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It's the costs, stupid!

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During Bill Clinton’s 1992 campaign against George H.W. Bush, strategist James Carville changed the focus of the campaign with one brilliant phrase: “It’s the economy, stupid.” Bush was considered unbeatable because of his record and stance on foreign policy issues, yet Carville understood the need to focus voters’ attention on the deeply recessionary economy which he believed Bush had not adequately addressed.

Sometimes, amid all of the heated rhetoric, all that is needed is the right phrase at the right time. This is more simply said than done, but as Carville showed, when it happens it is a powerful tool. So, why is it so darned hard for the insurance industry to utter the words, “It’s the costs, stupid”?

Absent the emotion and (what pundit George Will aptly referred to as) the American capacity for synthetic indignation, we would be well advised to bear in mind that the insurance companies reflect, but do not create the system’s costs. If you don’t like the price of an automobile you don’t blame the finance company.

The financing mechanisms in our industry mirror costs created and charged by other actors. This is not to absolve the insurance companies of reforms that need to be made in their sector. It is, however, time to focus the bright light of the public scrutiny on the real issue: “the costs.”

Partisan or bipartisan, televised or blacked out, regular or reconciliation, you can have all of the meetings and votes you want. Until we understand that the driver is the cost of care, we will undoubtedly continue to be “stupid.”