PHILADELPHIA (CN) — Investigating conflicts of interest in federal policymaking, a new study published Wednesday finds that financial investments in health care are comparable among members of congressional oversight committees on health care and other members of Congress not on such committees.
Published in the Public Library of Science, the study tracked how the value and composition of the health care industry assets held by lawmakers had changed over time. It also compared legislators who sat on committees and subcommittees with key responsibilities for health care legislation and oversight to legislators who didn't sit on the committees. Overall, it found that in the decade between 2004 and 2014, around a third of all members of Congress consistently held assets related to health care in fields such as biotechnology, pharmaceuticals, medical device supplying and health insurance.
According to Matthew McCoy, lead author on the study and an assistant professor of medical ethics and health policy at the University of Pennsylvania, the researchers were driven to investigate the topic after seeing reports in the news of Congress members’ conflicts of interest.
An example, McCoy said, would be Republican Representative Chris Collins, a New York Republican who was arrested in 2018 on insider trading charges related to his crafting health care legislation as a member of the House Energy and Commerce Committee while holding heavy investments in a biotech company.
McCoy said the study was conducted with the goal of seeing if those with more responsibilities in health care regulation also had more investments in the health care industry.
“If it turned out that that was the case, I think that would be particularly troubling,” McCoy said, “because it would suggest those people with the greatest impact on how health care legislation ultimately rolls out in the United States have the most to gain personally from investments in the health care industry.”
Since the data didn’t point in this direction after all, McCoy guessed that some people might be pleasantly surprised off the cuff. He was quick to point out, however, that the study also didn’t find any evidence that people who sit on health care committees divest in assets that are directly affected by the committees they work on.
In other words, McCoy explained, what we'd want them to do to that make sure that there's no undue influence from their financial interests on their legislative activity.
“But we didn't see any evidence of that either,” he continued. “There was basically no difference between people sitting on this committee and other members of Congress during the period that we examined.”
The study saw a median total value of around $43,000 in health care assets per member.
“Certainly nothing to sneeze at,” McCoy said of the number, noting there's quite high variation in the amount of assets between congressional members — with some holding hundreds of thousands of dollars and others holding around $100.
According to the paper, Republicans as compared with Democrats held a substantially higher total of health assets in both 2004 and 2014 — roughly $20.5 million to Democrats’ $7.2 million in 2004 and $31.1 million to Democrats’ $15.2 million in 2014.
The research was careful to note, however, that while Republicans held a higher percentage of members reporting health assets than Democrats in both the Senate and the House in 2004 (27% to 16%), by 2014 the percentages were roughly equal at (17% to 19%). Health care assets consistently accounted for less than 4% of members overall financial holdings, the study also found.
The research had several limitations, including its not analyzing data since 2014 — which was the most recent year the Center for Responsive Politics had disclosure reports available in bulk for the study — as well as that it did not analyze asset-holding trends in other areas that affect public health, like the energy sector.
Susannah Rose, a faculty member at the Cleveland Clinic Center for Bioethics, said Wednesday that she personally thinks the financial relationships of lawmakers with health care companies should be transparent.
“So then at least people can make decisions about whether they think they're having an undue influence on their decisions or not,” she explained. “I don't necessarily think that relationships with for-profit companies or donations or things like that are necessarily a concern, or a problem. In fact, they can often help good candidates, but I think that this kind of thing should be transparent, for people to be able to assess the risks involved.”
Future researchers might be interested in looking at data to see whether there is a relationship between holding financial assets in the health care industry and how a particular member votes on amendments or legislation, McCoy said, noting that up until now there have been a lot of concerns about physicians’ conflicts of interest but not as much about those of legislators.
“There's been quite a lot of research and quite a lot of reporting on financial conflicts of interest among physicians, and it was odd to me — and I think odd to my co authors, given this concern — that there hadn't been more energy spent figuring out what the conflicts of interest among healthcare legislators look like.”
He pointed out that to this extent when the Affordable Care Act was passed in 2010, it brought with it an open portal resource where anybody could search the name of a doctor online to see how much they might have received from the pharmaceutical industry.
Rose said Wednesday this government website fosters transparency but that health care organizations should also disclose on their public website their financial relationships with their physicians and others whenever there's a potential for a hybrid conflict of interest. She went on to say that while there are multiple kinds of conflict of interest can come into play while practicing health care, one major concern includes practitioners prescribing treatment in their own financial interest as part of a business deal with a for-profit company.
“You want to ensure that they're working in the primary interests of their patients,” she said.
McCoy thinks the same should be true for lawmakers with their constituents.
“People want to make sure that physicians aren't being influenced by their financial interests,” he said. “If you're concerned about that, I think you should be just as concerned if not more concerned about how the people who write the rules for the healthcare system might be influenced by their financial interests.”
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