Last week, we documented how the American Medical Association, which probably a the reputation among the laypublic for being a sage council of doctors, in fact is a rather aggressive lobbying organization, which has a history of giving mostly to Republican candidates for office.
The AMA, however, is hardly the only player in the health player game. Based on data collected from OpenSecrets.org, I've tallied the amount of contributions that each of the 99 current senators have received from Political Action Committees -- PACs -- from the health care industry since 1989. This includes PACs associated with pharmaceutical companies, hospitals, HMOs, health services companies, medical supply companies and physicians', dentists' and nurses' groups. It does not include any money collected from individual contributors -- only money collected from PACs.
For comparison, we've provided the overall amount of federal campaign funds each Senator has collected over the same period from all sources -- including PACs, individual contributions, and self-financing. The senators are ranked by the percentage of their overall bankrolls that they've received from health industry PACs; the top 10 follows below. We've also listed each senator's position on the public option -- a government-run health care policy that would be established to compete with private policies -- which vigorously supported by progressives and many health care wonks but is generally opposed by industry groups.
This is an interesting list -- five Democrats and five Republicans, with some surprising names (Sherrod Brown?) but mostly predictable ones. The senator who has been most dependent on special interest money is Mike Enzi of Wyoming, who has gotten about 12 percent of all of his campaign funds from health care lobbying groups. Enzi, who is quite conservative overall, has been more proactive and moderate on health care, where he is the ranking Republican member of the Committee on Health, Education, Labor and Pensions. Whereas Enzi routinely describes his ideas as bipartisan, however, many Democrats regard them overly industry-friendly: Enzi's plan would not mandate coverage, for instance, nor prevent insurers from denying health care on the basis of pre-existing conditions.
The Democrat most dependent on health care lobbying money is Kent Conrad of North Dakota. This might give one some pause when evaluating Conrad's co-op plan or his skepticism about the Senate's ability to pass a public option.
Several other Senators who are regulars in the health care debate, like Democrat Max Baucus and Republicans Orrin Hatch and Chuck Grassley, also rank in the top 10 in their dependance on health care lobbying money.
In general, indeed, those Senators whom the health care industry seems most inclined to give money to are not necessarily those who are complete deadweight on the issue. Rather, it's those like Enzi and Conrad who are pushing solutions which are invariably described as bipartisan but which are in fact likely to lock in an industry-friendly plan. The industry appears to be resigned to the strong likelihood that a health care reform bill will eventually pass through the Congress, and knows that whatever does get passed, for better or for worse, will be hard to undo. They want to make sure it's a good one -- for them.
A complete list of all 99 senators follows below.
Overall, health care PACs have given an average of $482,870 to Republican senators and $407,979 to Democrats. There is a larger discrepancy, however, when the contributions are taken as a share of overall campaign funds -- the average Republican senator has gotten 3.6 percent of his funds from health care PACs, while the average Democrat has gotten 2.1 percent of hers.
Senators in favor of a public option have received, on average, $335,308 or 1.8 percent of their total campaign contributions from health industry PACs. Senators opposed to it have received an average of $486,629 or 3.5 percent. Undecided senators have gotten $530,968, or 2.9 percent of their total campaign funds, from health industry PACs.
Ranking relatively low on the list -- 61st of 99 -- is Ted Kennedy of Massachusetts, who has gotten $492,129, or 1.4 percent of his total campaign contributions, from these PACs. Ranking somewhere in the middle are Ron Wyden of Oregon and Bob Bennett of Utah, who have pushed a somewhat eccentric plan which lacks a public option but is nevertheless rather favorably reviewed by many health care economists and policy wonks.
6.16.2009
On Health Care, Who's Hooked on Special Interest Money?
by Nate Silver @ 9:00 AM...see also fundraising, health care, interest groups, lobbying
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35 comments
For Obama this is personal -- he hates insurance comapnies bc of what they did to his mommy.
Now we all ahve to go on Medicaid.
Good luck getting treatment!
petekent01 (on twiter)
What I wonder is weather looking at the medical industry as a whole is the most illuminating lens for health reform. Nate wrote "This includes PACs associated with pharmaceutical companies, hospitals, HMOs, health services companies, medical supply companies and physicians', dentists' and nurses' groups."
It seams to me that for several issues from malpractice reform to mandated coverage the interests of doctors and insurers might be divergent or even opposed. All these different groups might be on the same page with regard to the public option, but i suspect that, in general, there is not a whole lot they agree on.
Kaufman (DE) got zero money.
put him in charge of the commission for reform.
Doesn't it kind of make sense that the top of this list is dominated by senators from the smallest states? Fewer available individual donations=higher % of PAC money...
@redread,
The reason they're getting money is the public option. They'll scuttle it if they can. All those contributing groups have one thing in common: they do very well under the current system, and stand to lose something when a public option brings competitive pricing into the market. All the "yes" votes at the bottom of the list, all the "no" votes up top...no accident, that.
Are you sure you've purged all the individual contributions from the OpenSecrets data?
They often merge in individuals who work for an industry with the PACs for that industry.
I only ask because I was under the impression Feingold refused all PAC monies, and the %s seem very large for Senators when more than half the money used in Senate elections comes from individual donors. These numbers just seem high.
You should be cautious not to exclusively focus on direct campaign contributions. I don't know to what extent this is universal, but there are currently adds sponsored by pharma (as best I can tell) supporting Frank Kratovil running in Maryland (basically the "call and thank Frank for voting for SCHIP" sort of ad). The implicit message is, I think, "we're spending money for you now when you don't even need it; and your margin was so close that we'll sink you if you're on the wrong side of health reform."
I haven't seen anyone else suggest this; curious if anyone here would endorse the idea: Obama should threaten every Dem congressman who isn't particularly vulnerable on healthcare (say, Kaiser's home district or something) with withholding his voter file in the event that the congressman votes against a good reform bill. I think that would trump any implied financial threat, and given the size of the Dem majority, I think it's a good risk to take.
Could we see that list sorted by outright Health Industry PAC contributions too?
Somebody like Specter, who has a huge fundraising machine, clocks in at #35 when expressed as a percentage, but looks to be #3 in total contributions from Health Industry PACs.
Also of note might be the timeframe or average for the tenure of each Senator. Again Specter is ~#3, but he's been there a long time.
@Polls_Apart,
The problem with no-nothings like you is that you refuse to give credit where credit is due. Stop blathering about oil prices and show some respect for Reagan who had the courage to call out the Soviet Union for what it was, for demanding that Gorbachev tear down the Wall and not giving a quarter to our Communist enemy. His immediate predecessor, like Obama, was a weak appeaser and did more to set back our international relations than any Prez in history, his legacy being the very Mullahs in Iran who torment us today.
To bring up Lebanon and Grenada shows how desperate your partisan attacks are. Perhaps Reagan should have ignited the Arab world by crushing Lebanon and he certainly was right not to tolerate a Soviet client state in the Caribbean. Although I am sure Obama would get along fine with its Commie leaders.
Give some credit to Bush 43 for forcing the UN to deal with the Syrians in Lebanon and making them get out. It was that action that set the stage for the moderate victory there in elections not Obama's silly speech in Cairo that like all his cotton candy addresses are forgotten in the wind and vanish leaving only a queasy stickiness behind.
As far as Venezuela goes, Obama giving bro hugs to Chavez is destined to further mire the people there in their peculiar misery and tyranny.
Talking to your enemies is fine, but leadership is needed to call them out and make them accountable.
Obama just seems to want to make nice. He is either weak or he likes these regimes and wants to make amends for all of our “past sins”.
Or perhaps these dictators are the ones who have the pics of him with men or copies of his various passports and birth certificates.
Whatever it is, Obama is not the sort of President America needs.
petekent01 (on twitter)
What are the model fit statistics for a logistic regression of "support public option?" on the % of a senator's money coming from the medical industry lobby???
I have a couple of what will probably be considered stupid questions. Why do we need congress and the president to set up a single payer system? We have the Internet. We have shown ourselves capable of incredible feats of organization. We clearly have the money (considering how much people are already paying for their crappy health care). Why are we going the Republican rout of wasting all that money using our *individual* buying power instead of our *collective* buying power? Why couldn't we just take the corruption out of the equation by bypassing the government altogether? That would also eliminate the need to placate the republicans. If they and theirs have troubles maintaining their private options.. too bad! Thats the free market (since we wouldn't be going through the government :D). I mean, they are fine and dandy with massive corporations decided what products live and die with THEIR massive spending power, so why not us? :D
I'm sure we could get somebody like Dean or whoever to negotiate for us. I mean I understand that it would probably be a huge undertaking.. but it could actually get done. If its not a good idea, then why isn't it? I'm very curious as to why I don't see other people suggesting this. I mean.. we got Obama into the white house with what amounted to a single payer system didn't we? We even gave Bauchus a run for her money within a very short time (we lost but it was still impressive) Heck we could get everybody solar panels, Internet, all that good stuff much cheaper if we took government out of the equation (not in a libertarian way of destroying government, just in an internet way of doing it ourselves). Without the republicans constantly watering down our bargaining position we could get quite the deal I imagine. Whatcha think?
You make one big assumption:
That any plan that benefits the industry is bad for consumers.
Typical liberal garbage. Also, it looks like there are far more Democrats who do not support a public option or who are undecided than are Republicans who are undecided or who support the public option.
You've just proved that the bi-partisan position is not to have a public option, which is the opposite of your motivation for writing this.
@ Raj
There's no model given because the relationship would likely be nonsignificant as soon as you control for the principle confounder, party identification.
From glancing at that chart, it looks like every single Republican is against the public option except Snowe (who is unknown). And no Democrats are against it except Landrieu.
Basically, the only overall relationship worth looking at between the public option and PAC doantions is between the unknowns and the Yes's on the Democrat side. Hardly any smoking guns here.
I think some other outcome measure is needed because view concerning the public option is clearly more related to party affiliation than amount of donations from PACs.
@JackWhistle: That is basically an extension of the George W. Bush healthcare plan. Glad to have you on-board.
@Bert Thank you for your reply but really.. I find it very hard to believe that Bush had it in his head to create any kind of national (or international considering the reach of the internet) kind of health care plan. A quick read of his positions suggested nothing of the sort. He created some new health care locations but thats.. about it (as far as I could find).
PeteKent is so pathologically despondent that Obama won that he can't think straight. However, I suspect his pathology is deeper than that and that he always feels and acts the way he is acting here (like a spoiled infant). And that he has never been able to think straight.
Rather than having eteKent hiujack every friggin thread it's time to shun him and his bizarre and hateful ideas. At this point I am installing whatever is necessary on my computer to keep this total loser's excretions from sullying my computer screen any further. PeteKent is the embarassment of 538. Why can't he just twitter himself since everything he says is just bullshit.
PeteKent - go away. You add nothing to the conversation. You don't know what you are talking about. You are regularly taken apart in thoughtful threads. And all you can do is deonstrate your hate and immaturity.
Go back to your birth certificate friends and do something useful. Suicide would also be a good option. Just go away.
There are a mutlitude of issues that no one really seems to want to face. Jack, your plan is good in theory but it would be next to impossible to impliment more due to different state restrictions than anything else (so we'd end up with state by state co ops by default). That's why the government would be necessary, to clear the red tape of each state. And then obviously you have the regulations in place that help insurers keep you from switching coverage during the year unless it's a pre qualified event. And the last thing anyone wants to end up with is Romenycare like we have in massachusetts, where everyone is now beholden to insurance companies with no rights whatsoever. The main problem, contrary to the false talking points, isn't the people without coverage, it's the people getting robbed with coverage. Something like 38% of all bankruptcies are due to medical bills FOR THOSE WHO PAY THESE THIEVES for insurance...Just sick!!!!
Is it necessary to include the McCain & Kerry Funds, I think it dilutes the totals. It looks like it includes their presidential campaigns.
In response to matador, Kaufman was appointed, so he hasn't had to raise money yet.
I think it would be interesting to see a table that showed Health Industry PAC contributions as a percentage of total PAC contributions.
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NATE - URGENT OFF TOPIC -
1) On the Iran vote - do the parties have scrutineers at each poll who stay and observe through to the end of the vote counting and then report the results of their poll back to their party HQ's?
2) WHAT is the PHYSICAL STRUCTURE of the VOTE - are the votes transported for central counting, counted locally?
3) NO ONE IS TELLING US HOW THE VOTE IS DONE. this is TOO important to not be reported. IF each parties scrutineers are not able to follow the ballots they oversaw all day through to the actual count then THEY do NOT have a democracy...
NATE HELP - this is your assignment should you accept it - as usual the Director will disavow any knowledge of you or your team -PLEASE FIND this out for us - NATE this message will disappear in five seconds. Cue Mission Impossible music and run credits.
Not every opponent of ObamaCare is bought and paid for. A lot of them simply feel that for several trillion dollars, we should do more than drive the uninsured rate from 19% to 13%, which is the meager payoff estimated by the CBO. Are you folks actually following the proposals? Or are you just "for it" because your leader is?
@JackWhistle - I've wondered the same thing, to be honest. I think it would even be possible, perhaps. In New York, the Freelancers Union was founded just for this purpose (and for advocacy for the self-employed) and today provides "low-cost health, dental, disability and life insurance to over 12,000 people" [from Wikipedia] who work as freelance talent in one of seven industries.
HOWEVER, one problem I see with your idea is that the most Internet-savvy portion of the population is also the most likely to be young and healthy -- and therefore the least likely to be willing to spend money on health insurance. At the other end of the spectrum are the uninsured who are probably most in need of health insurance, who are probably also the least Internet-savvy, taken as a group, being older, unemployed, undocumented, etc.
ON THE THIRD HAND: Given that most of the HR executives at most of the Fortune 500 would prefer to get out of the healthcare business since that expense isn't of any strategic interest to their companies (i.e., doesn't help them differentiate themselves from their competitors, so is a big expense that doesn't translate easily into eventual profits), maybe some kind of collusion between the Fortune 500 and enough uninsured self-employed or small business folks could, together, create a workable nonprofit cooperative (the co-op option, I guess) that has low premiums and deductibles but is a large enough population that it can afford to accept anyone else, regardless of pre-existing conditions.
Sherrod Brown's receipts from healthcare are not so surprising considering that some of the states' largest employers are associate with healthcare (http://en.wikipedia.org/wiki/Economy_of_Ohio#Major_employers). Cleveland Clinic and University Hospitals are both located in Cleveland (the heart of Ohio Democratic politics).
I had a guy argue with me that we shouldnt reform health care because it will put the insurance industry workers out of work.
Lieberman went on Political Capital with Al Hunt and said he did not support a public option. He does everything in lockstep with McCain and Graham.
Lieberman is from Connecticut,home (particularly Hartford) of many insurance companies.Nothing to do with the Evil Twins.
Here's something I would like the defenders of the current insurance situation to defend:
A medical procedure is being done for five years, replacing a procedure for many patients that had been the normal procedure for about 100 years. The newer procedure is the doctor and patient preferred method for specific circumstances. In those circumstances, it is now the procedure done in more than 90% of the surgeries.
This newer procedure allows for much faster recovery for the patient, and there are not as many follow-up visits to the doctor post-op for 95+% of the patients - in those few cases where there is need for more post-op visits, it is about equally caused by the patient not following the doctor's instructions, and/or the number of visits doesn't exceed the normal post-op consultations as the previously used procedure.
This newer procedure costs slightly more initially, but in the long run is actually less costly for the doctor and the patient, as there is the need for fewer follow-up visits, allows the patient to function as they need to faster, and causes fewer other problems than the previous procedure.
Because of differences in the procedures, the doctors asked Medicare for a new billing code, and after several years, Medicare assigned a new billing code (previously, the doctors were told by the insurance companies and Medicare to use the previous procedure's billing code).
Suddenly, because there's a new billing code, the insurance companies decided this is 'an investigational and/or exploratory procedure' and refuse to pay for the procedure, even though they've paid for more than 50,000 of such procedures over the past five years.
The review board that makes such decisions is made up of medical personnel, but almost always not personnel from the specific specialties (for instance, no ophthalmologists for eye surgery decisions, but the board includes cardio-pulmanary experts, experts in cancers, podiatrists, etc.)
(Due to Blogger's character limitations, I'll continue this post below.)
Mike in Maryland
My Blogger ID is http://www.blogger.com/profile/02848893412251095965
(continued from above:)
Another example:
Most doctors prefer to combine three procedures into a single operation. Two of the procedures are always done together, and cost about $5,000 total. The third operation costs $12,000 to $20,000.
If all three operations are done at the same time, the surgeon uses the same incision for all three. If done separately, the surgeon must make a new incision for the second operation. During the first operation (almost always for two procedures), the surgeon, through no mistake or 'malpractise', could cause the need for the second operation to be 'moved up' from a year in the future to within a month of the first operation.
Some insurance companies tell the doctors and patients that the patient must undergo two operations, as the insurance company will not pay the total cost for the three operations if done together, only the cheapest of the operations.
Doing two operations instead of one, and then having to schedule another operation, means:
- instead of one 1-hour surgery, the patient must endure two surgeries of at least 45 minutes each;
- two recovery periods for the patient;
- extra prep time for the surgical center;
- extra expenses in the surgical center (for example, two pre- and post-operation cleanups, which would be one if all three procedures were combined, which also means the surgical center is not available during those cleanup times);
- extra expense for the patient/doctor/insurance company, as two sets of personnel are needed (one set for each surgery) including scrub nurses, anesthesiologists, surgical center clean-up crew, additional expenses for cleaning equipment, additional scheduling expenses, additional billing expenses as two sets of billing need to be prepared and reviewed by the surgical center and two sets of billing need to be reviewed by the insurance company, etc.
- additional risk for the patient (any surgery, no matter what the reason, has a definite risk factor, especially when anesthesia is used. There also is the risk of infection each time an incision is made in the human body, infection from the equipment, surgical center environment, and/or the patient's home environment, etc.).
What does the patient get out of all this?
Two surgical procedures instead of one; lengthy fights with the insurance company to get the procedure authorized; delays in getting needed medical procedures, additional recovery time (meaning additional time off work, additional prescriptions, etc.), etc.
What does the doctor and surgical center get out of all this?
Extra expenses - one operation is less costly than two operations; more time spent advocating for the patient to the insurance company so the patient gets the needed medical procedure; more time with each individual patient, which means less time for additional patients with the same or similar problems; etc.
What does the medical insurance company get out of all this?
It's probably hoping the patient dies before all procedures are completed, thus saving the insurance company money, and/or if the patient doesn't die, holding onto the money for a couple more weeks so it can make more profit.
Mike in Maryland
My Blogger ID is http://www.blogger.com/profile/02848893412251095965
The AMA gave more money to Democrats in 2008 than Republicans. This study is meaningless also because the Democrats have a filibusterproof senate.
Democrats own the ball right now, nobody is stopping them from doing what they want. They also have a very popular president. I'm not falling for lies that some GOP senator in Wyoming is the reason the Dems can get government run healthcare done.
Try this, maybe the concept just sucks and America doesn't want some government official to make health care decisions such as, does your grandma need that MRI for her sore knee or not?
I want liberty and that includes liberty in personal health care.
BeanoCook,
What if it's not "some government official" saying that your grandmother can't get that MRI, but some insurance company executive?
It is more likely the insurance company will deny the MRI now, and more likely to happen in the future, than "some government official" will do so in the future.
The reason?
The government will more likely listen to the doctor, and listen to the reasons the doctor states, as to why the MRI is needed, than an insurance company that is looking at the quarterly bottom line, and only then after making sure there is a profit, then looking at the needs of the patient.
Or are you afraid that people will have to go on a wait list for things like a transplant as is the current situation in Canada? Maybe you should explore the reason for some things - in Canada, there is very little organ and tissue donation, and THAT is the reason for the wait list, not that the government is creating the wait list because of some policy decision to ration care.
Mike in Maryland
My Blogger ID is http://www.blogger.com/profile/02848893412251095965
@ Mike in Maryland
Under a government single payer system a government official NEVER makes a decision on whether a patient can have a procedure or not.The patient and the doctor decide.
Take it from one who knows from personal experience. I am on Medicare.
You're wasting your time arguing with the brainwashed (brainwasher?) BeanoCook.
Opus 132 said...
You're wasting your time arguing with the brainwashed (brainwasher?) BeanoCook.
Opus,
I know, and I've stated it plenty of times before - Do Not Feed The Trolls.
In my defense (weak though it is), I was not attempting to directly argue with the TROLL, but attempting to make some comments to belittle the intelligence of such a poster, and to let others who might start to be swayed by their mis-logic (or is it a complete lack of logic) from even starting to believe that they have anything of intelligence to say.
Mike in Maryland
My Blogger ID is http://www.blogger.com/profile/02848893412251095965
@John @Derek Thanks for the replies :). I see what you are saying. Didn't think about those problems before. I'm going to study this concept some more, see if any other organizations are trying it, see what problems they are encountering. I hadn't even heard of anyone trying this.
This is ludicrous:
BeanoCook said...
America doesn't want some government official to make health care decisions such as, does your grandma need that MRI for her sore knee or not?
I want liberty and that includes liberty in personal health care.
------------
Doesn't this guy know that grandma is likely to be on a government paid health insurance? In fact, a bit over HALF of the population is ALREADY on single payer health insurance from the government, when you combine Medicare, Medicaid, the Va, the Military, and governmental jobs. About 1/3 of the people are on private insurance, with the rest pretty much left out in the cold. Of that 1/3, 25% are not happy. So it's only about 1/4 of the population that is actually on private insurance and happy with it. Why are we trying to keep the insurance companies going? It wouldn't really change that much, except COST US LESS and everyone would be covered.
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