U.S. Representative
Bill Thomas

The Golden Leash Award

The Golden Leash is a symbol of the ties between special interest money and elected officials. It is awarded to Members of Congress who demonstrate egregious conduct in the quid pro quo practice of dollar democracy.


Take A Half-Million and Call Me In The Morning
Rep. Bill Thomas (R-CA) and the Health Care Industry


Who's on the Leash?
Overview
Representative Bill Thomas (R-CA)
Press Release

WHO'S ON THE LEASH?

Many members of Congress get large political contributions from health care interests. But not many take as much money -- or are as well situated to do something in exchange -- as Rep. Bill Thomas (R-CA).

When the Republicans took over the House of Representatives in the 1994 elections, Thomas rose to the chairmanship of the House Ways and Means Health Subcommittee. Since then he has taken on other leadership positions in Congress dealing with health care. He is administrative chairman of the National Bipartisan Commission on the Future of Medicare, and he is also on the GOP task force that is attempting to develop a Republican consensus on health care reform.

Between 1991 and 1998, Thomas collected more than half a million dollars -- $535,648 -- from hospitals, HMOs, physicians, health insurance companies and other health care interests.1 In the 1996 elections, Thomas ranked third in the House for contributions from the health care industry, excluding contributions from the insurance industry.2

Today, Thomas remains a faithful champion of the interests of his health care contributors over the interests of the public at large. In Congress, Thomas is:


OVERVIEW

Despite predictions that the rise of managed care would reduce spiraling health care costs and therefore make health care more widely accessible, the nation's health care woes are as bad as they ever were. In particular, costs are rising, the percentage of people with insurance is dropping, patients' rights are eroding, and choices are more limited.

Costs continue to rise. In 1996, the average amount spent per person for health care in the U.S., after adjustment for inflation, was about $3,800, more than double what was paid twenty years ago.3 This amount includes what is spent by all sources -- employers, consumers, and taxpayers. As a percentage of household income, the amount that people spend out-of-pocket has been increasing. In 1996, such expenses accounted for 14 percent of the median household income in the country.4

Forty-one million Americans lack any kind of insurance, a number expected to rise to 50 million by the 21st century.5 According to the U.S. General Accounting Office, between 1980 and 1995, the population covered by private health insurance actually decreased from 79.5 percent to 70.5 percent. Private health insurance coverage for children, people who retire early, and low-income families has declined more rapidly than for the rest of the population.6

What's more, 31 million Americans who do have private insurance are underinsured -- at risk of facing "ruinous out-of-pocket expenses if they get seriously ill," according to a recent report by Consumers Union, publisher of Consumer Reports. There are several ways that families may find themselves on the verge of financial disaster because of health care expenses. They may have a plan that doesn't cover prescription drugs which could mean catastrophe if, for example, a family member needs expensive chemotherapy for cancer treatment, or medication for chronic problems such as heart disease or diabetes. Families may also find themselves in trouble if their plan includes a lifetime limit on benefits, or if it lacks a cap on how much they must pay out-of-pocket.7

Legal loopholes also prevent consumers from holding managed care plans accountable when they make irresponsible decisions. A 1974 law known as the Employee Retirement Income Security Act (ERISA) granted substantial immunity to employers and insurance plans and preempted state regulation of HMOs. The idea was to encourage employers to offer health insurance nationwide, bestowing a benefit on consumers. With the rise of managed care, however, the law is now hurting consumers, according to groups such as the Center for Patient Advocacy, because it prevents patients from recovering damages when harmed by an HMO.8

Piecemeal attempts at health care reform in recent years are not living up to either politicians' predictions or consumers' needs. Despite the $24 billion Congress made available to states to expand children's health care coverage as part of the Balanced Budget Act of 1997, as many as nine million children may remain uninsured.9

When Congress passed and President Bill Clinton signed the Kennedy-Kassebaum Health Portability and Accountability Act of 1996, its champions said the legislation could extend health care coverage to 25 million people, by making it easier to take insurance coverage from job to job and cracking down on denial of coverage because of "preexisting conditions." Less than two years later, health care experts are saying that the law merely may have expanded coverage for just a few hundred thousand people.10

A study by GAO found that insurers are discouraging people from applying for coverage under the new law or charging them exorbitant rates -- as much as 600 percent of the standard premium. Some insurers refused at first to pay commissions to insurance agents who referred people for benefits under the law. The GAO also concluded that lack of adequate funding is straining state-level offices of the U.S. Department of Health and Human Services that have enforcement responsibility for the new law.11

Whenever Washington starts talking about reforming the system, the wealthy health care industry rallies, flooding the airwaves with advertisements and filling political campaigns with cash. Insurance companies, HMOs, doctors, hospitals, large employers -- there is a long and lucrative list of interests with a stake in health care. The only group that doesn't have a voice amplified by cash in these policy debates are the people with the most to lose -- consumers.


REPRESENTATIVE BILL THOMAS (R-CA)

California Representative Bill Thomas' campaign war chest has benefited greatly from his leadership position on a myriad of health care policies. Between 1991 and 1994, before he became chairman of the House Ways and Means Health Subcommittee, Thomas collected $171,550 from the entire health industry -- hospitals, HMOs, physicians, other health care companies, and health insurance companies.12 Between 1995 and 1998, he collected $364,098, more than twice as much, with the 1998 election cycle not yet complete.

Thomas raises far more than he needs. He outraised his 1996 general election opponent by 32 to 1,13 and ended that year with a surplus of more than $570,000.14


Health & Health Insurance Industry Contributions PAC & Indivs. ($200+) to Rep. Bill Thomas (R-Calif.)* 1991-1998

Election Cycle Total
92 $45,550
94 $126,000
96 $259,048
98** 105,050
TOTAL $535,648

*All health industry contributions as coded by the Center for Responsive Politics, plus insurance companies coded as "accident and health" companies or that earn a substantial amount of revenue from accident and health divisions. Excludes pharmaceutical companies and other health care product manufacturers.
** 1998 totals based on data released by the FEC by May 1, 1998. Source: Center for Responsive Politics

Thomas consistently has taken positions that place the interests of his wealthy contributors above the interests of patients:


HMOs & Members of Health Benefits Coalition PACs & Indivs ($200+) 1991-1998, By Amount, to Rep. Bill Thomas (R-Calif.)

Company/OrganizationTotal
Blue Cross/Blue Shield* $21,500
Cigna Corp $9,500
Health Insurance Assn of America $8,689
Food Marketing Institute $6,500
FHP Inc $6,000
Prudential Insurance $5,750
New York Life $5,500
American Assn of Health Plans $4,871
Aetna, Inc* $4,500
Assn of Private Pension & Welfare Plans $3,613
National Restaurant Assn $3,500
United HealthCare Corp $3,500
Mid Atlantic Medical Services, Inc. $2,500
National Fedn of Independent Business $2,500
PacifiCare Health Systems $2,000
American Insurance Assn $1,500
Comprehensive Health Services $1,000
Health Partners Inc $1,000
Humana Inc $1,000
National Assn of Health Underwriters $1,000
Scan Health Plan $1,000
Group Health Assn of America $500
Health Net $500
Kaiser Permanente $250
TOTAL$98,173


(1) All health industry contributions as coded by the Center for Responsive Poltics, plus insurance companies coded as "accident and health" companies or that earn a substantial amount of revenue from accident and health divisions. Excludes pharmaceutical companies and other health care product manufacturers. Data downloaded from Federal Election Commission on May 1, 1998. Data reflect the latest figures reported by candidates, so there may be inconsistency in periods covered.

(2) Makinson, Larry, The Big Picture: Money Follows Power Shift on Capitol Hill. Center for Responsive Politics, November 1997, P. 57. Does not include contributions from health insurance companies. Includes pharmaceutical and other health product contributions.

(3) Shearer, Gail, Hidden From View: The Growing Burden of Health Care Costs, Consumers Union, January 22, 1998, P. 57.

(4) ibid.

(5) ibid, P. 11.

(6) "Private Health Insurance: Continued Erosion of Coverage Linked to Cost Pressures," GAO Chapter Report, August 24, 1997 (GAO/HEHS-97-122).

(7) "Hidden From View," Consumers Union, pp. 11-12.

(8) Statement of Terre McFillen-Hall, Executive Director of the Center for Patient Advocacy, on the Patient Access to Responsible Care Act, October 22, 1997.

(9) "Hidden from View," Consumers Union, pp. 14-15.

(10) ibid.

(11) "Health Insurance Standards New Federal Law Creates Challenges for Consumers, Insurers, Regulators," GAO Chapter Report, February 25, 1998 (GAO/HEHS-98-67).

(12) See footnote 1.

(13) Duncan, Phillip and Christine Lawrence, Politics in America: 1998, Congressional Quarterly Press, 1997, P. 149.

(14) Center for Responsive Politics Web Site (www.crp.org).

(15) Transcript of memo found at www.his.com/~pico/hiaamem.htm.

(16) "White House Maps Out Healthcare Agenda for '98," by Jill Wechsler, Managed Healthcare, vol. 8, no. 2, pp. 14-15.

(17) "Managed Care Causes Groups to Spend and Arm and a Leg," by Mary Agnes Carey, Congressional Quarterly, April 11, 1998, P. 942.

(18) "Clinton Calls Managed Care Reform 'Urgent,'" Congress Daily, May 28, 1998.

(19) Membership list found on Web Site of the Health Benefits Coalition (www.hbc.com).

(20) Contributions coded as HMOs and select health insurance companies only as found by the Center for Responsive Politics.

(21) "GOP Leaders Tried to Put the Kibosh," Washington Health Week, March 2, 1998.

(22) "Patient Bill of Rights Ordered for All Federal Health Plans," by Susan Page, USA Today, February 20, 1998.

(23) H.R. 483 summary found on THOMAS Web Site (thomas.loc.gov).

(24) Prepared testimony of Gail Shearer, Director, Health Policy Analysis, Washington Office, Consumers Union, before the Subcommittee On Health And Environment Committee On Commerce, United States House of Representatives, Re: Medicare Select Program, February 15, 1995.

(25) "Necessity of Medicare Reforms Gives Congress Queasy Feeling," by William Neikirk, Chicago Tribune, March 5, 1998, p. 3.

(26) "Snags in Plan to Lower Age Limit for Medicare," by Lawrence J. Goodrich, The Christian Science Monitor, March 11, 1998, p. 5.

(27) H.R. 1234 (104th Congress) summary, found on THOMAS Web Site (thomas.loc.gov).

(28) "House Panel Votes To Cap Medical Malpractice Damages," Liability Week, No. 13, Vol.9, March 28, 1994.

(29) "Specialists Face Fee Cuts in Medicare," by Judi Hasson, USA Today, April 23, 1997, p. 1A.

(30) Statement of J. Edward Hill, MD to the Senate Committee on Finance, on behalf of the American Medical Association, Re: Private Contracting In Medicare, February 26, 1998.

(31) H.R. 2497 summary, downloaded from thomas.loc.gov.

(32) "AMA Supports Private Contracting for Medicare Patients," Statement Attributable to D. Ted Lewers, MD, AMA Board of Trustees, Found on AMA Web Site, (www.ama- assn.org/advocacy/statemnt/1219.htm).

(33) Prepared testimony of Beatrice Braun, M.D., American Association Of Retired Persons, Board Member, before the Senate Finance Committee, February 26, 1998; "AARP Decries Misinformation About Medicare 'Private Contracting;", AARP news release, April 1, 1998.

(34) "Political PAC-analia," by Jennifer Shecter, Nancy Watzman, and James Youngclaus, Center for Responsive Politics, October 1996.

(35) H.R. 415 summary (105th Congress); H.R. 2925 summary (104th Congress); found on THOMAS Web Site (thomas.loc.gov).

(36) "Health Care Reform Issues: Antitrust, Medical Malpractice Liability, And Volunteer Liability," Jennifer Wehner, FDCH Congressional Hearings Summaries, February 27, 1996.

(37) "MSA's Expected to Continue, Senate OKs Budget Plan," Medical Industry Today, May 27, 1997.

(38) "MSAs: Bill Would Expand Kassebaum/Kennedy Demonstration," Health Line, April 1, 1997.


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