Speaking before a crowd of insurance industry officials on Wednesday, President Obama's chief health care aide Kathleen Sebelius argued that they should embrace reform of the system rather than fighting it -- or else suffer the consequences in the form of lost customers.
"I'm hopeful that you will take the assets that you have, the influence and the bully pulpit that you have and use it to start calling for comprehensive reform to pass. Start looking at giving Americans some relief," the Health and Human Services Secretary said. "Instead of spending energy attacking parts of the proposal that you don't like come to the table with strengthening the parts that are there that you talked about from the beginning are central to comprehensive reform."
Sebelius's speech came on the second day of a conference hosted by the major insurance industry lobby group -- America's Health Insurance Plans -- in Washington D.C. One day prior, a host of union officials and progressive leaders had led thousands of protesters in a demonstration outside the same conference, accusing insurance giants of being "dark titans" and "domestic enemies" and calling for citizen arrests.
The Secretary's approach was a bit tamer. While she did occasionally take a tough tone with the AHIP crowd, the remarks were more conversational than lecturing. Indeed, some of the toughest snippets of the prepared remarks that the White House sent out to reporters were toned down in the actual address. Instead of calling out the lobby for launching a late-stage million-dollar ad campaign to defend their opposition to reform, Sebelius spoke more broadly about how the president's plan and AHIPs demands actually weren't that far apart.
"Over the last year we have seen tens of millions of dollars spent by the insurance industry spent on ads to help kill health reform and we started with a conversation a year ago saying this was an important step," she said. "And it might be understandable if the president or Congress was proposing something radically different than the plan you put forward yourself. For example if we started with the premise that we should just eliminate the private insurance market in order to do some kind of single payer system like Europe and Canada. And as you know there are members of congress who favor that kind of structure. But the president believed we should build on the existing system."
The somewhat cordial tone was set from the start, when Sebelius insisted that, despite the hype, she was not there "to vilify hardworking employees of insurance companies across the country." (The crew from the Daily Show, which grabbed and filmed attendees as they left the room, will probably take care of that.)
That said, Sebelius did make the case that health care reform was an economic imperative, both for the country and, longer-term, the insurance market representatives sitting in the ballroom.
"You can continue the opposition to reform, and if you do, and reform fails, I can give you a pretty good prediction of what happens next," she said. "By next march, when you are meeting again, premiums will take even a bigger bite out of American's wages, your market will shrink even further, more Americans will lose their employer sponsored insurance and we will have a situation where the market is unsustainable."
Adding a human element to the speech, she urged attendees to put themselves in "the shoes of your remaining customers for a moment" -- citing reports of sharp increases in premiums throughout the country. Sebelius asked those in attendance to pledge to be more transparent about their billing practices, including providing justification for the rate spikes.
On this narrow request -- and on her broader hope that AHIP offer constructive suggestions to improve the health care bill -- she was taken up on her offer.
"We accept the secretary's challenge to come back to her in a very short period of time with specifics to be added to the legislation that can help with cost control," said AHIP's CEO Karen Ignagni. "We will follow the AHIP practice of sharing information, making sure we are doing absolutely everything to insure that where we have diagnosed a problem we are doing everything we can to find solutions."