By Bara Vaida
JAN 27, 2011
Provided by Kaiser Health News
The health care battle didn’t end for doctors with the passage of the federal health law and their spending shows it.
The American Medical Association was the biggest spender for lobbying operations among health care groups last year. The AMA, which supported the Democratic health law, faced a serious backlash from members angry that planned cuts in Medicare reimbursements weren’t reversed by the law. To overturn the cuts, the AMA mounted a strong campaign on Capitol Hill.
Chart: Lobbying On Health Care Issues Falls In 2010
The AMA spent nearly $22 million for the year, an increase of nearly 9 percent. That effort helped the organization secure in December “a one year reprieve from the scheduled cuts resulting from the broken Medicare physician payment system,” said AMA President Cecil Wilson in a statement to KHN.
Overall, however, the health law’s enactment brought a decrease from the massive effort stakeholders staged during the heated congressional debate in 2009. Ten key health care players spent about $127 million on lobbying, down nearly 9 percent from 2009, according to lobbying documents filed with the Senate Office of Public Records on Jan. 20 for the fourth quarter of 2010 and records from the Center for Responsive Politics as of Jan. 26. The drop was led by pharmaceutical companies and that industry’s lobbying group, the Pharmaceutical Research and Manufacturers of America, which cut its lobbying expenditures by 17 percent for the year. PhRMA aggressively lobbied to get the health law passed in 2009, and then announced in early 2010 that its CEO, Billy Tauzin, was leaving.
“When legislation is moving, that is when we are engaged,” said Wes Metheny, PhRMA senior vice president, when asked why there had been a decline in spending. The health law passed last March. However, at least one major drugmaker, Merck & Co., and the CVS/Caremark increased their spending.
In addition to the AMA, the American Hospital Association, America’s Health Insurance Plans and the Biotechnology Industry Organization all spent more in 2010 on lobbying than in 2009, driven by lingering issues related to the health overhaul and the Medicare reimbursements.
“The doctors and hospitals still had to get a fix on” Medicare reimbursement rates, said Randy Fenninger, a senior policy adviser at Holland & Knight, whose firm represents hospitals, doctors and insurers. “And for the insurance and biotech industry, there was a lot of (federal) rulemaking which kept them very, very active.”
In addition to the 10 health care players, the seniors group AARP, which lobbies on health care as well as a number of other issues, boosted its expenditures by 5 percent to $22.05 million. AARP supported the health law and among its top issues in 2010 was getting a $250 rebate check out to Medicare beneficiaries caught in the “doughnut hole” for prescription drug reimbursements.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
What a pitiful amount of lobbying money. Listen, we should be the strongest and wealthiest of lobbying groups, defending the rights of patients and our profession before the government.
Instead, we allow the nurses to make us their whipping boys on capitol hill. How long can we allow this?
Thankfully, OBAMACARE is now officially struck down, and is no longer the law of the land. Hopefully the executive branch will stop work on implementing this unconstitutional non-law, and prevent a constitutional crisis.
We docs better start really lobbying, and FAST. We are the big losers at the political roundtable, and it’s time we stood up.
“Thankfully, OBAMACARE is now officially struck down, and is no longer the law of the land.”
It was struck down by two federal judges (Henry E. Hudson, Judge on the United States District Court for the Eastern District of Virginia and Roger Vinson, Judge on the United States District Court for the Northern District of Florida) and upheld by two others (George Steeh, Judge on the United States District Court for the Eastern District of Michigan and Norman Moon, Judge on the United States District Court for the Western District of Virginia).
Both Vinson and Hudson ruled that the law can be enacted while the case is on appeal, so you are unambiguously WRONG.
Additionally, Vinson’s and Hudson’s are the ONLY rulings against the law. The two that upheld the law join the following cases which were dismissed:
Sollars v. Reid -dismissed 4/2/10
Taitz v. Obama – dismissed 4/14/10
Archer v. U.S. Senate – dismissed 4/12/10
Heghmann v. Sebelius – dismissed 5/14/10
Mackenzie v. Shaheen – dismissed 5/26/10
Fountain Hills Tea Party Patriots v. Sebelius – dismissed 6/2/10
Coalition for Parity Inc. v. Sebelius – dismissed on 6/21/10
U.S. Citizens Association v. OMB – dismissed 8/2/10
Baldwin v. Sebelius – dismissed 8/27/10
Burlsworth v. Holder – dismissed 9/8/10
Schreeve v. Obama – dismissed 11/4/10
http://m.whitehouse.gov/blog/2010/12/08/health-reform-wins-another-round-court
Furthermore, Vinson’s and Hudson’s rulings were not without their criticisms.
Essentially, and although I’m not an attorney, I do have a basic understanding of the Constitution, the Constitution grants Congress certain powers and leaves others to the states (the Enumerated Clause). However, there is a clause called the Necessary and Proper Clause which allows Congress to perform actions not originally delegated in the Constitution in order to carry out actions which are specifically delegated in the Constitution. Paired with the Commerce Clause (which the ACA does), this allows Congress to make laws which affect interstate commerce, even if the provisions in those laws are not specifically mentioned in the Constitution that Congress can do.
This legal reasoning has been used on a wide range of now commonly accepted policies, from Civil Rights to the New Deal. And I can assure you that they are as Constitutional as can be.
Hudson’s ruling was called circular and tautological even by conservative legal experts. He wrote:
“[i]f a person’s decision not to purchase health insurance at a particular point in time does not constitute the type of economic activity subject to regulation under the Commerce Clause, then logically an attempt to enforce such provision under the Necessary and Proper Clause is equally offensive to the Constitution.”
Scott Lemieux at Lawyers, Guns and Money highlights why this is unsual:
“This not only contradicts nearly 200 years of precedent but is illogical on its face — if the necessary and proper clause merely gives Congress the power to do things it is authorized to do in other provisions, what is its purpose?”
Hudson also had seriously conflict-of-interest issues due to his involvement with the firm Campaign Solutions, Inc. This firm was involved (for fees in the millions) in campaigns during the last election for candidates that ran, as a part of their platform, on health care reform repeal.
Judge Vinson on the other hand wrote:
“the mere status of being without health insurance, in and of itself, has absolutely no impact whatsoever (not ‘slight,’ ‘trivial,’ or ‘indirect,’ but no impact whatsoever) on interstate commerce, at least not any more so than the status of being without any particular good or service. If impact on interstate commerce were to be calculated mathematically, the status of being uninsured would be represented by zero.”
This is incredibly faulty, if one understands how insurance pools work. Furthermore, the cost of inactivity (not purchasing insurance) clearly impacts the cost of activity (insurance premiums) in a society, as those without insurance more often than not pass on the costs of their care when do finally decide to get care onto those that do have insurance.
When you can’t pay your bill at the hospital, the cost of your care leads to charging more to people with insurance, increasing your premiums. Vinson was rightly criticized for misunderstanding this.
Finally, a group of law professors recently signed a petition (these are law professors, not scientists, so a petition with simply their names on it means more than say, a group of right-wing climate change deniers writing a petition with no research to back up their claims) claiming the ACA is about a constitutional as can be:
http://www.americanprogress.org/issues/2011/01/pdf/law_professors_ACA.pdf
In any event, the law will continue on while these cases make their way to the Supreme Court. Most people who follow these things say it will depend on what Justice Kennedy says.
One thing is clear: nothing you have said is correct or valid. Save the ditto head talk for Rush “Hypocritical Addict” Limbaugh.
“Hopefully the executive branch will stop work on implementing this unconstitutional non-law, and prevent a constitutional crisis.”
Nope, it will continue on, unabated.
“We docs better start really lobbying, and FAST. We are the big losers at the political roundtable, and it’s time we stood up.”
You’re right about this though: we should stand up. For universal health care.
Obamacare is not officially struck down. It’s laughable that you even had the intelligence to read this article. The house repealed the bill, and a vote to repeal it in the senate just failed (as Republicans conceded it would). The only next step is in the Supreme Court. 2 judges are against the bill, specifically citing the mandatory purchasing of insurance as unconstitutional. 2 judges have upheld it. So lets see where it ends up. I think it will probably be upheld by the supreme court, but don’t have enough background in the area to really justify that prediction.
@Wakeup Dude you don’t even know your politics. As said by Laugh, the bill has to go through the house and the senate. Even if by some miracle the bill is repealed by both, it would have still been voted down by Obama’s veto.
The bill is most likely unconstitutional but may be argued like a “tax” under the commerce clause of the constitution. So it does depend on how the Supreme court views it.
Now even the republicans want to make their own bill to increase competition between insurance companies. You really want that over Obamacare? I know its not great but I would rather have that than the republicans running our healthcare.
Yep – as it turns out the Republicans find the mandatory insurance part in violation of the “commerce clause”. But Democrats say it is justified under the “necessary and proper” clause.
Mandatory enrollment doesn’t promote self-responsibility, which is the core problem. Until a system is developed that supports and encourages the patient to better value their own health, money is going to hemorrhage which shouldn’t come from our salaries.
Physicians need to stop JUST posting on this website. Contact your state and federal societies to see what kind of bills are in play. AMA has certainly been whipped by the Democrats and are not aggressive enough to get the other players out of the picture (pharma, med equip reps, etc.) For example, why does a type and screen cost $300 plus? That’s more than a visit.