The Staggering Amount of Lobbying in Healthcare
The healthcare industry was originally aimed to be patient-centric, ensuring better treatment and care for all. Down the years though, the focus of the healthcare industry has turned to make more profits.
The healthcare industry is ridden with vested interests which don’t have anything to do with improving quality of care. Some special interest groups are lobbying for their interests and influencing the regulatory system making it more complicated and expensive. The difficult mandates keep physicians busy while the interest groups make their profit in the process.
The Lobbying Spree in Healthcare
We can see the examples every day in action, and the statistics speak for themselves- the total number of clients lobbying related to healthcare issues stands at 1,930; the number of reports listing area is 5,213. Groups have been lobbying all through history and trying to influence the government.
Health insurers spent $6.2 million in total on Capitol Hill during the beginning of 2017 according to disclosures by government reports. The companies lobbied over programs and regulations related to the health insurance market when the Republicans were trying to get rid of the Affordable Care Act (ACA). One of the issues was to remove the yearly tax on the insurance companies which contributed to the subsidies of low-income participants of the ACA.
Such companies had also lobbied when Barack Obama was the president during 2010- over 1,750 organizations and companies paid for 4,525 lobbyists according to the evaluation of Senate lobbying disclosure forms by A Center for Public Integrity. Among the lobbyists, some of the participants were big and small companies including insurance companies. The total amount spent by the lobbyists amounted to $3.47 billion, according to Center for Responsive Politics, a non-profit agency.
In 2016, over 11,000 organizations invested $3.12 billion lobbying the American government on healthcare issues. Among the top spenders, some of the companies were not even from healthcare like National Association of Realtors which is a trade association for real estate professionals. Even companies such as Verizon and Boeing roped in for the lobbying efforts. Amidst all of these, Amazon has created the largest team of lobbyists for any technology company to counter the administration of Donald Trump. In 2017, they spent $12.8 million on various issues including sales tax.
Even research has concluded that political and profit motives influence health care policy decisions while the political influence of caregivers and physicians have gone down. Too few counter the lobbying and vested interests, and we can give the example of Kaiser Permanente who won the first Health Equity Award from Centers for Medicare & Medicaid Services. The leading health system got the award for cutting down barriers and disparities involved in access to health care and its quality.
The examples are enough to make you understand why independent physician are in the position currently they are in.
Corporate Influence on Healthcare
Corporate companies may not run the government, but they sure know how to influence it. We have enough incidents of lobbying by companies and advocacy groups, and one has to read between the lines to get the implications. The companies can take advantage of loopholes in the system to pass some regulations or mandates which can even be unconstitutional.
The direct and indirect influence of the lobbyists increases the pressure on the physicians and takes a toll on their independence. They can shift the market towards their advantage by pushing for regulations or influencing them. They can hold a physician at knife point and get him immersed in different complications such as MACRA, MIPS, value-based reimbursement and so on. The corporate may not be able to prohibit independent physician practice, but they sure can make it difficult.
The mandates harm the doctors and seldom improve the quality of healthcare. No one is sure what quality metrics are chosen to determine such mandates and what definition of healthcare those companies go by. Even the people lobbying for the causes are not from the medical field- often the chief medical officer turns out someone with political influence rather than a medical expert! The companies are sometimes even from other industries who got attracted to the healthcare industry to get a slice of its profit pie.
The process will lead to a situation where there will be an overwhelming volume of mandates, laws and regulations will have some loopholes which only the special interest groups will be able to exploit. The lobbyists will be able to use them for their benefits while the physicians will be stressed and burnt out trying to comply with the regulations and mandates.
How can we come out of the Mess?
We have to stop the current trend and unless we can do that we are going down a steep hill. We as physicians should learn what is going on around us and adapt to it giving back a proper response. We have to utilize technology wisely — we shouldn’t depend on it 100% and should always consider the human element in any process.
We have to come up with a fitting strategy and integrate with technology in perfect synchronization. Physicians should also be politically aware and form alliances with prospective parties so that the lobbying can be limited. Taking any traditional age-old political approach is bound to fail — like the formation of unions. We should look to make alliances and think as individuals all acting towards the same mission and goal.
There should be a network of physicians for collaboration and providing support to each other. We should also fund and create a corporation that operates under physician supervision. We can take healthcare beyond the boundaries by forming a strong unity which makes the government pay heed to us.