• Lobbyists are still powerful

    Igor Volsky continues to commit actual journalism in an attempt to figure out what groups really might want out of health care reform.  What does he find?

    PHARMACEUTICAL INDUSTRY: The industry doesn’t expect Republicans to reopen the doughnut hole, but it does want Congress to “reauthorize the Prescription Drug User Fee Act, or PDUFA, which allows companies to pay fees to the Food and Drug Administration to accelerate product reviews.”

    LARGE EMPLOYERS: “They don’t want to repeal it,” said Geoff Manville, principal in Mercer’s Washington Resource Group. “But large employers for their part want to amend the law and make changes, largely around provider payments and delivery-system reform.” Big employers “would like to see more aggressive pay-for-performance measures that aim to improve patients’ health results while reducing costs in the Medicare program, he said. “That’s the 800-pound gorilla that drives the entire health-care system.”

    INSURERS: “The insurance industry is working to persuade the next Congress to roll back a roughly $70 billion tax on insurance companies that takes effect in 2014, saying it will disproportionately hit small businesses that insure their workers. It also wants lawmakers to allow insurers to widen the rating bands that dictate how much more insurers can charge older customers. Insurers also want to tackle the growth of health costs by enacting a new measure to give robust protections against medical malpractice lawsuits to doctors who follow certain “best practice” guidelines.”

    HOSPITALS: The American Hospital Association formally came out “in support of Sen. Cornyn’s bill to repeal reform’s Independent Payment Advisory Board (IPAB).” “America’s hospitals support the repeal of IPAB because its existence permanently removes Congress from the decision-making process and threatens the long-time, open and important dialogue between hospitals and their elected officials about the needs of local hospitals and how to provide the highest quality care to their patients and communities,” they wrote in a letter.

    DOCTORS: “The American Medical Association (AMA) is warning of ‘a catastrophe’ if lawmakers don’t step in to block the 23 percent cut, which is scheduled to take effect Dec. 1, and another 6.5 percent cut that’s due a month later.”

    Interestingly, none of them seem to want outright repeal.  You have to remember that, over the course of health care reform, pretty much all of these groups were on board.  Pharma?  They were fine with it.  Doctors?  Yep, the AMA voiced support.  Even insurers weren’t fighting it.  Sure, they all want more now; that is their nature.  But none of them are acting as if this was “rammed down their throats”.  Even AARP was OK with it.

    In fact, the only group I can remember that was reliably against the whole thing was, well, Republicans.  I’m not denying they are a large group, but the usual industries and stakeholders don’t hate this nearly as much.  And they carry a lot of weight.

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    • Most doctors did not support the health care ‘reform’ bill. The AMA represents only a relatively small minority of doctors, mostly those employed by academic medical centers. Doctors in private practice overwhelmingly opposed the bill.