Lobbying's influence on Medicare "Reform"



Lobbying's ills shine through in Medicare law

Watchdogs say Congress caved

By Dana Wilkie

COPLEY NEWS SERVICE
February 16, 2006

WASHINGTON – Behind the Medicare prescription-drug bill that Congress
passed in 2003 is a story that involves more than aging Americans and
their medications – one that helps shed light on why Congress is
being pressured to limit lobbyists' influence on Capitol Hill.

The passage of the prescription-drug plan – which seniors across the
country are slamming for its confusion, high costs and capriciousness
– comes with accounts of strong-arm tactics to push it through the
House by pharmaceutical and health care companies showering campaign
gifts on key lawmakers, and cozy arrangements for those who wrote the
bill and then departed for lucrative jobs as lobbyists.

“It's a perfect example for lobbying reform, because pharmacies got
everything and the customers got nothing,” said Rep. Bob Filner,
D-San Diego.

Representatives from the pharmaceutical and health care industries
acknowledge that lobbyists try to bend lawmakers' ears, but they say
lobbyists' impact on policy-makers tends to be exaggerated.

“You don't see lobbyists in the office any more than you see people
from back home,” said Ken Johnson, a former congressional staffer and
now a senior vice president with the Pharmaceutical Research and
Manufacturers of America, or PhRMA, the drug industry's top lobbying
group. “Lobbyists have influence on the Hill, but not as much as you
might think.”

The stories of Jack Abramoff and Randy “Duke” Cunningham – the
former lobbyist and the former Rancho Santa Fe Republican congressman,
respectively – have focused attention on a capital culture that tends
to foster cozy relationships between lawmakers and those who try to
influence them. Abramoff pleaded guilty to fraud, tax evasion and
conspiracy to bribe public officials. Cunningham pleaded guilty to tax
evasion and conspiracy charges stemming from his ties to defense
contractors. He resigned his House seat and admitted to accepting $2.4
million in bribes.

The circumstances surrounding Abramoff and Cunningham involved criminal
activities. While there are no such allegations surrounding the passage
of the Medicare bill, there are plenty of complaints that the sort of
influence that drug-and health-company lobbyists enjoyed in the writing
of the bill should be limited in the future.

The influence peddling involving Cunningham and Abramoff might seem far
removed from the average voter. But Medicare is not.

President Bush championed the so-called Medicare Part D program as a
way to give Medicare and Medicaid patients more insurance options and
to lower drug costs. But it's become a sore subject at many a
politician-arranged town hall meeting.

Americans complain that the new insurance sometimes pays for one drug
but not another, or that they are automatically placed in plans that
don't pay for their prescriptions. There is anger about delayed access
to drugs and frustration over complex provisions.

“For every elected official in Washington, there are at least two
lobbyists running around ... with gobs of money,” said Barry Fowler,
a Hillcrest resident who soon will be eligible for Medicare. He worries
that the medications he and his wife, Sharon, take could be too costly
or unavailable under the plan. “It's very clear that big oil,
pharmaceuticals and other entities are really the branch of the
government that controls this society.”

Bush recently addressed criticism of the program in his weekly radio
address, saying that his administration is working to fix glitches in
the system and that the results so far indicate the new Medicare plan
“is a good deal for seniors.”

Recent polling, however, shows that more than half of the program's
recipients found the prescription coverage guidelines hard to
understand and that by 2-to-1 they said the program doesn't work.

Listen to almost any government watchdog group and you'll hear that one
reason Medicare drug costs are out of control is because Congress caved
to the demands of drug companies and prohibited Medicare from
negotiating quantity discounts. That, even though the Veterans Health
Administration is able to save taxpayers billions of dollars through
such negotiations.

Critics of the program say the drug benefit's 10-year cost will be $1.2
trillion. The Bush administration says the cost to the government will
be about $724 billion. Throughout the debate in 2003, supporters
estimated the cost at $400 billion over 10 years.

“What you're seeing here is what happens when a pharmaceutical
industry, through lobbying and campaign contributions and influence
buying, gets a program that it wants,” said Larry Noble, executive
director of the Center for Responsive Politics, a congressional
watchdog. “What the industry lobbied against was any type of uniform
system, and they very much got free rein over what they were going to
offer and how they were going to offer it.”

The “influence buying” that Noble mentions is well illustrated, he
said, in the case of former Rep. Billy Tauzin, the Louisiana Republican
who was chairman of the House Energy and Commerce Committee and who
oversaw regulation of the pharmaceutical industry. Tauzin helped craft
major parts of the Medicare bill. After it passed, he left office and
became president of PhRMA.

While federal laws prohibited Tauzin from lobbying for a year after
leaving office, his new job nonetheless gives him considerable
influence over health care policy-making in Washington.

“There is a growing perception that members of Congress no longer
come to Washington to serve the public,” said Sen. Dianne Feinstein,
D-Calif., who recently introduced a bill that would prevent members of
Congress and their staffs from lobbying the House or Senate for two
years after leaving the Hill. “We must close the revolving door
completely.”

In the five years before the Medicare vote, HMOs, health services
companies, health insurers and pharmaceutical manufacturers gave some
of their largest campaign gifts to lawmakers who wrote key parts of the
legislation, or who were leaders on committees responsible for passing
it, according to the Center for Responsive Politics, a nonpartisan
research group that tracks money in politics and its effect on
elections and public policy.

Tauzin got $274,500; Rep. Bill Thomas, R-Bakersfield, got more than
$432,000; Sen. Orrin Hatch, R-Utah, took almost $427,000; Rep. Nancy
Johnson, R-Conn., took $731,517; Sen. Max Baucus, D-Mont., received
$271,649; and Sen. Charles Grassley, R-Iowa, took $296,429.

Moreover, the 10 companies that won lucrative federal contracts to
offer nationwide prescription Medicare coverage, including
California-based Pacificare Health Systems, gave a collective $6.5
million to members of Congress over the past six years.

This infuriates Medicare critics, who say these contributions won
congressional favor, which led to a bill that prevented Medicare from
negotiating drug prices. And that arrangement, critics say, ensures the
profits of drug and health care companies, at the expense of the
taxpayer.

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