Aides become lobbyists in health care gold rush 

From the House floor just before passing the health care bill, Speaker Nancy Pelosi praised her staff for "a remarkable job, dazzling us with their knowledge and their know-how." For senior health care adviser Arshi Siddiqui, whom Pelosi thanked by name, that shout-out might have been worth a small fortune.

Siddiqui played a key role in drafting the "reform" that will reshape our health care system, and she has since been hired by a K Street lobbying firm representing health insurers, drug companies, and device makers.

It's the beginning of the Great Health Care Cashout, in which the "reform's" authors become consultants or lobbyists for the affected companies.

Law firm Akin Gump announced Siddiqui as the newest partner in the firm's "policy practice in Washington" (read: lobbying shop). Among Akin Gump's clients are drug makers Pfizer and PharmAthene. Aetna, the big insurance company, is also a client, as is the lobby group America's Health Insurance Plans. Other health-sector clients include the California Association of Physician Groups, device-maker Covidien, General Electric, Johnson & Johnson, and the Kansas Bioscience Authority.

We don't know yet if Siddiqui will technically be a lobbyist, or mostly consult clients (Pelosi's office couldn't provide her contact information, and Akin Gump said she was not yet on the firm roster, so I couldn't reach her for comment). But in either event, she is monetizing her "public service," putting her intimate knowledge of the "reform" law to work for the likes of Pfizer, Aetna, and anyone who can pay.

Then there's Peter Rubin, a top staffer for Sen. Barbara Mikulski on the Senate health committee. Rubin e-mailed his colleagues in early April: "With the imminent arrival of baby #2, I have decided to take a job at Sanofi-Aventis starting on May 3rd. It has been an unbelievably amazing experience to work for [Mikulski] and watch health reform go from a hearing to a law that actually helps people."

Huffington Post reporters Arthur Delaney and Ryan Grim, who first published this e-mail, noted it was not Rubin's first spin through the revolving door: He was a drug industry lobbyist before coming to the Senate side to "reform" our health system. Now he'll help drug maker Sanofi-Aventis navigate this new system, and continue to shape it -- because there's still plenty of lobbying to be done.

John E. McDonough, another "reform" co-author who has recently left Capitol Hill, explained in an audio interview with the City University of New York: "This new law is, in itself, not the end. It will be corrected, fixed, improved on repeatedly over the coming decades." (McDonough is in academia, and he told me by e-mail he has done no consulting for drug companies, insurers, or other big health-sector players.)

The "reform" boom is common knowledge. Michael K. Loucks, a health care lawyer moving from the Department of Justice to the law/lobby firm Skadden Arps, told the New York Times: "There are so many changes, and some of the provisions in the legislation are incredibly ambiguous." He predicted "an enormous amount of work done by lawyers helping clients figure out what the new legislation means and how it impacts them."

You can't blame Loucks for going where the dollars are, nor begrudge Rubin for looking out for his kids' future. But with staffers like Rubin and Siddiqui, you have to wonder about the incentives they faced while writing this bill -- if only subconsciously. The drug lobby mostly got what it wanted from the bill, and heartily endorsed it. Would a less Pharma-friendly bill have constrained staffers' job prospects?

More fundamentally, the lure of the cashout promotes bigger government. If Siddiqui, Rubin, and their colleagues had cut back government's role in health care, they would have dampened the demand for lobbyists. Instead, a "reform" packed with subsidies, mandates, and regulations increased the need for lobbyists. And who better to help you navigate, game, and tweak the new system than the "public servants" who created that system?

The Great Health Care Cashout has just begun. We're setting up a scoreboard at to track key health care staffers' exodus to K Street.

Next, we can expect a Great Wall Street Cashout, and maybe a Great Climate Change Cashout. They all follow the same pattern: Increase government control of some sector of the economy, then become a highly paid consultant for that sector. It's nice work, if you can get it.

Timothy P. Carney, The Examiner's lobbying editor, can be reached at He writes an op-ed column that appears on Friday.

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