Democrats Lead in Early Health-Sector Presidential Campaign Donations

WASHINGTON, Aug. 23 -- Reversing a 15-year trend, physicians and health-industry groups are contributing substantially more money to Democratic presidential campaigns than to GOP efforts.

What's more, candidates most closely associated with plans for universal coverage are receiving more of the early money from health sector contributors.

Seventeen candidates of both parties have raised more than million so far, the fastest start to presidential fund-raising ever, according to the Center for Responsive Politics (www.opensecrets.org) and a Perspective by Robert Steinbrook, M.D., in the Aug. 23 issue of the New England Journal of Medicine. He is the NEJM's national correspondent.

The contribution turnaround from the health sector is dramatic and could represent a significant concern to the GOP nominee. For the first six months of this year, Democratic candidates raised a total of .9 million from the health sector (which includes physicians, drug companies and hospitals, among other groups), compared with .1 million for Republicans (56% to 44%).

This new Democratic advantage is all the more remarkable considering that since 1990 Republicans have received three-fifths of campaign donations from the health sector. The last time Democrats topped the GOP in donations from health sources was in 1992 with 51%.

The three leading money-raisers among Democratic candidates all favor expanding access to health care with the help of government programs.

Sen. Hillary Clinton (D-N.Y.), is the leading fundraiser and has collected .1 million, of which .7 million (2.7%), was from the health sector. Widely criticized in 1993-94 in the health industry during her efforts to reform health-care delivery, which failed, Clinton has moderated her positions and won over many of her one-time critics, said Dr. Steinbrook.

When she ran for reelection to the Senate in 2006, she ranked first among all Senate candidates in contributions from doctors and other health professionals, and second in donations from hospitals and nursing homes, the NEJM found.

Sen. Barack Obama (D-Ill.) is second among Democrats with .9 million in contributions, of which .2 million (2.1%) was from health sources. Former North Carolina Senator John Edwards was third with .1 million, and only ,000 from the health sector.

On the Republican side, former Massachusetts Gov. Mitt Romney collected .4 million, including .4 million (3.1%) from the health industry. Romney last year signed legislation requiring individuals to purchase health insurance as a means of achieving near universal coverage.

Former New York Mayor Rudolph Giuliani was second, taking in .6 million, including ,000 (2.5%), from health sources. He's been critical of Democratic plans for universal care, likening them to socialized medicine. Sen. John McCain, R-AZ, was third with .3 million including ,000 from the health sector. Campaign contributions to former Tennessee Sen. Fred Thompson were not reported because he has not officially entered the race, the NEJM noted.

The early trend in donations may be more telling than in previous years because health care is the No. 1 domestic issue for voters, ahead of immigration and the economy, according to leading polls. The potential for major reform seems greater than it has for many years, noted Dr. Steinbrook.

It was not clear whether the contribution shift to the Democrats will continue. It may depend on details of health-reform plans each will offer.

The health reform plans offered by the candidates so far, even by Clinton, have been sketchy at best. For physicians and the health industry, the devil will be in the details.

The American Medical Association and many of its physician members have traditionally favored Republicans. But the 2008 election may be different. The AMA has gone on record supporting several ideas promoted by Democrats.

The AMA's policy-making House of Delegates voted in July in favor of expanding the State Children's Health Insurance Program, calling on Congress to spend billion over five years. The Democratic candidates agree. President Bush wants to spend less and has warned that expanding the program beyond low-income children could be a stalking horse for a government-run single-payer system.

The AMA favors universal coverage and will launch a "Voice for the Uninsured" media and education campaign this fall to put pressure on Congress. However, the House of Delegates rejected a resolution that would have added publicly funded universal access to health insurance to the AMA's list of options. Opponents argued that could give cover to politicians who favor a single-payer system.