Only the naïve would expect a public official to be pure as an angel these days, what with today’s megabuck campaigns and the cash dangled before legislators by special interests which have much to gain (or lose) from governmental decisions. In health care, it’s especially tricky since the entire system has been morphing into a money-making machine for its many stakeholders. The outcome of this latest drive to overhaul the system will depend a lot on how loudly that money talks.
Thanks to The New York Times we now hear that Tom Daschle, the president’s choice for Secretary of Health and Human Services, had neglected to pay some taxes on the free car-and-driver services provided by a prominent businessman and Democratic fundraiser. He is the second cabinet appointment to forget about his taxes—but in the euphoria generated by a new administration, apparently neglecting one’s taxes is forgivable as long as they eventually get paid.
So perhaps the most significant revelations from the newspaper were those that came at the end of its story. Daschle, who has worked for the law firm Alston & Bird as a special public policy adviser with an emphasis on health care, received “more than $390,000 for speeches to groups like America’s Health Insurance Plans,” the Times reported. AHIP will be a key force in determining whether reform ever actually happens. Daschle also “received more than $5,000 for giving ‘policy advice’ to the insurer United Health.” UnitedHealthcare, one of the nation’s biggest health carriers, has a big stake in reform.
All this is a bit unsettling. In our profession, most media outlets long ago cracked down on speaking fees paid to journalists who sometimes addressed similar groups. The justifiable fear was that reporters who took speaking fees might be subtly—or not so subtly—biased toward those who gave them money, and that would affect how they reported on their benefactors when it came time to do the tough story. How could a journalist who has taken money from, say, UnitedHealthcare report critically on the subsidiaries in its empire that cherry-pick the healthiest people and leave the rest stranded without coverage; or the unsavory sales practices that might accompany its growing Medicare prescription drug business; or the high deductible health plans it markets that leave some policyholders underinsured when serious illness strikes; or its health IT business that could profit from mining patients’ medical records?
The same questions can be asked of Daschle, and Fox News Sunday did that yesterday. A company press release shows how important these lines of business are to United. In Daschle’s hearing before the Senate Health, Education Labor, and Pensions Committee in early January, senators dodged the hard questions and essentially gave Daschle a free pass to confirmation, which we noted on Campaign Desk.
We would like to know just what kind of advice Daschle gave United and how, for example, he might square such advice with the looming fight over cutting the federal government’s overpayments to sellers, including United, of the now infamous Medicare Advantage plans. And what’s his position on a public, Medicare-like insurance option—which is sure to be opposed by United and AHIP? The media need to find out and prod the Senate Finance Committee for answers. The public deserves no less from the man who will help decide whether or not they have health care in the coming years.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.