Despite last week’s post on lobbying and lobbyists I’m happy to report I was not kidnapped or harmed by lobbyists this past week for drawing heat to their livelihoods. Recall, last week I posted on the record $3.5 billion spent in 2009 on lobbying at the federal level. I want to follow up that post by sharing with you the list of Top 20 lobbying clients in 2009 as identified by the Center for Responsive Politics. Here they are:
Lobbying Client (Total Amount Spent on Lobbying Efforts in 2009):
1. U.S. Chamber of Commerce ($144,496,000)
2. ExxonMobil ($27,430,000)
3. Pharmaceutical Research & Mfrs. Of America ($26,150,520)
4. General Electric ($25,520,000)
5. Pfizer Inc. ($24,619,268)
6. Blue Cross/Blue Shield ($22,715,439)
7. AARP ($21,010,000)
8. American Medical Association ($20,830,000)
9. Chevron Corp. ($20,815,000)
10. National Association of Realtors ($19,477,000)
11. American Beverage Association ($18,850,000)
12. American Hospital Association ($18,347,176)
13. ConocoPhillips ($18,069,858)
14. Verizon Communications ($17,820,000)
15. FedEx Corp. ($17,050,000)
16. Boeing Co. ($16,850,000)
17. BP ($15,990,000)
18. National Cable & Telecommunications Assoc. ($15,980,000)
19. Northrop Grumman ($15,180,000)
20. AT&T Inc. ($14,729,673)
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You're right, www.opensecrets.org is an interesting site. I spent a little time there and found something very interesting. Leading the pack of "Top Givers" in the 2008 election cycle: Trial Lawyers. I promise you that I’m not making these figures up. You can see them for yourself:
ReplyDeleteTop Givers In The 2008 Cycle
Leading the pack of "Top Givers" in the 2010 election cycle: Trial Lawyers.
Top Givers In The 2010 Cycle
So, taking your advice, I asked myself Has spending such vast sums on lobbying improved the quality, scope, and reach of legislation and policy emanating out of Washington to make the everyday lives of a greater multitude of citizens better and more productive? Not surprisingly, unless you're a trial lawyer the answer is NO. However, if you are a trial lawyer, the money appears to have been well spent since not only have the Democrats blocked any effort at tort reform, they have actually written sweetheart deals into pending legislation for their dedicated benefactors:
Buried in Speaker Nancy Pelosi's 1,990-page bill is a provision that provides "incentive payments" to each state that develops an "alternative medical liability law" that encourages "fair resolution" of disputes and "maintains access to affordable liability insurance." Sounds encouraging. Read on, however, and you come to this nugget: The state only qualifies if its new law "does not limit attorneys' fees or impose caps on damages."
[...]
Huge contingency fees and damage awards are the mother's milk of frivolous lawsuits. That's why 30 states have adopted caps on awards as the core of their reform, with huge success. Texas imposed malpractice caps in 2003, and the state has been rewarded with fewer lawsuits, a 50% drop in malpractice premiums, and a flood of new doctors. The House bill is intended to discourage other states from doing the same.
The Pelosi bill also provides these incentives only if states adopt watered-down alternatives to existing malpractice caps. Those alternatives include certificate-of-merit rules, which in theory require lawyers to get medical proof before suing but in practice mean that lawyers recruit and finance "expert" witnesses.
States could also provide "early offer" rules, which are supposed to encourage fair settlement of legitimate claims. But as organizations like the Manhattan Institute have noted, those offers only work if combined with restrictions on lawyer fees and damage awards that reduce the incentive to go for the jackpot judgment.
... And a Buried Tort Bomb, WSJ
Of course, it's not about the money, lawyers always have justice and the victims best interests at heart, right?
9/11 Billable Billions, Lawyers in line for half of $4B "toxic" pot, New York Post
More on the 9/11 Lawsuit Scam, John Stossel
Anonymous,
ReplyDeleteTo a certain extent, I have to agree with you. Yes, the lawyer lobby is well-financed and powerful. Generally, lawyer or non-lawyer lobbyist, I'm personally troubled by the role that money and special interest influence plays in American politics.
In theory I'm for tort reform. The only problem is that if I go to a hospital to have my right leg amputated due to some medical condition, I'd be troubled and not want to have my damages capped if the hospital negligently amputates my left leg instead of my right leg (the correct leg). Further, what about a situation where a hospital or doctor does something negligently to end the life of your spouse, child, sibling, parent, or grandparent? Would you accept $10,000 as adequate compensation for their life? Personally, that is my take on tort reform. Something to think about in the tort reform debate.
I have my doubts that the healthcare system in this country is broken for a vast number of citizens simply because of a lack of tort reform and damage caps. Even if we impliment tort reform, I doubt that private insurance companies will focus on bringing down policy premiums and extending coverage to more citizens. Afterall, these are private entities whose primary objective is to maximize earnings and return value to shareholders. We will still get denied coverage for pre-existing conditions, and certain critical tests and necessary treatments will be denied to manage cost and profits for the insurance company.
Fraud, mismanagement of some testing, lack of electronic medical records, lack of competition in some places, and a plethora of factors drives a number of American's inability to receive adequate healthcare. Looking past any political orientation or affinity, I think we lose our ability to problem solve and create effective public policy if we focus in on just one facet of a problem.
I'd be troubled by the examples that you offer as well. Unfortunately, no one can set a monetary value on the loss of a life or a limb and awarding someone $20 million is just as arbitrary as $250,000. The difference, of course, is the effect those awards have on the larger system of medical care as this USA Today piece relates:
ReplyDeleteAt $210 billion annually, defensive medicine is one of the largest contributors to wasteful spending, and it can manifest in many forms: unnecessary CT scans, MRIs, cardiac testing and hospital admissions. A 2005 survey in the Journal of the American Medical Association found that 93% of doctors reported practicing defensive medicine.
[...]
In an optimal system, every case tried should involve clear medical malpractice — wrong-site surgery or performing an incorrect procedure, for instance. But the reality is far from that. Poor medical outcomes occasionally occur despite textbook medical care.
A landmark study from The New England Journal of Medicine analyzed more than 1,400 malpractice claims and found that in almost 40% of cases, no medical error was involved. Facing such an unpredictable malpractice climate, a physician's instinct is to increase testing.
[...]
Every test has the risk of a "false positive," which is a positive test in the absence of disease. Doctors generally act on every abnormal result, so a simple X-ray finding could lead to further tests, such as an advanced imaging scan or biopsy. When you consider that a CT scan can expose patients to radiation equivalent to several hundred X-rays, and a biopsy might have serious complications such as bleeding or infection,there comes a point where increasing the frequency and degree of diagnostic studies could lead to harm.
Following massive awards in cases involving babies stricken with cerebral palsy, in which trial lawyers claimed that the outcomes were the result of negligence, many obstetricians began performing C-sections in cases where they might otherwise have opted not to. Thousands of C-sections have been performed in response to these lawsuits. The cause of cerebral palsy has since been determined to be a maternal virus and not any negligence on the part of the attending obstetrician. In the name of justice, shouldn't the lawyers who have reaped hundreds of millions from these cases be required to return that money? What about the lawyers who made millions on cases involving silicone breast implants, since shown to be completely safe, shouldn't they be required to return those judgments? And where do the doctors go to get their reputations back? How about the rest of us who have paid hundreds of billions in additional insurance costs as a result of these kinds of cases and the defensive medicine they have spurned, not to mention the real and potential harm they have caused? Perhaps the trial bar should be brought to judgment.
The influence of lawyers on our political system has been considerable. Everything from laws which no ordinary citizen can decipher to sweetheart clauses written specifically for the trail bar to exploit. One would think that such a situation would give pause to lawyers expressions of indignation at the behavior of others, but then it's always been an effective tactic to vilify those one seeks to destroy. Just call it jury prep.
I completely agree with Professor Grant's comments. We completely lose our ability to problem solve and create effective public policy if we focus in on just one or two facets of a problem.
ReplyDeleteOne does not get to focus on the problematic facts of health care until health care as a whole is fixed, until all Americans have health care.