Thursday, January 7, 2010

Return of the Usual Suspects: Shadowy Interest Groups Lobby on Health Reform

Dan Eggen, in the Washington Post:

--wanted to know who pays for some of the lobbying activities around health reform legislation. In some cases it's clear who pays what piper; in other cases the organization is registered as a nonprofit and it's harder to track down where the money trial leads. In the process Eggen reintroduces us to some of our ol' friends from "astroturf" days, that we have encountered previously in this blog, or even when I was writing HOOKED. (For newcomers, "astroturf" relates to false grass roots, and describes an organization that is intended to look like a legitimate, grass-roots citizen advocacy group, when in fact it is almost completely bank-rolled and controlled by powerful corporate interests channeling their funds through their usual PR apparatus.)

The oldest of our old friends (in more ways than one) is the 60 Plus Association, a self-proclaimed conservative alternative to the AARP. When AARP was lobbying against some Pharma-friendly provisions in the 2003 Medicare Part D legislation, notably the provision that prevents the government from using its buying power to bargain down drug prices, it found itself opposed by the 60 Plus Association, which posed as a legitimate senior advocacy group. As I recounted in HOOKED, investigations showed that this outfit and others like it were in fact the creations of Pharma-funded PR firms, and had no office addresses and no membership lists. 60 Plus in 2007 reported no membership dues and less than $2M in revenue. This past year 60 Plus has spent $9M on TV spots that attack health reform as an evil plot against seniors. The "founder and president," James L. Martin, insisted to Eggen that 60 Plus had received no funding from drug companies, insurers, or the Republican Party, but refused to say where the money did come from.

Other old friends: Partnership to Improve Patient Care, headed by former Congressman Tony Coelho, "formed by the drug industry in November 2008 to lobby against binding government effectiveness studies"; and Center for Medicine in the Public Interest, a "think tank" led by Peter Pitts, who co-incidentally works as global healthcare chief at Porter Novelli, a PR firm who is employed by many big drug firms. Eggen reports that Pitts earned $250,000 in 2007 as head of CMPI, but did not report what his other job at Porter Novelli paid during the same period.

The blurred money trail provides some insights into how a drug firm, if it wished, could have it both ways. Through PhRMA, the firm could get brownie points by insisting that it is pro-health-reform and even is willing to give up some future profits in the name of being a good corporate citizen. Behind the scenes, via one of these PR or lobbying efforts, the firm could be working to assure that whatever bill is passed is one favorable to Big Pharma.


Michael Kirsch, M.D. said...

"the firm could be working to assure that whatever bill is passed is one favorable to Big Pharma. " Don't you think that there is enough backroom and secret dealings to favor Big Government? I suspect that various stakeholders have adopted the 60-plus strategy to further their own interests and to disguise their identity.

Howard Brody said...

Dr.Kirsch: I appreciate your thoughtful comments and contributions as always. In this particular instance, no, I do not think there are enough backroom and secret dealings to favor Big Government. There is today no political party that represents Big Government. The Reagan Revolution scared the Republicans and Democrats equally and no one will today advocate for a mainly governmental solution to a problem. As evidence I could simply point to single-payer health care. This reform proposal is highly favored by many policy analysts, and would, according to all projections, save a lot more money quicker than any alternative reform plan. Yet it was never even on the table for discussion and at one point Sen. Baucus had some single payer advocates arrested when they tried to speak up during one of his committee hearings. Nor were non-single-payer (but heavily government regulated) European systems such as Netherlands and Germany, that save a lot of money compared to ours, ever seriously considered as possible models for reform. Best wishes, Howard

james gaulte said...

Two thoughts:

1) Do you consider ARRP a legitimate senior advocacy group or an insurance brokerage outfit who will benefit from limiting the Medicare Advantage?

2) I see the two parties a bit differently.I see them as both regularly bringing about more government generally(contrary rhetoric notwithstanding) and/or more government programs which favor special interests (contrary rhetoric about serving the public notwithstanding) a number of which can be characterized as "Baptist and the Bootleggers". I agree neither party labels themselves as big government advocates but government grows and grows regardless of which party hold the upper hand.

James Gaulte (Retired Doc's thoughts)