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Health sector lobbyists shovel big $ to McCain, Obama

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In an article in today’s New England Journal of Medicine, journal correspondent Dr. Robert Steinbrook analyzes the millions of dollars making their way to the campaign coffers of both parties and both presidential candidates.

As of July 2008, health lobby contributions added up to a paltry 3% of all presidential campaign contributions. Still, $29 million is nothing to sneeze at. And this election cycle, the health sector, represented by health professionals, hospitals and nursing homes, and pharmaceutical and health products industries, reversed a long-standing trend by giving more money to Democratic presidential candidates ($17.7 million) than to Republican candidates ($11.2 million) from January 2007 to July 2008. That’s according to the Center for Responsive Politics and reported by Steinbrook.

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Of that haul, Sen. Barack Obama received $8.8 million and Sen. John McCain received $4.7 million. The last time the Democrats got more money from health interests than Republicans was 1992, when Bill Clinton was running for his first term.

But those millions are just presidential campaign contributions. Since 2006, the health sector has spent more money on lobbying the federal government than any other sector of the economy. In 2007 alone, interest groups representing healthcare spent $450.7 million in lobbying efforts -- some $35 million more than the financial sector shelled out.

A lot of donors cover themselves by contributing to both parties. But here’s what Steinbrook says about why the Democrats might be raking in more this election cycle:

‘Like other groups, healthcare interests seek access to and influence with candidates and elected officials. The Democrats’ fundraising advantage probably reflects the likelihood that they will continue to control Congress, regardless of who becomes president. However, it may also reflect other factors, such as a perception that healthcare is a more important issue for Democrats than Republicans, the realization that Obama’s proposals are more likely to increase federal funding for healthcare and to expand federal regulation of health insurance than McCain’s, and the greater potential for new legislation affecting the sector if Obama is elected and the Democrats extend their control of Congress.’

The two candidates’ plans for healthcare reform are vastly different, Steinbrook writes.

Another article in the Aug. 21 New England Journal of Medicine summarizes the differences. ‘The candidates’ opposing views of healthcare reform reflect fundamentally different assumptions about the virtues and vices of markets and government,’ writes Jonathan Oberlander, professor of health policy and administration at the University of North Carolina at Chapel Hill and author of the article.

The centerpiece of the McCain plan, Oberlander writes, is a change in the tax treatment of the employee health insurance benefit. Now, employees don’t pay taxes on that benefit. Under McCain’s plan, they would be taxed on their insurance benefit, and the revenue from those taxes would fund tax credits ($2,500 for individuals; $5,000 for families) to obtain private insurance. There would be an insurance pool to guarantee coverage for those with pre-existing conditions or who are otherwise uninsurable. His plan also calls for deregulation of the insurance markets, as well as Medicare reform, enhanced competition, faster introduction of generic drugs, emphasis on preventive care, greater use of information technology in healthcare, and malpractice reform.

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Obama’s plan, Oberlander summarizes, includes a ‘play or pay’ employer mandate requiring businesses to offer health insurance or pay a tax, creation of a new national health plan, like Medicare, for the uninsured and small businesses, a mandate that all children be covered, subsidies for low-income Americans, and increased regulation of private insurance plans to end risk-rating based on health status. His plan also includes accelerated adoption of electronic medical records, emphasis on disease prevention, provider payment based on performance and outcomes, allowing Medicare to negotiate prices with the drug industry and the establishment of an institute, akin to the National Institutes of Health, to research the effectiveness of treatments and medical care.

Whoever wins, the health sector is putting up its money. Steinbrook writes: ‘Regardless of whether Barack Obama or John McCain becomes the next president of the United States, there is no shortage of healthcare money seeking to influence what happens after the votes are counted.’

--Susan Brink

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