In the sense that they know people are demanding reform, if they don't push a bill through that does not include a public option or if reform fails they are toast. As they put it-
"If healthcare goes down this year, you are going to end up with single-payer care much sooner than anyone expected"
http://articles.latimes.com/2009/jun/07/business/fi-healthcare7?pg=1"The rate of aging far and away exceeds the birth rate," said Sheryl Skolnick, a CRT Capital Group healthcare investment analyst. "That's got to be very scary. . . . This is the biggest fight for survival managed care has ever faced, at least since they went bankrupt in the late '80s."
With Democrats in power and public sentiment strongly in favor of change, the industry can't afford to just say, "No; we're against this," said Julius Hobson, a Washington, D.C., lobbyist for hospitals and insurers with law firm Bryan Cave.
"This time, you get the sense something is going to happen," he said. "So to stand up and just say no is probably not wise, because politically you could get run over."
For insurers, getting "run over" would be the adoption of a so-called single-payer plan, where the government pays all medical bills. Such a plan would wreak havoc on the private insurance market, and is widely viewed as politically unfeasible this year.
So the best way for the industry to preserve the private insurance market -- and derail the campaign for a single-payer system -- may be to go along with more palatable proposals on the table now, said Jeffrey Miles, a healthcare analyst and president of the Miles Organization, a Los Angeles insurance brokerage firm.
"If healthcare goes down this year, you are going to end up with single-payer care much sooner than anyone expected," he said.