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Trustworthiness is the currency of influence
WASHINGTON - If you were to measure the influence any group has in politics by how much money is contributed to campaigns, the healthcare sector would deservedly be labeled influential. But lobbying insiders say it's not just the money that gives the healthcare industry authority - it's the effectiveness of the advocates the industry employs - and that effectiveness - maybe to the surprise of some - is dependent as much on trustworthiness as on anything.
According to the Center for Responsive Politics (CRP), a nonpartisan, nonprofit research group tracking political contributions in the U.S., the healthcare sector as a whole ranks fifth in the top 13 interest groups giving the most money to political campaigns.
CRP's healthcare interest group category includes doctors, doctors' associations and pharmaceutical companies. In the 2011-2012 election cycle, the healthcare interest group contributed $112,948,240, with 36.9 percent going to Democrats and 44.8 percent to Republicans.
CRP also notes that the healthcare industry figures prominently among its all-time heavy hitters list (140 biggest givers to federal-level politics between 1989 and 2012). Some of the healthcare organizations on that list include: the American Medical Association, ranked #17 giving a total of $28,200,557; the American Hospital Association, ranked #47 giving a total of $18,629,82; GlaxoSmithKline, ranked #84 giving a total of $12,016,25; the American Society of Anesthesiologists, ranked #94 giving a total of $10,837,437; and Bristol-Myers Squibb, ranked #134 giving a total of $7,520,799. (See the associated chart.)
When you track money and politics, one thing that is noticeable is that influence generally follows money said Kathy Kiely, managing editor for the Sunlight Foundation, a nonpartisan, nonprofit organization dedicated to government openness and transparency. But money doesn't decide everything.
"Does money help a lot? It sure does," she said. It buys boots on the ground in terms of putting lobbyists in front of lawmakers and, when given strategically - for instance, contributing money to support both Republican and Democratic candidates - it means you have a place at the table no matter which party is in power.
But, contrary to popular opinion, it is trust - not vote buying - that is the currency of influence, industry observers say, and that is why organizations shouldn't be uneasy about engaging lobbyists to get their message out to lawmakers.
"... (Y)ou are not going to burn a bridge faster on Capitol Hill then if a staffer or member of Congress feels that you weren't being fully honest with them," said Maggie Elehwany, JD, the head lobbyist for the National Rural Health Association. "Obviously, you're there to hopefully persuade them of the right path to take legislatively, but you have to be 100 percent honest. Your integrity is all that you have. Otherwise, your clients are not going to trust you and certainly Capitol Hill will never invite you back into their office."
"You don't last in this business if you're not honest, not reliable, not informed, not trustworthy ...," said Howard Marlowe, president of Washington, D.C.-based lobbying firm Marlowe & Co. As president of the American League of Lobbyists, Harlowe has recently begun a publicity campaign to remake the largely negative image of the lobbying profession.
As Harlowe and Elehwany point out, lobbyists, sometimes also called advocates, are not the "necessary evil" many believe them to be - necessary, maybe, they would argue, but evil? No. The job of an effective lobbyist, they said, is to become an expert on their clients' issues, strategize and think ahead, amplify the message of those clients and educate lawmakers and thought leaders on the issues.
"The term 'lobbying' becomes a bit of a misnomer because it suggests that the bulk of the work is a meeting in which somebody is persuaded to say 'yes' who was otherwise going to say 'no,'" said Mark Lutes, a lawyer in the healthcare and life sciences practice of the firm Epstein Becker Green, which has an associated organization that operates as a lobbying unit.
That misunderstanding of lobbying does a disservice to what lobbying actually does, he said - the educational activity, the coalition- and case-building activity - that informs lawmakers and thought leaders.
While various sectors of the healthcare industry have varying degrees of influence, said Lutes, those that engage in advance thinking/strategizing and relationship-building, enjoy more success.