The old saying, “Never look a gift horse in the mouth,” has a lot of subtle shades of meaning - especially when you look at the $80 billion PhRMA has put on the table and $155 billion hospital groups are prepared to give up to fund health care reform.

Is the root of the saying that it’s rude to be critical of a gift, or that you won’t like what you see when you check the teeth on that horse?  Or perhaps, if you plan to be skeptical you shouldn’t even accept the gift?

While the left takes these industry commitments - along with the Wal-Mart endorsement - as signs of impending victory, it is important to look at the critical questions a few news organizations are starting to ask.

Politico’s Carrie Budoff Brown pointed out that the hospital deal is less than the $200 Billion Obama suggested cutting from hospital payments.

“There was no way we could tolerate $200 billion,” an industry executive told WaPo’s disgraced reporter Ceci Connolly, writing with Michael D. Shear over the weekend.

Politico’s report continues:

Budoff Brown also suggests taking the deal could blunt industry opposition and lobbying against the reform bills.

The two nags together don’t come close to the $2 billion in savings industry groups pledged in May to support reform, Brown points out.

Elsewhere on Politico, David Rogers  takes on the PhRMA offering in particular.

His article Drug deal may be bad trip for Dems suggests the pharmaceutical industry is openly and callously playing the Senate and House reform leaders against each other with the elderly caught in the middle - a new, more humiliating donut hole.

“About 6 million low-income elderly, who had received some drug benefit under Medicaid, were moved into the new Medicare D program in 2006, and this shift effectively freed drug companies of the tougher rebates demanded under Medicaid. ”

Not to mention details of the gift that would require seniors to buy more name-brand drugs instead of generics.
The deal Baucus made with PhRMA in 2003 effectively put $86 billion back in the drugmakers’ pockets, Rogers writes, suggesting this gift really isn’t much of a concession in the first place.

So while the Huffington Post and Sen. Chuck Schumer, D-N.Y., crow about the new Senate Democrat supermajority making reform fillibuster-proof (not to mention Republican-proof), other’s aren’t so sure about calling the race just yet.

What Carrie Budoff Brown and David Rogers hint at, RedState’s Moe Lane spells out explicitly - Senate Democrats’ 60-vote supposed majority evaporates pretty quickly when you consider industry money-influence in a number of vulnerable 2010 races (in districts John McCain carried, no less).

“That would be Senators Bayh, Bennett, Gillibrand, Lincoln, and Specter, mind you.  After all, none of you are scared of taking a firm position on an issue that’s splitting the country right down the middle, are you?” Lane taunts.

The New Republic’s health care blog, The Treatment, takes on both industry groups, looking for the bad teeth in their bites.

Still, you have to wonder: Could these industries be giving up more? The drug deal, at least, doesn’t look all that great–except, perhaps, to the drug industry. My reading of the agreement–and, to be clear, there’s still a lot of ambiguity here–is that the drug industry has agreed to kick in some of its own money to help fill in the “donut hole” in the Medicare drug benefit.

That’s very nice and will, I think, make it easier for seniors to afford their drugs. But it also seems that, as part of the deal, seniors have to buy more drugs from name-brand manufacturers rather than generics. It’s entirely possible that the name-brand drug industry – that is, the companies represented by PhRMA – could actually come out ahead.

… And in terms of the hospital groups’ offerings, Jonathan Cohn writes:

“On the other hand, it’s not clear whether, perhaps, this is an example of some hospitals effectivelly cutting a deal that hurts others. Insofar as the savings come from reduced payments for charity care–payments that now flow through Medicaid–is this a case in which suburban and speciality hospitals actually do just fine but charity hospitals take a hit?”