The private, for-profit health insurance companies will always be the enemies of true health care reform. The problem is that they are a pure waste in the system. They are the financial equivalent of a parasite. Medicare does a better job than they do. Even if they could play a limited, positive role in a truly workable all-payer system, private insurers would fight that because it would require dramatically shrinking their power and profits. In this post-Citizens United world, the for-profit insurance companies are planning to spend big to influence the upcoming elections:

WellPoint Inc., UnitedHealth Group Inc. and three other health insurers, criticized by Democrats during the overhaul debate, are seeking to influence how the new law will be implemented, and possibly change it, by campaigning for supportive congressional candidates.

Senior government-relations staff from UnitedHealth, WellPoint, Humana Inc., Aetna Inc. and Cigna Corp. have been meeting for at least two months to discuss the plan, which may include creation of a $20 million war chest, said two people familiar with the matter.

The for-profit health insurance companies plan to spend millions over the coming years to fight true reform and to fight members of Congress who support reform. This is why the new health care law was never a step toward reform. By funneling hundreds of billions in government subsidies to these companies and forcing millions of Americans to become their customers, the new law make these enemies of reform larger, richer and more powerful. Progressive Democrats will suffer in future elections because instead of using the new health care law to weaken their enemies, they used it to impose mandatory membership while shoveling huge government subsidies to them. They have provided these behemoths with even more money to use in political ads against progressives.

I suspect the failure to weaken the power of the insurance companies and reduce their size by creating a public option will cost Democrats for decades. From both a political and policy perspective, it was a terrible idea. Democrats are going to have a lot of fun trying to prove to Americans that they did a good job with their health care reform bill when their chosen partners for implementing it, the private health insurance companies, intend to fight and undermine it.

I don’t know what strange world progressive or Democratic base voters live in, where they were able to convince themselves this new law was a victory. Making your long- term enemies larger and providing them with billions in new resources is a strategic defeat. Democrats passing a law making the purchase of private health insurance mandatory is like Republicans passing a law making labor union membership mandatory at every workplace.