Turn Off the Spigot: Money vs. Med4All

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The COVID pandemic has exposed the flaws in the US health care system as never before, reinforcing longstanding arguments for creating an expanded Medicare for All system in the country. The Public i has previously published articles (see June, November and December 2019 and April 2020 issues) exposing the flaws in arguments against this policy and clarifying how its implementation can reduce the overall costs of health care delivery by as much as $5 trillion over a ten-year period and to family budgets by as much as $3000 per year.

In a context where 69 percent of Americans support expanding Medicare, the will of the majority has been consistently disregarded in Washington. Again and again the major roadblock to reform has proved to be the enormous amounts of money the health care industry pours into the legislative process.

Proof of the power the health care industry wields in our body politic and how it blocks reform is evident. 2019 was the year that a number of pro-patient policy reforms, modest in nature, were considered in Congress. The health care industry response was a record $594 million spent on lobbying, up five percent from 2018—a sum that is the highest of any sector.

Within the sector, the pharmaceuticals/health products industry spent a record $295 million to combat the reforms calling for regulation of drug prices—one of which even came from the Trump Administration—and the proposed policy changes failed to move forward.

With proposed legislation before Congress to avoid surprise medical bills, health professionals and health services/HMOs also broke lobbying spending records, while hospitals neared the all-time high they hit in 2009. The legislation went down in defeat.

Doctors, hospitals and emergency medical providers also successfully joined together to oppose bipartisan legislation to cap the amount of money patients have to pay for out-of-network services. These industries maintained that the legislation, which would have lowered pay for some specialists, was too favorable to insurers.

2019 was not the only year that health care industry money poured into Congress and state legislatures. One case study in particular highlights the damage this spending does to any chance of health care policy reforms, to say nothing of implementation of a Medicare for All system.

Medicare For All and the Partnership for America’s Health Care Future

The 2018 midterms resulted in the arrival of 48 freshman lawmakers who had campaigned on enacting Medicare for All, and the return of 123 House Democrats who had signed on as co-sponsors of the Medicare for All bill. In response, a panicked health care industry launched the Partnership for America’s Health Care Future, designed to “change the conversation around Medicare for All,” and minimize the possibility that such a policy would become part of the Democratic Party’s political platform in 2020. They hoped to do this by undermining growing public support for Medicare for All, as well as by shaping elite opinion in Washington.

One of the people helping to manage the Partnership’s campaign is Lauren Shaver, a former top staffer for Hillary Clinton. She and members of consulting firms with long-established ties to the Democratic Party were pivotal in outlining a strategy that combined approaches like a speakers bureau, newspaper editorials, digital ads and candidate briefings.

The efforts of the Partnership have attracted robust industry support. Among its members are formidable industry groups, including the Health Care Leadership Council, the Federation of American Hospitals, and America’s Health Insurance Plans. Under the umbrella of these entities are further powerful players, including various state Blue Cross/Blue Shield companies, Aetna, Kaiser Permanente, Tenet Health, Health Alliance, Baxter, Bristol-Meyers Squibb, Genentech, Mayo Clinic, Merck, Pfizer, Abbott, Johnson and Johnson Health Systems, and the McKesson Corporation.

Thankfully, certain key entities are missing. With a growing number of doctors and physicians who actually support Medicare for All, a resolution at the American Medical Association (AMA)’s 2018 convention to join the Partnership was voted down.

The AMA aside, the power and purpose of the Partnership is perhaps the major roadblock to making Medicare for All a reality. Consequently, inspired first by National Nurses United and joined by national groups like Business for Medicare for All, Health Care Now, Labor Campaign for Single Payer, Progressive Democrats of America and Democratic Socialists of America, a focused strategy of multiple Medicare for All advocates is getting legislators to reject Partnership money.

Efforts for Patients Over Profits in Our Backyard

Here in Illinois the Illinois Single-Payer Coalition (ISPC) and its local Central Illinois chapter have joined in this effort by launching a Patients over Profits campaign targeting Illinois Senators Dick Durbin and Tammy Duckworth.

The Patients over Profits campaign focuses on getting our senators to sign a pledge to no longer take money from any member entity of the Partnership. Since the beginning of the pandemic in March, ISPC has repeatedly contacted each senator’s office in an effort to set up a Zoom meeting to discuss the pledge.  ISPC also wanted to share with the senators online petition evidence collected from their constituents urging them to spurn health care industry contributions. ISPC has been stonewalled and to date no such meeting has been scheduled by either senator’s office.  Moreover, during the period of attempting to set up meetings, Durbin’s staff communicated to ISPC that he wanted to see data showing support for Medicare for All among individuals with employer-sponsored insurance.  ISPC rushed to supply this data by conducting an online survey, yet even after sending the data to his office, the requested meeting eluded it.

Only after the 2020 election, when taking such an action did not risk losing votes, did Durbin’s staff notify us that he would not sign the pledge. In sum, repeated efforts to even get a hearing from the senators on matters of intense interest to many Illinoisans have all come to naught. Such disrespectful treatment of his constituents is behavior that sustains anger and apathy among our citizenry, helping to explain rising doubts about the health of American democracy going forward.

Could Senator Durbin and Duckworth’s behavior itself be proof of the necessity of ISPC’s Patients over Profits campaign? ISPC has uncovered evidence that Senator Durbin received as much as $456,969 in contributions from the health care industry in 2020. For Duckworth, the figure is $746,059. These figures, moreover, are a gross underestimation, as they do not include money from insurance companies, to say nothing of possible dark money sources.

ISPC says, “Enough!” The Patients over Profits campaign will continue. Online petition efforts and related educational workshops will continue. A new campaign phase includes efforts to expose Durbin and Duckworth’s recalcitrance through letters to the editor and newspaper stories—all of which will be used to exert pressure on Senator Duckworth in particular as she gears up for a 2022 election. Finally, it is hoped that once it is safe, direct action efforts may be in the offing. For more info on statewide ISPC’s Patients Over Profits campaign, go here.

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