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If this was a sports event or some really stadium-packing group like the Rolling Stones or U2, it would have been sold out in minutes and the scalpers out in force. But as the event I am referring to is the battle over health care reform that will be fought out in the halls of Congress and over many months, tickets are still to be had.

In any case, this promises to be one hell of a battle, even if it does go on for months. Upwards of $2 trillion annually is at stake here in terms of the tab for health care in this country. Entrenched forces are not going to walk away from that lightly and those attacking the status quo are going to have to be mighty determined if they are to make over the current system the way they want.

One thing about President Obama in his drive to reshape the health care system in the U.S. is that he has stayed on message and managed to get a lot of Democrats in Congress behind him. Given the man’s track record of pulling off surprises, I would not be at all complacent if I were one of the industries to be affected.

Those industries, meanwhile, realized that simply saying no is not going to cut it with the President, the Congress and the public. So they have made gestures-execs from six health care-related trade groups presented the President with a pledge in May to work to shave some $2 trillion or more over 10 years from the cost of health care.

By some accounts, however, these organizations immediately started to backpedal, saying that what they said was misrepresented or exaggerated.

What’s proving to be the galvanizing point of focus here is the so-called public option,’ wherein the government could be a provider of insurance to those who aren’t covered by group or individual plans.

The cries have already gone up about how the public option with the government’s muscle behind it would eventually crowd out private insurers from the market. This, critics say, would spell the end of health care as we know it in this country.

I think it’s important for insurers and others involved in this battle to realize that for a lot of people a change that spells the end of health care as we know it in this country is not exactly the worst possible outcome. Some of these people, in fact, might welcome such a development.

One such very vocal critic of insurers and their allies is Paul Krugman, Nobel Prize winning economist and New York Times columnist. His June 5 column in the Times was headlined Keeping Them Honest.” And sorry to say, the them’ he was referring to are health insurers.

Krugman argues, in fact, that only the public option will keep insurers honest. His column ends, “Right now the health insurers are promising to deliver major cost savings. But history shows that such promises can’t be trusted. As President Obama said in his letter [to Senators Max Baucus and Edward Kennedy], we need a serious, real public option to keep the insurance companies honest.”

This battle is just beginning to heat up. Not only are Senate Democrats promising some kind of public option in any health care reform scheme, but more and more talk is filling the air about taxing health insurance benefits.

Republicans, for the most part allies of the health insurance business as it is, are saying they’re being locked out of the legislative process and thus any bill won’t be bipartisan.

The way this is shaping up, the summer of ’09 could be one of the hottest on record. Just what we journalists love.


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