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As Long as We Remember...

August 3, 2009

Failure may be the only option

Richard B. Weldon Jr.

Okay, by now you have to have spent time wondering why, in spite of all of the rhetoric thrown around over the last few decades, we’re no closer to substantive and meaningful healthcare reform than we’ve been before.


Ignore the partisan biases, if you can. Set aside the conditioned obligation to blame insurance companies, doctors, lawyers, brokers, pharmaceutical manufacturers, or anyone else associated with the system, at least for now.


To put it simply, the system is designed for failure: failure to achieve reform; failure to limit the role of the insurance carrier in your doctor/patient relationship; failure to control the cost of prescription drugs; and failure to limit nonsensical multi-million dollar verdicts for either honest mistakes or frivolous claims.


Americans are skeptical of the Congress and its ability to actually deal with an issue as complex as reforming our healthcare delivery system. In a recent national poll, 60% of voters expressed the belief that members of Congress place the interests of contributors over the needs of constituents; and 79% believe that dependence on excessive campaign contributions will prevent the Congress from acting on tough issues.


Oh, really? Common Cause, a national issues advocacy organization, has studied the question of the influence of political contributions by special interests on health care reform. The results of this study are equal parts illuminating and unsettling.


The healthcare industry, composed of insurance companies, brokers, hospitals, drug makers, and healthcare professionals, have spent over $1.4 million a day lobbying our Congress this year. The report, entitled “Legislating Under the Influence” and available through Common Cause’s website, offers a number of startling insights.


Health industries – including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals – have contributed over $372 million in campaign contributions to members of Congress since 2000.


Political spending by the health industries has increased 73 percent since 2000. Health interests contributed about $94 million to candidates for Congress in the 2008 election cycle, up from about $54 million in the 2000 cycle.


Members serving on committees and subcommittees with jurisdiction over health care reform in the House and Senate received the lion's share of health industries' largesse.


Committee members raised $178 million from the industries this decade – roughly half of the industries' contributions to the entire Congress. Since 2000, the House members sitting on health committees have raised twice as much money from the health industry per election cycle as non-committee members (an average of $171,000 compared to $87,000), and the average House member on a key health subcommittee hauled in three times as much per cycle ($269,000). Senators with plum committee posts also enjoy sizable fundraising advantages.


The industries engage in "switch-hitting" – shifting campaign contributions between Democrats and Republicans to win access with the party in power. In 2000, with Republicans controlling the House and a closely-divided Senate, Republicans on health-related committees received more than double what Democrats received (68 percent to 32 percent) from the health industries. In 2008, with Democrats controlling both the House and Senate, over 61 percent of the industries' contributions to committee members went to the majority Democrats and just 39 percent went to Republicans.


The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end of 2009. That comes out to about $2,600 per day per member of the House and Senate. The pharmaceutical lobby alone spent $733,000 per day in the first quarter of 2009. Since 2000, the industries have spent over $3 billion on lobbying, with the total increasing every year and rising more than 142 percent over the course of the decade. In each of the past four years health interests have been the number-one lobbying force in Washington, measured in expenditures, and have averaged over $1 million per day.


Groups like Common Cause and the Center for Responsive Politics remind us that there are forces beyond the strictly ideological that confuse and confound the process of legislating a solution of any kind.


Are we being overly optimistic to believe that real reform is possible in this environment? Are we destined to suffer under a system in which we can all identify major flaws simply because the gang we’re counting on to do the hard work has almost no incentive to do it?


We elect a new House of Representatives every two years. That places incumbent members of Congress in the position to be perpetual fundraisers. Is it any wonder that those who serve on committees dealing with healthcare would look to the industries they regulate as sources of easy campaign money?


It would be like asking Willie Sutton to take a post-prison job counting and stacking currency in a bank vault, in more ways than one. Willie, despite his desire to do the right thing, would be so tempted that we’d almost be setting him up to fail.


See what I mean?

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