Do Obama’s deals with hospitals break pledge?

WASHINGTON - In cutting deals with hospitals and drug makers, President Barack Obama is giving a private inside track to special interests that's at odds with his promise to make policy in the open.

Obama promised Americans he would hold special interests at arm's length — that it would no longer be business as usual in Washington. He pledged to open government and let the public and press hold his administration accountable.

And just over two months before the 2008 election, Obama promised before an audience in Chester, Va., to hash out a health care overhaul in public. "We'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies," he said then.

That didn't happen.

Deals have been made in private
Instead, the administration's multibillion-dollar deals with hospitals and pharmaceutical companies have been made in private, and the results were announced after the fact. Both industries promised Obama cost savings in return for an expanded base of insured patients; beyond that, the public is in the dark about details.

In some ways, it resembles what his party criticized President George W. Bush for doing with oil and gas companies as Vice President Dick Cheney wrote a national energy plan in the early days of the Bush administration.

As the Bush White House did, the Obama White House is refusing to release visitor logs that would let people see everyone going in and out during the thick of discussions over major national policies.

Just as environmentalists complained they were shut out as Cheney drafted energy policy, employers now complain that the Obama administration isn't giving them enough say in health care policy. Like the environmentalists, employers fear a new policy will come at their expense.

"There's beginning to be a little bit of, 'Where are all these deals getting us?'" E. Neil Trautwein, chief health care lobbyist for the National Retail Federation, said recently, referring to business concerns that the hospital and drug company pacts would force employers to pay more for workers' medical benefits. "Is this going to add to the process or subtract from it?"

The White House had no immediate comment.

Less practical to open the door
So what happened to the promises?

When cutting special interests out of his campaign and then his administration, Obama targeted people currently registered as Washington lobbyists. He never said he would cut off the companies, unions, trade associations and others that employ lobbyists — just lobbyists themselves. And even then, he has made exceptions here and there.

Presidents, regardless of party, prefer to keep their dealmaking private, obscuring what's being said, what's being taken and given, and by whom. It's messier and less practical to open the door to a lot of public input, particularly on a national scale. It's much easier to use polls to gauge what the public thinks.

That means the interests whose ideas make it into national policy are usually those with the money and clout to press their case in Washington and the power to block any idea they haven't helped shape.

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