How high is the cost of wielding influence in Washington? Steep, according to recent federal disclosure reports.
For the first half of 1996, the AMA outspent all other health groups, shelling out a whopping $8.7 million in lobbying expenses (See chart). Ironically, the only group to spend more than the AMA was tobacco giant Phillip Morris Cos., which spent more than $11 million.
The American Hospital Association spent slightly less than $2 million, the most among hospital groups.
The new disclosures also detail the outside lobbying firms with which organizations contract.
For example, the AMA paid the Washington firm of Timmons and Co. $140,000 for the first six months of 1996, primarily to push anti-managed-care legislation. The firm's president is Tom Korologos, an influential confidant of GOP presidential nominee Bob Dole.
The AHA employed three lobbying firms, at a total cost of $110,000 from Jan. 1 to June 30.
Lobbying firms often are used by organizations to gain access to lawmakers or because of expertise or experience in a certain area.
Such firms often work for a variety of health clients. For example, influential Republican lobbyist Deborah Steelman, whose firm includes former Federation of American Health Systems President Michael Bromberg, was paid $20,000 by Minneapolis-based managed-care giant United HealthCare Corp., $80,000 by the National Association of Psychiatric Health Systems, $80,000 by Humana, $80,000 by the Healthcare Leadership Council and had nearly a dozen other healthcare clients including several pharmaceutical manufacturers and integrated health systems.
The Federation of American Health Systems, which represents investor-owned hospitals spent a relatively modest $505,000, including about $65,000 on three outside lobbying firms.
The new disclosures were required under a lobbying reform act passed by Congress in 1995.
They offer the first glimpse into what has always been a closely guarded secret-the strategies and finances of some of the most influential special interests in Washington.
Anyone who lobbies Congress must disclose twice a year, in a filing with the Clerk of the House, how much they spent on items like salaries, entertainment and other overhead costs and incidentals related to their lobbying activities.
The new disclosure forms also detail what issues every group and every outside lobbying firm worked on.
For example, AMA lobbyists sought to influence lawmakers on a variety of Medicare and Medicaid bills, legislation to change medical malpractice laws and several anti-managed-care measures.
A number of individual hospitals also filed lobbying disclosure forms, primarily in relation to a construction project or research grant. The largest hospital listed in the disclosure forms was Northwestern Memorial in Chicago, which spent $260,000. Although the hospital is undertaking a multimillion-dollar building project, the filing cited only its concern with the federal budget and health reform legislation.
"The various organizations that we are affiliated with, such as the AHA and the AAMC, play an extremely important role in our total government relations efforts," said Lauri Sanders, a spokesman for Northwestern Memorial.
"However, like many other healthcare institutions, we have some issues unique to our institution for which we use consultants," she said.