A recent Daily Journal at CarolinaJournal.com reviewed Bruce Yandle and Adam Smith’s book, Bootleggers & Baptists, which describes political alliances between groups pursuing the same ends for different reasons: bootleggers’ profits and Baptists’ moral causes.
The review highlights the role of bootleggers and Baptists in the development, approval, and implementation of the federal Affordable Care Act.
Smith and Yandle devote a full chapter to the Affordable Care Act, publicizing the way in which “the president himself constantly shaped and reshaped the initiative to garner Bootlegger support, even while heaping public scorn on big business elements in the health sector.”
The result of this coordinated approach led to results no one necessarily wanted. “Although the aims of reform were widely agreed upon — expanding coverage, reducing costs, and improving the overall quality of the system — they were also vague enough to leave plenty of room for Bootleggers and Baptists to operate,” Smith and Yandle explain. “[T]he fuzzier the ends of a reform campaign, the greater the opportunity for Bootleggers to fill in their desired fine print when choosing the means. And of course, with 17 percent of the economy weighing in the balance, suitably designed health care reform legislation could pump billions of dollars in the direction of the hard-working Bootleggers.”
Given Baptist cover for bootleggers’ activity, the authors conclude, “This is ultimately how Americans ended up with a ‘reform’ package that seems highly unlikely to achieve its twin purposes: reducing health care costs while expanding health care coverage. … We submit that the twin demands of winning Baptist sympathy while placating Bootlegger economic interests played a decisive role in determining the final shape of Obamacare.”
For more evidence of bootleggers and Baptists at work in the health care arena created by Obamacare, look no further than the latest issue of Bloomberg Businessweek.
The battle over soaring U.S. drug prices is heading for the states.
With the price of some treatments topping $100,000, patient groups are pushing for state laws to make sure insurers cover most of the costs. Their campaign is backed by an important ally: the drug industry.
Rules adopted in four states since last year cap what insurers can charge patients out-of-pocket for expensive medicines — typically, to $150 a month. Similar legislation is under consideration in at least nine other states, according to the insurance industry, driven in some cases by patient-advocacy groups supported by companies like Pfizer Inc. under a campaign called Cap the Copay.
If successful, the lobbying may short-circuit health insurers’ attempts to persuade drug companies to moderate their prices. By limiting copayments, drugmakers effectively insulate Americans with health insurance from the full cost of their products, relieving public pressure for lower prices. Without the flexibility to charge higher copayments for expensive medicines, insurers say the prices trickle down to all consumers in the form of higher monthly premiums.
“Proposals that place a cap on prescription drug coverage without addressing the price side, what’s charged for the drug, will only drive costs higher for patients, and for state governments, and for employers,” Karen Ignagni, president of America’s Health Insurance Plans, the industry’s Washington lobbying group, said in a phone interview. “It’s a shell game that’s being played on consumers.”
