Monday, July 27, 2009


A few weeks ago there were a spate of articles that the health care industry was spending "$1.4 million a day" lobbying the Congress. Now, from About $2 Million Daily Spent on Health Care Ads "As lawmakers and the president wrangle over the details of health care reform, interest groups across the political spectrum are taking to the airwaves in response to the numerous proposals coming out of Washington. Media expert Evan Tracey speaks with Ray Suarez about the ads."

Apparently we are supposed to be appalled by this...
Usually this blogger can be counted on to reflexively 'tut, tut' about the money spent to buy access and influence, and to sway legislation. However, this time not so much, and for multiple reasons:
  • First, this blogger is unsure about the numbers. The earlier articles had "the health care industry" (or "major health interests" per another article) spending $1.4 million a day. This more recent article states that "the health insurance industry" spent $35 million in 1993 and in 1994, and that "health care reform advertising" spend this year (which appears to encompass all the players in health care reform plus the political parties as well) has been $45 million and is "approaching $2 million per day." . OK, so these numbers don't add up... two million dollars a day sounds outrageous, but how does that square with $45 million so far this year?? Was that amount spent over a 20-day stretch even though we are approximately 200 days into the calendar year? Was nothing spent on the other 180 or so days? Or is it actually per day i.e. at least approximately $300 million so far this year?
  • Second, all of these articles are remarkably lax regarding who is spending the money. Reading them and much of the accompanying commentary one could be forgiven for concluding that "health insurance industry" and "health care industry" are one and the same. In matter of fact they are not. The health care industry comprises a number of different groups, with differing interests, including the health insurers, the pharmaceutical and other medical/surgical supply companies, the provider organizations (i.e. hospitals, nursing homes, etc.), and the health professionals (i.e. the physicians, etc.). and, very importantly, in many ways their interests are often opposed. For example, the hospitals often find themselves playing a zero sum game with the insurers; ditto the health professionals and the insurers; and sometimes even the health professionals and the hospitals. So, go ahead, add up the sums these various groups are spending, to get a big number that sells stories... while ignoring the fact that many if not most of these expenditures cancel each other out!
  • But it's a lot of money you splutter! Hell, yes, it is... However, given the stakes involved is this any surprise? And, despite what some might have you believe, not all of this is done for base motives! A lot of this spending is defensive in nature, as none of the groups can afford to leave the field of battle open to the other groups without paying a heavy price, and finding that the system has been reformed on their backs! The main villains here are the politicians, who have set up the rules of the "game" by which all parties are playing! Sure, every so often a politician will decry the influence of money, but who exactly is it all aimed at? Yup, them, and they have their hands in every pocket... And, if you look closely, often the ones fussing are the ones most 'on the take.'
Bottom line: Let's a) have some greatly improved reporting, and, b) would it be possible to focus on the important details rather than just going for the easy (but meaningless without the accompanying detail) '$x million a day' soundbite? Yes, it is more work but it would be greatly appreciated...

Legislating under the influence
Familiar Players in Health Bill Lobbying
About $2 Million Daily Spent on Health Care Ads
Health Care Battle Takes to the Airwaves

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