It was an odd scene. There was Karen Ignagni, head of the health insurance lobby, introducing President Obama’s Health and Human Services Secretary Kathleen Sebelius. Before the two women shook hands today at the insurance industry’s annual conference at the Ritz-Carlton in Washington DC, Ignagni said to Sebelius, “It is a delight to welcome you here today to speak with us.” A delight?

Sebelius has been heavily criticizing the health insurance industry in recent weeks, castigating insurers for double-digit premium hikes and rising profits. Meanwhile, the insurance industry just launched a seven-figure television ad campaign that blames hospitals and doctors for driving up health spending – the implication being that the Democratic reform bills don’t do enough to cut costs.

Both women were smiling at each other today, but I imagine they were simultaneously biting their tongues and grinding their teeth.