Columbia/HCA Healthcare Corp. is using the political clout of its giant work force instead of hiring lobbyists to press its stands on issues in the nation's capital.
Executives of the healthcare giant say they're proud of the Louisville, Ky.-based company's grass-roots style of political action.
Turning employees out to vote is preferable to "having a lobbyist talking over dinner," said Lindy Richardson, the company's senior vice president.
"Our strength comes from the fact that we are committed to educating our employees," Ms. Richardson said.
Columbia/HCA says it generated more than 175,000 letters to members of Congress from its nearly 130,000 employees in 32 states to help defeat President Clinton's proposals for healthcare reform this year.
The company also urged the 220,000 members of the National Association of Senior Friends-a group it created that conducts events at Columbia/HCA hospitals and offers travel discounts-to write letters and make calls to lawmakers.
Columbia/HCA President and Chief Executive Officer Richard Scott and Ms. Richardson, a specialist in marketing and public affairs, made numerous trips to the nation's capital and elsewhere, meeting with an estimated one-third of Congress' 535 members.
Columbia/HCA executives held "candidate forums" at company offices around the country. On the eve of Kentucky's primary election last May, Columbia/HCA employees in the state received a letter from Mr. Scott endorsing four congressional candidates.
Before next month's election, Mr. Scott will write a letter endorsing federal and state legislative candidates in Kentucky. Ms. Richardson said similar letters will go out over the signatures of division presidents around the country.
But healthcare industry experts said Columbia/HCA's scorn of traditional influence-peddling techniques is exaggerated. It shouldn't obscure the company's heavy dependence on-and vulnerability to-government, they said.
"Rick Scott has much to gain or lose, depending on what government does," said Uwe Reinhardt, a Princeton University healthcare economist.
As attention turns to the state capitals, and as states turn their Medicaid programs over to private companies, Mr. Scott "will be quite worried about how he has to bid for that business," Mr. Reinhardt said.
"He'll also have to keep an eye on the feds and Medicare. So he'll be a big political player, schmoozing with all the right people," he said.
If Columbia/HCA's merger with Nashville, Tenn.-based Healthtrust is completed, it would only amplify that corporate voice, enabling it to reach politicians through some 45,000 more employees nationwide.
Healthtrust's workers have a political-action committee, just as Columbia/HCA employees do. And "we have a grass-roots campaign very much like theirs," said spokeswoman Paula Lovell.
Among those closely watching Columbia/HCA's merger with Healthtrust are potential new political adversaries for the company-physicians of all stripes and certain insurance companies that have invested heavily in building HMOs and managed-care networks.
"We have great concerns as to what will happen when a group such as this develops a monopolistic level in an area," said James Todd, M.D., executive vice president of the American Medical Association.
Columbia/HCA hasn't taken undue advantage of physicians and competing hospitals yet, Dr. Todd said. But at state and federal levels, he acknowledged, physicians are seeking protection from being excluded from HMOs or the kinds of networks Columbia/HCA easily could form.
The merger would give Columbia/HCA a toehold in three new states, all in the West, and a firmer footing in California and fast-growing Utah and Arizona.
Still, it's the boosting of Columbia/HCA's political strength in the Southeast and the Southwest-especially in Florida and Texas-that impresses Washington insiders.
"It's clear Rick (Scott) will be able to speak, both as an industry leader and someone with all those employees in multiple states and districts," said Michael Bromberg, executive director of the Federation of American Health Systems, a for-profit hospital lobbying organization. "I think that's really what makes (members of Congress) move."