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Healthcare expert for sale

Healthcare expert for sale

Picture of Trudy  Lieberman

Leave it to the Brits to tell us Americans about our healthcare system. In this case the telling is done by Guardian columnist Glenn Greenwald (an American, by the way), who takes us back into the world of revolving-door lobbyists—the ones who come from industry, do a stint of government service for much lower pay, and then when it’s kosher again move back to the private sector to earn their keep until retirement.

Greenwald’s latest post leaps off some reporting by Politico to focus on the story of Liz Fowler, a name that is not new to CJR. Nor is it new to Greenwald, who profiled Fowler’s activities in a Salon blog post a couple of years ago.

Herewith is a brief Fowler curriculum vitae: In 2001 she had a plum job as chief counsel for the Senate Finance Committee, which deals with healthcare bills. As Greenwald’s old Salon post notes, her biography says she “played a key role” in the 2003 Medicare prescription drug law that created a new senior drug benefit—a benefit provided via private insurers,not the government, as is the case for other Medicare benefits. A few years later she landed a position at WellPoint as a vice president overseeing the giant insurer’s lobbying activities.

Fowler then returned to Senate Finance in 2008 to work for Sen. Max Baucus, who chaired the committee, which was becoming Action Central for health reform. Fowler and Baucus pretty much wrote the bill that became Obamacare—and which, we should note, did not include a proposed “public option,” which was popular with ordinary people but not the insurance companies that lobbied hard to make sure it was out of the mix.

For her services Fowler was rewarded with yet another government job, as deputy director of the Center for Consumer Information and Insurance Oversight at the Department of Health and Human Services. In her HHS job she had to “balance” the interests of consumers and insurers. Then this week Politico’s Dave Levinthal and Anna Palmer had a scoop: Fowler is returning to the private world, this time to a senior level position leading global health policy at Johnson & Johnson’s government affairs and policy group.

The revelation prompted Greenwald to take another look at Fowler and the revolving door. He writes:

The pharmaceutical giant that just hired Fowler actively supported the passage of Obamacare through its membership in the Pharmaceutical Researchers and Manufacturers of America (PhRMA) lobby. Indeed, PhRMA was one of the most aggressive supporters—and most lavish beneficiaries—of the health care bill drafted by Fowler. Mother Jones’ James Ridgeway proclaimed “Big Pharma” the “big winner” in the health care bill. And now, Fowler will receive ample rewards from that same industry as she peddles her influence in government and exploits her experience with its inner workings to work on that industry’s behalf, all of which has been made perfectly legal by the same insular, Versailles-like Washington culture that so lavishly benefits from all of this. 

…This is precisely the behavior, which, quite rationally, makes the citizenry so jaded about Washington.

Reporters are jaded too, and that’s why these revolving door stories are not news any more. Other than a solid article by The Huffington Post’s Sam Stein and Christina Wilkie, hardly anyone seems to have followed up on Politico’s scoop. The fact people move in and out of government is hardly a story.

But what they do while they’re in government—and out of it—is. Especially as we move toward implementation of Obamacare, I want to know more about Fowler’s handiwork and the far-reaching effect she has had on healthcare policy.

A decade ago WellPoint laid out a strategy to pursue business in the individual market, precisely the big new market Obamacare sends their way. Will government rules that Fowler may have worked on give the company an edge in the kinds of policies it can sell and the regulations it must follow? What about the provision—first written into the Medicare prescription drug law and later apparently inscribed in the Affordable Care Act—that prohibits the government from negotiating Medicare drug prices with pharmaceutical makers, even though many experts believe those negotiations would help lower the price of medicine for seniors? Johnson & Johnson and other drug makers probably didn’t care much for that idea. Nor did insurance companies like the notion of revealing the prices of their policies on those new government-mandated disclosure forms consumers are starting to see when they shop for a policy.

It’s a good bet Fowler was party to discussions on these issues. But it’s stuff like this—the role of the lobbyist turned government employee, the nitty-gritty of legislation—that we know so little about. We need good reporting to help us learn more.

This post originally ran in the Columbia Journalism Review.

Image by Alex Proimos via Flickr


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