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Healthcare Lobbyist Hosts Ben Nelson Fundraiser

One of the big questions left as healthcare reform moves toward the Senate floor is whether a small group of Democrats from red states, most with heavy ties to business, will attempt to filibuster the final bill. Among them is Ben Nelson (D-Nebraska), who reportedly was telling folks back home he would not filibuster in June, but now might help block a vote.

Just in time to celebrate this change of heart, Nelson's having a little get-together tomorrow, hosted by a former Republican Congressman and a health insurance lobbyist... and you're invited!* 

The Sunlight Foundation obtained an invite for the event, which is being held at the "UPS Townhouse", a popular place for these kinds of functions.

So what's it all about? Perhaps getting to know our hosts a little better would help:

• Amy Tejral- once Nelson's Legislative Director, Tejral has found more lucrative work representing insurers like Aetna, United Health Group, Blue Cross Blue Shield, Bravo Health and pharmaceutical giant Medco at lobby-shop Avenue Solutions, which specializes in "creating opportunities the private sector needs in Washington."  As the firm's website says: "We maintain relationships for the long haul and for the hot issue... Among Democrats, we have relationships with all the key players, from the Leadership, to Committees, to the newest Members." 
• Henry Bonilla- a former Republican Congressman from Texas, now a lobbyist for The Norman Group.
• Sheryl Bonilla- wife of Henry, who lobbies for UPS on Healthcare, among other issues.

Should be an interesting event, particularly because there's no telling who the guests, each ponying up $1000 for lunch, will be. It's a safe bet, however, that more than a few of them will have some involvement with the insurance and pharmaceutical industries, looking to curry favor with show their steadfast support for Senator Ben. 

*If you've got $1000 to donate to Nelson's 2012 Senate bid.

Update 1: Turns out that Nelson was working very hard today to wreck the public option by reviving "triggers". Sure to please at least a few of tomorrow's donors.

Today's TIME magazine/Aspen Institute Lobbying Salon

For most of today, TIME magazine and the Aspen Institute ran a conference on healthcare reform just a few blocks from the Capitol, an event funded by lobbying group PhRMA and foreign pharmaceutical giant AstraZeneca. The "symposium" was billed as "a series of can't miss conversations" featuring "Tom Daschle, Richard Gephardt and other health care leaders to diagnose health care reform battle in final days of the debate."

Instead, this TIME/Aspen Institute event was a who's who of the pharmaceutical industry lobby, with Tom Daschle thrown in for good measure. Not only did the event welcome lobbyists and their opinions with open arms and little disclosure, it literally acted as an on-the-clock opportunity for Gephardt to lobby. 

How do I know? Gephardt has said just as much on his firm's website, which states, "on behalf of our client CAMI, Dick Gephardt joined other health care leaders to diagnose health care reform." Good luck finding a reference to the PhRMA offshoot CAMI anywhere in the Aspen Institute/TIME magazine promotional materials, however.

In fact, here's the description the organizers offer for the panel discussion with Gephardt, moderated by a TIME "senior editor", titled "The Payoff of Medical Research Reform":

Medical science research holds great promise in the delivery of cures and the prospects for economic recovery. How do we maintain a focus on innovation and risk-taking even as we seek to avoid more expensive health care? Our panelists discuss the potential of biomedical research beyond the act of discovery.

Note there's no reference there to the actual payoff going on-- Gephardt's take home from presenting his lobbying agenda (You can find more information on CAMI  and Gephardt's work for them in my recent feature in The Nation).

A few months back, many in Washington's press corps were giddy to eviscerate The Washington Post for a proposed series of off-the-record "salons" between reporters, government officials and lobbyists at publisher Katharine Weymouth's mansion. Certainly, the Post deserved the criticism. However, it is events like this TIME/Aspen Institute "symposium" that do the real damage, allowing lobbyists, veiled in the establishment authority of TIME magazine and the non-partisan non-profit credibility of the Aspen Institute, to get a public stage from which to share their biased, self-serving "expertise". As a means of shaping public perception, that's far more powerful than any private get-together between reporters, lobbyists or government officials-- something that happens, salon or no salon, on a daily basis in DC anyway. 

So, while TIME and the Aspen Institute have done something shameful and compromising (even in simply pairing themselves with a large lobbying group like PhRMA), don't expect to hear anything about it from the Washington press corps, with the exception of glowing reviews in tomorrow's papers describing how these "healthcare leaders" earnestly discussed reform.

Bill Nelson and the Public Option

Most politicians, try as they might, can't manage to vote on an issue and emerge having no clearly discernible position on the matter. One who can, apparently, is Florida's Senator Bill Nelson, who cast near-simultaneous votes for and against the public option last week on the Senate Finance Committee. First, he voted against the Rockefeller amendment, considered the stronger of the two options before the committee, and then pivoting to support the weaker Schumer amendment. Both versions failed.  In any case, after these two votes, it's hard to call Bill Nelson a strong supporter of a robust public option.

Which is why the following letter I've obtained, one that Nelson seems to be sending his constituents, is pretty amusing. The person who forwarded it to me specifically complained to the Senator's office about Nelson's non-support of the Rockefeller amendment, which is noticeably absent from a reply that could have been written by HCAN:

I'm writing you because I know that you're interested in health care reform.

There’s been a lot of confusing information flying around about the latest developments on health care reform. Most of the media is declaring as dead the idea of a public insurance plan. They’re wrong.

A public insurance plan may be down, but it’s not out.

As The New York Times reported on Wednesday, the Senate Finance Committee rejected two Democratic proposals to create a government insurance plan to keep private insurers in check.

Leadership tells me one of those plans, by Senator Schumer, still has a shot at being included in the final bill. And that’s the plan I voted for. I believe it offers help for consumers through fair competition to private insurers.

While it was defeated in the committee by 13-10, Senator Schumer promised right after the vote he’ll keep fighting to get his proposal in the broader health care bill. He’ll have my continued backing.

We’re going to keep fighting to make health insurance available and affordable for all Americans.

Sincerely,
Senator Bill Nelson

So what's the deal here? Seems like Bill Nelson would like to keep his progressive supporters on board, despite his hot and cold take on the public option. I just wonder what Nelson is telling public option opponents, writing to complain about his vote for the Schumer amendment. Either way, sounds like a classic case of trying to have it both ways while avoiding a principled stand.

Also, check out this nice breakdown of the Finance Committee votes from the Sunlight Foundation.

I'm not a disinterested expert, I just play one on TV

As my feature on Dick Gephardt was going to press, I got an e-mail from a source directing me towards this MSNBC appearance by the former Congressman. At the time, Sam Stein at the Huffington Post wrote up a good summary, with the main take away being Gephardt's calling the public option "not essential". 

Yet, what struck me most in watching the clip was not what Gephardt said, but what Dylan Ratigan didn't: that Gephardt's opinion on healthcare reform cannot be presented without some serious caveats about his lobbying work. Ratigan does some good work from time to time (see, for example, this from just a day or two ago), and I'd like to give him the benefit of the doubt here and say this was some oversight in vetting guests. However, there's a great story (like a Pulitzer winning one, say) on how cable news does such a terrible job disclosing the true interests of  its guests and "experts".

I also really like Gephardt's line on being "more confident now than I've ever been" that healthcare reform will pass this year. As I mention in my article, it was only back in April that Gephardt was telling Democrats to throw in the towel and go for incremental reform.

Anyway, if you've read my piece, this clip does a pretty good job proving my point about the way "expert" status can be manipulated.  Fact is, many lobbying firms eagerly advertise their principals as being able to act as experts for the media on issues relevant to their clients, making anything they publicly say or write an extension of their job promoting the narrow interests of their wealthy clients.

So, if you see a lobbyist on TV, he's there for a reason:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Update 1:  Forgot to add earlier that Gephardt also lobbies on behalf of GE/NBC Universal. From Roll Call: 

“What we have found invaluable is his experience,” said Rick Cotton, general counsel for NBC Universal, a client of the firm. “He brings credibility and highly relevant strategic experience that make him stand out.”

Democrats Go to Bat for Big Pharma

[Originally posted at The Nation's Capitolism blog on 7/30/2009]:

At a North Carolina town hall yesterday, the President went out of his way to mention a brewing legislative battle on Capitol Hill: the fight over how long to grant drug manufacturers monopolies on a new class of drugs called biologics and when to allow cheaper, generic alternatives.

The current proposed legislation--HR 1427 introduced by Representatives Waxman (D-CA) and Deal (R-GA)-- would grant biologics the same 5-year period of exclusivity traditional pharmaceuticals receive now and would limit a manufacturer's ability to get an extension of that monopoly, requiring, for example, a "significant therapeutic advance."

However, Representatives Eshoo (D-CA), Inslee (D-WA) and Barton (R-TX) are planning to introduce an amendment which tows the brand-name industry line that a 12-year monopoly is needed and waters down the criteria for a given biologic's period of exclusivity to be extended. The practice of getting extensions for small tweaks to the original product--things like shifting the delivery method from a pill to an injection or changing the dosage from twice a day to once a day--has been labeled "evergreening" by consumer groups. This month, the European Union's antitrust regulator said she would begin to monitor the practice closely.

In a copy of the amendment obtained by The Nation, the conditions under which a drug's exclusivity may be renewed are numerous and strikingly vague:

"A change…that results in a new indication, route of administration, dosing schedule, dosage form, delivery system, delivery device or strength; or a modification to the structure of the biological product that does not result in a change in safety, purity, or potency."

This essentially grants big drug manufacturers the ability to wait until the 11th hour to make slight adjustments and receive a substantial extension.

These prolonged monopolies, preventing the production of generics and keeping drug prices high in a healthcare system fraught with increasing costs, might explain why the President has expressed concern about the issue.

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Full text of the Eshoo, Inslee and Barton Amendment is below. Also, for more information on the biologics issue, check out this recent editorial from the Post.

Fact Checking Obama on Transparency

[Originally posted at The Nation's Capitolism blog on 7/23/2009]:

During last night's primetime press conference, Christi Parsons of the Chicago Tribune asked President Obama a pointed question about the transparency his administration had often promised during the campaign and seemingly failed to deliver once in power. The President's response, short and direct, was also relatively misleading. Examining the record, we fact-check his remarks.

1) Meeting Health Care Executives

Obama: "Well, on the list of health care executives who've visited us, most of the time you guys have been in there taking pictures, so it hasn't been a secret. And my understanding is we just sent a letter out providing a full list of all executives. But frankly these have mostly been at least photo sprays where you could see who was participating…"

Fact-Check: Until yesterday, that the Obama administration was having meetings with health care executives and lobbyists at the White House as early as February 4th was not public knowledge. When Citizens for Responsibility and Ethics in Washington (CREW) filed a freedom of information request last month for records pertaining to visits by 18 industry executives and lobbyists, their request was denied. An earlier FOI request in May for information on Coal industry executives and their White House visits was similarly denied, both using the same legal arguments that the Bush administration employed to keep Dick Cheney's energy task force meetings out of the public eye. CREW has filed suit in both cases.

Also worth noting is that yesterday's letter released by the White House did not affirm (or satisfy) the FOI request from CREW, but rather was an "exercise of [presidential] discretion"--basically the White House saying that while they believe the public is not necessarily entitled to this information, they'll provide it anyway.

2) Putting Health Care Negotiations on C-SPAN

Obama: "With respect to all the negotiations not being on C-SPAN, you will recall in this very room that our kickoff event was here on C-SPAN, and at a certain point you start getting into all kinds of different meetings--Senate Finance is having a meeting, the House is having a meeting. If they wanted those to be on C-SPAN then I would welcome it. I don't think there are a lot of secrets going on in there."

Fact-Check: Regarding C-SPAN, Obama told a crowd at an August 11, 2008 town hall, "What we'll do is, we'll have the negotiations televised on C-SPAN so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies." With regards to there not being "a lot of secrets going on" in congressional meetings, this article from today's Roll Call describing the secrecy surrounding Sen. Max Baucus' bipartisan talks would suggest otherwise.

3) TARP transparency

Obama: "And the last question with respect to TARP. Let me take a look at what exactly they say we have not provided. I think that we've provided much greater transparency than existed prior to our administration coming in. It is a big program. I don't know exactly what's been requested. I'll find out and I will have an answer for you."

Fact-Check: Testifying before congress the day before the President's presser, TARP Special Inspector General Neil Barofsky told lawmakers that "although Treasury has taken some steps towards improving transparency in TARP programs, it has repeatedly failed to adopt recommendations that…are essential to providing basic transparency."

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For a comprehensive list of Obama White House transparency short-comings, check out this post from Glenn Greenwald.

Health and Wealth

My contribution to the June 24 issue of The Nation:

HEALTH AND WEALTH: 

As the White House begins a push for healthcare reform, it starts at a significant disadvantage, perhaps as large as $1.38 billion. According to the Center for Responsive Politics, a nonpartisan group that tracks campaign contributions and lobbying expenditures, that's the sum that five industries--pharmaceuticals/ health products, insurance, health services/HMOs, hospitals/nursing homes and health professionals--spent lobbying lawmakers from 2007, the first full year Democrats controlled Congress, to the most recent first-quarter filings for 2009.

In fact, starting in 2006 healthcare interests have spent even more than the financial services industry to sway lawmakers. Since 1998, three of the top ten lobbying spenders have sought to influence healthcare policy; the American Medical Association's $204 million in the past decade was second only to the perennial top lobbyist, the US Chamber of Commerce. Beyond lobbying, hundreds of millions have been spent by healthcare interests in campaign contributions in the past two election cycles alone.

So what does all this money buy? According to Nate Silver, renowned number-cruncher and blogger atFiveThirtyEight.com, a whole lot. Silver crafted a method to measure how lobbying might be shaping Democratic senators' votes on a healthcare bill with a public option--which 76 percent of Americans support, according to a recent NBC/Wall Street Journal poll--and concluded that the low sum of $60,000 in campaign contributions over the past six years would cut in half the odds of a centrist Democrat supporting the plan.   SEBASTIAN JONES