Commentary—

Health Care Players Must Pay

By Lindsay Renick Mayer

How Congress aims to reform America’s health care system can be literally a matter of life and death. For some industries, it could mean the difference between weathering the economic storm or shuttering their businesses. Nobody knows yet what the shape or scope of the final bill will be. It may not even make it to President Obama’s desk.

But one thing is certain: the American health care system is set to get a lobotomy and diverse special interests are spending big bucks to make sure they’re in the surgery room when it happens.

“Whenever the government delves into some part of the private sector, by necessity it triggers the interest of any private entity involved in that area,” said Michael Franc, vice president of government relations at the Heritage Foundation. “When the government has the authority to determine prices for any kind of service or the terms and conditions under which people receive health care, all the different provider groups will have to get involved. They’ll have to or they won’t survive.”

Starting in the 2008 election cycle, the health sector has given more money to Democrats — who had seized control of Congress in 2006 — than to Republicans, according to the nonpartisan Center for Responsive Politics. This was the first time since the 1992 election cycle, right before the Clinton administration’s failed health care reform attempt, that the health sector made Democrats its financial darlings.

In the 2008 election cycle, the sector gave $90.7 million, or 54 percent of the total, to Democratic candidates and party committees, compared to $76.6 million to Republicans. That difference is even more pronounced in the first three months of 2009, when Democrats collected 60 percent of the total $5.4 million in contributions. Obama, who made health care reform a large part of his presidential election platform, brought in $18.8 million from the health care sector in the 2008 election cycle — far more than any other presidential hopeful.

Health providers, insurers and pharmaceutical companies have taken multiple approaches to winning over the federal lawmakers shaping the legislation. The health sector boosted its campaign contributions compared to the last presidential cycle, to $167 million in 2008 from $123 million in 2004. The various health industries have also steadily increased their lobbying efforts, from $448 million in 2007 to $484 million in 2008. So far this year, the sector has paid lobbyists $126.8 million to do its bidding on Capitol Hill. And those expenditures will only increase as the chairs of the five main committees working on health care legislation continue to iron out the details: Will the plan include a government insurance option? Will Congress mandate that all individuals, including the 47 million that are currently uninsured, purchase health insurance? And where will the money come from to pay for the reforms?

The health sector — which includes some industries that are diametrically opposed to one another in their answers to these questions — eclipses all other sectors but the financial sector in lobbying spending since 1998, putting $3.4 billion into its efforts.

Of course, it’s not just the health sector that has something at stake — or something to gain. Business associations, labor unions, environmental groups, high-tech companies and consumer advocates are also trying to shape the final outcome, weighing in on the public option, the individual mandate and how best to cut costs. They’re also mining through the more nuanced, industry-specific details among the hundreds of pages of draft legislation.

Because Democrats hold comfortable majorities in both the House and Senate, the industries now face an atmosphere that is much different from the Clinton years, when it was easier to oppose proposals without much fear of retribution. And with a Democratic president whose vows of comprehensive reform helped get him elected, industries that traditionally didn’t feel they needed to make concessions are growing defensive. All financially interested parties now sense that they must pay to play.

(Lindsay Renick Mayer writes for Capital Eye, the online newsletter and blog of the Center for Responsible Politics, a nonpartisan research organization in Washington, D.C., that tracks the influence of money on elections and public policy at its website, www.opensecrets.org.)