The healthcare industry, especially including insurance companies, derailed Bill and Hillary Clinton's reform efforts in the early 1990's. With President Obama, they're taking a different approach. In a letter to the White House, they've promised to reduce the growth of healthcare spending by $2 trillion over the next decade—all by themselves. The President lost no time in releasing it today with familiar rhetoric about the skyrocketing cost of healthcare. Noam Levey writes about health reform for the Los Angeles Times.