Health Care: Who Will Be at the Table?

Following the (insurance company) money

Barack Obama has made a big deal about who will be at his table when the time comes to craft health care legislation. His politics of inclusion embraces everyone, it seems, and as he has said in Iowa and beyond, when it comes to health care he would have a large table. “I will have insurance company representatives and drug company representatives at the table,” he said. “They just won’t be able to buy every chair.” Maybe not, but how many chairs they will get is the question, and not just for Obama. Will the number of chairs be proportional to the contributions special interests have given to the various campaigns?

Of course, no one will know the answer until the stakeholders roll up their sleeves and begin the horsetrading that may or may not produce a law. But campaign contributions are given for a purpose—often to support an ideology and to buy influence. There’s a reason why money is called the mother’s milk of politics. And the media should be telling folks from where the milk is flowing. Such stories have been scarce.

One exception is The New York Times, which had a fine piece last fall by Raymond Hernandez and Robert Pear checking contributions made by the health industry, including drug companies, doctors, hospitals and nursing homes, and insurance carriers. The story’s most revealing quote came from Mary Nell Lehnhard, senior vice president of the Blue Cross and Blue Shield Association, who told the Times “As long as the candidates are willing to talk to us, we can educate them.” In other words, if they get to the table, their voice will be heard., the Web site of the Center for Responsive Politics, says that for the first nine months of 2007, the candidates raised about $420 million altogether and were “on track to collect an unprecedented” $1 billion before it’s all over. According to Opensecrets, Obama and Hillary Clinton combined had raised 41 percent of the total that all candidates have raked in so far.

CJR asked the Center to break down contributions from the health insurers and found that both Clinton and Obama outpace other candidates when it comes to insurance-company gifts. For the first nine months of 2007, the last reporting period, Clinton had received about $120,000 and Obama $130,000—more than double the amounts Giuilani and Romney got from health insurers. Edwards, with his anti-corporate message, received only $19,000 from that group.

That money is significant. For Clinton, half of it came from BlueCross/Blue Shield, Kaiser Permanente, and Unitedhealth Group. For Obama about 60 percent came from those carriers, some of the country’s largest. They will want to make sure that the way we do health care business won’t change in a way that is unfavorable to them under either a Clinton or Obama plan.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.