March 29, 2020

Reaping Profit After Assisting on Health Law

That means boom times for what might be called an Obamacare cottage industry, providing work for dozens of former administration and mostly Democratic Congressional officials whose immersion in health policy minutiae, and friendships, make them invaluable to private business.

Dr. Dora Hughes, for example, has a medical degree from Vanderbilt and a master’s in public health from Harvard and never envisioned joining a law firm. But Dr. Hughes, a former Obama administration official, has something Washington lawyers and lobbying shops covet: an insider’s understanding of the new health care law.

After nearly four years as counselor to Health and Human Services Secretary Kathleen Sebelius, she left government last year to work for Sidley Austin, which represents insurers, pharmaceutical companies, device makers and others affected by the law. She is not a registered lobbyist, but rather a “strategic adviser,” although some call that a distinction without a difference.

“Health policy is what I do,” Dr. Hughes said in a recent interview. “It’s what I’ve always done, so I’m not doing anything differently. My work is not based only on relationships or trying to curry favor.”

The health care industry now spends more money on lobbying in Washington than any sector of the economy — more than $243 million last year alone, slightly higher than the $242 million spent by financial, insurance and real estate companies, according to the Center for Responsive Politics here.

Of the “revolving door lobbyists” profiled by the center, those specializing in health care account for 12 percent, more than any other economic sector.

Critics say these former officials are cashing in, trading on the relationships and expertise they acquired while working for the taxpayers, and cite such career moves as proof that Mr. Obama has not lived up to his promise to change the culture of influence peddling in the capital.

Liz Fowler, a onetime executive with WellPoint, the insurer, helped draft the legislation as the chief health counsel for the Senate Finance Committee and later joined the administration. Now she runs global health policy for Johnson Johnson, the medical equipment and pharmaceutical giant, which strongly backed the health bill and stands to benefit from it.

Ms. Fowler is not a registered lobbyist, but she does provide in-house advice on the bill — work that has drawn criticism from publications like the British newspaper The Guardian and the Web sites Salon and The Huffington Post, where the journalist Bill Moyers singled out Ms. Fowler, asserting that “when push comes to shove, corporate interests will have the upper hand.”

Yet the progression from government to the private sector is also predictable, a window into the peculiar rhythms of life in the capital. Young aides, often fresh out of college or graduate school, acquire highly specialized knowledge but eventually settle down, build lives and long for jobs that pay more and let them see their children at night.

Those were considerations for Dr. Hughes, who has a 3-year-old, and Yvette Fontenot, a mother of three who began her Washington career in 1997, analyzing Medicare for the Office of Management and Budget. Ms. Fontenot worked on the health bill as a Finance Committee aide and later moved to the White House. Four months ago she joined Avenue Solutions, a boutique lobbying shop.

“Every client out there is interested in the Affordable Care Act and what it means,” said Ms. Fontenot, who like Dr. Hughes concentrates on strategic advice. With exchanges soon to go live, she said, companies “want to know whether there is a potential to build on this, to make changes.”

Many of the former health care officials are lawyers or lobbyists, though not all. Nancy-Ann DeParle, Mr. Obama’s former “health czar” and later his deputy chief of staff, now guides health care investments as a partner in a new private equity firm, Consonance Capital, with colleagues from her pre-White House days. Bob Kocher, a doctor, management consultant and former member of Mr. Obama’s economics team, is a California venture capitalist, helping finance health start-ups.

Article source: http://www.nytimes.com/2013/09/18/us/politics/reaping-profit-after-assisting-on-health-law.html?partner=rss&emc=rss

U.S. Releases Graphic Images to Deter Smokers

In the first major change to warning labels in more than a quarter-century, the graphic images will include photographs of horribly damaged teeth and lungs and a man exhaling smoke through a tracheotomy opening in his neck. The Department of Health and Human Services selected nine color images among 36 proposed to accompany larger text warnings.

Health advocacy groups have praised the government plan in the hope that images would shock and deter new smokers and scare existing smokers into quitting.

The images are to cover the upper half of the front and back of cigarette packages produced after September 2012, as well as 20 percent of cigarette advertisements.

“These labels are frank, honest and powerful depictions of the health risks of smoking and they will help encourage smokers to quit, and prevent children from smoking,” Kathleen Sebelius, the secretary of health and human services, said in a statement Tuesday.

The four leading tobacco companies were all threatening legal action, saying the images would unfairly hurt their property and free-speech rights by obscuring their brand names in retail displays, demonizing the companies and stigmatizing smokers.

The government won one case last year in a federal court in Kentucky on its overall ability to require larger warning labels with images; the specific images released on Tuesday are likely to stir further legal action.

The Kentucky case is before the United States Court of Appeals for the Sixth Circuit.

The new labels were required under landmark antismoking legislation giving the Food and Drug Administration power to regulate, but not ban, tobacco products. The Family Smoking Prevention and Tobacco Control Act required F.D.A. action on the graphic warning labels by Wednesday, the two-year anniversary of President Obama’s signing it into law.

The United States was the first nation to require a health warning on cigarette packages more than 25 years ago, but since then, at least 39 other nations including Canada and many in Europe have imposed more eye-catching warnings, including graphic photographs.

“This is a critical moment for the United States to move forward in this area,” F.D.A. Commissioner Margaret A. Hamburg said in an interview. “The trends in smoking really support the need for more action now. For four decades, there was a steady decline in smoking, but five to seven years ago we leveled off at about the 20 percent level of adult and youth smoking in this country.” 

  Lawrence R. Deyton, director of the F.D.A. Center for Tobacco Products, said the government estimates — based on other countries’ experience — that the new warning labels will prompt an additional 213,000 Americans to quit smoking next year.

“We are pleased with the images they picked,” said Nancy Brown, chief executive of the American Heart Association. “They strongly depict the adverse consequences of smoking. They will get people’s attention. And they will certainly be much more memorable than the current warning labels.” 

  Gregory N. Connolly, a professor and tobacco expert at the Harvard School of Public Health, also praised the strength of the pictorial warnings, but he said the F.D.A. needed to take tougher action against cigarettes.   “What’s on the pack is important, but if you really want to cut smoking rates, you’ve got to get inside the pack and deal with ingredients like menthol and nicotine,” Dr. Connolly said.  

The nine images chosen in the United States include some that are among the most graphic of the 36 draft images. But they also include some of the less vivid, including a cartoon depiction of a baby rather than a photo in the draft set that showed a mother blowing smoke at a baby.

The images to appear on cigarette packs on a rotating basis also include one of a man proudly wearing a T-shirt that says: “I QUIT.”

All of the packs will also contain a toll-free telephone number for smoking cessation services.

The F.D.A. has already proposed nine different text warnings that will be paired with the photographs, including, “Warning: Cigarettes cause cancer” and “Warning: Quitting smoking now greatly reduces serious risks to your health.”

The government surveyed 18,000 Americans of all ages to determine which of the 36 proposed labels would be most effective to deter smoking.

The F.D.A. can revise the selection of color photographs in the future.

A submission to the F.D.A. by R. J. Reynolds, Lorillard and Commonwealth Brands, the second, third and fourth largest cigarette makers, said the “nonfactual and controversial images” were “intended to elicit loathing, disgust, and repulsion” about a legal product.

Those companies and a few others filed suit in Kentucky in August 2009 over several provisions of the law. United States District Judge Joseph H. McKinley Jr. ruled that the companies could be forced to put graphic warning labels on the packages, but said they could not be forced to limit marketing materials to black text on a white background, saying that was too broad an intrusion on commercial free speech.

  Gregg Perry, a spokesman for Lorillard Tobacco, said on Tuesday that the company was reviewing the graphics and would not comment at this time. A spokeswoman for R.J. Reynolds repeated its earlier opposition to thegraphic labels.  Altria said it would not comment.

Altria, the parent company of Philip Morris, the only major tobacco company to support the overall F.D.A. legislation, said in a letter earlier this year that the graphic warning provision was an unconstitutional part of the law “added in a last-minute amendment.”

The rate of smoking in America has been cut roughly in half, to about 20 percent, from 42 percent in 1965, but health officials say progress has stalled. Smoking remains the leading cause of preventable death, killing 443,000 Americans a year, according to the Centers for Disease Control and Prevention.

Each day, an estimated 4,000 youths try their first cigarette and 1,000 a day will become regular smokers, the government says.

Article source: http://feeds.nytimes.com/click.phdo?i=13c49d51f544b30dd00407b9a6e20753

Prescriptions: Double-Digit Insurance Rate Increases Get More Scrutiny

Federal officials announced new rules on Thursday that require health insurers that decide to raise their rates sharply to provide more justification for the higher premiums.

“We know increased scrutiny works,” said Secretary Kathleen Sebelius, of health and human services, in making Thursday’s announcement. She cited several recent examples of state regulators, in places like Rhode Island and North Dakota, being able to pressure health insurers to reduce their proposed increases.

The federal health care law requires states to review large rate requests, and the new regulation sets the threshold for review at 10 percent, beginning Sept. 1. Federal officials eventually plan to establish different thresholds for different states. Federal regulators can conduct the reviews if state insurance regulators do not.

The new rule is going into effect as insurers are announcing record profits and flush reserves. In a front-page article in The Times last week, the sizable gains were linked to how people have been delaying or forgoing care, even as insurers have still been raising premiums. They claim they expect health care costs to go up, once people start to go to the doctor when they feel as if they have more money in their pockets.

“Focusing on health insurance premiums while ignoring underlying medical cost drivers will not make health care coverage more affordable for families and employers,” said Karen Ignagni, the chief executive of America’s Health Insurance Plans, a trade group, in a statement responding to the new rule.

She also warned against “an arbitrary threshold for review” that may not adequately take into account the complicated array of factors that determine premium rates. [Read more…]

Article source: http://feeds.nytimes.com/click.phdo?i=9b4a3efabcee4987222560255b5a511e