Health Care Lobbying, Political Action Committees, and Spine Surgery

Area of Science:

• Health Policy and Political Science
• Surgical Advocacy and Lobbying
• Medical Economics

Background:

• Significant financial investments are made in healthcare lobbying, with a small fraction supporting direct patient care providers.
• Physician-based Political Action Committees (PACs) play a role in advocating for specialized medical interests.
• Understanding the financial strategies of PACs is crucial for analyzing their influence on healthcare policy.

Purpose of the Study:

• To analyze the political contributions and lobbying strategies of PACs representing spine surgeons.
• To compare the financial activities and participation rates of different physician-based PACs.
• To identify trends in political donations within the spine surgery professional community.

Main Methods:

• Retrospective review of data from PACs of the American Association of Neurological Surgeons (AANS), American Association of Orthopedic Surgeons (AAOS), and North American Spine Society (NASS).
• Data collected biannually from 2006 to 2018 from OpenSecrets and the Federal Election Commission.
• Statistical analysis of PAC contributions, donation patterns, and member participation rates.

Main Results:

• In 2016, the AAOS PAC had the highest contributions ($2,648,218), significantly exceeding AANS ($348,091) and NASS ($183,612).
• Orthopedic surgeons were more likely to donate to their PAC than neurosurgeons (P < 0.001), with AAOS showing the highest spend per member.
• The majority of donations targeted federal candidates, with a notable proportion supporting Republican candidates across all three PACs.

Conclusions:

• Spine surgery lobbying is unique due to representation by three distinct physician PACs, with AAOS exhibiting the greatest financial influence and member engagement.
• Effective choreography of donation strategies is essential for physicians to maximize their collective voice in policy discussions.
• The findings highlight the significant role of financial contributions in shaping legislative priorities relevant to spine surgery.