The influence game: Health lobby truces may fray

Associated Press | 5/20/2009, 4:48 a.m.

WASHINGTON — Reshaping the nation’s health care system has spurred some shotgun marriages of convenience.

Lobbyists for drug makers and a liberal group place newspaper ads promising “A healthier America starts today” and featuring smiling families. A slick Web site offering one-click ways to contact Congress, share health care stories and even buy T-shirts is run by a coalition of business, labor and the AARP.

Momentum for redoing the medical system has been helped by unlikely alliances that broadly embrace President Barack Obama’s drive for overhaul but gloss over prickly issues like how to pay for it. Those political unions, though, will likely fray when Congress begins to pencil in the details.

“Everyone wants to play, and play constructively,” said Christopher Jennings, a health policy lobbyist who was a White House adviser during President Bill Clinton’s failed attempt to rework health care 15 years ago. “But that doesn’t mean at the end of the day that will happen. They want to see specifics.”

At least two factors have brought traditional enemies together in support of better, more affordable care: Wildly soaring medical costs and elections that gave Democrats control of the White House and Congress. Both make action this year likelier.

“The energy in this town is finally being devoted to listening to how to solve problems,” said Karen Ignagni, president of America’s Health Insurance Plans, representing the same insurance companies that helped kill Clinton’s effort.

But coalitions are motivated by more than altruism.

Joining a coalition “makes me a good guy,” said Joseph Antos, health policy expert at the conservative American Enterprise Institute. “It means, ‘Yeah, we’d like to see health reform, but we’d also like to have a seat at the table when you’re discussing precisely how you’re going to cut my payments.’”

In the latest example, leaders of the nation’s doctors, hospitals, insurers, and drug and medical device manufacturers — plus the Service Employees International Union, the biggest health care union — met with Obama at the White House last week after pledging to slow the growth of health care spending by $2 trillion over the next decade. They didn’t say how.

Groups joining coalitions owe their first allegiance to their own constituents. Highlighting that, medical interests have spent $128 million lobbying this year, more than any other industry, including lobbying for the financial industry at $112 million, according to the nonpartisan Center for Responsive Politics, which tracks such spending.

“At this point we’re trying to work constructively with Congress and the administration to make sure that whatever bills come out are as good as they can be,” said Nancy H. Nielsen, president of the American Medical Association, which got 400,000 patients to contact lawmakers last year and help thwart cuts in Medicare payments to doctors. “And when we see what they are, we will make sure we activate those who need to be activated.”

Also positioning itself is AARP, whose 40 million older members make it one of the most formidable lobbies. It flexed that muscle last month when it drew 50,000 callers to a “town hall” telephone conference on health.