Just yesterday I found myself wondering whatever became of Elizabeth Fowler. I made a mental note to myself to do a google search because I suspected she had -- or soon would be -- moving on from her last job, now that her work was done. I wondered if she would become a lobbyist or perhaps a health insurance company executive.
You don't know who Elizabeth Fowler is? She had the good fortune to serve her country, the Senate, and Senator Max Baucus not once, but twice, and in the process played a major role in writing and ultimately passing perhaps the two most consequential pieces of healthcare legislation since Medicare. In between she was Vice President in charge of Policy (i.e. she was a big-time lobbyist), for WellPoint the nation's largest health insurance company.
Alas, before I could type "Elizabeth Fowler + where is she now?" into the Google search engine the truth burst forth from the blogosphere beginning with an obscure article in the Billings Montana Gazette that soon caught the eye of David Sirota. Sirota and the Gazette reported that Ms. Fowler was moving to the Obama administration as "Deputy director of the Office of Consumer Information" at the Department of Health and Human Services (HHS), where she will largely oversee and implement the new insurance law passed earlier this year. Actually her full title, it turns out, is Deputy Director of the Office of Consumer Information and Insurance Oversight," suggesting that she will also be responsible for overseeing and regulating health insurance companies under the new law.
Elizabeth Fowler is an attorney with a Ph.D. from the Johns Hopkins School of Public Health. We don't know a whole lot about her prior to her first stint with the Senate Finance Committee which commenced in 2001, but prior to that she was employed by Hogan & Hartson, then the oldest major Law/Lobbying firm in the nation's capitol. During her tenure there the firm represented numerous major players in the healthcare and pharmaceutical industries including The American Hospital Association, Amgen, Biotechnical Industry Organization, Glaxo SmithKline, Healthcare Leadership Council, Northfield Industries, Sanofi-Aventis, and perhaps most notably, PhRMA, the lobbying arm of the pharmaceutical industry. It is not unlikely that at least some of these associations were helpful to her in attaining her next position with the Senate Finance Committee working with its then ranking Democratic member, Max Baucus, who would later become Chair. Baucus, over his career, has received nearly $4 million in campaign contributions from the health sector, nearly $900,000 from the pharmaceutical industry alone, and has been referred to as a "Lackey" for the health care industry.
Fowler's first tour of duty with the Senate Finance Committee was not without controversy. Serving as the Chief Health and Entitlements Counsel, she played a major role in forging the Grassley/Baucus compromise bill that led to the 2003 enactment of the Medicare Modernization Act which gave birth to Medicare Part D and Medicare Advantage. That legislation, among other things, forbade Medicare from negotiating the cost of pharmaceuticals and generously subsidized the pharmaceutical industry, swelling both that industry's profits and the federal deficit. The bill also created the infamous "donut hole" that required seniors to pay 100% of their prescription costs between $2700 and $4,350 in any given year.
The Medicare Modernization Act took effect in January 2006, and it was about that time that Elizabeth Fowler moved on to her new career as a Vice President and senior lobbyist for WellPoint Insurance where she remained until Max Baucus summoned her back to the Senate Finance Committee in February 2008. Health care reform was becoming a part of the national agenda, and Senator Max Baucus wanted to take ownership of the process. Toward that end he once again enlisted the aid of Elizabeth Fowler, luring her away from WellPoint and naming her Chief Health Counsel to the Senate Finance Committee where she supervised a staff of about 20 in overseeing the drafting of the actual bill. Fowler replaced Michelle P. Easton who left to become a lobbyist for Tarplin Downs & Young, representing clients that included, among others, Wyeth Pharmaceuticals; WellPoint; Astra Zeneca; Amgen; Blue Cross Blue Shield Association, and, of course, PhRMA. It is not at all unlikely that she will soon be lobbying the overseer of the new healthcare bill, Elizabeth Fowler. Prior to joining the Finance Committee Easton had actually worked as a lobbyist for PhRMA, apparently demonstrating, along with Elizabeth Fowler, that one of the qualifications for counseling Senator Max Baucus on issues relating to healthcare reform is a previous cozy relationship with the pharmaceutical industry and WellPoint.
Baucus's press release touting Fowler's return to government service somehow failed to mention her recent employment as a WellPoint executive In a speech on the Senate floor the following month Senator Baucus again sang the praises of Elizabeth Fowler, singling her out as the one person who "put my team together, my health care team, Liz Fowler worked for me many years ago." Baucus mentioned that Fowler had "left for the private sector," again failing to mention her specific employment as a Vice President and lobbyist for WellPoint. "She then came back when she realized that she could be there at the creation of health care reform, because she wanted to, in certain sense that be her professional lifetime goal. She put together that white paper last November 2008, um, 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures and all bills both sides of the aisle came from."
Politico, in a piece virtually overflowing with admiration for Fowler, but which also did not elaborate upon her recent career beyond stating that it was in the "private sector," similarly left no doubt about who was the driving force behind the Baucus healthcare bill. Politico called Fowler the "chief operating officer" among the major players in the Senate health care negotiations, who "directs the Finance Committee health care staff, enforces deadlines on drafting bill language and coordinates with the White House and other lawmakers" as well as being the troubleshooter, "identifying policy and political problems before they ripen."
The Finance Committee bill that finally emerged and was largely the model for the bill that ultimately passed earlier this year was not without its good points, but it was a far cry from the universal, comprehensive healthcare bill many were hoping for and expecting. Excluded from any input into the legislation were proponents of single-payer healthcare which is arguably the only system that can provide true universal, comprehensive healthcare while radically reducing the cost of healthcare delivery. In May of 2009 when the Senate Finance Committee held hearings not one single-payer advocate was invited to testify. When thirteen single-payer advocates stood up one-by-one during two separate hearings to request a seat at the table Senator Baucus, in apparent amusement, had them arrested, one-by-one and removed from the chamber. The bill that ultimately emerged and passed excluded a public option (opposed by the health insurance industry), and included mandates requiring the purchase of health insurance from private for-profit health insurance companies. The bill does little to reign in insurance premiums and includes subsidies that will funnel billions of dollars into the coffers of those same insurance companies.
The healthcare bill recently enacted barely begins its roll-out until the year 2014, and does not conclude it until the end of 2019. Oversight of the process and of the players will be crucial in determining whether the bill is to live up to even its limited promise or instead becomes entangled in a bureaucratic web saddled with unsustainable costs. I for one will not sleep better at night knowing that Elizabeth Fowler is in the driver's seat.