RICHMOND -- Several years ago, when she was starting out here as a lobbyist for the Virginia Hospital Association, Katharine M. Webb got a valuable piece of advice from a methodical Richmond delegate named Jerry Baliles.
"Katie," Webb recalls Baliles as saying, "never come down here unprepared." Much to the chagrin of Baliles, who went on to become governor, Webb never forgot the lesson.
During the past month, Webb and several other representatives of Virginia's medical establishment executed a textbook campaign to defeat a Baliles administration proposal to charge daily fees on hospital and nursing home beds to finance indigent health care. Immediately after being informed of the proposal in the last week of December, the lobby lined up hospital executives from around the state, including J. Edward (Ned) Sweet Jr. of Alexandria Hospital and Don Harris of Fairfax Hospital, to attack the fees as an onerous "sick tax" on patients.
By the end of January, just when the General Assembly's 140 members were getting their bearings for the session, the proposal was dead. The administration tried to find a legislator who would sponsor a bill enacting the fees, but could not. Baliles has eclipsed many of his predecessors by his cool, cerebral and above all methodical approach to problems, but in this case he was simply skunked.
The governor subsequently vented his anger at the lobby's success with an unusually harsh blast at Webb and her comrades in arms. The hospital lobby, Baliles suggested, was guilty of "obstructionism," a sin compounded, he said, in view of its record of "comity and cooperation." That cooperation, Baliles did not have to mention, has often been in the form of election-year contributions to Democratic candidates from the political action committee of the hospital association.
Baliles' truculence was understandable; like most folks, he hates losing. But at the same time, he completely missed the point: The hospital lobby alone did not kill the bed fee proposal. When the governor and his lieutenants failed to lay the groundwork for the proposal, they sealed its fate.
All the lobbyists had to do was come along with an unfriendly shove, which of course is what they are paid to do. Lobbyists have essentially two missions in their professional lives, to ensure passage of legislation that somehow benefits their industry or client's interest, or run a defensive action to kill off what they view is a noxious new proposal -- like a $5 daily fee on every hospital bed in the state.
Experienced lobbyists such as the two who work for the state's prosperous hospital industry know where the pressure points are in the Virginia General Assembly. The job of Webb and her colleague Laurens Sartoris, both of whom spent years as state government employees, is simply to find those pressure points and push on them, in ways subtle or obvious or both.
They did, so there's a stalemate of sorts in Richmond, the kind of standoff in which nobody wins in the long run. True, Baliles had the satisfaction of thundering from the safety of his Capitol office, but he is still no closer to solving what he freely admits is a crisis in health care financing than he was when the lobbying war started a month and a half ago. Many legislative leaders believe his call for a two-year moratorium on new medical services will have little, if any, demonstrable effect on containing health care costs.
Meanwhile, the hospitals, while not exactly gloating, are secure in the knowledge that the bed fee proposal is dead for the moment. However, they too run the risk of losing the most important public relations Hospitals may run the risk of losing the battle to maintain their credibility.
battle they have faced in years: how to maintain their credibility with their legislative allies at a time when, as Baliles quite rightly noted, the cost of one hospital aspirin tablet may be as much as a whole bottle at the supermarket.
Something has turned far too sour in what for some time had been a fairly thoughtful dialogue between government and industry. Not only have the two sides stopped talking, but the finger-pointing shows no sign of abating. The governor does not suffer particularly -- he has called for a yearlong legislative inquiry into health care costs -- and the hospitals have what they want for now.
What is remarkable, even disturbing, is that a solution to the state's seemingly intractable problem of health care financing has eluded two old friends: the state's Democratic establishment and Virginia's politically astute medical industry.
Perhaps neither side will suffer, insulated as both are by the cloak of Capitol politics. What seems most clear is that the loser may be the person who has occasion to need the services of a Virginia hospital in the next 12 months.