Who Will Be at the Table? Part XI

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During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is the time to look at just what kind of seats special interest groups are having at Obama’s table and what they’re doing to bring the public around to their ways of thinking. This is the eleventh of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.

At the end of June, an invitation came my way to attend a virtual press conference where health care experts were to discuss “the ramifications of a public plan.” Intrigued, I RSVPed. The purpose of the call was to introduce the new “Hands Off MY Health” campaign aimed at spotlighting “the risks of government-run health care.” Call moderator Robert Goldberg explained that the campaign consisted of a “labyrinth of sites” which examine single-payer systems around the world and give some thoughts on what a public plan can and cannot do. When an operator at the beginning of the call said: “Welcome to the APCO world wide conference call,” my ears perked up.

APCO Worldwide is a super influential PR consulting firm that specializes in grassroots organizing, coalition building, and using political campaign tactics to create an environment that supports their clients’ legislative and regulatory goals. A 1995 APCO Associates pamphlet entitled “Political Support Services” says that “APCO applies tactics usually reserved for political campaigns to target audiences and recruit third-party advocates.”

Was APCO behind the convener of the press call, CMPI Advance, a newly-formed advocacy offshoot of the Center for Medicine in the Public Interest? The Center advocates a free-market approach to health care, especially when it comes to drugs and medical devices; in 2006, according to Politico, its biggest contributors were Pfizer and Pharma. Sourcewatch says its advisory board includes such right-wing think tank luminaries as Sam Kazman of the Competitive Enterprise Institute, Dr. Merrill Mathews from the Council for Affordable Health Insurance, and Grace Marie Turner, president of the Galen Institute.

Goldberg, the Center’s vice president and director of programs, is also well-known in conservative circles. In my book, Slanting the Story—The Forces that Shape the News, I noted that Goldberg had been instrumental in building support for legislation that weakened the FDA. In the late 1990s, he was a senior research fellow at Brandeis. Edward Hudgins, then director of regulatory studies at the Cato Institute, told me: “We try to keep a stable of academics to write things for us,” and he tried to use Goldberg as often as he could.

I knew that APCO had done work for insurance companies a few years back to help them deflect attention from the messages Michael Moore sent in his movie Sicko. APCO worked with insurers to develop a strategy for handling media and public inquiries when the movie premiered. It helped create talking points and advised industry reps to maintain that government-run health care is bad and that other governments ration care. APCO helped set up a third-party front group, Health Care America, to discredit the movie, and it monitored the mentions the group got in the press.

Could insurance company and Big Pharma fingerprints be found on the Hands Off My Health campaign, whose goal seems to be stopping a public plan (“government-run health,” in PR-speak)? According to Sourcewatch, APCO’s clients have included Novartis Pharmaceuticals, Pfizer, Roche, and Pharma. And after all, insurers and drug companies are not exactly friends of a public plan option.

And was CMPI Advance the kind of third-party outfit APCO says it specializes in recruiting—a surrogate for insurers and drug companies to spread their messages far and wide throughout the conservative and mainstream media? The press call featured Dr. Gary Puckrein, president of the National Minority Quality Health Forum, who said “we have tremendous reservations about government plans,” and Dr. Val Jones, founder and CEO of Better Health Network. Jones said that a public plan would force physicians to treat people as codes, not patients. (Presumably she meant the medical billing codes that doctors use.) Their comments mirrored the tone of the content found on the campaign’s labyrinthine Web sites, which—sleekly designed, supplying tons of information in short, digestible bites—have clearly been done by a pro.

The sites are awash with stuff that raises doubts about a public plan and the possiblity of stifling medical innovation, such as op-eds by Goldberg from outlets like the American Spectator and the Detroit News. There are quotes disparaging or questioning such a plan from academics like Princeton economics professor Uwe Reinhardt, elected officials like Sen. Joe Lieberman and Michael Enzi, and editorial boards of newspapers like The Washington Post and the Chicago Tribune. There are links to articles by people like Family Research Council senior fellow Ken Blackwell, who casts doubts about the actual number of uninsured folks in the country. Page after page urges site visitors to “Join the fight against government-run health care” by signing a petition telling politicians to “do no harm to our health care system,” and noting that the public plan is a “poison pill for patients, doctors and the entire American health care system.”

One site zooms in on what’s wrong with health systems in other nations; its home page refers visitors to the Center for Medicine in the Public Interest’s new mini-documentary called Off-label: Universal Healthcare. In the mini-doc, Goldberg and Center president Peter Pitts—who himself is a partner in another PR agency, Porter Novelli—claim they will help viewers separate fact from fiction about health care. The documentary also features man-on-the-street interviews that appear to create confusion about the difference between government and universal health care.

Besides the mini-doc, the site presents health care facts (“The Centers for Medicare and Medicaid Services (CMS) reported that the cost of Medicare Part D is $189 billion less than predicted”), health care horror stories from victims in foreign countries, and case studies from those countries discussing such things as low doctor salaries, underinsurance, and quality of care.

The press needs to realize that sites and campaigns like these don’t just spontaneously come together. They are inevitably cynical publicity efforts on the part of corporations that, when it comes to health reform, primarily have their own financial interests in mind. No doubt there will be more slick PR jobs and messages racing to the public through all kinds of groups. It’s beginning to sound a lot like 1993-94. For the press and the public, it’s caveat emptor once again.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.