[Peace-discuss] Health Care Lobbyists Secretly Secure Democrats' Opposition to "Medicare for All, " Internal Documents Show

[David Johnson]

Health Care Lobbyists Secretly Secure Democrats' Opposition to "Medicare for
All," Internal Documents Show

 <https://theintercept.com/staff/leefang/>
https://theintercept.imgix.net/wp-uploads/sites/1/2018/03/Lee-Fang-headshot-
bw-crop-1521415569.jpg?auto=compress%2Cformat&q=90&h=60&w=60
<https://theintercept.com/staff/nick-surgey/>
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 <https://theintercept.com/staff/leefang/> Lee Fang,
<https://theintercept.com/staff/nick-surgey/> Nick Surgey


August 2 2018, 4:00 a.m.

 <http://documentedinvestigations.org/> 

 <http://documentedinvestigations.org/>  

 

The 1st Congressional District of Hawaii is about as far from Washington,
D.C.'s pitched political battles as you can get - not typically seen as a
national bellwether. Yet the race for the congressional district, centered
in southern Oahu, is one of several competitive elections that has attracted
the attention of big-money lobbyists seeking to influence the direction of
American health care policy.

Hawaii's 1st District seat, which was vacated by incumbent Democratic Rep.
Colleen Hanabusa, who is running for governor, has attracted six serious
candidates to the Democratic primary in this reliably blue district.
According to documents obtained by The Intercept, at least three of the
candidates took time out from their schedules to talk to a consultant
dispatched by the Healthcare Leadership Council, a lobbying group that seeks
to advance the goals of the largest players in the private health care
industry.

Now, the 1st District candidates working with the Healthcare Leadership
Council - former state Sen. Donna Mercado Kim, Hawaii Lt. Gov. Doug Chin,
and Honolulu City Council Member Ernest Martin - are taking heat from their
opponents for talking to an industry-friendly group, even as public opinion
is increasingly rallying to positions opposed by giant health care
companies.

"Democrats running in a primary election will say they support 'Medicare for
All,' but what do they say to lobbyists behind the scenes?" said
<https://theintercept.com/2018/07/05/climate-change-left-politics-policy/>
Kaniela Ing, a state lawmaker vying for the 1st District seat on a
democratic socialist platform, warning of Democrats who make progressive
promises when campaigning, but then work hand in hand with industries when
in office. "We need health care champions, not puppets."

One of the leading candidates has campaigned on a promise to crack down on
over-priced pharmaceuticals and promote single payer health care, but told
the consultant dispatched by the Healthcare Leadership Council that he would
maintain drug industry-friendly pricing policies and views Medicare for All
with skepticism.

The Healthcare Leadership Council has closely tracked what its lobbyists
have described as the "leftward movement" within the Democratic Party. In
Hawaii and other states, the lobby group wanted to know if ideas popularized
by Sen., Bernie Sanders, I-Vt. - such as aggressive proposals to reduce the
cost of pharmaceuticals and institute a single-payer health care system
modeled on Medicare - were taking hold.

The council, which spends over
<http://990s.foundationcenter.org/990_pdf_archive/363/363668803/363668803_20
1612_990O.pdf> $5 million a year on industry advocacy and brings together
chief executives of major health corporations, represents an array of health
industries, including insurers, hospitals, drugmakers, medical device
manufacturers, pharmacies, health product distributors, and information
technology companies.

The group's focus on competitive open seats around the country - like
Hawaii's 1st Congressional District - is aimed at shaping the next
generation of lawmakers' views on health care policy.

 
<https://www.documentcloud.org/documents/4618671-Hawaii-1st-District-HLC-Sur
vey.html#document/p1>
https://assets.documentcloud.org/documents/4618671/pages/Hawaii-1st-District
-HLC-Surveys-p1-normal.gif

 
<https://www.documentcloud.org/documents/4618671-Hawaii-1st-District-HLC-Sur
vey.html#document/p1> Healthcare Leadership Council Dossiers for Hawaii's
1st Congressional District Candidates12 pages

 

The Healthcare Leadership Council's outreach in Hawaii began in January. In
an email obtained by The Intercept, the group told candidates that it was in
the process of forming a coalition to "jointly develop policies, plans, and
programs to achieve their vision of a 21st century system that makes
affordable, high-quality care accessible to all Americans" - language that
obscured its national campaign to monitor and blunt the energy behind
progressive health policy reforms. The email included an invitation for the
candidates to take a meeting in Honolulu.

Kim, Chin, and Martin agreed to speak to the Healthcare Leadership Council,
which then
<https://www.documentcloud.org/documents/4618671-Hawaii-1st-District-HLC-Sur
veys.html> drew up dossiers on each candidate based on their answers to the
survey questions. The dossiers, which were obtained by The Intercept and
Documented, profiled each of the candidates, including their photos,
biographical sketches, contact information for their campaigns, and a
checklist for determining their positions on certain issues of importance to
the Healthcare Leadership Council. (Kim and Martin's campaigns did not
respond to a request for comment for this story.)

In an email to The Intercept, Michael Freeman, executive vice president of
the Healthcare Leadership Council, said that his organization surveys
"congressional candidates every election cycle regarding their views on a
wide range of healthcare issues."

The dossiers offer the candidates' general outlook on health care policy
issues, as well as their answers on specific policy positions. Of Kim, the
former state senator, the group's profile says, "She is very pro-market,
opposes any attempt at single payer, does not support price controls on
pharmaceuticals and agrees that Medicaid and Medicare need to be managed by
the private market."

Chin is a "moderate Democrat that has represented healthcare providers in
Med-mal lawsuits," said the Healthcare Leadership Council's profile. Chin,
the survey noted, "supports the market concept advocated by HLC and does not
think a single payer/Medicare-for-All approach would work in Hawaii."

"Martin supports a majority of HLC's positions," the profile on the Honolulu
City Council member says. "He does not want single payer." But, the dossier
noted, Martin needed better education on health policy.

In some cases, what the candidates told the lobbyist appeared to differ from
what they told voters.

Chin indicated to the Healthcare Leadership Council that he supports its
position that the "best way to achieve the lowest prices for Medicare
beneficiaries in the Medicare Part D program is through the current process
of private sector negotiation," according to his dossier.

As it stands now, the Medicare law, authored under
<https://www.motherjones.com/politics/2016/10/drug-industry-pharmaceutical-l
obbyists-medicare-part-d-prices/> the influence of the drug lobby, prevents
the agency from using its collective bargaining power to negotiate lower
prices for pharmaceuticals as part a benefit program known as Part D.
Progressive health care activists have agitated for the government to become
directly involved in negotiations. Public Citizen, a watchdog group, claims
that allowing Medicare to negotiate for lower-priced drugs could save
<http://www.valuewalk.com/wp-content/uploads/2015/10/283117277-Medicare-Part
-D.pdf> $15 billion per year from the program's budget.

Drug industry groups like the Healthcare Leadership Council - which is
funded by pharma giants Amgen, Johnson & Johnson, Merck, Pfizer, Novartis,
Novo Nordisk, and Bristol-Myers Squibb - have opposed the negotiation route.

Chin's claim, according to the Healthcare Leadership Council documents, that
he supports the industry-friendly status quo contrasts sharply with what he
has said in public. In July, he told local news website Civil Beat that he
<https://www.civilbeat.org/2018/07/candidate-qa-u-s-house-district-1-doug-ch
in/> supports "steps like empowering the federal government to negotiate
lower prescription drug prices for Medicare beneficiaries." (Civil Beat and
The Intercept's publisher, First Look Media, were founded by Pierre
Omidyar.)

In response to a request for comment from The Intercept, Chin stuck with his
public position that Medicare Part D should include negotiations with
drugmakers over prices. "Doug Chin speaks with seniors across Hawai'i who
are making heartbreaking sacrifices to buy the life-saving prescriptions and
get the quality health care they need. That's why he supports the merits of
a single-payer system, and it's why he will demand that Medicare use its
existing authorities - and support giving it new powers - to negotiate
better deals for seniors," said Chin's campaign manager, Dylan Beesley.
"Doug was endorsed by End Citizens United because he is committed to getting
the secret cash from big drug companies out of politics - for good."

The campaign's statement did not address a question from The Intercept about
why the council lists Chin as supporting its position that Medicare should
not negotiate directly with drug companies - or the discrepancy with his
public stance.

The dossiers indicated that all three candidates who met with the group were
rated as positive leaders who shared much of the Healthcare Leadership
Council agenda and were the type of politicians who might turn to the group
to help formulate policy.

Yet the Healthcare Leadership Council didn't blanket all the state's
congressional candidates with requests for meetings. Beth Fukumoto, a
Republican-turned-Democratic state legislator who launched her campaign for
the 1st Congressional District seat in March, had not heard from the group,
according to a campaign spokesperson. Another candidate for the seat, former
Rep. Ed Case, a conservative "Blue Dog" Democrat who has served recently as
a senior executive at Outrigger Hotels, did not respond to a request for
comment from The Intercept about whether he had received any requests from
the Healthcare Leadership Council.

The group also kept tabs on candidates that could be a threat to its agenda.
In its internal profile for Ing, the democratic socialist candidate, the
Healthcare Leadership Council noted that Ing vocally supports a
single-payer, public health care system. "One of Kaniela Ing's top
priorities will be to promote a single-payer, Medicare-for-all system," the
dossier says.

Lobbyists for the group have told health industry executives to remain
vigilant about the threat of single payer.

"It would be a mistake for us to overlook the growing number of lawmakers
who are supportive of measures to expand significantly government's role in
healthcare," the
<https://www.hlc.org/app/uploads/2016/02/HLC-STRAT-2018.pdf> Healthcare
Leadership Council warned in a report published at the end of last year.

The report observed that Sanders, the Vermont senator, had introduced a
"Medicare for All" bill during every congressional session, typically by
himself. But when
<https://theintercept.com/2017/09/13/obamacare-over-single-payer-medicare-fo
r-all-bernie-sanders/> he unveiled his latest version of the legislation in
2017, Sanders "had 14 Democratic senators with him, including some thought
to be presidential contenders in 2020." Even more moderate members,
including Sen. Tim Kaine, D-Va., and Sen. Michael Bennet, D-Col., had
introduced a public option bill that would provide patients with the ability
to purchase a government-sponsored insurance plan that would ensure access
with Medicare providers, paying Medicare reimbursement rates.

The Healthcare Leadership Council report said that while these ideas do not
have the political support to pass at the moment, the "momentum on the
Democratic side of the aisle is undeniable." The group has warned health
care executives to remain vigilant and dispatched its team of lobbyists,
which
<https://www.opensecrets.org/lobby/clientlbs.php?id=D000051712&year=2018>
includes a bipartisan team of two former members of Congress and several
former senior congressional staffers, to keep tabs on rising candidates.

The Healthcare Leadership Council's outreach to candidates was not limited
to Hawaii. Lobbyists working with the group have surveyed congressional
candidates for open seats in Indiana, Kansas, California, Minnesota,
Illinois, and New Mexico.

For instance, Young Kim, the Republican nominee for California's 39th
Congressional District, an open seat and one of the most competitive races
in the country, spoke to the Healthcare Leadership Council earlier this
year.

"She has very little understanding of the healthcare delivery system, but
wants to learn," the
<https://www.documentcloud.org/documents/4618670-Young-Kim.html> dossier on
Kim noted. "Her philosophy is similar to HLC's overall agenda. She supports
the market as the real innovator in healthcare does not support California's
effort to implement a Medicare for All system." The lobbyists who drew up
the dossier found that Kim agreed with the Healthcare Leadership Council on
88 percent of the policy positions it inquired about.

Other  <https://www.documentcloud.org/documents/4618669-Hagedorn.html>
dossiers noted that some Republican candidates were privately skeptical of
repealing the Affordable Care Act. Jim Hagedorn, a Republican candidate for
Congress in Minnesota, shared internal polling from his campaign with the
Healthcare Leadership Council, revealing that health care is the No. 1 issue
in his district. Though he expressed support for "free market healthcare,"
Hagedorn conceded that he has heard from "many farmers having to choose to
not to carry insurance and gamble that they do not need it."

The Healthcare Leadership Council's candidate outreach program is part of
the group's ongoing push to develop "get-out-the-vote" efforts for favored
politicians, develop "early connections to successful congressional
candidates," and aggregate data about up-and-coming lawmakers so that health
care executives and lobbyists can quickly facilitate meetings and
relationships, according to an internal document explaining its political
approach to member companies. The group
<https://www.hlc.org/regional-advocacy/> boasts on its website that it has
conducted 3,900 meetings with lawmakers, staff, and candidates around health
care issues.

The group also organizes coalition efforts with patient organizations,
industry letters to regulators, and regular coffee sessions between
legislators, congressional staff, and health industry executives.

The threat of government expansion into health care, however, has added new
urgency to the council's outreach efforts.

 
<https://www.documentcloud.org/documents/4617924-HLC-SinglePayer-v3.html#doc
ument/p1>
https://assets.documentcloud.org/documents/4617924/pages/HLC-SinglePayer-v3-
p1-normal.gif

 
<https://www.documentcloud.org/documents/4617924-HLC-SinglePayer-v3.html#doc
ument/p1> Healthcare Leadership Council Talking Points on "The Ramifications
of Single-Payer Healthcare"3 pages

 

The Healthcare Leadership Council also recently produced a set of talking
points to warn of the "ramifications of single-payer healthcare." The
document makes the outlandish claim that "Medicare for All" proposals might
resemble the failed health care system of Venezuela and prophesies extreme
cuts in care and health services.

In reality, the "Medicare for All" program proposed by an increasing number
of Democrats would be akin to the system in Canada, under which the
government provides health insurance coverage free of cost for patients to
seek care with private-sector providers. Leading health policy
<https://www-tc.pbs.org/moyers/journal/07102009/ahip2.pdf> watchdogs have
found that the system in Canada and similar government-run health plans
provide higher quality medical services at a much lower cost than the U.S.
system.

The alarmist positions relayed in the talking points reprise a familiar role
for the group.

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Health insurance whistleblower Wendell Potter previously
<https://www.salon.com/2009/09/15/potter_pr> worked closely with the
Healthcare Leadership Council. Potter later leaked documents detailing a
health insurance industry plan to stigmatize single payer during the 2008
election, hoping that scare tactics would dissuade successful Democrats from
championing the idea. The anti-single-payer plan
<https://www-tc.pbs.org/moyers/journal/07102009/ahip2.pdf> included outreach
to moderate Democrats at organizations such as the Progressive Policy
Institute - the think tank arm of centrist group Third Way - to position the
idea as an extremist threat to the Democratic Party. The plan called for
supporting groups that would
<https://www-tc.pbs.org/moyers/journal/07102009/ahip2.pdf> broadcast
supposed "horrors of government-run systems."

The Healthcare Leadership Council also served as a coordinating organization
for health industry lobbyists to launch attacks against President Bill
Clinton's push for a national health care plan in 1993. During the debate
over the bill, industry organizations sponsored misleading campaign
commercials to mobilize mass opposition to the policy.

At a gathering of health care executives in 1994, at the height of
negotiations, then-Council President Michael David Bromberg
<https://www.washingtonpost.com/archive/business/1994/02/06/health-cares-hea
vy-hitter/ffb30371-3ef2-4cac-8b58-3fc7db1c702e/?utm_term=.02a9e92efa63>
reportedly rose from his chair and confronted then-first lady Hillary
Clinton, threatening that if she did not agree to industry demands, the
industry would strike back and campaign against her and her husband's plan.

 

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