The New Health Dialogue

Follow the money.

It’s one of the most famous lines in journalistic lore, and The Washington Post's Dan Eggen takes us on that chase in his reporting on interest group financing that seeks to shape the health reform debate.

Health care is a multi-trillion dollar industry in the U.S. directly employing more than 16 million Americans. In 2008, total U.S. spending on health care reached $2.3 trillion --  a sixth of our economy.

Not surprisingly, such a large and economically important sector has produced no shortage of interests groups with a stake in the final outcome of health reform. Last year alone these groups spent more than $600 million on lobbying and advertising to influence the health debate. Understanding how that money actually gets spent is where Eggen’s piece becomes so useful.

In the world of health care there is a list of maybe twenty or thirty words, some permutation of which describes every interest group, advocacy organization, and stakeholder coalition around. Start with a coalition here or a campaign there. Add in some words about patient, doctors, or medical care and top it off with a healthy dose of patriotism and you’ve got yourself a recipe for the kind of ambiguous “non-partisan” non-profit organizations that have become ubiquitous in today’s debate.

So how do we make sense of a public discourse where groups that sound the same say exactly opposite things on health reform? Our best bet, as Eggen does, is to follow the money. Here’s a quick overview of some of the groups and interests profiled in the article:

• Partnership to Improve Patient Care: Formed by the drug industry to lobby against binding comparative effectiveness studies.

• American Council on Science and Health: Industry friendly group with Betsy McCaughey on the board. Need we say more?

• Health Care for America Now: A key pro-health reform group representing a coalition of unions and labor groups with funding from the liberal Atlantic Philanthropies.

• Conservatives for Patients' Rights: An anti-health reform group founded by Rick Scott, former CEO of Columbia/HCA more famous for his association with the biggest health care fraud scandal in U.S. history.

• Center for Medicine in the Public Interest: An off shoot of the Pacific Research Institute, which has received funding from Pfizer, PhRMA and Philip Morris over the years.

Eggen’s list is by no means exhaustive. Nor should it be seen as an indictment of political discourse on health reform. Complaining about money in politics is sort of like acting surprised that there's gambling  in Casablanca.

The health reform debate has seen more strange bedfellows than Tiger Woods, but with results that have by in large benefited the current state of affairs. To be sure, we can and should question the interests and motives of major players  of all stripes  in the current debate. But can anyone really argue that it’s not better having them at the table, spending their money trying to shape the debate rather then kill the discussion altogether?

What’s important, and in many ways different from the last health reform debate, is the degree of transparency that does exist today.  Bob Woodward had Deep Tthoat. Eggen, and the public in general, have groups like OpenSecrets, SourceWatch, and FactCheck.org combined with a hyperactive media environment to help unwind the Gordian Knot of money, interests, and political spin. With so many voices and views, it’s much harder for a single study or iconic ad to derail the debate. And that’s a good thing.

And just in case you’re wondering, you can see all our funding sources on the About Us page of New America’s Health Policy Program.