The New England Journal of Medicine has an online article detailing the amount of money being spent by health-related organizations this year on lobbying. (NEJM Article) The amounts are phenomenal. For the first nine months of this year, almost $400 million has been spent and it is a safe guess that the spigots haven’t closed up recently. Pharmaceutical and other health product companies led the way with $200 million; hospitals followed with a healthy $77.5 million; health care professionals chipped in $60 million and health plans and health service companies trailed at $53 million. No wonder insurers are getting beat up the most–they aren’t spending enough on lobbying or contributions.
The article also discusses campaign contributions and again, health interests rank very high among industries. Given the somewhat secretive and very rushed process of drafting the various bills, it is quite realistic to imagine that these lobbyists are actually writing much of the language and getting a lot of what they want in the proposals. Hard to see how a good reform that is really best for the country and its citizens comes out of a process so dominated by moneyed interests.
A good example is malpractice reform. The Congressional Budget Office, responding to a letter from Senator Jay Rockefeller, reinforced its earlier conclusions that malpractice reforms would both lower malpractice premiums and lower health spending by reducing defensive medicine. (CBO Letter) The CBO strongly reinforces its belief that current research demonstrates that savings will occur, to the tune of $54 billion in federal deficit reduction alone over the next ten years. Across all health spending, the effect would be even larger. CBO also said there was no research evidence to support the notion that tort reform would worsen health outcomes. Senator Rockefeller was clearly carrying the plaintiffs’ bar’s water and properly got rebuffed. Quick, check and see how much he and others have received in campaign contributions from those trial lawyer groups. So here we have a mechanism for creating substantial savings, which could be applied to pay for health coverage for the uninsured, but campaign contributions from plaintiffs’ lawyers will keep it from even being seriously considered. Is this a great country or what?