Two Mea Culpas

Here’s an attempt to recover from two mistakes yesterday. My post on our dismal prospects for real health care reform prompted a couple readers – thanks to Hal Andrews and Fred Goldstein – to take me to task for suggesting that lobbying ought to be abolished.

And Barry Passett – who was a lot closer to the events in question than I was – pointed out that I misstated the reason that the Clinton’s reform effort was killed, and in doing so over-simplified the issue.

I wanted to put my clarifications into a post rather than a comment, to give them the attention they deserve. And I’ve revised yesterday’s post to reflect the corrections.

Hal and Fred rightly pointed out that the First Amendment protects
"…the right…to petition the Government for a redress of
grievances.
" Lobbyists – professionals paid to buttonhole and persuade
legislators in the lobbies and corridors of government – were at
America’s first Congress and, before that, in the British Parliament.

In this sense, lobbying is simply paid advocacy. Lobbyists have always been
paid for their connections, convincing style and demonstrated
effectiveness. More recently, they have been required to be registered and to publicly disclose their direct contributions to lawmakers and candidates. Theoretically, any individual
advocating for a position also has the right to be heard by our
representatives.

Less clear and more controversial is the subject of contributions of financial value to lawmakers, and whether those contribution are merely supportive donations, or quid pro quos
("this for that"), favors in exchange for desired outcomes. Since the
Founding, Congress has imposed increasingly stringent guidelines on
contributions. These have made the process somewhat more transparent.
But those with resources to pursue their policy objectives haven’t been
deterred. And the likelihood of being effective remains better with a
history of contribution than without.

The proposals that have best addressed this would prohibit direct
contributions to candidates and lawmakers in favor of government-based
campaign financing. This would limit the resources available to candidates and legislators, but also reduce
concerns about the exchange of money for influence.

While Mr. Obama made lobbyist influence a campaign issue, it remains to be seen whether his Administration and the new Congress will
embrace serious contribution/campaign finance reforms that return the focus of policy to the common over the special interest. If Mr. Obama REALLY wants to be an historic President, he could champion revising the ways that our lawmakers can be influenced, since that is the substrate of our paralysis on all significant national problems.

Which leads me back to my second
argument that significant policy reforms in other areas will be
achieved only through the activism of the nation’s most influential
individuals, our business leaders, or not at all.

On my recounting of what killed the Clinton reforms, I am red-faced
by my good friend Barry Passett’s correction, and grateful for his clarification. That said, the point
ultimately is a quibble. This was one more example of sacrificing the
common interest for the special interest, even if the small business
lobby’s motivation at that point, was fear of Big Government Health Care.

More recently that group’s strongest player,
the National Federation of Independent Business (NFIB), became an
unlikely bedfellow with four organizations far more predictably in favor of universal coverage – the American Cancer Society’s Cancer Action Network (ASC CAN), the American Hospital Association (AHA), the American Catholic Health Association (ACHA) and Families USA – in sponsoring a reprise of the Harry and Louise ads. This time the couple was more contrite and desperately hopeful for universal coverage. Apparently, things didn’t work out the last time quite as they imagined.

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TiredDocBarry Carolbev M.D. Recent comment authors
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TiredDoc
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TiredDoc

My patients’ insurance cards look the same whether they have HMO or PPO. Upon enrollment in HMO, do you think they know the difference? After a few months, they come to realize the difference between Spam and steak. Do the insurance companies want them to know? Of course not.
I hope that these insurance companies are forced to dissolve and we can switch to a single-payer, universal coverage system that is fair for all.

Barry Carol
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Barry Carol

In periods of crisis like we’re now, it’s often possible to bring about substantive reforms (on a bipartisan basis) that would not possible in the absence of crisis, lobbying pressure notwithstanding. As President Obama’s newly appointed Chief of Staff, Rahm Emanuel, said recently, “A crisis is a terrible thing to waste.” Moreover, current CBO Director, and soon to be appointed to head the Office of Management and Budget, Peter Orzag, commented repeatedly, unsustainable growth in healthcare costs is the root cause of the federal government’s long term fiscal imbalance, while the states continue to struggle to keep up with their… Read more »

bev M.D.
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bev M.D.

It wouldn’t bother me at all if all lobbyists, or for that matter all companies in general, were barred from financial contributions to politicians. Campaign expenses have gotten WAY out of line (5 billion total in the last election?) and this is mostly money wasted. Let’s have a “reset” of campaign expenses the way housing prices are “resetting” and consumer spending is “resetting”. (And, hopefully, executive compensation someday, please heaven.) The concept of what is normal spending needs to drop an order of magnitude across the board.