Deals with a broad consortium of health industry groups promised to slow the growth of medical spending by 1.5%. Then, it was a deal with big drug makers, promising savings of $80 billion over 10 years, by lowering the cost of medicine for the elderly. Now major hospital associations are pledging to save more than $150 billion over a decade. But what has been little discussed is what the industry groups will be getting in return for their cooperation, whether or not the promised savings ever materialize.