On this political day in the USA, the beginning of the Presidential primary season, I thought it fitting to discuss politics and healthcare. When one first hears or sees the words politics and healthcare together, the most common thought to me as a physician was either one of the business of lobbying politicians or the politics of the medical establishment. Nowhere is the crossroads of these worlds more tightly knit than the American Medical Association. It is the single biggest healthcare lobby, yet only less than 20 percent of physicians are members. Does this statistic reflect, much like the electorate in general, the dissatisfaction in the way our representatives represent physicians? Other healthcare stakeholders (pharmaceutical, medical device, and insurance companies, and hospitals) as well have, of course, both political agendas and lobbying organizations. In 2011, the AMA spent $16.2M, Blue Cross/Shield $15.1M, the American Hospital Assn $14.6, the pharmaceutical manufacturers $14.2, and Pfizer alone spent $10.9M on lobbying federal legislators.(source:http://www.opensecrets.org/lobby/top.php?showYear=2011&indexType=s). What is intriguing is that these organizations have themselves morphed into forms like political parties. They design and carry out their specific agendas with methods copied from a political playbook. Grass roots single issue campaigns are organized, filtered through third-party organizations, with PR campaigns are very much like political ones, bombarding the public with half-truths utilizing scare tactics. This was seen from both sides during the recent debate over healthcare reform, the Harry and Louise commercials of 1994 (paid for by the ‘Coalition for Health Care Choices’, a cover for the Health Insurance Association of America).
Relevant to this discussion is the entrance of large corporations (from telecommunications to insurance) entering the wireless health technology industry. It was not an accident that on the same stage at the recent mHealth Summit 201’s keynote speaker session were representatives from Qualcomm, Intel, and the FCC. There is little doubt that corporate America’s foray into mHealth will accelerate adoption in part because of lobbying efforts that will take place. Lobbying might be good for the industry as a whole, but will it be at the expense of start-ups or small businesses? I certainly hope not. I would like to see partnerships continue and flourish between the large and small companies. As mHealth becomes bigger, I would like it to remain patient-focused, which is where the rest of healthcare should be, not legislator-focused. .