Politico reported this week that President Obama was secretly in league with drug companies during the year-long debate over the passage of federal health reform in 2009, even while he was publicly posing as a populist enemy of the drug industry.

The Washington Examiner ran a similar story, and also pointed out that Max Baucus was a part of the plot in which the White House secretly agreed to massive concessions to drug makers, who in turn agreed to come out in favor of the Affordable Care Act, otherwise known as Obamacare.

These concessions are costly:in making them, the Obama White House reversed several positions that Obama took during his 2008 run for president.  The Examiner reports that in the summer of 2009,

…the emails show, drug lobbyists, White House officials and aides to Sen. Max Baucus hammered out a deal that formed the backbone of Obamacare. The final bill would subsidize prescription drugs, force states to include drug coverage in Medicaid, and expand private insurance coverage of drugs. Also, the White House pledged to oppose policies that Obama had promised on the campaign trail: allowing reimportation of prescription drugs and empowering Medicare to negotiate for lower prices on the drugs Medicare is paying for.

In return for Obama giving away the farm, drug companies agreed to support passage of the Affordable Care Act and even run TV ads favoring it.

I don’t know what to make of all of this. There is no easy answer.  The Affordable Care Act has many good components, and clearly you have to make deals to pass something big in Congress. But at what cost?

Also, the Examiner article fails to mention the most important concession by the White House: surrendering on the issue of a “public option” for U.S. citizens. This was Obama’s original proposal for a government-provided health insurance plan for purchase by citizens at a low price, which would have competed with private plans. The public option was (and is today) always popular, could have passed Congress easily with the President’s leadership if he had wanted to follow through with it, and would have been the best thing for the country.  But it was never used as anything more than a bargaining tool by the White House, something to surrender as a concession.  And now we learn about the many other giveways to health industry.

I suppose it is possible (although I believe improbable) that the final product and outcome were the only possible scenarios in which anything could have gotten through. The fact that Baucus was responsible for helping broker the deal (the least surprising aspect of this story) makes me wonder.

In the end, I fear that the famous mentality of White Houses past and present, of wanting to pass something, anything, at all costs just so that you can declare victory, appears to have prevailed here in these arrangements. In essence, the drug industry got whatever it wanted, and the price of it all was to simply support the legislation. That’s not exactly a hard bargain.  It’s more like something out of the Devil and Daniel Webster.

Also, given that Obama’s health reform passed Congress with not a single Republican vote,  what was the support of the drug industry really worth in the end? Was it even necessary? The Democrats who voted for the Affordable Care Act got slammed in the 2010 mid-term elections.  In retrospect, would the 2010 mid-terms have been much worse if the drug companies, having been denied their bag of goodies by the Obama White House, had opposed the Affordable Care Act from the get-go?  I doubt it.