For Maryland politicians with a need to fill their campaign coffers, there's no better source of wealth than health.
Locked in annual battles in the General Assembly over managed care and professional turf, special-interest groups in the health-care field have poured millions of dollars into statewide political campaigns and legislative races in the four years since Maryland's last general election.
Campaign finance reports at the state elections board show that health-care interests are well on their way to repeating their 1994 role as the leading industry sector for political contributions.
A recent scandal involving ties between managed-care companies and state Sen. Larry Young -- a recipient of generous industry donations before he was expelled from office in January -- appears to be having little effect on donations.
The amount of health-care influence on Maryland politics is almost impossible to quantify exactly. State statutes -- unlike federal laws -- do not require individual givers to list their employers and occupations. Corporate names often give few clues to companies' roles in health care.
But a review of 35 August campaign finance reports by political action committees with identifiable stakes in health-care policy shows they have raised more than $1.5 million and donated about $800,000 to Maryland political campaigns during the 1998 election cycle.
At the time, with three months to go before the general election, the PACs still had more than $330,000 in cash on hand.
The totals do not include races for Congress, which are governed by federal law, or donations made by companies and individuals involved in health care.
In the governor's race, the split of health-care dollars gives a vivid demonstration of the power of incumbency.
Computer searches for corporate names including such words as "health," "medical," "care," "dental" and "nursing" uncovered more than $150,000 in contributions to Gov. Parris N. Glendening, while Republican challenger Ellen R. Sauerbrey received $11,010 from such sources.
Kathleen Skullney, executive director of Common Cause/Maryland, said health-care PACs were by far the largest category of contributors in the state's 1994 election. Seven of the top 20 PAC givers were health-related, she said.
Skullney said that in this election year, the health-care PACs appear to be ahead of their pace in 1994, when they spent $814,000.
Representatives of the various PACs say their contributions help them establish friendly relationships with legislators -- especially those who sit on the committees that oversee the state's regulation of health care.
'Doesn't buy anything'
"It doesn't buy anything. What it does is create some access," said Marvin Hoss, a member of the board of the Maryland Psychological Association PAC.
The various industries and professions in the health-care sector do not speak with one voice. Health-maintenance organizations and their four Maryland PACs, for instance, are consistently on the opposite side of issues from physicians, who operate the state's largest PAC in terms of money raised. (The trial lawyers' PAC is larger in terms of donations made in Maryland races.)
Maryland's professional health-care PACs cover the body politic from head to toe: the psychiatrists have a well-financed PAC, the podiatrists a modest committee. The eye physicians and optometrists both have PACs -- as do chiropractors, massage therapists and physical therapists.
By far the largest of the health-care PACs is the Maryland Medical PAC, affiliated with the Medical and Chirurgical Faculty of Maryland.
As of the August report, the physicians' PAC had raised $530,311, of which $168,800 had been donated to Maryland political campaigns and health policy causes. The doctors had $68,061 remaining to carry them through election day. The medical PAC also contributes heavily at the federal level through the American Medical Association's PAC.
Running second in money raised was the Health Policy Leadership Alliance, an affiliate of the Maryland Hospital Association, with $114,145 raised and $68,435 in donations.
Two other large PACs filed reports riddled with contradictions and mistakes, making it difficult to determine where they rank.
The Maryland State Dental Association PAC -- which said last week that it had reported incorrect figures -- will submit a revised report showing that it raised $110,356 and donated $77,482 in Maryland races. Similarly the HFAM Nursing Home PAC will report that it raised $82,276 and spent $46,894.
HMOs spend on lobbyists
Another large player in health-care politics is the managed-care industry. But while HMO interests are among the heaviest spenders on lobbyists in Annapolis, they do not appear to have matched the cumulative campaign spending power of medical-care providers.
Unlike the hospitals, physicians and dentists, the managed-care industry's trade association does not operate a large PAC. Instead, the industry wields its power through a small association PAC and three company-affiliated committees that together raised $131,777 and donated $126,546. Some managed-care companies are also heavy direct contributors to campaigns.
D. Robert Enten, the Maryland HMO Association's chief lobbyist in Annapolis, said he doesn't feel he's at a disadvantage.
"When push comes to shove, the industry has been treated fairly by the Maryland General Assembly," he said. He noted that General Assembly leaders last session opposed a bill to subject HMO medical directors to regulation by licensing authorities despite receiving heavy financial support from proponents.
While HMOs may not lead the pack in political donations, there is little doubt that the managed-care trend is a driving force behind the mobilization of health-care dollars. Each year, the General Assembly deals with scores of bills related to HMOs -- many of them seeking to force insurers to pay for services other special interests believe they should cover.
Hoss, of the psychologists' PAC, said the growth of managed care was one of the main reasons his profession has stepped up its political activity. "I guess we resented that managed care came down on us with as heavy a hand as they did," he said.
Typically, health-related PACs' decisions on which candidates will get money and how much they will get are made by a small board of about five to nine activists.
Lobbyists advise PACs
Lobbyists are no longer allowed to double as PAC officials, but they continue to play an important advisory role in the decisions -- and that is no secret to the legislators they deal with.
Hoss said his committee relies "fairly heavily" on the advice of its lobbyist, J. William Pitcher. Hoss said one reason the PAC still had $28,975 on hand as of its August report was that Pitcher urged board members to hold back "a nice big chunk" for giving right before the election.
Most of the PACs give the overwhelming majority of their donations to incumbents -- with the largest amounts going to the most powerful officials on a sliding scale. Thus, a typical health PAC might contribute $4,000 to the governor, $2,000 to the speaker of the House and the Senate president and $1,500 each to the chairmen of the committees that oversee health issues.
A member of those committees, regardless of party, can usually count on $500, and any legislator who asks can usually count on receiving $100. PAC leaders say most contributions are made at the request of the recipients, who are seldom shy about asking for money.
"I get in the mail every day requests from candidates who want money," said Zoe O'Brien, treasurer of the nurse practitioners' modest PAC.
Some legislators who have shown a keen interest in health-related issues collect more than the typical lawmaker. Sen. Paula C. Hollinger, for instance, has built a reputation as a fierce defender of patients' rights and a biting critic of HMOs. Not surprisingly, the Baltimore County Democrat receives thousands of dollars from health-care provider PACs and little if any money from managed-care companies. Because Democrats hold all the key statewide offices and legislative leadership posts, as well as strong majorities in both houses of the General Assembly, they collect the bulk of the money given out by health-care interests. But most of the PACs give to members of both parties. Sen. Christopher J. McCabe, a Howard County Republican who sits on one of the Senate committees that deal with health issues, is among a handful of legislators who do not accept PAC money -- because, he said, taking a disproportionate amount from a special-interest group could compromise a legislator's objectivity. He estimated that if he accepted PAC money, he could raise $15,000 to $20,000 from health interests for his contested re-election campaign.
McCabe said he doubts that special-interest donors are attempting to buy specific votes. Rather, he said, PAC money can energize a legislator who is already sympathetic to fight even harder for the giver's cause.
"They're trying to identify a few key people who can really be a champion for their position by putting in a bill, putting in an amendment or killing a bill," McCabe said.
He rejected the argument that PACs are using contributions to ensure access. "I think most of us in the legislature are pretty accessible to everybody," McCabe said.
But O'Brien, the nurse practitioners' PAC official, said that, for lTC members of a little-understood profession, it's easier to explain their point of view if they attend a key lawmaker's fund-raiser. "If we've given them $500," she said, "I think they do pay more attention -- rather than go in empty-handed and say 'listen to us.' "
%
Top 10 health PACs
Political action committee -- Maryland Medical PAC
Raised -- $530,311
Donated -- $168,800
Cash on hand -- $68,061
Political action committee -- Health Policy Leadership Alliance
Raised -- $114,145
Donated -- $68,435
Cash on hand -- $33,897
Political action committee -- Maryland Dental Assn. PAC
Raised -- $110,356
Donated -- $77,482
Cash on hand -- $11,762
Political action committee -- HFAM Maryland Nursing Home PAC
Raised -- $82,276
Donated -- $46,894
Cash on hand -- $42,978
Political action committee -- Individual Practice Assn. PAC
Raised -- $60,788
Donated -- $55,621
Cash on hand -- $3,302
Political action committee -- Maryland Psychiatric Assn. PAC
Raised -- $60,401
Donated -- $23,880
Cash on hand -- $9,633
Political action committee -- Optometric PAC
Raised -- $56,107
Donated -- $54,330
Cash on hand -- $10,955
Political action committee -- Blue Cross/Blue Shield Employee PAC
Raised -- $55,922
Donated -- $55,055
Cash on hand -- $1,664
Political action committee -- Maryland Psychological Assn. PAC
Raised -- $53,841
Donated -- $29,086
Cash on hand -- $28,975
Political action committee -- Pharm PAC
Raised -- $40,683
Donated -- $34,395
Cash on hand -- $0
NOTES: Affiliate of Maryland Hospital Association. Revised figures provided by PAC. Affiliate of Mid Atlantic Medical Services Inc., an HMO operator.
SOURCE: Rankings are based on Aug. 18 campaign finance reports filed with Maryland's State Administrative Board of Elections, except where new figures have been provided by PACs in response to inquiries about discrepancies. Some reports are incomplete or contain errors. Amounts carried over from 1994 election cycle are deducted from total raised to reflect 1998 cycle only. Thus, in some cases, money donated to Maryland candidates plus cash exceeds amount raised.
Pub Date: 9/22/98