Bad news for investors in the health-care industry: the companies you invest in just pledged to give back 1.5% of their expected U.S. revenue growth to President Obama yesterday. Maybe.

Industry leaders from across the sector -- representing health insurers like UnitedHealth Group (NYSE:UNH) and Aetna (NYSE:AET), doctors, hospitals, drug companies like Pfizer (NYSE:PFE), and medical-device makers like Boston Scientific (NYSE:BSX) -- pledged to cut $2 trillion in costs over 10 years.

The difference in health-care reform this year compared to the Clinton-era health-care reform is remarkable. In the 1990s you had the health insurers running ads featuring "Harry and Louise" sitting around their kitchen table talking about what a terrible idea health-care reform was. Now everyone's holding hands and hanging out at the White House together.

So what changed? Well, clearly the health-care industry figures it's easier to set policy from within rather than fight it this time around, but there could be an additional motive for volunteering to give up that future revenue.

Is there a pill to cure bad PR?
Not that I know of, but the health-care industry, and pharma in particular, could certainly use one.

The sharply rising cost of prescription drugs makes pharma look bad. Consumers don't care that research and development costs megabucks and that companies only have a limited time to recoup those costs before a drug begins to experience generic competition. All they see is the hit to their pocketbook.

Direct-to-consumer advertisements don't make things better. Companies run them because they work, but the ads aren't exactly public relations-friendly, because they flaunt the fact that pharma is making money off of customers' illnesses. The worst part is that life-saving drugs, like cancer treatments from Bristol-Myers Squibb (NYSE:BMY) or Eli Lilly (NYSE:LLY), where the companies might be able to score some brownie points for saving lives, typically don't have direct-to-consumer advertisements, because ads targeted to doctors are more effective.

Merck (NYSE:MRK) has even run into public relations issues when marketing to doctors. The company published articles in a bound magazine that was made to look like a scientific journal and even had an official sounding title: Australasian Journal of Bone and Joint Medicine. The idea of a compilation of articles about Merck's drug wasn't a bad idea, but the company should have marked it as an advertisement and not try to fool doctors into thinking this was a reputable source of peer-reviewed information.

Will this really hurt investors?
Health care reform may ultimately hamper margins a tiny bit, but the industry's pledge isn't likely to change things much.

First, there's plenty of waste in the system. From pharmaceutical companies cutting unneeded sales reps and outsourcing R&D to getting uninsured patients taken care of earlier before their health problems fester into larger, more expensive issues, there's plenty of costs that can be cut from health-care spending. If companies pass some of those savings on to customers, margins won't be hurt and investors will see the cash continue to flow in.

Second, and more importantly, who's really going to know if the industry actually saves Americans the $2 trillion promised? Even if someone goes back and checks, pledging the cuts to the White House as a group allows individual companies a way out by blaming the other members of the group if that goal is missed.

Health-care reform will happen; the cost of health care can't grow faster than GDP forever. But that doesn't mean that investors should abandon the sector. The industry has clearly decided that it can work better from the inside and if it can increase the number of people in the system -- by requiring health insurance, for instance -- then companies may be able to drop costs but keep overall revenue (and profits) up.

Investors just need to keep an eye on the progress. Whether Obama and Congress will go for that remains to be seen.

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