Politico is perhaps the most DC of all DC publications. Before Axios came along, it had the market cornered on content aimed at people who like to think of themselves as power players or who need to know what the power players are doing. DC’s lobbyists, consultants, government workers, and corporate types are thirsty for insider information, and Politico is there to send it into their inboxes every morning.
Mike Allen started Politico’s flagship newsletter Playbook years before he founded Axios, and it made the site a pretty penny by charging thousands of dollars to sponsor the newsletter—while also muddying the waters for readers, who were treated to ad content running alongside Allen’s political analysis.
The ads are now much more clearly marked, but they’re still there. In addition to Playbook, Politico has many other newsletters covering specific policy areas or regions of the country. It has one for tech, one for defense, one for labor, and so on. It also has Pulse, the one for healthcare, which I read most days. Like Playbook, Pulse is usually sponsored each week. And for the majority of this year, it’s been sponsored by the Pharmaceutical Research and Manufacturers of America (PhRMA), the pharmaceutical industry trade association with more cash than they know what to do with. In 2017, PhRMA’s revenue was a staggering $456 million, mostly from membership dues. It spent $128 million on lobbying and $68 million on advertising.
So why not spend some of that cash—whatever it costs, which Politico wouldn’t tell us, but it’s obviously a fraction of a fraction of that absurd revenue figure—on reaching the capital’s most important power players?
By Splinter’s count, Politico Pulse was sponsored by PhRMA 72 percent of the time in 2018, for 36 weeks out of 50. No other group sponsored the newsletter for more than two weeks. So what message has PhRMA been pushing so hard in ads targeted at DC’s influencers? Mostly fighting wars with other powerful and nefarious actors in our nightmare healthcare system: hospitals, pharmacy benefit managers, and health insurers. But not entirely! This week, for example, they paid for the privilege of telling Pulse readers about their opposition to Donald Trump’s very limited price control proposal on Medicare Part B (which covers drugs you receive at the doctor’s office):
** A message from PhRMA: Medicare Part B reimburses for medicines using a market-based Average Sales Price, which includes the rebates and discounts negotiated between manufacturers and insurers in the commercial market. Replacing this market-based system with government price setting is the wrong approach. Protect seniors’ Medicare Part B. **
Protect Part B, because if we can’t charge whatever we like for it, it’ll go away, I guess? (This is bullshit; they just don’t want to lower prices.)
Back in September they had a different enemy:
** A message from PhRMA: New analysis shows some hospitals mark up medicine prices 700% or more. This means if a hospital purchased a medicine for $150, a 700% markup could result in patients being billed $1,050 for that medicine. These hospital markups lead to higher costs for everyone — patients, employers and payers. **
This is very amusing to me, because while it is true that hospitals mark up prices, sometimes to absurd levels—a $15 Tylenol pill, for example—it is also true that drug prices are extremely high because pharmaceutical companies set them so high.
Who else has earned the targeted fire of PhRMA? From an edition of Pulse in July (emphasis theirs):
** A message from PhRMA: Middlemen make more money when your medicine prices increase. We think that should change. That’s why we are advocating for reforms that prevent pharmacy benefit managers and other entities in the supply chain from being paid off the list price of a medicine. https://onphr.ma/2LrlPoK **
Once again, PhRMA is going after an enemy that is Also Bad but whose badness does not change how super fucking bad Big Pharma is. Pharmacy benefit managers (PBMs) do raise the prices of drugs before they sell them to patients, skimming off that extra as profit, but—and I don’t know how many different ways there are to say this—pharmaceutical companies are primarily at fault for listing their drugs at such high prices and for working so hard to prevent generic competitors from entering the market.
But who else has sponsored Pulse? A bunch of groups who aren’t much better. The Pharmaceutical Care Management Association—which represents PBMs—sponsored the newsletter in the first week of April, with the following message:
** A message from the Pharmaceutical Care Management Association (PCMA): Pharmacy benefit managers (PBMs) are hired by employers, unions, and government programs to negotiate aggressive discounts from drug companies and drugstores. PBMs continue to keep overall spending and out-of-pocket costs down despite massive price hikes by drugmakers. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com. **
Don’t listen to pharmaceutical companies—we are actually good! We lower your prices! Look at our dumb website!
Meanwhile, at the end of May, the Coalition for Affordable Prescription Drugs—wow, doesn’t that sound good? I love affordable drugs!— ran this ad:
**A message from the Coalition for Affordable Prescription Drugs (CAPD): Drug companies alone set the list prices of prescription drugs, which continue to rise year-after-year at near double-digit rates. Patients can’t benefit from innovative drugs if they can’t afford them. It’s time to stop pricing out patients. Learn more. **
Yeah! Stop pricing me out! Except, who does CAPD represent? Pharmacy fucking benefit managers. Once again. Its members include CVS Health (a PBM), United Health and, weirdly, John Deere.
At the end of November, Pulse was sponsored by the biggest and baddest of all the straight-up evil Washington lobbyist groups: the Chamber of Commerce.
** A message from U.S. Chamber of Commerce: Millions of Americans could face more than a $450 tax hike when the Health Insurance Tax (HIT) returns in 2020. Congress must act soon to delay or repeal harmful and poorly constructed ACA health taxes such as the HIT, the Cadillac Tax, and the Medical Device Tax. **
Fighting taxes on the various industries represented by its members is pretty much the Chamber of Commerce’s raison d’être. The premise of this message—this tax hike is bad for consumers—just takes for granted that health insurers must pass on that tax to consumers in the form of premiums, which they do not have to do.
PhRMA flooding Politico readers’ inboxes makes a lot of sense given what they’re facing in DC. The industry is seeing louder opposition from across the political spectrum, with even Donald Trump’s administration making noises about drug prices, and Democrats introducing significant legislation that would lower drug prices (and hurt their profits). If they’re flooding the health insider news channels with ads blaming everyone else in the healthcare industry for drug prices, perhaps they’re a bit worried.
That’s why all these ads, from PhRMA and their competitors, are aimed at persuading DC policymakers that it isn’t or is Big Pharma’s fault that drug prices are so high. With this new interest in the problem of high drug prices, PhRMA has an incentive to push the blame onto others, and others have an incentive (but less cash) to defend themselves. Of course, ultimately all of these actors are invested in the private healthcare system as it is, and would stand to lose from single payer. That’s why, despite PhRMA’s sniping at insurers and hospitals over drug prices, they’ve joined forces to form the Partnership for America’s Healthcare Future, a bullshit nonprofit that exists to fight single payer. When it comes to defeating single payer, they’re all on the same side.
The unanswered question is how, or if, these sponsorships affects Politico’s coverage. It certainly feels weird to have your healthcare news sandwiched between SPONSORED BY AMERICA’s HEALTHCARE BASTARDS, INC., but it’s harder to say whether or not the actual reporting is influenced by this relationship.
In 2016, the Politico reporter who primarily writes Pulse addressed this very question in an interview:
It might be helpful to explain how our newsletter — PULSE — gets put together. It’s embarrassingly low-tech; at any given point, I keep five-to-ten Microsoft Word documents, each devoted to an upcoming day’s issue. If I know that there’s a big cancer summit on Aug. 24, say, I’ll be working on news and tidbits for days, so when the night of Aug. 23 comes around, I’ve already got a chunk of it done.
What that means is that I’m crafting each issue with zero knowledge of who’s “presenting” it. Even the test email that I send to the editors to review doesn’t have the ad language attached. I suppose I could sleuth it out, but it’s just background noise to me — and it’s never, ever been a factor in what we write.
In response to our request for comment, Politico publicist Cindy Andrade provided the following statement:
There is a complete separation between the business team and editorial team at POLITICO, especially when it comes to our journalism and content creation. Sponsorship of our newsletters and other offerings has no influence on editorial content, as reporters and editors don’t know who the sponsors are ahead of time or how much they spend.
In the same email, Andrade said the sponsorships are “no different than any other advertising—the buyer purchases ad space next to the content that is related to their industry.” She compared it to political advertising running on CNN. It is a little different, though, at least in terms of scale: It would be like if seven of every 10 ads on CNN were suddenly from a Trump super PAC or the Chamber of Commerce.
Surely the Pulse reporters would have noticed after a while that PhRMA seemed to be paying their bills that year, but that doesn’t mean they were influenced by it. For readers, it’s the same problem that dogs campaign finance advocates: Except for in really obvious cases of quid pro quo, leaked emails, or closed-door fundraisers, it’s easy for politicians to say that there’s no evidence of influence on them by the industries that give them money. A normal reader, not one addled by Beltway hand-waving about influence, might see the newsletter is so heavily sponsored by PhRMA and reasonably think: What the fuck?
Perhaps the more interesting way to think of it is this: If Politico was writing stuff that genuinely pissed off the pharmaceutical industry, or the hospital industry, or the Chamber of Commerce, would PhRMA still sponsor them for 70 percent of the year? Would you see the Pharmaceutical Care Management Alliance popping up? It’s possible you still would, because maybe reaching DC’s elite right in their inboxes is more valuable than whatever is said about them between the ads. But I dream of a world where DC’s power elite can’t open their inboxes without being reminded that the pharmaceutical industry is killing people for profit.