Influencing Healthcare Policy – Lobbying, Incentives & Insurance

Benjamin Franklin is credited as saying, "An ounce of prevention is worth a pound of cure," but policymakers seem more influenced by the money he's pictured on.

Ben Franklin said, “An ounce of prevention is worth a pound of cure,” but policymakers seem more influenced by the money he’s pictured on.

By Wayne Caswell, Founding Editor, Modern Health Talk

As President Trump’s administration transitions from the Obama era, a conservative ideological shift will influence healthcare policy, but so will other factors. They are discussed here, based on my response to “The Past, Present and Future of Healthcare Policy” at ReferralMD.

Influencing Healthcare Policy

Although The Patient Protection and Affordable Care Act, more commonly known as ObamaCare, has flattened the curve to the lowest annual cost increase in decades, it still has not reduced overall costs for many reasons. These include (1) special interest lobbying to protect industry revenues & profit, (2) misaligned incentives, and (3) an insurance middleman that adds more cost than value. It is unlikely that any “repeal and replace” strategy can live up to Trump’s promises because of these three factors.

LOBBYING — According to Steven Brill’s TIME Magazine report, the medical industry (hospitals, insurers, drug companies, testing companies & equipment providers) spends three times as much as the military industrial complex on lobbying. They do that to protect their $3.5 trillion/year revenue from being cut in half to match what other advanced nations pay. So, future health reforms must also address the corrupting influence of big money in politics, and politicians must be willing to take on incumbent players that don’t want to lose $1.75 trillion/year. (

INCENTIVES — While the old fee-for-service business model promotes excessive testing and treatment, Obamacare encouraged alternative models  such as Accountable Care Organizations, Patient-Centered Medical Homes, and EMR Meaningful Use incentives. We’ve already seen significant results from those efforts, but they were just a start. We also need to better align incentives with the goals of population wellness to diminish the need for medical care in the first place. And we must believe what Benjamin Franklin knew, that “an ounce of prevention is worth a pound of cure.” (

INSURANCE — The U.S. is the ONLY advanced nation without universal healthcare. Instead, we offer health insurance — IF your employer provides it, or you can afford it. While these other nations see healthcare as a basic right and social responsibility, the fear here is giving away FREE healthcare to anyone who doesn’t work hard enough, doesn’t have enough determination, or is a “Loser” and doesn’t deserve it. (

Related Articles

Over the last five years, I’ve posted well over 100 articles on healthcare policy. Here my Top 10 Favorites:

  1. US Healthcare System has Cancer. Can Trump Fix it?
  2. Escape Fire: The Fight to Rescue America’s Healthcare (documentary film)
  3. Transforming Our Flawed Healthcare System
  4. Health Care Reform – Progress and Next Steps (by President Obama)
  5. Let the Health Care Reform Debates Begin, Again
  6. Chipping Away at Healthcare Special Interests Yet?
  7. HEALTH or SICK Care?
  8. Disrupting Healthcare with Functional Medicine 2.0
  9. Corporate Behavior and Rising Health Care Costs
  10. Wealth Inequality, Healthcare and the Economy


Comments on “Influencing Healthcare Policy – Lobbying, Incentives & Insurance


    The Battles Ahead: Meet the Biggest Opponents of Single-Payer – WOW! This excellent piece is part of Fighting for Our Lives: The Movement for Medicare for All.

    Public Opinion about the Future of the Affordable Care Act — (New England Journal of Medicine) This politically neutral article shows how public opinion differs between Democrats and Republicans based on differences in their core values. (interesting)


    As we closely watch what Tom Price does as HHS Secretary, keep in mind what influences healthcare policy the most: (1) special interest lobbying to protect industry revenues & profit, (2) misaligned incentives, and (3) an insurance middleman that adds more cost than value. Those who most oppose him are patients & physicians, while those who support him are large players in the medical industrial complex. So, it’s hard to imagine any progress in lowering costs and improving care under his watch.

    Tom Price confirmed as HHS secretary, industry reacts (Fierce Healthcare)

    “Democrats opposed Price for his views on the Affordable Care Act, Medicare and Medicaid, and due to ethical concerns over his investments in healthcare companies. … But Democrats aren’t the only ones who have concerns about Price leading the agency.” Physicians have concerns too.

    10 things to know about new HHS secretary Tom Price (Fierce Healthcare)

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