The thousands of lobbyists (registered and unregistered influence peddlers) are pushing each other out of the way as this hurriedly prepared gigantic spending bill is being assembled. This bill is considered to be a great opportunity to insert provisions that groups may have had on their wish lists for some time. The concrete lobbyists are battling with the asphalt lobbyists over whether money should go mainly to repair work or new construction projects while the solar energy folks compete with the geo-thermal business interests for government favors,just to mention two contests of the many that are underway.
A Forbes article had this to say:
...Lobbyists for virtually every conceivable interest have tried shaping the measure, lured by its enormous size and scope, its must-pass status and a sense that budget pressures will make federal dollars scarcer in legislation later this year.
"This is a bill that's got just about as much room as you need," said Steve Verdier, top lobbyist for the Independent Community Bankers of America, which successfully supported expanded tax credits for home buyers and other provisions it said would help create jobs. "So if you've got some ideas you've been trying to push for a number of years, this is certainly the vehicle you want to use."
Various health care interests are well represented and in the game . Here is one news story of the lobby efforts for the Hospice business. The Biotech sector is asking for money for research claiming that with the credit crunch investment firms are no longer supplying some of the funds they typically rely upon for certain research projects.See here for a detailed discussion of what tactics the CAM (complementary integrative medicine) forces are using to get their feet into the doors of the health care reform funding,a key element of which appears to be coopting the preventive medicine angle.
This item suggest that there is money to made in the medical technology and computerized medical records provision of the stimulus bill and big players are interested.
This article outlines some of the conflicts involved in the electronic medical records issues and some of the players concerned with protection of patient data privacy and says in part:
Lobbyists for insurers, drug benefit managers and others in the health industry are mobilizing a campaign to persuade Congress that overly stringent privacy protections would frustrate the potential benefits of digital records.
The 20 billion dollar "jump start" of the health IT is a large enough slice for a number of interests to send their lobbyists to secure what they can get. I wonder though if the really big prize in will be the opportunity to data mine. Think of it, everyone's medical records on line somewhere, medications, procures, history,insurance data.Clearly the privacy issue mentioned above is critical and an issue of that important should not be part of legislation that is hurried through congress on the winds of rhetoric claims that delay will turn "crisis into catastrophe".Shoot, ready, aim is not the way to go.The British experience with their NHS IT adventure should give us some pause.
If you feel some reassurance that HIPAA will be protective, it is instructive to look into the lobbying origins of what the law was all about in the beginning. In spite of its veneer of privacy protection it was not about protecting patient privacy and facilitating medical insurance portability. A strong case can be made that it was driven by the health insurance lobby to obtain a federal law to give broad access to patient records and to facilitate insurance claims processing. That was achieved and the rest can be considered either collateral damage or incidental benefit. I am afraid of the collateral damage,unintended consequences and intended benefit to special interests that are all likely to occur as the health care IT bill is hastily put together under the watchful and helpful eyes of the relevant interested "stake holders".