One-third of HHS appointees hop to industry jobs, raising conflict-of-interest concerns

One-third of HHS appointees between 2004 and 2020 left for jobs in the industry, according to the first comprehensive study of the "revolving door" in healthcare regulation in Health Affairs

The study is the first of its kind to analyze the revolving door — inflows from and exits to industry — of government appointees to HHS between 2004 and 2020. The authors note that such churn can present conflict-of-interest risks between the industry and the governmental body that regulates it. 

Of the people appointed to HHS between 2004 and 2020, 15 percent were employed in private industry immediately before their appointment. At the end of their tenure, 32 percent departed to industry, taking jobs with biopharmaceutical and device manufacturers, health insurers, information and communication technology firms, real estate firms with medical property portfolios, and consulting firms. The greatest net exits to industry were from the CDC and CMS. 

"The exit of government employees to industry may lead to pro-industry bias as employees with an eye to leaving make decisions favorable to private firms where they are hoping to get jobs," wrote study authors Genevieve Kanter, PhD, associate professor of public policy at USC Price School of Public Policy, and Daniel Carpenter, PhD, professor of government and chair of the department of government at Harvard University. 

The authors note that the existence of a revolving door between HHS and industry is not problematic in itself, but the scale of the revolving door identified by the study is concerning and merits further scrutiny.

"The risks posed to the functioning of and public trust in HHS warrants study into how these government-industry flows are affecting agency decision making, especially in offices with the highest net exit rates," wrote Drs. Kanter and Carpenter. "Where there exist vulnerabilities, analysis can focus on how current laws and regulations can be refined or better enforced. Given the complexity and subtlety of mechanisms of industry influence, regulation of the revolving door will require innovative legal and regulatory strategies."

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