Health Care Reform, Lobbyists and the Importance of “Being There”

Georges de La Tour, Das gute Schicksal, 1633-1639 (detail)

“Since it cost such a lot to win,
And even more to lose….”

J. Garcia & R. Hunter, “Deal”

This last week NPR’s All Things Considered ran an interesting story focused on lobbyists in the Health Care reform debate. NPR reports that

Between 1998 and 2008, the number of registered lobbyists on health care more than doubled, to 3,627, according to the Center for Responsive Politics. The statistic doesn’t include players who don’t engage in lobbying as defined by federal law - among them, grass-roots organizers, producers of TV campaigns and former members of Congress who remain in Washington as senior advisers to corporate clients.

And that

Spending on lobbying jumped even higher over the past decade. Organizations lobbying on health care spent $484.4 million in 2008, more than two and a half times the spending in 1998.

There is no reason to think that this year’s figure will not easily surpass that. More than 15% of the nation’s GDP is “on the table” so to speak, and an ox gored now will suffer a long long time. According to an informative, very well charted, but not widely reported (a big thank you to “Blue Bunting” over at Care2), recent report from Common Cause

The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end 2009. That comes out to about $2,600 per day per member of the House and Senate. The pharmaceutical lobby alone spent $733,000 per day in the first quarter of 2009. Since 2000, the industries have spent over $3 billion on lobbying, with the total increasing every year and rising more than 142 percent over the course of the decade. In each of the past four years health interests have been the number-one lobbying force in Washington, measured in expenditures, and have averaged over $1 million per day.

This Common Cause chart below, which like NPR utilizes data from the Center for Responsive Politics, illustrates these numbers rather well (I highly recommend taking a quick look at the report itself, there are a number of charts showing the amounts received by Congressman, Health Committee, and Party).  $1.4 million per day is a lot of money. And as that was the average expenditure from the first three months of this year, one might think that as the debate heightens, so may have the money– which is to say that the $513 million estimate for 2009 may be conservative. The question of course is why. All Things Considered offers the following:

Why spend so much? Three words: return on investment. While a drug company might spend a few million dollars lobbying, it stands to gain, or lose, billions in the outcome.

One big example: the 2003 Medicare drug legislation, under which Medicare began covering prescription drugs. One provision shifted poor, elderly consumers from Medicaid to Medicare - more bluntly, from a program where the government can negotiate with drug companies over prices, to a program where the new legislation prohibited such negotiations.

Most estimates find that the Medicaid-to-Medicare shift was worth billions of dollars for the drugmakers. Meanwhile, the Center for Responsive Politics puts the pharmaceutical industry’s 2003 lobbying expenditures at $126.1 million.

That would seem to be a bargain.