Interests Cause Small Health Reform Conflict

When I started reporting on a doctor-rating project in three pilot cities including Denver, I was relieved to discover I had no conflict of interest. Even though I was among those who received a survey, I never returned it. After reviewing my responses, I decided I was being too hard on my doctor and shredded it instead.

But it seems conflicts of interest are hard to avoid among those close to the debate about national health care reform.

I recently saw a Washington Post article pointing out that Lewin Group, a Falls Church, Va.-based consulting firm whose stats often are cited by opponents of a public insurance option, is owned by Ingenix Inc., a subsidiary of UnitedHealth Group Inc., the nation’s largest health insurer.

The article said lawmakers, who have been quoting Lewin data showing more than 100 million U.S. residents might leave their employers’ health plans if a government-run alternative were available, have not disclosed that the consultant is owned by an insurer that would lose out if such a scenario ever occurred.

Lewin Group, whose clients include government and private groups with diverse political perspectives ranging from the liberal Commonwealth Fund to the conservative Heritage Foundation, has no record of ever lobbying lawmakers. In fact, Republican and Democratic lawmakers have regarded its analyses as independent and unbiased. But UnitedHealth’s 2007 acquisition of Lewin presents the appearance of a conflict of interest, the article suggested.

The situation got me wondering what other conflicts of interest exist among others involved in the health care reform debate.

Nearly 1 in 4 members of Congress held investments in health care companies during 2007, the most recent year for which data is available. More of them may be indirectly invested if any of their retirement money is in an S&P Index fund.

UnitedHealth, Merck & Co. Inc. and Pfizer Inc. were among the most popular direct investments in lawmakers’ portfolios, according to the Center for Responsive Politics, a Washington-based organization that follows the money in U.S. politics and its effect on elections and public policy. All three companies also are among the biggest spenders on federal lobbying so far this year. In fact, the health care sector spent more than any other industry on lobbying, collectively forking over some $133 million to protect its interests should Congress pass health reform, according to the center.

Susan Bayh, the wife of Sen. Evan Bayh, D-Ind., earned nearly $1 million in cash, stock and stock options between 2006 and 2008 while serving on the board of Indianapolis-based WellPoint Inc., a leading critic of a public option. Citing Lewin Group’s analyses, WellPoint repeatedly has said it would be put at a competitive disadvantage if health reform includes a public health option. Ms. Bayh also sits on the boards of at least three other health care companies and once worked as a lawyer for Indianapolis-based Eli Lilly & Co. But Sen. Bayh says he is “agnostic” about a public plan option.

Sen. John Kerry, D-Mass., and wife Theresa Heinz hold between $22 million and $27 million in health care companies—more than any other lawmaker and spouse—but the senator supports a public plan option.

And Rep. Jared Polis, a Democrat from my home state of Colorado, supports a public health insurance option, but has invested between $1 million and $5 million in BridgeHealth International Inc., a Denver company that specializes in medical tourism.

While it is essential that lawmakers and consultants disclose potential conflicts of interest, I’m not convinced their health care company connections, investments or the industry’s lobbying efforts are having much influence over lawmakers’ opinions about health reform.

As one lobbyist recently put it, “We give them money, and then they do whatever they want. Then we give them more money, and they still do whatever they want,” he said.