The real obstacle to health care reform is becoming clearer by the day. It’s the country’s patchwork system of services, a hodge-podge of private for-profit entities with their own special interests to protect.

And here’s the kicker: Much of it has nothing to do with actual delivery of medical care.

Insurance companies have been spending millions of dollars lobbying Congress, particularly the Senate, to kill the public option plan. The U.S. Chamber of Commerce would like to see a proposal mandating employer insurance coverage shot down. Both objectives are now in sight as “moderate” Democratic senators cave in to their demands.

But it’s not over. Pharmaceutical companies have yet to weigh in. Look for their campaign – and it’s going to be a big one – to begin when Congress gets back from their recess in September.

See Bloomberg’s report today on drug companies’ $100 million ad campaign on health overhaul.

Not surprisingly, pharmaceutical companies don’t like the idea of allowing Medicare – or a government-based public option plan – to negotiate lower drug prices. Nor do they appreciate an option that wold allow the purchase of prescription meds from Canadian companies.

Watch for hard and sharp attacks on both of these proposals.

The campaign is being run by The Pharmaceutical Research & Manufacturers of America (PhRMA), the Washington-based lobbying arm representing 28 drug makers, including Pfizer and GlacoSmithKlein.

The industry did cut a deal with the Obama administration to discount brand-name drugs for Medicare recipients who fall into coverage gaps. It will supposedly lower drug costs by $80 billion over 10 years.

PhRMA will be trying to get two basic messages across. One is that re-importation of drugs is “a safety issue” that could put patients in the U.S. in jeopardy.

“We will have to fight that because we think that is the wrong thing to do from a patient standpoint,” Merck & Co. CEO Richard Clark told Bloomberg.

We should find it comforting that it has absolutely nothing to do with money, making sure investors get their 10 percent, and guaranteeing that execs get their multi-million-dollar bonuses. It’s purely a safety issue.

The second message is that negotiating lower prices will lead to fewer research projects and therefore negatively impact medical progress.

This is why real health care reform is falling victim to a thousand cuts.

If 10 people are holding a document, and each one is pulling in a different direction, it gets torn apart. It’s beginning to sound like that will be the fate of the country’s latest, greatest effort to give everybody access to health care.





