[jonas21]

Many of the groups that spend the most on lobbying are composed of "normal" people who have banded together for some common interest. For example:

- The AARP ($21M annual spend) has 38M members

- The National Association of Realtors ($54M annual spend) has 1.5M members

- The American Medical Association ($24M annual spend) has 300K members

Of course that doesn't mean that their interests necessarily align with your interests.

[0xdeadbeefbabe]

Also if they want my money then their interests align.

[smallmancontrov]

"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices." - Adam Smith

[ben_w]

A curious choice of quote on a tech forum attached to a VC firm :P

[smallmancontrov]

You know what would be cool? A national startup accelerator!

[programmertote]

It really irks me for some reason that American Medical Association (one of the top spenders in lobbying) is doing the lobbying. I did a quick Gemini/Google search and these are the topics they lobby for.

``` Core Legislative PrioritiesMedicare Reform:

Fighting to fix stagnant physician payment formulas and account for inflation.

Prior Authorization: Pushing to reduce administrative roadblocks and delays enforced by insurance companies.

Scope of Practice: Opposing laws that expand independent clinical roles for non-physicians like nurse practitioners and pharmacists.

Burnout Reduction: Supporting federal and organizational relief to help doctors manage workplace stress and administrative tasks.

-- Public Health and Science

Public Health Crises: Supporting science-based policies on vaccinations, gun violence prevention, and chronic disease reduction.

Digital Health: Guiding regulations for artificial intelligence and telehealth integration in medical practices ```

Most of these are about keeping the gate (i.e., doctor's compensation high). The US doctors are the highest paid in the world (among developed countries like UK, Canada, France, Germany, Italy, etc.) by a long shot. Kind of mad if you think about it.

Disclaimer: My spouse is a specialist doctor. You can say I have selfish interest in keeping doctor's salaries high in the US. But I can't help highlighting that doctor's guilds (like AMA) are part of the reasons why the healthcare expenses are so high in the US.

[rchowe]

One of the ways that the AMA gatekeeps is to limit the number of medical school seats and residency slots in the US (residency is run by Medicare).

Quality of life (at work) for many physicians is arguably pretty bad due to long hours, administrative requirements, and insurance requirements / prior auth. Physicians should lobby to get some of these things fixed by regulation, because it's likely the only way they will get fixed! However, a physicians lobby of any kind is going to have a tough time reducing healthcare costs because they have a significant financial incentive to gatekeep and their members can pay high dues to spend a lot on lobbying.

I wonder if the AI meant PAs instead of pharmacists -- as I understand it, a pharmacist's scope of practice is quite distinct from a physician.

[smallmancontrov]

Yeah, doctors have been wilding and it's curious how completely they have been able to avoid public backlash for it. Probably some combination of knowing your doctor and more strongly associating billing/insurance with the financial pain even though providers are a big part of the cost spiral.

[neutronicus]

It's a "temporarily embarrassed millionaire" variant, I think. "Temporarily embarrassed parent of a future doctor".