Lambert here: Sebelius. And after the great job she did with the ObamaCare website launch, too. Ka-ching.
By Roy Poses, MD, Clinical Associate Professor of Medicine at Brown University, and the President of FIRM – the Foundation for Integrity and Responsibility in Medicine. Cross posted from the Health Care Renewal website
The latest example of the health care revolving door was made barely public just before the US Labor Day holiday. Per the Triangle Business Journal,
Humacyte Inc., a biotechnology company based in Research Triangle Park, has beefed up its board of directors by adding former U.S. Secretary of Health and Human Services Kathleen Sebelius and life sciences industry veteran Dale Sander.
The 11-year-old Humacyte develops novel human tissue-based investigational products that are being developed for potential commercialization for applications in regenerative medicine and vascular surgery. Sebelius adds a significant amount of heft to the company’s now eight-person board.
From 2009 to 2014, she served as the 21st Secretary of the HHS, leading the effort to pass and implement the Affordable Care Act. She’s also been named by Forbes as one of the 100 most powerful women in the world.
Prior to serving as secretary of HHS, Sebelius served as governor of Kansas, two terms as the Kansas insurance commissioner and four terms in the Kansas legislature.
‘Secretary Sebelius is undoubtedly one of the most distinguished health care industry leaders of our time and we are honored to have her join our organization,’ said Carrie Cox, chair and chief executive officer of Humacyte, in a statement. ‘Her tenure in the public sector, and deep understanding of the rigors of the regulatory process and policy will provide unique perspective and insight to support our goals to improve care for Humacyte’s first application for patients with End Stage Renal Disease.’
I will just raise a tired, ironic eyebrow in response to a lawyer, politician, and government leader with no direct biomedical or health care training or experience, and no apparent health care industry experience being called a “distinguished health care industry leader.”
The big issue here is, of course, the revolving door.
It now seems that any randomly selected top US government official who has responsibilities directly related to health care could turn out to be a past or future health care corporate lobbyist, consultant, board member, or executive. The revolving door is now well established between the US government and the country’s huge and growing corporate health care sector. Recent (2015) examples include:
– a former Director of the Center for Medicare and Medicaid Services who was a Columbia/ HCA executive and who became the CEO of America’s Health Insurance Plans (a trade and lobbying group) (look here)
– various officials involved trade agreements (that heavily affect health care) who came from or went to industry (look here).
– some US Food and Drug Administration officials who were involved in the lax regulation of amphetamines in “natural” products who came from or went to the “natural” supplements industry (look here).
But the latest example is a big one, since it involves the top US health care official, the Secretary of the DHHS.
As we have said endlessly, the ongoing and increasing revolving door phenomenon clearly suggests excess coziness between industry and government, now to the extent that industry and government leaders of health care are becoming interchangeable. This suggests that health care is increasingly run by this cozy ingroup, who very likely put their own interests ahead of those of patients and the public.
This is at best crony capitalism, and makes a mockery of that famous sentence in President Lincoln’s Gettysburg Address:
government of the people, by the people, for the people, shall not perish from the earth.
The revolving door is clearly a kind of conflict of interest. Government officials who can look forward to extremely lucrative employment in health care industry (regardless of their actual experience in health care or the health care industry) may be much more inclined to seem friendly to the industry while in office. Government officials who just came from industry are likely to maintain their industry mindset and be mindful of their industry friends.
Worse, some experts have suggested that the revolving door is in fact corruption. As we noted here, the experts from the distinguished European anti-corruption group U4 wrote,
The literature makes clear that the revolving door process is a source of valuable political connections for private firms. But it generates corruption risks and has strong distortionary effects on the economy, especially when this power is concentrated within a few firms.
Finally, the revolving door on its currently massive scale starts to look like corporatism (or corpocracy), “the organization of society by major interest groups.” One variant of corporatism prominent in the last century was fascism (on the model of Mussolini in Italy). Of course, many of us in the US ought to see corporatism as antithetical to how our government and society is supposed to function – supposed to function.
Thus, the revolving door in health care seems like it ought to bear scrutiny. Yet most examples of the revolving door are very anechoic, being noted mainly in the business media, and usually barely there. I have seen almost no notice of it in the health care, health policy, or medical literature. (For example, so far Ms Sebelius’ new job has appeared in a corporate press release and a single article in a local business newspaper, as far as I can tell.)
So once more with feeling… The continuing egregiousness of the revolving door in health care shows how health care leadership can play mutually beneficial games, regardless of the their effects on patients’ and the public’s health. Once again, true health care reform would cut the ties between government and corporate leaders that have lead to government of, for and by corporate executives rather than the people at large.