Healthcare Lobbyist – A Day in the Life

The term lobbyist was popularized by Ulysses S. Grant, who used it to describe the self-promoting individuals he often encountered in the lobby of the Willard Hotel, which stood just two blocks down from the White House. In contemporary American politics, that lobby is more of a metaphorical one, but lobbyists are as real as they’ve ever been. And in the US healthcare system, they’re an integral part of what influences overall policy.

According to research by Accenture, the US healthcare system is so complex that more than half of the country does not understand how to navigate it. Changing that system is orders of magnitude more difficult. But that’s the charge of healthcare lobbyists, who advocate for the interests of patients, providers, insurers, pharmaceutical companies, or others in the healthcare industry. Leveraging subject-level expertise and a mastery of the art of persuasion, healthcare lobbyists fight to make meaningful adjustments to the US healthcare system.

The stakes are absurdly high. In 2019, four of the six top spenders on lobbying in the US were healthcare-related organizations. Together, they doled out roughly $100 million, outspending cash-flush tech companies like Facebook and Amazon. But what that money could possibly buy is even more valuable: changes to a healthcare system that spends the most of any rich country—but still delivers some of the worst outcomes to the people who use it.

The epicenter of the lobbyist industry is situated in proximity to the federal government, on Washington DC’s K Street. A 2011 report in The Washington Post estimated that there were over 13,000 lobbyists across all industries in Washington DC, but with the vast majority of lobbying expenditures going to fewer than 300 firms. Furthermore, the turnover amongst those firms was extremely low. The top ten highest-paid lobbying firms across all industries pulled in nearly a quarter-billion dollars in 2018 alone.

A lobbyist doesn’t necessarily need to live in the nation’s capital, however, nor do they need to work directly at a law firm. Healthcare lobbyists can be employed by pharmaceutical companies, insurance agencies, healthcare providers, nonprofit organizations, or any other outfit with a footprint in the healthcare industry. They can work at the federal, state, or local level.

This is a modern and mobile profession that centers around a mix of networking and analysis, and a healthcare lobbyist will often take their job with them across multiple locations.

The primary responsibility of a healthcare lobbyist is to advance the interests of their client. Who that client is will have an enormous impact on the actual tasks at hand: the needs of a pharmaceutical company can diverge significantly from the needs of a public health organization, for example. Still, some general similarities do exist across the daily responsibilities of many healthcare lobbyists.

Typical daily responsibilities of a healthcare lobbyist may include:

• Cultivating personal and professional relationships
• Meeting with elected officials and policymakers
• Drafting potential changes to current policy
• Analyzing the impacts of different policy proposals
• Organizing broader support through fundraisers
• Educating and advising other stakeholders

Healthcare lobbyists generally fall into two categories: direct lobbyists and indirect lobbyists.

• Direct lobbyists, also called inside lobbyists, will focus on influencing government officials and their staff directly.
• Indirect lobbyists, also called outside lobbyists, will attempt to influence people outside the policymaking community, who can in turn pressure policymakers.

Both categories require a strong skill set and educational background.

A firm understanding of the legal and policy frameworks undergirding healthcare is a requirement for practically all healthcare lobbyists. In order to meet the complexity of this profession, healthcare lobbyists almost certainly will need a graduate-level education.

Many direct healthcare lobbyists have a law degree, which facilitates their work with legal teams as well as law-minded politicians. Indirect healthcare lobbyists may have less formal legal training but typically have strong skills in public relations, including the use of social media.

Both categories may also have graduate-level, healthcare-focused training, such as that provided through a master’s of healthcare administration or a master’s of public health. An understanding of finance, statistics, and data analysis is beneficial as well.

Healthcare lobbyists are not mere number crunchers, as they need to be able to understand, educate, and sell the complex workings of particular forms of healthcare policy. This is a networking profession, so interpersonal skills, communication, and persuasion are all immensely important. In the final analysis, a successful healthcare lobbyist is evaluated on what they can get done and how.

Experience is highly valued in healthcare lobbyists. And, at the highest level, healthcare lobbyists are an extremely exclusive bunch who often count former politicians amongst their ranks. But this is not an impossible profession to enter: grassroots organizations, public health advocates, and internship roles all provide opportunities for healthcare lobbyists to cut their teeth and build up their experience.

While there is no certification requirement for healthcare lobbyists, those who pursue this career will most likely need to register themselves with state and federal governments. This level of disclosure is critical for promoting transparency and compliance across all of a lobbyist’s actions and a failure to observe the complex laws around the profession can have severe penalties.

Fees, rules, and requirements around lobbying and registering as a lobbyist vary substantially from state to state, and role to role, but a general guide can be found through the National Conference of State Legislatures (NCSL).