I read with interest today’s report in the Courier-Journal by Tom Loftus summarizing the lobbying efforts of the Kentucky Optometric Association in promoting a bill that would expand their scope of practice and give their licensure board more freedom to define what other things they can legally do. The administration of medications and the ability to perform laser surgery are among them.
Two things are remarkable to me. The first is the swift and overwhelmingly bipartisan support for the bill. The second is the remarkable amount of money spread so widely among legislators of both parties. The money, also called campaign contributions, was given to 137 of the 138 members of the state legislature and both gubernatorial candidates. It was good business for the lobbying community as well: at least 18 of them helped to spread the fertilizer. The only legislator who did not receive a contribution was representative David Watkins, who also happens to be a physician of the MD variety. His position appears to be similar to that of the Kentucky Medical Association and might be paraphrased as, “If you want to practice medicine, go to medical school.” (Disclaimer: I am a member of the KMA.)
Some $400,000 in political contributions were spread around in the past two years alone. To put things in perspective, the Kentucky (MD) Physicians PAC gave only $70,050 during the same period, and the Ophthalmologic (MD) Physicians pack gave $20,750. The MDs were obviously outbid by the ODs. The bill passed out of the Senate by a vote of 33 to 3. I did not think anything could pass out of the Senate with such cooperation nowadays!
I don’t know whether to laugh or cry when I hear legislators and their benefactors assert that all the money sloshing around has absolutely no bearing on the success or failure of a given issue. Is there anybody else in the world who actually believes this? I don’t think so. If the optometrists thought it didn’t make any difference, would they have given up so much of their hard-earned income? If money didn’t make any difference, why are there any limits at all on campaign giving? In my opinion, legislators who actually believe the money doesn’t make any difference are deceiving themselves. Their claims sound exactly the same to me as when physicians assert that all the money, trips, meals, and perks given to us by the pharmaceutical and medical device industries have no effect on the way we practice medicine. I do not believe either camp. It just runs against the laws of human nature. Even if legislators and doctors believe themselves, few others can miss the obvious conflict of interest. Sen. Webb received the most money of any legislator and had the best explanation. Her father was an optometrist: “These people are my friends.”
It was this latter statement that prompted me to select this article for this Blog. It brought back to my mind a disturbing event in my own history as a card-carrying lobbyist. I was pitching the position of my employer to a Kentucky state legislator who with a smile, and about in these words, told me of his quandary: “Some of my friends support this position, but some of my friends the other.” When I approached the legislator later, the response blurted out in obvious anger was, “But you don’t give me any money!” This same Kentucky legislator is still accepting money from his friends. If there is a dividing line between freedom of speech and legalized bribery, I cannot see it without new glasses.
Kentucky Health Policy Institute
16 Feb 2011