Wendell Potter: How Corporate PR Works to Kill Health Care Reform

September 14th I addressed a gathering at the Center for American Progress in Washington, DC and delivered these remarks:

It is easy to think of efforts to influence lawmakers as the exclusive domain of K Street lobbyists. Much has been said and written about the millions of dollars the special interests are spending on lobbying activities and the hundreds of lobbyists who are at work as we speak trying to shape health care reform legislation. Very little by comparison has been written about the millions of dollars that special interests are spending on PR activities to accomplish the same goal and that are vital to successful lobbying efforts.

One of the reasons I left my job at CIGNA, where I headed corporate communications and was part of the Legal & Public Affairs division, was because I did not want to be involved in yet another PR and lobbying campaign to kill or gut reform. I finally came to question the ethics of what I had done and been a part of for nearly two decades to influence decision-making and bill writing on Capitol Hill.

When I testified before the Senate Commerce Committee in late June, I told the senators how the industry has conducted duplicitous and well-financed PR and lobbying campaigns every time Congress has tried to reform our health care system, and how its current behind-scenes-efforts may well shape reform in a way that benefits Wall Street far more than average Americans. I noted that, just as they did 15 years ago when the insurance industry led the effort to kill the Clinton reform plan, it is using shills and front groups to spread lies and disinformation to scare Americans away from the very reform that would benefit them most. The industry, despite its public assurances to be good-faith partners with the President and Congress, has been at work for years laying the groundwork for devious and often sinister campaigns to manipulate public opinion.

The industry goes to great lengths to keep its involvement in these campaigns hidden from public view. I know from having served on numerous trade group committees and industry-funded front groups, however, that industry leaders are always full partners in developing strategies to derail any reform that might interfere with insurers' ability to increase profits. My involvement in these groups goes back to the early '90s when insurers joined with other special interests to finance the activities of the Healthcare Leadership Council, which led a coordinated effort to scare Americans and members of Congress away from the Clinton plan.

A few years after that victory, the insurers formed a front group called the Health Benefits Coalition to kill efforts to pass a Patients Bill of Rights. While it was billed as a broad-based business coalition that was led by the National Federation of Independent Business and included the U.S. Chamber of Commerce, the Health Benefits Coalition in reality got the lion's share of its funding and guidance from the big insurance companies and their trade associations.

Like most front groups, the Health Benefits Coalition was set up and run out of one of Washington's biggest PR firms. The PR firm provided all the staff work for the Coalition while an executive with the NFIB, which has long been a close ally of the insurance industry, served as a front man.

One of the key strategies of the Health Benefits Coalition as it was gearing up for battle in late 1998 was to stir up support among conservative talk radio and other media. Among the tactics the PR firm implemented for the Coalition was to form alliances with important conservative groups, such as the Christian Coalition and the Family Research Council, to get them to send letters to Congress or appear at HBC press conferences. The Health Benefits Coalition also launched an advertising campaign in conservative media outlets. The message was that President Clinton owed a debt to the liberal base of the "Democrat" Party and would try to pay back that debt by advancing the type of big government agenda on health care that he failed to get in 1994. The tactics worked. Industry allies in Congress made sure the Patients' Bill of Rights would not become law.

The insurance industry has funded several other front groups since then whenever the industry was under attack. It formed the Coalition for Affordable Quality Healthcare to try to improve the image of managed care in response to a constant stream of negative stories that appeared in the media in the late '90s and the first years of this decade. It funded another group with a different name about the same time when lawyers began filing class action lawsuits on behalf of doctors and patients. Like the Health Benefits Coalition, this one, called America's Health Insurers, was created by and run out of a powerful Washington-based PR firm.

The insurance industry called on that same firm again in 2007 to help blunt the impact of Michael Moore's movie, Sicko. The PR firm created and staffed a front group called Health Care America specifically to discredit Moore and to demonize the health care systems featured in the movie. The media contact for Health Care America was a vice president at the firm who had served previously in PR roles at the Blue Cross Blue Shield Association and in the Bush administration.

The PR firm also activated conservative allies and enlisted the support of conservative talk show hosts, writers and editorial page editors to warn against a "government-takeover" of the U.S. care system. That is a term the industry uses often to scare people away from any additional involvement of the government in health care. Health Care America also placed ads in newspapers. One such ad, which appeared in Capitol Hill newspapers, carried this message, "In America, you wait in line to see a movie. In government-run health care systems, you wait to see a doctor."

The PR firm's work on behalf of the industry included feeding talking points to conservatives in the media and in Congress and placing columns and op-eds written for the industry's friends in conservative and free-market think tanks like the American Enterprise Institute, Heritage, CATO, the Manhattan Institute and the Galen Institute.

With this history, you can rest assured that the insurance industry is up to the same dirty tricks, using the same devious PR practices it has used for many years, to kill reform this year, or even better, to shape it so that it benefits insurance companies and their Wall Street investors far more than average Americans.

The creation and funding of front groups and the use of shills on Capitol Hill and in the media are not the only tactics PR people use to support and enhance lobbying efforts. Other activities include, of course, the implementation of grassroots and grass-tops campaigns. But a much more subtle tactic is to provide supposedly accurate and objective information to "educate" members of Congress and their staffs.

Business Week recently described how health insurers, United Health Group in particular, have been hard at work behind the scenes providing a treasure trove of data to key senators. If lawmakers believe the information and date the insurers are feeding them is comprehensive and objective, they are mistaken. Corporate representatives, especially the PR people who work with the media and who write talking points, are masters at the selective use of data and disclosing only the information their employers want to be disclosed.

What does this all mean for our country and our democracy?

During my 20 years in corporate communications and public affairs, I participated in the steady growth and influence of largely invisible persuasion -- and at a time when newsrooms are shrinking and investigative journalism seems to be vanishing. The number of PR people long ago surpassed the number of working journalists in this country. And that ratio of PR people to reporters will continue to grow. The clear winners as this shift occurs are big, rich corporations and other special interests. The losers are average Americans, most of whom are completely unaware how their thoughts and actions are being manipulated to achieve corporate goals on Capitol Hill.

Wendell Potter is the Senior Fellow on Health Care for the Center for Media and Democracy in Madison, Wisconsin.


This comment sounds like it came from a tried and true Fox (Fixed) News devotee the most misinformed group of people in the World. Wendell Potter is telling the truth and exposing the empty suits that are the foundation of current " Neo-Conservative" movement. And of course this person hides behind the cowardice of anonymity.

Great stuff Wendell. I hope you take this one step further and educate the American public on exactly how we are being manipulated. It is NOT enough to know that we "are" being manipulated (which the vast majority are still unaware of and the rest don't want to believe it), we must know "how" our minds are being re-programmed by propagandists. You need to open the playbook big business is using to brainwash America. People need to know that Propaganda by Edward Bernays is the main manual of the public relations industry. Everyone can and should read it: www.whale.to/b/bernays.pdf. People need to recognize that we do NOT live in a democracy. The changes have occurred so slowly with such precision that they are imperceptible to most (like the frog which is boiled to death by slowly turning up the heat). The elite make all of the rules and simply manipulate the blind masses to believe they have input and choices. Government is a puppet whose strings are pulled by multi-national corporations whose strings are in turn pulled by boards of directors who are made up of the richest 1 percent who have more financial wealth than the bottom 95 percent combined. “If voting changed anything, they'd make it illegal." ~ Emma Goldman People need tp read 1984 by George Orwell: www.ministryoflies.com/1984.pdf. People need to read Poker Without Cards by Dr. Ben Mack (another public relations insider who walked away to level the playing field for small business and help consumers protect themselves): http://www.greylodge.org/gpc/PDFS/PWC.zip. People should go watch "Why current therapies for chronic disease don't work & why lifestyle medicine can't fail" - Dr. McDougall presentation at an American College of Legal Medicine conference: https://ssl.sonic.net/mcdsite/free/DLV04-V01.zip. The primary reason most people remain blind to the manipulation is because the propagandists have re-programmed their minds to only accept the "profitable" side of every story. To not even consider the other side of the story and to feel defensive and angry towards the non-profitable side of the story. The "other" side of the story has conveniently been labeled a "conspiracy theory." NOTHING has been left to chance. “As a brander/marketer what you are looking for is the way you can change someone’s perception that will create a more profitable story for you and then how you substantiate that perception.” ~ Dr. Ben Mack

Mr. Potter, Thank you for using your talent of effective communication to speak for the American people instead of the insurance industry. Working in the industry myself, I understand the courage it likely took to not only speak out, but speak out as loudly as you have. There's a job & then there's a purposeful calling...you chose wisely. Well done and know that you have the support of the Nation as well as many industry insiders. You're making history- keep it up!

Dear Mr. Potter: I am sure that you are going down a very difficult road and I applaud you for taking a stance on Health Care reform. Having worked in a cancer center for many years, I can tell you from firsthand experience that thousands of Americans with some type of health insurance are not receiving adequate treatment for their cancer because they cannot afford the copayments or payments for their treatment. The first assessment that was made on the patients prior to the actual chemotherapy was whether or not they could afford the co-payments. I have seen many people go into bankruptcy or sell their homes to pay for treatment. Conversely, there I saw people who had multiple coverage over treated for their cancer, to the point where there great insurance coverage was a detriment to their end of life experience. They were over treated for their condition.

Dear Wendell, Thank you, thank you for speaking out for those of us who cannot. As a former clinical partner at CIGNA, I know you to be an exceedingly honest man. I am not afraid of the public option; we need it! The current medical system is broken. I pray our lawmakers are strong enough to do what is right and include a public plan in any final health reform legislation enacted by Congress. A public option will require that private insurers compete against the public plan's essential benefits package. Guess what? The public plan's benefit structure may be richer than what some private insurers currently provide and the out of pocket costs may be less and the degree of cost shifting to the insured that currently goes on may be reduced. And yes, the administrative costs will have to go down.

This was an excellent commentary/article and I commend you for writing it. I would like to hear you expose the names of the PR firms as well as the top executives who are responsible for "being in bed" with the insurance companies and anti-health-care-reform companies. I think it's important that the public know the culprits by name and face.

Mr. Potter: We were co-workers in the Public Affairs department when you arrived at Humana as a brilliant writer. I was laid off when Humana divested itself of its for-profit hospital division, but was re-hired about a year later. I finally left Humana due to my own crisis of conscience. I, too, could no longer work in the deceptive environment fostered and rewarded by top executives. I often wondered how the late Wendell Cherry's own insurance claim would have been handled had he not been a co-founder of the company. Were his medical records scrutinized in the same manner as Joe Public's? Would his claim for coverage due to cancer have been denied since he'd been a lifelong smoker? I am over 50 and, like so many others, am currently unemployed and cannot afford healthcare insurance. I am terrified of what the future holds. As you have so clearly stated, a public option absolutely must be included in any healthcare reform bill. There is NO other way the healthcare insurance industry will make available an affordable product which cannot be cancelled at their discretion. I applaud you! As a PR professional, you knew It would take a figure of your stature and integrity in the industry to focus attention on the real story. You undertook great personal risk to lead this counter-campaign. You are and have always been a straight shooter. You have my total support in Louisville, KY.

Republicans have done a pretty good job at persuading senior citizens that Democrats are out to gut Medicare. This is sickening since Democrats essentially created Medicare and protected it from Republican attacks over decades. Something needs to be done to fix the health care system and insurance in this country. I'm not saying that I have the answer, but I've seen the devastation left behind from inadequate health care.

I am not a community organizer or a crusader but my own unpleasant experience with my long term disability insurance carrier has motivated me to speak out. Those of you who believe you have coverage in the event of an unexpected catastrophic illness because you have paid premiums on a LTD policy, need to know that there is an excellent chance that your claim will be denied and you'll never receive the benefits you paid for. If your claim is denied you can appeal but this is an extremely cumbersome process that requires an attorney. Attorneys that handle these cases often do not work on contingency as the likelihood of winning is slim. Therefore at the worst possible time when you have no income you need to lay out the cash for an attorney. Most people can't and the insurance companies know this so of course the deck is stacked against us. Even if by some miracle you manage to come up with the cash and win your appeal, the insurance company is liable only for the benefits you were originally entitled to. There is no legislated accountability or punitive damages in these cases. CIGNA is a LTD insurance provider so I know you understand the dilemma Mr. Potter and how much of this process I've actually left out because to include all the detail would require pages not paragraphs. Usually by the time your benefits are reinstated, the disabled claimant is so far in debt or has left the debt to the family that survives - people have actually died before their claims were approved. Good Morning America did an excellent expose on these insurance companies and the lives they've destroyed by arbitrarily denying claims. In many cases these companies have written protocols to ensure a fair and impartial review, but in many cases they don't follow their own protocols because they know that their policy holders rarely challenge them and if they do and win, no big deal because the companies are only obligated to pay the benefits they would have paid had the claim been approved from the outset. Start legislating consequences like punitive damages for these companies and maybe these unethical practices will stop. If there's an area of healthcare in need of reform this is it! Please help. Thank you.