An op-ed in Friday’s New York Times (7/5/13), hit the nail on the head about health care costs. It’s entitled “Diagnosis: Insufficient Outrage.” http://www.nytimes.com/2013/07/05/opinion/diagnosis-insufficient-outrage.html?partner=rss&emc=rss&wpisrc=nl_wonk_b&_r=0
I would argue, however, that considerable outrage exists about health care costs. There are just precious few places to focus that outrage into possible positive action. What can members of the public do about out of line hospital CEO salaries? How can individuals protest insurance rate increases? How can anyone make sense of a hospital bill? Who holds hospitals accountable for the lack of billing transparency? What I discovered in my research on costs and transparency is that there is one word that is totally lacking in health care—“accountability.” And too many times there is no recourse.
To take up where “Insufficient Outrage” left off is an article from Sunday’s NY Times about the money going into campaigns for and against the Affordable Care Act. The article concludes: “The Campaign Media Analysis Group at Kantar Media estimates that from 2010, when the law was signed, to 2015, $1 billion will be spent on ads that criticize or defend it. That includes ads for candidates who oppose the law. Half of the $1 billion has already been spent, the group said.”
Money and Politics: Where’s the Public Interest?
Given our interest in price transparency and the current public interest in affordability and accountability, I began digging deeper on money and politics. And, even I was stunned by what I found. Here is a list of the top contributors in health care for 2011-12. This does not include money from PACs or lobbying. http://www.opensecrets.org/industries/indus.php?ind=Hcontrib
The top five health care donors in 2011—2012, Adelson Drug Clinics, at $41,494,800, followed by Cooperative American Physicians at $2,965,980, Mutual Pharmaceutical at $2,332,500, American Dental Association (ADA) at $2,047,415 and DE Shaw Research at $2,007,054. The American Medical Association (AMA) follows DE Shaw as the sixth highest contributor at $2,002,115.
It should be noted 2011-12 was a heated presidential election. All the Adelson Drug Clinic, Cooperative American Physician and DE Shaw Research donations went to “outside groups”, as well as the bulk of the donation from Mutual Pharmaceutical. These groups did not donate to any listed Republican or Democratic Senators or Representatives as the other donors did.
Adelson Drug Clinic has two clinics: Las Vegas and Israel. They specialize in treating drug addicted adults and teens. Cooperative American Physicians is a California malpractice liability group, Mutual Pharmaceutical is a generic drug manufacturer, the ADA is the professional association of dentists, and DE Shaw specializes in computational biochemistry. So there you have it.
Here are links to their respective websites and the business profiles of some groups:
I now have more questions than answers. I highly recommend spending some time on www.opensecrets.com website where this data comes from. It is the website name for The Center for Responsive Politics. The website has a list of topics. Select ‘health’ and have “fun”seeing who is getting how much from whom. Their latest 2013 report was just published July 2nd.
This makes me wonder how we can find this same data on a state by state basis, so we know what our state and local elected officials receive in donations.
Money and Health Care 2009: Debating the Affordable Care Act
Common Cause (www.commoncause.org) has a report about 2009 health care donations to Congress by the various health care sectors. What makes 2009 so interesting is because it was the first year of Obama’s first Administration and the year preceding the passage of the Affordable Care Act in 2010. Not only does the report show donations by industry sector, it also names the Senators and Representatives who received the largest donations. The appendices list donations to members of the Congressional Committees dealing with health care—health care, finance, labor and pensions and related committees. The dollars are staggering and outrageous.
Hats off to Common Cause and their leadership in tackling the pernicious problem of money in American politics and to the Center for Responsive Politics for shining light on donations to our elected officials.
What Does This Mean for Accountability?
I’m not sure there is any. This is a hard conclusion for me. But, the more I dig into issues, the fewer safeguards I find. Where does someone like Esther turn for help when her long-term care policy inadvertently lapsed? (See When Consumer Protection Isn’t There, Part II). She made a simple error—she moved. Her long-term care premium notices were returned to the company because the postal forwarding time expired. The company knew she was moving because they approved the new retirement community as a facility that would be covered under her policy. AARP came to my mind as an advocate for her. But, I am not sure it would have come to her aid. Nearly half of its income comes from the sale of products such as Auto insurance, Medicare supplemental insurance and long-term care. Their long-term care company of choice is Genworth, the very company that cancelled Esther’s policy.
Insurance is regulated state by state. Consequently, consumer protection laws and regulations vary state by state making any multi-state campaigns unwieldy.
There is more to cover about accountability, but in the interest of keeping this at a reasonable length, I will end here today and add more to the story next week. Stay tuned.
Kathleen O’Connor © July 7, 2013.