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What's Been Taking So Long?

From Politico's Pulse:

The weekend included high drama for the drug industry as lobbyists huddled with Democratic staffers to work out a fee structure and donut-hole fix that wouldn’t bust the $90-billion commitment they made to pay for reform, industry sources said. Drug makers were asked to sign off on multiple solutions so that backup options were available should any of the fixes run into problems passing muster with the Senate parliamentarian. The industry also decided to drop its push to be carved out from an independent Medicare payment advisory board--vowing instead to fight it if it becomes law, sources said. There was “real heartburn with the bill over the weekend and over the last week,” an industry source said. But insiders expressed confidence that their issues were on the road to resolution.

The broad outlines of the eventual House-Senate compromise on health care reform have been clear for a while now. But nailing down the details isn't easy, as the excerpt above suggests. And it's particularly difficult because lawmakers don't yet know what the Senate parliamentarian will rule outside the bounds of reconciliation. Throw in the need to get acceptable Congressional Budget Office estimates, and you can see why this process has taken as long as it has.

One worrisome note: I had been hoping that, as part of the final package, reformers would manage to extract at least a little more money from the drug industry. That may not be the case, although it's good reformers at least got the industry to back down from a demand drugs be exempt from the new Medicare advisory board.