Ever since The Intercept (11/20/18) found several planning documents by the Partnership for America’s Healthcare Future (PAHCF), a benign-sounding corporate alliance formed to prevent any kind of reform and prop up the dysfunctional US healthcare system’s profits, corporate media have been reporting on the PAHCF’s efforts to defend the US’s for-profit healthcare system (The Hill, 6/28/19).
The lobbying group declares that its aim is to “change the conversation around Medicare for All” in order to “minimize the potential for this option in healthcare from becoming part of a national political party’s platform in 2020.” According to media reports, one healthcare executive reassured employees in a company meeting that the healthcare industry has “done a lot more than you would think” to sabotage any move in the direction of universal healthcare (Washington Post, 4/12/19). The PAHCF’s massive coalition of lobbyists representing virtually every part of the for-profit healthcare industry are united not only in opposition to a single-payer system like Medicare for All, but also to “every single Democratic proposal that would significantly expand the government’s role in healthcare.”
But the healthcare industry’s efforts to block all meaningful change in our medical system would not be nearly so successful were corporate media not working in tandem to spread these same lobbyist talking points.
According to the Center for Responsive Politics, the healthcare industry has spent over $2 billion on lobbying across the past four years, more than any other industry. PAHCF has been recorded to have bought around half of all political advertising in the early-voting state of Iowa in the summer of 2019, and their million-dollar attack ads were broadcast throughout the 2020 Democratic presidential debates. PAHCF is also engaged in an astroturf campaign that doesn’t disclose that several “voices throughout the nation” parroting the insurance lobby’s talking points—presented as ordinary Americans who fear universal healthcare—have ties to lobbying firms and health insurance corporations (Splinter, 3/19/19).
What are some of these talking points? According to the New York Times’ “Healthcare and Insurance Industries Mobilize to Kill ‘Medicare for All’” (2/23/19):
The lobbyists’ message is simple: The Affordable Care Act is working reasonably well and should be improved, not repealed by Republicans or replaced by Democrats with a big new public program. More than 155 million Americans have employer-sponsored health coverage. They like it, by and large, and should be allowed to keep it….
In a daily fusillade of digital advertising, videos and Twitter posts, the coalition, the Partnership for America’s Health Care Future, says that Medicare for All will require tax increases and give politicians and bureaucrats control of medical decisions now made by doctors and patients—arguments that echo those made to stop Medicare in the 1960s, Mrs. Clinton’s health plan in 1993 and the Affordable Care Act a decade ago.
Politico’s “The Army Built to Fight Medicare for All” (11/25/19) reported that the PAHCF’s “core conviction” is that “things aren’t actually that bad,” and explained why the industry group opposes any reform (even a deeply flawed public option) to expand the public sector’s healthcare coverage:
The industry still views single payer as the doomsday scenario. But by early 2019, it’d become far from the only worrying possibility, as prominent Democrats floated all manner of routes to universal healthcare. The problem: Each achieved their goal in roughly the same way—by having the federal government annex broad swaths of the private insurance market, either by creating a competing public option or expanding the existing Medicaid or Medicare programs deeper into the private sector’s territory.
Those plans might sound more palatable to the ordinary American, but to Partnership members it still meant fewer customers, lower pay rates and a new, unnecessary regime of profit-pressuring regulations. So as each 2020 presidential contender rolls out their own signature take on an overhaul, the response from the Partnership has been loud and unflinching: No.
“The politicians may call it Medicare for All, Medicare buy-in, or the public option,” reads an ad run by the Partnership during September’s Democratic presidential debate. “But they mean the same thing.”
If this all sounds familiar, that’s because these are the same talking points echoed by corporatist Democrats, and amplified by corporate media, that FAIR has critiqued throughout this election cycle (FAIR.org, 4/29/19, 6/25/19, 7/1/19, 10/2/19).
When corporate media aren’t busy featuring negative op-eds from politicians that PAHCF’s undisclosed lobbyists helped write, one can find regular columns featured in The Hill (1/31/19) and the New York Times (10/19/18) telling us not to get “too excited about Medicare for All” because it’s a “terrible” idea championed by “young Bolsheviks” that would make Trump look like a “sure winner in 2020.” There are no shortage of op-eds in the Washington Post (2/19/19, 2/22/19, 10/25/19, 1/7/20) echoing the “government-run healthcare” canard, telling us that we don’t need to go “full Canada” because Medicare for All is a “pipe dream” and a bunch of “pointless quibbling.”
Politico (9/23/19) made the disingenuous and incoherent argument that pitting a public option that leaves the wasteful and parasitic health insurance industry intact against Medicare for All is a “false choice,” and a “fear tactic sowed by defenders of corporate greed meant to divide us,” while simultaneously arguing that “preserving the option for employers and unions to continue to innovate in healthcare is critically important.”
Meanwhile, the New York Times dutifully followed PAHCF guidelines by attacking both a public option and Medicare for All. The Times’ “How a Medicare Buy-In or Public Option Could Threaten Obamacare” (7/29/19) argued that a public option “may well threaten the ACA in unexpected ways.” After noting how the “ACA is a solidly profitable business for insurers,” in spite of “stock drops” over “investor concerns over Medicare for All proposals,” the Times raised fears that a
buy-in shift in insurance coverage could profoundly unsettle the nation’s private health sector, which makes up almost a fifth of the United States economy. Depending on who is allowed to sign up for the plan, it could also rock the employer-based system that now covers some 160 million Americans.
The Times’ “Medicare for All Would Abolish Private Insurance. ‘There’s No Precedent in American History’” (3/23/19) argued for the status quo, which leaves tens of thousands of people dying every year from a lack of insurance, with an estimated 530,000 families suffering medical bankruptcies every year, with relentless and unsustainable drives to raise premiums and deductibles to maximize profits and lower for-profit insurers’ “medical loss ratio” (the figure given to investors to inform them of how much money they lost to medical claims). Before concluding with a statement from Mark Bertolini—a former CEO of insurance company Aetna—informing us that “it’s not that simple” to “shut down all the private insurance companies,” the Times warned readers that
doing away with an entire industry would also be profoundly disruptive. The private health insurance business employs at least a half a million people, covers about 250 million Americans, and generates roughly a trillion dollars in revenues. Its companies’ stocks are a staple of the mutual funds that make up millions of Americans’ retirement savings.
Such a change would shake the entire healthcare system, which makes up a fifth of the United States economy, as hospitals, doctors, nursing homes and pharmaceutical companies would have to adapt to a new set of rules. Most Americans would have a new insurer — the federal government — and many would find the health insurance stocks in their retirement portfolios much less valuable.
Corporate media have also boosted centrist presidential candidates taking the most money from the healthcare industry (FAIR.org, 4/28/19, 7/3/19, 9/9/19, 12/12/19). Joe Biden is a reliable mouthpiece for the PAHCF’s opposition to Medicare for All by constantly lying about the proposal, even shamelessly using dead family members to attack it. A company linked to Biden’s campaign has also been caught testing messages “designed to undercut support among Democrats for Medicare for All,” finding that Democrats are “most swayed by” arguments that the “program would impose a heavy cost on taxpayers and threaten Medicare for senior citizens.” Pete Buttigieg famously flip-flopped on the issue after accepting the legal bribes often euphemized as “campaign contributions.”
That corporate media is pushing PAHCF’s pernicious talking points should not be surprising; former insurance executive turned whistleblower Wendell Potter confessed in his book Deadly Spin how PR executives like himself “cultivate contacts and relationships among journalists and other media gatekeepers” to manipulate coverage and public opinion to quash reforms. In a recent New York Times op-ed, Potter pointed out that one of the major themes of healthcare coverage is essentially an insurance industry hoax:
We were told by our opinion research firms and messaging consultants that when we promoted the purported benefits of the status quo that we should talk about the concept of “choice”: It polled well in focus groups of average Americans….
But those of us who held senior positions for the big insurers knew that one of the huge vulnerabilities of the system is its lack of choice. In the current system, Americans cannot, in fact, pick their own doctors, specialists or hospitals — at least, not without incurring huge “out of network” bills.
When a staunchly consistent Medicare for All advocate like Bernie Sanders has an increasingly serious shot at winning the Democratic Party’s nomination for the 2020 election cycle, it’s especially important to push back against the overwhelming propaganda onslaught from the gargantuan healthcare industry.
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NOW THAT THE midterms are finally over, the battle against “Medicare for All” that has been quietly waged throughout the year is poised to take center stage.
Internal strategy documents obtained by The Intercept and Documentedreveal the strategy that private health care interests plan to use to influence Democratic Party messaging and stymie the momentum toward achieving universal health care coverage.
At least 48 incoming freshman lawmakers campaigned on enacting “Medicare for All” or similar efforts to expand access to Medicare. And over the last year, 123 incumbent House Democrats co-sponsored “Medicare for All” legislation — double the number who supported the same bill during the previous legislative session.
The growing popularity of “Medicare for All” in the House has made progressives optimistic that the Democratic Party will embrace ideas to expand government coverage options with minimal out-of-pocket costs for patients going into the 2020 election. But industry groups have watched the development with growing concern.
Over the summer, leading pharmaceutical, insurance, and hospital lobbyists formed the Partnership for America’s Health Care Future, an ad hoc alliance of private health interests, to curb support for expanding Medicare.
The campaign, according to one planning document, is designed to “change the conversation around Medicare for All,” then “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.”
Behind the scenes, the group attempted to sway candidates during the midterms, encouraging several of them to focus on shoring up the Affordable Care Act instead of supporting single-payer health care.
The documents show that Partnership representatives spoke to the staffs of Democratic Sens. Bill Nelson of Florida and Joe Donnelly of Indiana, and received confirmation that both senators would maintain their “moderate position.” When the team met with Rep.-elect Lori Trahan, D-Mass., she said that although she does not speak about the issue, she agreed that “language around single payer should be tempered.” (None of the three politicians’ offices provided responses to inquiries from The Intercept.)
In several competitive races, the Partnership pressed candidates to use industry-crafted talking points when speaking about health care. In one internal planning document circulated with health care lobbyists, the Partnership touted its influence over Danny O’Connor, the Columbus, Ohio-area Democrat who ran for the 12th Congressional District, claiming that O’Connor used Partnership talking points “in national news interviews.” (O’Connor’s campaign did not respond to a request for comment.)
Several of the candidates who agreed to embrace the Partnership’s messaging and policy ideas, including Donnelly and O’Connor, came up short on Election Day. A recount ending on November 18 confirmed that Nelson received fewer votes than Republican challenger Rick Scott. But soon after Election Day results came in, the Partnership went on the offensive, informing reporters that candidates who embraced “Medicare for All” had also lost, pointing to the defeat of progressives such as Kara Eastman in Nebraska. The group also relied on research from the business-friendly Democratic think tank Third Way to argue that victorious pro-“Medicare for All” candidates couldn’t attribute their success to having supported “Medicare for All” because few Democrats explicitly mentioned the policy in their campaign advertisements.
“’Medicare for All’ didn’t win,” said Joel Kopperud, the vice president of government affairs at the Council of Insurance Agents and Brokers, one of the industry groups backing the Partnership. “I don’t think that the Bernie Sanders $32 trillion solution that’s going to eviscerate the insurance for 156 million Americans is really something that’s going to be helpful to the party in critical states,” he added in an interview with The Intercept.
Kopperud represents insurance brokers who sell employer-based health insurance coverage. He noted that his organization has a vested interest in backing the Partnership. “Medicare for All,” as some envision the policy, would eventually eliminate the need for most health insurance plans — a death knell for companies represented by the CIAB.
Private health care lobbyists are confident that they can prevent any federal expansion of Medicare in Congress, given Republican control of the Senate and the White House. In the states, CIAB and other private health groups have easily defeated measures to develop single-payer proposals, such as the ColoradoCare ballot question in 2016.
But the political calculus could be changing. Recent election gains by Democrats in state government could create new opportunities for proponents of expanded government-backed health care initiatives. Gov.-elect Gavin Newsom of California campaigned on single payer and is expected to have one of the largest Democratic supermajorities in recent memory in the legislature, though California has a notoriously complex state constitution that would likely require an amendment before any significant government plan could be created.
The growing momentum for “Medicare for All” could raise expectations for the next time Democrats are in full control of power in Washington, industry groups worry. They are already pressuring conservative-leaning caucuses in the House of Representatives, such as the Blue Dogs and New Democrats Coalition, to push back against insurgent progressives’ demands.
For industry opponents of expanded government health insurance, there are two main challenges. One is combatting growing public support for the idea. The other is shaping elite opinion within the Beltway.
Over the last two years, several opinion surveys show rising support for expanding Medicare. In March, the Kaiser Health Tracking Poll found that 59 percent of Americans support the idea, and by August, a poll conducted by Reuters-Ipsos found an astounding 70 percent of Americans support “Medicare for All,” including a majority of self-identified Republicans.
But the Partnership is quick to zero in on research that shows support for the idea drops precipitously when respondents are told that the plan would require ending employer-based coverage, tax increases, and increased government control.
The campaign has worked with advertising agencies to draw up a series of messages to convince select audiences. Several of the messages, categorized as “positive,” are dedicated to educating the public on more minimal reforms that do not include expanding Medicare. Other messages, categorized as “persuasion” and “aggressive,” are designed to instill fear about what could happen if “Medicare for All” passes.
In the coming weeks, the Partnership plans to ramp up a campaign designed to derail support for “Medicare for All.” The group, working with leading Democratic political consultants, will place issue advertisements to target audiences, partner with Beltway think tanks to release studies to raise concerns with the plan, and work to shape the public discourse through targeted advocacy in key congressional districts.
The Partnership has tapped consulting firms with deep ties to Democratic officials. Forbes-Tate, a lobbying firm founded by former officials in President Bill Clinton’s administration and conservative Democrats in Congress, is managing part of the Partnership coalition. Blue Engine Message & Media, a firm founded by former campaign aides to President Barack Obama, has handled the Partnership’s interactions with the media.
In one planning document circulated over the summer, the Partnership suggested a series of messages to wean Americans away from supporting single payer. The talking points emphasize that the current system provides “world-class care,” and that any move away from the Affordable Care Act would be “ripping apart our current system.”
The strategy exploits familiar themes that have long been used by business groups against new government health care programs, calling for allies to say lines such as “bureaucrats in DC have no understanding of a person’s medical situation and will be making decisions about your health care instead of doctors.”
The Partnership plans to form a speakers bureau of former Democratic elected officials who can leverage the media to make the case that expanding Medicare is bad politics and policy. The memo names former Democratic Majority Leader Tom Daschle, now a health insurance lobbyist at the law firm Baker Donelson, as one such potential surrogate.
The memo points to early success in shaping media coverage, citing several “earned media” columns such as one published in August by former Rep. Jill Long Thompson, D-Ind., which argues that Democrats should only focus on small reforms to the Affordable Care Act, and warns against wasting political capital on pursuing a “government-controlled health insurance system.” Thompson, now an associate professor at Indiana University Bloomington, did not respond to a request for comment.
Adam Gaffney, president-elect of Physicians for a National Health Program, a national coalition that advocates in favor of “Medicare for All,” said he is not surprised by the messaging.
“What we’re seeing is the wages of success: With single payer on the rise, it was only a matter of time before the insurance companies, big pharma, and other big-money groups came out swinging,” said Gaffney, who also serves as an instructor at Harvard Medical School.
“The smear of ‘socialized medicine’ has been used a thousand times and has lost its bite,” he added.
Influencing the 2020 Democratic Field
“We’re all focused on 2020,” Lauren Crawford Shaver, a partner at Forbes-Tate who is helping to manage the Partnership campaign, recently told the National Association of Health Underwriters in a podcast produced by the group.
Shaver, a former top staffer for the Hillary Clinton presidential campaign, explained to the group that she is working to peel support away from the “Medicare for All” bill sponsored by Sen. Bernie Sanders, I-Vt. The Sanders bill is currently sponsored by several rumored 2020 Democratic presidential candidates, including Sens. Elizabeth Warren, D-Mass.; Kamala Harris, D-Calif.; and Kirsten Gillibrand, D-N.Y.
“The No. 1 thing we need to focus on is that there are a lot of likely candidates that currently support the Senate bill,” said Shaver. “We need to make sure we educate the public, we educate both parties, and we educate all the campaigns about both the policy and political challenges.”
Shaver encouraged health care companies concerned about the growing popularity of “Medicare for All” to mobilize opposition among clients, customers, and employees. Industry groups will likely have workers or customers residing in key districts who can be tapped to influence wavering lawmakers on Capitol Hill.
The Partnership plans to “take stories of how these proposals would directly impact your clients and the constituents of the policymakers who are voting for or against these proposals,” Shaver said.
The Partnership strategy echoes the health insurance industry’s campaign to shape the 2008 presidential primary. At that time, the health insurance lobby group known as America’s Health Insurance Plans, or AHIP, tapped the consulting firm APCO to develop an effort to label any government-run insurance option as an existential threat to Democratic political goals. The initiative emerged from a plan to minimize the impact of Michael Moore’s documentary “Sicko,” which was deeply critical of the American health care system.
The campaign involved planting studies with think tanks, mobilizing pundits on television, and sponsoring YouTube videos on “the horrors of government-run systems,” among other publicity tactics. The APCO-crafted blitz leaned on right-wing voices such as Fox News pundit John Stossel, conservative think tanks like the American Enterprise Institute, and centrist Democratic groups such as the Democratic Leadership Council, a now-defunct group associated with the Third Way. The 2008 campaign adopted a two-pronged strategy: position private health insurance as the only positive solution to America’s health care woes and “disqualify government-run health care as a politically viable solution.”
Now, the same lobby groups are involved in a similar effort. AHIP, the insurance trade group behind the 2008 plan, is also a sponsor of the Partnership’s 2020 campaign, along with the Federation of American Hospitals, Pharmaceutical Research and Manufacturers of America, the Blue Cross Blue Shield Association, the Biotechnology Innovation Organization, and the American Medical Association.
Not only are the same health insurance groups financing a renewed campaign against “Medicare for All,” but many of the same players who worked to undermine the public option during the ACA debate are now fighting for influence within the party. The public option was the government-run insurance plan that advocates intended to use to compete with private insurance and bring down consumer costs. In one version of the plan, the public option would pay doctors and other providers the same reimbursement rates as Medicare.
Despite a pledge by many Democratic candidates to eschew corporate PAC donations, health care lobbyists have funneled cash to many incoming lawmakers through the New Democrats PAC, the Blue Dog PAC, and other centrist committees. Unsurprisingly, the centrist New Democrats Coalition, the caucus of business-friendly centrist Democrats, has worked to depress momentum for “Medicare for All,” reprising the role centrist Democrats played in killing the public option during the Obama administration. In 2009, then-Sen. Joe Lieberman, I-Conn., a founding member of the New Democrats caucus, threatened to join the Republican filibuster against health reform unless the public option was dropped from the bill.
Immediately following the midterm elections this month, the Washington Post published a column by Third Way warning that “Medicare for All” “failed the Hippocratic Oath” because opposition to the plan helped Republican candidates, thus causing “harm” to the long-term health interests of voters.
But advocates for “Medicare for All” are feeling optimistic.
“In terms of tactics, it sounds like they will just be updating the same lines they used in the 1990s to sideline reform efforts and in the ACA fight to keep single-payer health care off the table,” said Eagan Kemp, a health care policy advocate with Public Citizen. “The Partnership for America’s Health Care Future would be more accurately titled the ‘Partnership for Profiting Off America’s Health Care.’”
Private health care interests will certainly have much more money, media attention, and political resources with which to campaign. Advocates, however, are hoping Americans see past the public relations smokescreen and support health care as a human right.
“There is no brand loyalty to insurance companies, which are rightly seen as parasitic,” Gaffney, the PNHP leader, said.
“Once single payer is widely understood as a program that covers everyone, that doesn’t impose copays and deductibles, that has more comprehensive benefits than existing plans, and that doesn’t employ restrictive insurance ‘networks,’ support will only grow,” he added.
^5000The mainstream imperialist media lie CONSTANTLY. Literally 24/7. And it's getting worse.
All of them do it: radio, tv, the newspapers, the movies. The internet. No exceptions.
The corporate Big Lie is pervasive and totalitarian. CBS does it. NBC does it. ABC does it.
CNN does it. FOX does it. NPR does it. And of course the NYTimes and WaPo do it.
Thousands of "diverse" voices telling you the same lies. Enough to convince anyone.
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