World and Nation

At Obama Health Care Meeting, Goals Not Shared

President Barack Obama engineered a political coup on Monday by bringing leaders of the health care industry to the White House to build momentum for his ambitious health care agenda.

Obama pronounced it “a historic day, a watershed event,” because doctors, hospitals, drug makers and insurance companies voluntarily offered $2 trillion in cost reductions over 10 years. The savings, he said, “will help us take the next and most important step — comprehensive health care reform.”

Robert Gibbs, the White House press secretary, said Obama had told the health care executives, “You’ve made a commitment; we expect you to keep it.”

If history is a guide, their commitments may not produce the promised savings. Their proposals are vague — promising, for example, to reduce both “overuse and underuse of health care.” None of the proposals are enforceable, and none of the savings are guaranteed. Without such a guarantee, budget rules would normally prevent Congress from using the savings to pay for new initiatives to cover the uninsured. At this point, cost control is little more than a shared aspiration.

Still, the event was significant. There was something in it for Obama, and something for the industry — though not necessarily the same thing. Their interests overlap but do not coincide.

For Obama, the White House meeting was an opportunity to showcase his consensus-building approach. He is not cracking the whip on the health care industry so much as wooing it, just as he said he would in the campaign.

For the health care and insurance executives, the savings initiative helps them secure a seat at the table where many decisions about their future will be made in the next year. They also ingratiated themselves with Democrats in the White House and Congress who are moving swiftly to reshape the nation’s health care system.

“We came together in a serious way a couple of weeks ago,” said David H. Nexon, senior executive vice president of the Advanced Medical Technology Association, one of the six health care industry groups that promised to lower costs.