Even as the state seeks to revamp the health care system to save costs, hospitals, insurers and other groups are pouring more money than ever into lobbying to fend off impending cuts.
Total lobbying spending in the state topped $200 million for the first time in 2010, up from $197.8 million the prior year to reach $213.4 million.
Although lobbying overall rose, much of the increase during the past five years has been due to the growing amount from health care groups as other embattled industries spend less.
Health care lobbying reached $31.1 million in 2010, up from $30.6 million the previous year, while real estate and construction lobbying dropped to $21 million from $22.6 million in 2009. Education lobbying dipped to $13.3 million from $13.9 million.
Nearly one in seven lobbying dollars spent in New York last year was spent by health care-related organizations, according to The New York State Commission on Public Integrity, which issued its 2010 report several weeks ago.
Health care providers argue they’re forced to lobby, after being put on the defensive by state efforts to trim billions.
As part of an effort to shrink the state’s $10 billion deficit, New York approved Medicaid cuts expected to reduce costs by $2.8 billion, still less than the $3 billion many expected.
“Lobbying has become a standard part of hospitals’ business in these tough times,” said Janine Logan, a spokeswoman for the Nassau-Suffolk Hospital Council. “The Hospital Council fights hard for equitable allocation of public funds that meet the basic cost of providing care to all patients at all times.”
Hospital groups argue they’re spending on lobbying simply to survive.
“Lobbying is a give-and-take process,” said Logan, who said the hospital industry nationwide agreed to $155 billion in Medicare payment reductions over 10 years, while Long Island hospitals will absorb $1.8 billion in cuts, although she hopes “those reductions will be offset by achieving widespread health coverage for all Americans.”
“If we didn’t lobby, things would be even worse,” Logan said of state and federal cuts. “If we didn’t lobby and interact with our legislators about what’s better policy clinically and operationally, that could cause a problem.”
Some lobbying groups have had, at best, mixed results. The Medical Society of the State of New York, for instance, spent more than $700,000 in 2010, lobbying for things such as a cap on pain and suffering awards.
The state’s Medicaid Redesign Team approved a proposal to cap pain and suffering at $250,000, based on input from groups such as the Hospital Association of New York, the Nassau-Suffolk Hospital Council and the American College of Obstetricians and Gynecologists.
“You have to be there to respect the general public interest,” said Joanne Doroshow, president of the Center for Public Integrity, who argued the Medicaid Redesign Team represented its own interests.
But the cap wasn’t enacted in part because of lobbying by trial lawyer groups. Assembly Speaker Sheldon Silver, affiliated with a Manhattan law firm that includes medical malpractice cases, has opposed caps on pain and suffering awards.
Although money spent on medical lobbying doesn’t guarantee success, lobbyists with a hearty health care practice are doing well, nevertheless.
Wilson Elser Moskowitz Edelman & Dicker, which has an office in Garden City, topped the charts in 2010 with $10.6 million in total revenue, followed by Manhattan’s Patricia Lynch Associates with $8.1 million, GreenbergTraurig at $5.5 million, Bolton St. Johns at $4.7 million and Hinman Straub Advisors at $4.4 million.
1199/SEIU, the health care union, and the Greater New York Hospital Association, which collectively spent $6.9 million, led the second-biggest lobbying effort in the state.
SEIU seems to have been successful on many fronts. Gov. Andrew Cuomo appointed an SEIU official to be co-chair of the state’s Medicaid Redesign Team, which some critics questioned as a conflict of interest.
SEIU also pushed for a living wage requirement for home health care aides, which has been enacted.
While unions and large trade groups are behind the biggest lobbying efforts, local groups such as the Nassau-Suffolk Hospital Council do their own lobbying.
Along with Logan, Council CEO Kevin Dahill and COO Wendy Darwell are registered lobbyists; a portion of their compensation reflects this responsibility.
Logan said the state budget empowered the Department of Health commissioner to make cuts when Medicaid spending reaches a 4 percent increase. That, Logan said, could precipitate more lobbying.
“This could lead to another round of cuts and is one reason why hospitals must remain diligent in their efforts to educate and lobby lawmakers and regulatory agencies,” Logan said. “Our lobbying efforts are as much for the survival of hospitals as they are for the continued availability of hospital services for patients.”