in exchange for the White House abandoning key elements of the president’s promises to reform the pharmaceutical industry. They flooded Congress with campaign contributions, and hired dozens of former Capitol Hill insiders to push their case. How they did it—pieced together from news accounts, disclosure forms including lobbying reports and Federal Election Commission records, White House visitor logs and the schedule Sen. Max Baucus releases voluntarily—is a testament to how ingrained the grip of special interests remains in Washington.

In the 2008 campaign, Obama declared his intention to include all stakeholders as he sought to reform the nation’s health care system, but also supported key Democratic health reform policies. Among these were several that targeted the pharmaceutical industry: Allowing re-importation of drugs from first world countries with lower drug prices and providing Medicare with negotiating authority over prescription drug prices in the recently enacted Part D program. These weren’t just promises, Obama had already voted for both of them as a senator in 2007. (Roll Call Vote 132 and Roll Call Vote 150.)

Set to carry out this agenda were two Capitol Hill veterans, schooled in the monied Washington culture, chief of staff Rahm Emanuel and deputy chief of staff Jim Messina. Emanuel was a former fundraiser, Clinton administration official, investment banker and member of the Democratic leadership in Congress. Messina was the former campaign manager and chief of staff to the powerful Senate Finance Committee chairman Max Baucus. Both were known for their unparalleled legislative abilities.

Because of Obama’s decision to develop a plan operating through the legislative process, members of Congress also played key roles. Early on, the pharmaceutical companies were told to deal directly with Senate Finance Committee chairman Max Baucus. Baucus would be the vehicle for the deal worked out behind the scenes by the White House and PhRMA.

Central to this effort was PhRMA president, CEO and top lobbyist Billy Tauzin, a longtime Democratic member of Congress who switched party affiliations after Republicans gained control of Congress in 1994. By switching parties Tauzin was able to maintain his influence and even rose to be Chairman of the House Committee on Energy & Commerce. Tauzin became the poster child of Washington’s mercenary culture. He crafted a bill to provide prescription drug access to Medicare recipients, one that provided major concessions to the pharmaceutical industry. Medicare would not be able to negotiate for lower prescription drug costs and reimportation of drugs from first world countries would not be allowed. A few months after the bill passed, Tauzin announced that he was retiring from Congress and would be taking a job helming PhRMA for a salary of $2 million.

Tauzin’s job change became fodder for a campaign ad that then presidential candidate Barack Obama ran in the spring of 2008 simply titled “Billy.” It featured the candidate, sleeves rolled up, talking to a salon of gasping Americans about the ways of Washington. “The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry making $2 million a year.” The screen fades to black to inform the viewer that, “Barack Obama is the only candidate who refuses Washington lobbyist money,” while the candidate continues his lecture, “Imagine that. That’s an example of the same old game playing in Washington. You know, I don’t want to learn how to play the game better, I want to put an end to the game playing.”

Aiding PhRMA in their outreach to Congress would be a squadron of lobbyists to push their health care reform priorities. Over the course of 2009, the drug industry trade group spent over $28 million on in house and hired lobbyists. Aside from PhRMA’s massive in-house lobbying operation, the trade group hired 48 outside lobbying firms. The total number of lobbyists working for PhRMA in 2009 reached 165. Some 137 of those 165 lobbyists representing PhRMA were former employees of either the legislative or executive branches. Of these dozens were former congressional staffers including two former chiefs of staff to Max Baucus.

According to data compiled by the Center for Responsive Politics, drug makers contributed huge sums to congressional campaign committees during the same period—from January to the end of October (4th quarter numbers are still being totaled), industry political action committees, employees and their family members flooded lawmakers with over $8 million. Those contributions tilted heavily to Democrats over Republicans by a 57 to 42 percent margin—the first time in any election cycle going back to 1990, the first year that the Center for Responsive Politics began tracking industry giving, that Democrats were so favored. Given their majorities on Capitol Hill, and the new President’s intention to reform America’s health care system, the new tilt was perhaps not surprising.


Key Meetings Between White House, Max Baucus and Pharmaceutical Companies [click here for a visual timeline]
March 5, 2009 Billy Tauzin, President & CEO of PhRMA and Jeff Kindler, CEO & Chairman of Pfizer, chairman-elect of the Board of PhRMA White House
April 20, 2009 Kevin Sharer, CEO of Amgen Sen. Max Baucus
April 20, 2009 Kevin Sharer, CEO of Amgen White House
May 7, 2009 David Brennan, CEO of AstraZeneca, Chairman of Board of Directors of PhRMA Sen. Max Baucus
May 8, 2009 David Brennan, CEO of AstraZeneca, Chairman of Board of Directors of PhRMA White House
May 19, 2009 Billy Tauzin, President & CEO of PhRMA and James Hall, PhRMA lobbyist White House
June 2, 2009 Billy Tauzin, President & CEO of PhRMA; James Hall, PhRMA lobbyist; Kevin Sharer, CEO of Amgen; Jeff Kindler, CEO & Chairman of Pfizer, chairman-elect of the Board of PhRMA; Miles White, CEO of Abbott Laboratories White House
June 2, 2009 Billy Tauzin, President & CEO of PhRMA; Kevin Sharer, CEO of Amgen; Jeff Kindler, CEO & Chairman of Pfizer, chairman-elect of the Board of PhRMA; Miles White, CEO of Abbott Laboratories Sen. Max Baucus
July 7, 2009 Billy Tauzin, President & CEO of PhRMA; Kevin Sharer, CEO of Amgen; Jeff Kindler, CEO & Chairman of Pfizer, chairman-elect of the Board of PhRMA; Miles White, CEO of Abbott Laboratories (David Brennan, CEO of AstraZeneca, Chairman of Board of Directors of PhRMA is also listed in visitor logs for an appointment date) White House (Deputy Chief of Staff Jim Messina; Chief of Staff Rahm Emanuel and Max Baucus’ chief of staff Jon Selib are scheduled to meet at the same time; Independent reports place Emanuel in the meeting)

On March 5, the White House held a meeting with major health care industry leaders to try to bring them to the table and see what could be done to gain their support. In attendance were Billy Tauzin, president, CEO and top lobbyist for PhRMA, Pfizer CEO Jeff Kindler, America’s Health Care Plans (AHIP) Chairman Karen Ignani, Tom Donohue of the Chamber of Commerce and Robert Wood Johnson Foundations’ Risa Lavizzo-Mourey. A day before the White House meeting Tauzin appeared on CNBC touting health care reform and promising to work closely with the Obama administration. In the interview he touted it as an “optimistic plan”, acknowledging that the industry did have a few problems but was glad to have a chance to discuss these. Some were caught dumb-founded by this apparent change of heart on behalf of an industry long adverse to health care reforms.

On April 15, Jim Messina and Jon Selib, chief of staff to Senate Finance Committee chairman Max Baucus, convened a meeting at the headquarters of the Democratic Senatorial Campaign Committee (DSCC) with leaders of organized labor and health care groups, including PhRMA. At the meeting, the groups decided to form two nonprofit entities to promote reform efforts, Healthy Economy Now and Americans for Stable Quality Care, that would be almost entirely funded by PhRMA. The two groups spent $24 million on their advertising campaigns; the contract to produce and place ads went to White House Senior Advisor David Axelrod’s former firm, AKPD, which owed Axelrod $2 million.

In the next month, CEO’s from pharmaceutical companies would meet with Baucus and administration officials at least four times. These talks preceded a major public event at the White House, one critical to its strategy to promote health care reform. On May 11, PhRMA and other trade industry groups pledged cost cutting measures to the White House that would save, they claimed, upwards of $2 trillion over the next decade. President Obama announced the deal in the State Dining Room, flanked by leaders of the various trade groups; the administration followed up with a media blitz in the press and on the White House Web site.

The next day, Healthy Economy Now’s PhRMA funded ad campaign ran their first advertisement in support of the health care reform process calling for the government to finally “fix” the nation’s health care cost problems. While many elements of the $2 trillion cost cutting pledge fell apart, the drug industry remained committed to the process in the hopes that they could ultimately win out and defeat the provisions they most feared in closed-door meetings with the White House.

The first occurred on June 2. White House visitor logs show PhRMA’s top executives, including Tauzin, and industry CEOs met with Sarah Fenn from the White House Office of Health Care Reform. On the same day, the publicly available schedule of Senator Max Baucus shows Tauzin and the same industry CEOs met the Senate Finance Committee chairman. What ultimately resulted from these coordinated meetings would be revealed by Baucus on June 20.

In a press release featuring a statement by Tauzin, Baucus revealed that the pharmaceutical industry had accepted $80 billion in cost cutting measures to be included in the Senate Finance Committee version of the bill. According to news reports, Baucus initially proposed $100 billion in cost cutting measures, but the executives and lobbyists meeting on June 2 were able to win the lower figure.

The terms of the initial cost-cutting deal included $30 billion go directly towards closing the “donut hole” in Medicare prescription drug coverage.  The “donut hole” is a term for the gap in coverage that occurs within the Medicare prescription drug coverage. For those purchasing prescription drugs through the Medicare program coverage cuts off at $2,700 spent and does not pick back up again until $6,154 is spent by the participant. The amount proposed in the deal, 50 percent coverage for drugs within the coverage gap, however, would not completely close the “donut hole.”

In Baucus’ press release, Tauzin is quoted as saying, “This is a once-in-a-lifetime opportunity and, working together, we can make this hope for a better tomorrow a reality today.” This “once-in-a-lifetime” opportunity also extended to the pharmaceutical industry’s ability to blunt the long-term Democratic agenda of lowering prescription drug prices through Medicare negotiations, re-importation and quicker release of generics onto the market. After making such a grand statement of support through cost cutting proposals it was time for the pharmaceutical industry to finally force the White House and Democrats to take certain chips off the table.

Baucus proceeded with a plan to convene a bipartisan group in an effort to craft the bill desired by the White House. These participants included Democrats Kent Conrad and Jeff Bingaman and Republicans Chuck Grassley, Mike Enzi and Olympia Snowe. Baucus’ decision and the need to solidify deals with groups like the pharmaceutical industry – which were reliant on Baucus producing a bill – slowed down the legislative process making it impossible for Congress to meet the White House’s announced August recess deadline for passing health care reform.

Soon after, PhRMA’s big guns and industry lobbyists paid the White House another visit on July 7 and this time met with Rahm Emanuel and Jim Messina (Baucus’ chief of staff Jon Selib is also listed in White House visitor logs for this meeting). In August, The Huffington Post’s Ryan Grim reported on an internal memo that was drafted at that meeting that outlined the policies that would not be allowed into any final version of health care reform. These included Medicare prescription drug negotiations, drug re-importation, and the lowering of prices for drugs available through Medicare Part D and Part B. The deal would be $80 billion in cost cutting and absolutely no more.


While the $80 billion deal was cut with Baucus’ committee, other congressional committees continued to mark-up their own versions of health care reform without the knowledge that the White House was relying on Baucus to produce the final product. In the House of Representatives, the House Energy & Commerce Committee leveled a direct threat to the $80 billion deal. Energy & Commerce Chair Henry Waxman sought to include all of the provisions that PhRMA had gotten the White House and Baucus to cut out of the reform bill. These included drug reimportation, Medicare negotiating power and speedier release of generics to the market. According to previous analysis of the measures proposed by the committee, these measures would have totaled hundreds of billions in cost cuts, far exceeding the $80 billion cap agreed to by the White House, Baucus and PhRMA.

The cost cutting measures passed in the Energy & Commerce bill spooked the board of PhRMA, which included all of the CEOs involved in the deal-cutting meetings with the White House and Baucus. The board pressured Tauzin to go public with the deal to ensure that the White House would recognize it and not renege. On August 4, the Los Angeles Times, in an exclusive report, featured quotes from Tauzin claiming that a deal between the White House and PhRMA existed and that, as Tauzin put it, “The White House blessed it.” Tom Hamburger wrote in the article, “For his part, Tauzin said he had not only received the White House pledge to forswear Medicare drug price bargaining, but also a separate promise not to pursue another proposal Obama supported during the campaign: importing cheaper drugs from Canada or Europe.”

The White House’s Jim Messina later confirmed Tauzin’s claim, stating, “The president encouraged this approach … He wanted to bring all the parties to the table to discuss health insurance reform.”

Democratic lawmakers were furious. Rep. Raul Grijalva, chairman of the Progressive Caucus, asked, “Are industry groups going to be the ones at the table who get the first big piece of the pie and we just fight over the crust?”


On September 7, Baucus’ bill made a private circulation on the Hill; pharmaceutical industry cost-cutting did not exceed $80 billion. Five days later, the New York Times reported that PhRMA planned to spend up to $150 million in an advertising blitz in support of Baucus’ bill. The Times noted that the ad spending “…would be a follow-up to the deal that drug makers struck in June with Mr. Baucus and the White House.” On September 16, Baucus released the full text of his legislation to the public.

The White House, PhRMA and Baucus still had to fight a few battles to keep the deal intact. The key amendment targeting the PhRMA deal in committee mark-up came from Sen. Bill Nelson from Florida, which has one of the largest Medicare participant populations in the nation. The pull of constituent needs clearly put Bill Nelson into a position to push for further cost cutting in Medicare prescription drug pricing. His target: closing the “donut hole” completely.

Nelson claimed that his amendment would generate $106 billion in revenue, or from PhRMA’s perspective increase their cost-cutting to $186 billion.  That would be unacceptable to PhRMA, to Baucus, to the White House and to the pharmaceutical industry who had made the deal. Other Senate Democrats, Tom Carper and Robert Menendez voted with Republicans and Baucus on the committee to defeat the amendment.  It is little surprise the Carper’s Delaware is home to AstraZeneca and Menendez’ New Jersey is home to Merck and Bristol-Myers-Squibb, all of which lobbied for the $80 billion cap.

Senate Majority Leader Harry Reid introduced the final bill, with the cap in place, on November 19. Debate began on Dec. 3, and with it come one more attempt by members to change the terms of the deal. Senator Byron Dorgan introduced an amendment that would allow for drug re-importation, but as the date for voting drew near, the Federal Drug Administration (FDA) released a letter objecting to the proposal that echoed pharmaceutical industry talking points: “…as currently written, the resulting structure would be logistically challenging to implement and resource intensive. In addition, there are significant safety concerns.” Dorgan’s amendment was defeated with numerous Democrats previously in support of reimportation switching to “no” votes.

On Christmas Eve, the bill passed the Senate with the PhRMA deal fully intact.


New Year’s Eve passed with no further action on health care reform. Public opinion regarding the health care reform bill had been slipping throughout 2009. It reached a fulcrum in the special election to replace the deceased senator Ted Kennedy in Massachusetts on January 19, 2010. Newly minted senator Scott Brown campaigned that he would be the senator to provide Republicans with the votes to filibuster the final health care reform bill. Democrats ran for cover. Despite having the largest majorities of any party since the 1970s, Democrats put the brakes on their agenda, particularly health care reform.

In the end, the pharmaceutical industry’s support for health care reform would be left up in the air. After spending $100 million in advertising in support of legislation that Tauzin and key executives hoped would be a windfall for the pharmaceutical industry, the legislative process had flat-lined. In February, the board of PhRMA, split over the deal cut by Tauzin, pushed Tauzin to resign his post.

In an interview with Diane Sawyer, President Obama owed up to failures in the process of passing health care reform, “[T]he health care debate as it unfolded legitimately raised concerns not just among my opponents, but also amongst supporters that we just don’t know what’s going on … And it’s an ugly process and it looks like there are a bunch of back room deals.”

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  • aprilglaspie

    The no negotiating deal was made by Tauzin and Shrubco. It was a done deal before Obama was elected.Attempting to pin this on the President is an absolute crock of merde.

    • uuberdude

      Tauzin’s efforts led to the no negotiation law regarding Medicare. The ACA is not likewise prohibited, but there are no provisions in the ACA to permit it. That should be changed, and would be wildly entertaining to watch. Congressional Republicans would do backflips and balance beach balls on their noses.

  • Jo

    It is odd but I was paying $100 for Advair, then suddenly it went to $250 last summer. I didn’t have prescription coverage.

    Obama is being played like a fine guitar.

  • Mikes Stern’s comments are right on.

    They illustrate the paradox between the public, private, and local interests in the country today. They illustrate how little one district or one state really cares about the overall health of the nation by allowing the people they put into office to run amock in corrupt deal making.

    Our only line of defense against this is supposedly the moral high ground of the presidency. However, we have seen just how money can be dangled to replace sound policy execution.

    Any politician who claims to be on the high ground knows that money is always a secondary aspect of final compromise and that principled agreement must be reached first. Reimporation, ability to negotiate for better prices, etc. were principles that were never for sale, but Obama made them so. The FDA concerns over the “safety” of imports gave this one the kiss of death.

    Here is a president who has elected majorities, populist favor, and moral vision who squanders it on the likes of the very person he used is his campaign to make campaign points and get votes. Any moral leader worth his/her salt would have laughed in these peddlers faces including Karen Ignani.

    If Obama looses his moral compass immediately after his inaugural address and the people of Montana do not care who Max Baccus represents to the rest of the nation, then just who are we and what have we become as a nation.

    Mark Ahearn

  • americayeah

    Pharma agreed to spend more than $150 million on ads touting a health care overhaul? Who made this deal?

  • whenwego

    Thanks for a well-researched article. So rare to find these days! I do believe it is this Phrma deal that killed all respect for Obama from the left. And now the Democrats could lose Congress – regardless of whether he wins or loses in 2012, the Obama presidency appears over.

  • jimmyjimereeno

    Re Obama: FUCK THIS GUY.

  • Douvie

    Infuriating. And the White House wonders why they are distrusted?

  • michael

    Thanks for your excellent investigative reporting on the White House deal with Pharma.

  • Dusty h

    As a nurse I read this latest deal that Obama tried to make with Pharma? Yes, I understand why, but at the same time at my age of 67 now realize all my years of voting meant nothing? Politicians do not listen to the little guy but to the big business lobbyist? As a lifetime Republican I have tried for years to get a Public Option to stop the greed I have seen as a hospital nurse? I now do not plan to vote again WHY? If I was Obama I would do all I could to get in the Public Option and bypass the filibuster? No more deals with anyone go for the gusto and so what if he only has one term, make it a good one term for the working people in this country. As far as the media goes now I realize they too follow their business owners and who pays them not what their conscience tells them after all? Go and read the real life stories on AARP about what it is like to not have health insurance, or even with a co pay and you have a catastrophic illness you can go bankrupt? Why can’t we the voter see that this Congress has protected themselves with a great retirement and best health care possible? WHY? This is fair yet they do not care if we have health affordable
    care for our own families? Then they even forced our local hospitals to take in the immigrants that we the tax payer had to pay for WHY? Yes, all as caring people should take care of anyone who is sick but how do we continue unless we decrease the cost that are ridiculous? Dig deeper into this like above with Pharma and the insurance and medical companies and their profits off of the sick ?

  • marv bullock

    While this message does shed light on what appears to be some hypocrisy, the $80bil concession was nothing to sneeeze at. Keep in mind pharma was going to spend at least what it did, $300mil, possibly more to block OB’s plans for reform.And in this case the compromise had to be pursued through the lobbyist, pharma. Rememberthe process is about compromise,and OB was able to get some give from the industry. You may not know Pfizer, the company i worked for is being criticized for being a part of that concession that it probably wishes it had never agreed to those price concessions since healthcare appears to be going down. No entity can get all it wants. So i am not so sure other than the appearance this was all that bad in that it occurred directly with lobbyist behind closed doors. You know as well as i know, these practices don’t stop on a dime. If OB waved a wand and dictated those kind of changes over-night , he would be assassinated by now.


  • Jackson P.

    If I could use some Obama-isms: Look. Let me be clear. Nobody said change was gonna be easy.


    Look – the history of healthcare is replete with examples of lobbying interests tanking reform efforts by the strength of marketing campaigns and whining to minority politicians. Obama knew he needed Pharma on his side to mitigate their inevitable MASSIVE public campaign against ANY reform effort.

    Let me be clear – This is not a good thing. No policymaker wants to place an arbitrary limit like this. But simple strong words against “backroom dealings” are meaningless if, in the end, nothing has happened. And for the past 40 years, nothing has happened.

    Nobody said change was gonna be easy – Obama had to choose between not negotiating on principle, in which case his reform efforts would have been attacked with much more ferocity. Think disingenuous “socialism and death panels” accusations times 3.OR he could negotiate, mitigate a major opposer, and take the heat for cowtowing to special interests. If history teaches us anything, the first option would have killed health reform from the start. The second option got us closer to reform (not Obama’s reform, but reform of ANY kind).

    Use your strong words if you like, but this was a difficult and pragmatic decision to negotiate with the enemy. Black and white exist in politics, but gray is the only real shade in policy. Obama chose policy over politics. I applaud him, but with a sigh.

  • DeserveLiberty

    This is not Capitalism, this is Corporatism, which is the first cousin of Fascism. It is all allowed to happen as a result of a strong central government that is out of the control of the people.

  • urban legend

    As wonderful as this is, and it vastly surpasses anything I’ve seen from the supposedly professional journalists from America’s top journalism schools, where is the discussion of how the public option came, seemed to go, seemed to come back for a bit on the opt-out concept, and finally went again for good?

    The recurring public view was that after strongly advocating it in his campaign, Obama and his team, especially Emanuel, would say something lukewarm about it, then after a blogger furor Obama would claim again he was strongly in favor of it, and then whenever enthusiasm built back up — as it did enough in the first couple of weeks of October enough to force the opt-out concept of a public option into the initial Baucus committee version — “our” team in the White House would go out to the talk shows and dampen enthusiasm again. Indeed, the week after articles appeared that discussed renewed public option momentum over favorable comments about the opt-out concept from Democrats as disparate as Nelson, Baucus, Schumer and Howard Dean, the team of Emanuel, Jarrett and Axelrod on the Sunday shows deliberately failed to express even the mildest interest in that approach, even though it obviously could have been given a compelling narrative — “what could be fairer than letting each state makes its own decision?” — making it difficult for any Democratic Senator to oppose it.

    The only background I can think there could have been to explain this inconsistent messaging was that Obama had already agreed with the insurance industry (as possibly pharma, too) to kill the public option even as he pretended to his base that he supported it.

    In any case, I cannot believe the industry simply did not care enough about the public option ever to negotiate over it with the White House.

  • CB

    Per the FDA backup of the drug companies on importation of drugs…

    I have been taking prescription drugs from India, New Zealand and Australia for years. They are the same as the U.S. drugs in that they have exactly the same effects (all positive).

    They cost 1/3 the price of the “generic” version sold in local pharmacies.

    I met a surgeon from India and took the opportunity to ask him about the safety of drugs from CIPRA and Torrent, two Indian companies. He laughed at my question and assured me that I have nothing to worry about. My experience backs him up.

    We are being robbed and our government of/by/for the people has come to the aid of the robbers.

  • George

    My compliments to Mr. Blumenthal. I become nostalgic when I re-call that at one time we had a free press, and Americans expected such products from the “Fourth Estate”.

  • I ceased calling myself a Republican when Medicare Part D, written by Rep. Tauzin was passed. Pres. Bush had control of the House and Senate and had a once in a generation chance to fix Medicare and wasted it. Medicare has a 38 trillion dollar unfunded deficit. Funds that should have been reserved for Medicare were spent by Congress for general use. instead of rectifying this impending catastrophic bankruptcy, Republicans passed a program that is the antipathy of free market competition. Medicare4all??? There will not be Medicare for anyone unless drastic action is taken. Physician payments from Medicare Part B have been cut 53% since 1996. Hospital payments through Medicare Part B have increased every year with exponentially increasing hospital and drug charges. Physicians are being asked to treat Medicare patients for less than their cost resulting in increasing numbers of Medicare providers dropping out of the program. To increase participation in a bankrupt program is illogical.
    Chris Smith MD

  • ajflny

    Why are we whining about a health bill no one wanted?
    To a person, all my friends and associates, and their wives, from Ivy league trained scientists who were strong Obama supporters, to right wing businessman, and their liberal wives, had grave misgivings about this “reform” bill.

    1. All were employed.
    2. All had health insurance.
    3. All knew how to game the system in terms of getting good results and doctors out of this system.
    4. No smokers or morbidly obese people in this group. Three cancer survivors however.
    5. There was a uniform feeling that nothing whatsoever in the bill increases the supply of resources.
    6. So the conclusion of my cohort was that it would ultimately be we
    who pay to insure the less fortunate ones, and we would be rewarded by having to wait behind them in doctors’ waiting rooms.

    The enemy was us.

  • I am second generation,born in the states my grandparents came from Canada,i have no health insurance,fools should have stayed there.

  • Bernard Kaye

    I agree with Jane, Mike, Bob, Daniel, Richard, all: we have an ox in a ditch.

    President Obama and his cohort(not a compliment)are not able to marshal their forces to attend to the enemy so well defined in the splendid Paul Blumenthal piece: it is us!

    An analogy: I do not cuss out right-wing commentators, I do cuss out those who listen and follow without verifying.

    Ronald Reagan was for me an abomination but “Trust but verify.” was sage advice.

    I have a low estimation of the American voting public which I suspect is shared by President Obama and his closest advisors. They were cowed into a pathological muteness regarding health care,reminiscent of John Kerry’s weird muteness over “swiftboating.”

    They feared to aggressively confront their critics as did the Clintons in the nineties, perhaps fearing that our great unwashed could not handle such heated controversy.

    If they so feared, I agree with them.

    I reside in Texas, no matter what President Obama and the Democratic Party said (assuming at least some cohesive approach by Democrats), a single utterance by any popular right-wing radio or TV commentator would have and could today obliterate it.

    We have an ox in a ditch on all issues.

    Bernard Kaye

  • I need a fistful of stents to repair the broken heart I have from my dear Democrats’ botching of this healthcare bill. Oh woe is we.

    I made the first mistake too. We should never never ever ever have uttered “single payer” or “public option.” We should always and only have said *Medicare4All.* Then we would have obviated/done an end-run around those ‘socialist,’ ‘Europeans’ idiot canards.

    We should start now saying, “We need a simple system like Medicare4All.” The SnakeBrainicans hate Medicare, but dare not speak out against it with the shrill venom they use for ‘socialist.’

    Talking about sucker attacks to the humanly-hearted, the icepick in the eye of the brutal [Medicare4All] exile and the absurdobscenestupid deal with Pharma could have been filthyHideous sucker blows by a NorquistRove mole, fergawds’ sakes. Et tu, Rahm? I still reel.

  • Jane

    To Mike Stern:

    I don’t share your low estimation of the American voting public. Unfortunately, it appears that Obama and his White House team were also cowed into thinking that Harry and Louise advertisements had more power over voters than the President’s message on healthcare reform. Tragically, they were wrong.

    At the outset last year, poll after poll showed that the overwhelming majority of Americans wanted healthcare reform in order to end the price-gouging of the drug and health insurance companies. Obama’s votes as senator and positions as presidential candidate show that he was in touch with the American voters on this issue.

    At the beginning of his term this highly popular president had the bully pulpit, and the ear of the American people. So he did not need to “create momentum for healthcare reform by getting Pharma’s endorsement” as you say; nor did “getting Pharma to put large amounts of money in support of a lobbying and public relations campaign for healthcare reform” arouse anything but suspicion on the part of the public. It’s not as if groups that supported sane health insurance premiums and drug prices could not afford their own ad campaigns, either, as we have come to see. Large American industries, small businesses as well as individual citizens have been badly bled by the drug and health insurance giants.

    Once healthcare reform was sabotaged by the deal outlined in this excellent reporting, the American public was not too stupid to smell a rat, and support deteriorated.

    Obama sold his own power short. Now that it’s all out there, perhaps he can still recoup a decent health reform bill. The statement by HHR secretary Kathleen Sebelius on the price gouging of Anthem and Wellpoint in California is a good start.

  • Bernard Kaye

    President Obama is naive, the Democratic Party is not functioning, the Republican Party is fully functioning, phRMA and its allies are laughing if not gloating and those without health insurance, many of whom, including many children, are ill or lack periodic checkups and care are suffering in the wealthiest (I did not say greatest) nation on Earth.
    I am ashamed of my country.
    I agree with Richard N. Snyder (and Plato)and having had contact with the DNC and Democratic Party, I am not at all optimistic about reforming health care, creating jobs or anything else:not stopping collection of employee, employer and self employed persons’ FICA contributions several months ago was a lost opportunity. How many chances do we expect? Deficits can prevent hunger, homelessness and poverty and fund health care when well managed and self-cure in prosperity.
    I think President Obama has turned on us or perhaps he is a mirage achiever.
    Bernard Kaye

  • Bob

    Your article explains a lot why the whole process appeared to be a clusterf**k. When you look at the details it WAS a clusterf**k !
    Yes, James Brown, they are all whores. We’re paying for it and we’re certainly getting screwed.

  • Daniel Schuman


    Your points (to my mind) are spot on. To address your last paragraph, I would make one additional point:

    Politicians know that the game of balancing the best policies and sufficiently good politics is an iterative one. An imperfect solution now can be improved in the future. And in that future, there’s a new political reality that may allow a politician to reach further in achieving a new compromise.

  • Plato was correct.

    The most efficient form of government is government by the one, denoted as “monarchy” when beneficent, and denoted as “tyranny” when evil.

    Less efficient is government by the few, denoted as “oligarchy” when numerous composite factions of society, representing a broad array interests, sit at the table, and “plutocracy” when only a few of those factions sit at the table, representing only a few narrow interests.

    “Democracy”, or rule by the many contending factions and interests, is denoted as the least efficient of good governments, and the least efficient of bad governments, generally tending toward stasis.

    So, while we may crave for a Marcus Aurelius, we would be more likely to get a Stalin; while the Democrats are probably more “oligarchic” than the Republicans, who tend to be more “plutocratic”, we seem stuck in the stasis of government ostensibly “democratic in form, but teetering between oligarchy and plutocracy.

    And after the Citizens United case, the di were cast in favor of plutocracy.

    The history of Obama’s “health care” fiasco illustrates the above, and confirms Plato in all respects.

    This leaves the disgruntled citizen craving for a “man on a white horse” to produce reform as a “diktat”. Unfortunately, that path usually leads to the unintended consequence of tyranny.

    So, I guess,in the broader picture, of which the Health Care fiasco is only an illuminating example, we are currently having to pay the price for our institutions, which is stasis and decline.

  • Jane

    People can argue there will always be deals, negotiations, etc. in Congress.

    But for the White House to engage in a stupid backroom deal that guts the raison d’etre for health care legislation–that’s sabotage of a high order.

    The more people know of your excellent investigative work, the more hopeful I am that we can achieve real healthcare reform–
    i.e. controls on the price-gouging of PHRMA and the health insurance industry.

  • This is a fascinating glimpse into how the political marketplace works. Presumably, the Obama administration made a straightforward calculation—the benefits of striking a deal with Pharma appeared to outweigh the costs. The benefits included (1) obtaining x billion in “savings” (or, perhaps more accurately, the appearance of x billion in savings); (2) creating momentum for healthcare reform by getting Pharma’s endorsement; and (3) getting Pharma to put large amounts of money in support of a lobbying and public relations campaign for healthcare reform (and, conversely, ensuring that Pharma did not put similar amounts of money in a campaign against the legislation). The administration might also have hoped that Pharma could help to deliver certain marginal votes in favor of the legislation (eg, Republicans who receive large amounts of contributions from Pharma or whose constituencies benefit from the drug industry), although there is no evidence of this in the piece.

    It is tempting to make this into a morality play in which the Obama administration was “corrupted” or “bullied” into rejecting the “right policy” (ie, allowing reimportation and Medicare drug price negotiations) by the evil drug lobby. But this seems like a mischaracterization. The deal looks like a straightforward political negotiation in which the administration had at least as much bargaining power as did Pharma. If the political marketplace is going to be used to “divide up the pie” (to paraphrase Rep. Grijalva), it would be naïve to think that it is going to be on any basis other than tradeoffs among various actors seeking to maximize their own interests.

    But shouldn’t politicians put the “public interest” (ie, the policy that will maximize benefits to the public at large) above such mundane considerations? That assumes politicians are capable of analyzing complex policy questions to come up with the “right” solution, which seems like a dubious assumption. Like voters, most politicians are probably “rationally ignorant” with respect to most policy questions. And even if they know (or think they know) the right policy answer, what would happen if they routinely put good policy ahead of good politics? They would be replaced, that’s what. Which is why you have never heard of a legislator who says “this bill is bad for my state or district, but I am voting for it because it will be in the overall public interest.”

  • mr.ed

    A horsewhip is not enough.

  • Step by step, we are becoming a nation of fat, sick, pill-popping, helpless fools. President Obama has reneged on so many campaign promises – health care reform, repudiation of the worst of the Bush Doctrine policies, ending lobbyists’ influence over the political processes that are currently at a standstill thanks to the obstructive behavior of corrupt legislators, and on and on – that anyone who still believes he stands for “change” or something better than the last eight years is completely deluded.

    The timeline of our government’s failure to institute any meaningful changes in our sickness industry as presented in this article is indeed illuminating and disturbing. And not to quibble, but when author Blumenthal says “Some were caught dumbfounded by this apparent change of heart on behalf of an industry long adverse to health care reforms,” he means “averse,” not “adverse.”

  • Hah! It sounds like “The One” is trying to blame everybody else but his own self and WH staff for “backroom deals.” What a fuckwad. I saw through him more than two years ago and knew I would vote Green again.

    Get a clue, ppl.

  • After Citizen’s United, this only gets worse… by an order of magnitude. Thanks for the video, it was tough to watch, but you’ve convinced me I voted for someone who can be easily bullied by corporate interest.

  • Dana H.

    The irony is that it was the alleged capitalists in big pharma who were ready to sell us (and ultimately themselves) down the river to socialized medicine. Despite any current deal, price controls would have been inevitable had health care “reform” passed. Tauzin got his just deserts in the end.

  • Dan

    “it looks like there are a bunch of back room deals”

    Funny, that.

  • Wow, very impressive article as to the “smoke-filled back rooms” where legislation is produced.

    Are they all whores?

  • Citations for video:

    Pharma’s lobbying to Congress:

    Calculation of savings with cost-cutting policies: