The Guardian July 14, 2004


Prescription for plunder

USA: In the final push for Medicare prescription drug 
legislation, the pharmaceutical industry, Health Management 
Organisations (HMOs) and related interests spent more money and 
hired more lobbyists in 2003 than ever before, according to a 
report issued by Public Citizen.

The pharmaceutical and managed care industries spent a combined 
US$141 million last year, according to Public Citizen's analysis 
of newly released federal lobbying disclosure records.

Drugmakers and HMOs hired 952 individual lobbyists in 2003 — 
nearly half of whom had "revolving door" connections to Congress, 
the White House or the executive branch. That's nearly 10 
lobbyists for every US Senator.

"The Medicare Modernization Act, a top priority of President 
Bush, promises to safeguard industry profits at the expense of 
America's taxpayers", said Frank Clemente, director of Public 
Citizen's Congress Watch. "Considering the legion of lobbyists 
unleashed by pharmaceutical companies, HMOs and allied industry 
front groups, no wonder taxpayers ended up with a bill tailor-
made to serve these special interests instead of senior 
citizens."

Since 1997, Public Citizen has conducted an annual study of 
Washington lobbying by the pharmaceutical industry.

Among findings in the latest report:

* In 2003, the drug industry spent a record US$108.6 million on 
federal lobbying activities and hired 824 individual lobbyists — 
both all-time highs.

* This army of lobbyists helped ensure that the new drug benefit 
will be administered by private companies.

* The new law expressly prohibits the government from using its 
bargaining clout to negotiate lower prices and effectively bans 
the "reimportation" of cheaper drugs from Canada.

* Managed care lobbyists helped ensure their clients got a 
windfall in the bill — US$531.5 billion over 10 years based on 
data from the Medicare actuary — as enrolment in managed care 
plans is expected to climb from 12 percent to 32 percent of all 
Medicare beneficiaries.

Revolving door connections

* Both the pharmaceutical and managed care industries relied 
heavily on lobbyists with "revolving door" connections. In all, 
431 lobbyists employed by the drug industry or HMOs — or 45 
percent of all their lobbyists — previously worked for the 
federal government. Among them were 30 ex-US Senators and 
Representatives — 18 Republicans and 12 Democrats.

* At least 11 top staffers who left the Bush administration 
lobbied for the drug industry and HMOs in 2003. White House and 
administration insiders working as lobbyists on the Medicare bill 
included several former top advisers to Bush, Vice President Dick 
Cheney and Department of Health and Human Services (HHS) 
Secretary Tommy Thompson.

* Since Bush signed the new Medicare law at least four key Bush 
administration officials have exited to help industry clients 
benefit from the Medicare bill that they wrote or promoted. 
Another six top congressional staffers at the centre of 
negotiations over the Medicare bill now lobby for drug companies 
or HMOs.

* The revolving door spins both ways. Three prominent drug 
industry and HMO lobbyists have recently moved into senior health 
policy positions at HHS.

* Drug industry and HMO executives and lobbyists ranked among 
Bush's elite fundraisers. Twenty-one executives and lobbyists 
achieved "Ranger" or "Pioneer" status by collecting at least 
US$200,000 or US$100,000, respectively, for Bush in the 2000 or 
2004 campaigns.

"The revolving door between the White House and K Street has made 
the Bush administration indistinguishable from the industry," 
said Craig Aaron, senior researcher for Public Citizen's Congress 
Watch and lead author of the report.

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