The health care industry now spends more money on lobbying in Washington than any sector of the economy—more than $243 million last year alone, slightly higher than the $242 million spent by financial, insurance and real estate companies, according to the Center for Responsive Politics here.Of the “revolving door lobbyists” profiled by the center, those specializing in health care account for 12 percent, more than any other economic sector.Critics say these former officials are cashing in, trading on the relationships and expertise they acquired while working for the taxpayers, and cite such career moves as proof that Mr. Obama has not lived up to his promise to change the culture of influence peddling in the capital.
Of course, this is the kind of thing that one would expect with any major reform, but big, monolithic laws that depend on special interests for their existence are especially likely to invite a feeding frenzy among the lobbying class. Obama is running into a central contradiction of progressive governance: it’s extremely difficult to both limit lobbyist influence and pursue big ambitious laws that centralize political power in DC.The influence of lobbyists on Obamacare should be especially disconcerting to true progressives given that important details of the law are still being determined. The NYT double dipped in Obamacare anxiety today by running a second story on the murky fate of drug coverage under the ACA:
States running the marketplaces where the plans will be offered have not released details about which drugs will be covered. Insurers have said little about how much consumers will be asked to contribute or what types of restrictions will be placed on certain medicines. Of the few states that have revealed specifics, some have plans that will require patients to contribute as much as 50 percent of the cost of the most expensive drugs.
It’s not clear how much of this lingering uncertainty will be affected by federal policy, but given the stories that came out this summer about Congressional price-fixing, it’s likely more than most Americans will be comfortable with. All the more the reason to pursue consumer-based reforms that allow the consumer, instead of the special interests, to set prices.