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Harry and Louise Ad Campaign Revisited

Posted by medconsumers on July 8, 2009

The $20 million national ad campaign, sponsored by Conservatives for Patients’ Rights (CPR), continues on TV, the Internet, and radio. CPR wants the U.S. medical care system to remain largely as is, but calls for reforms like allowing more competition among insurance companies, posting prices of medical treatments, and more consumer responsibility for personal health behaviors. CPR is backed by the same public relations firm that did the Swift Boat Veterans for Truth ad campaign, which turned presidential candidate Senator John Kerry, the war hero, into John Kerry, the liar.

Initiated in March, the CPR campaign is widely viewed as today’s version of the insurance industry-backed “Harry and Louise” ad campaign which had a major role in sinking the Clinton Administration’s attempt at health care reform. It’s time to pick apart the CPR campaign.

Central Message: A government-run health plan [the purported goal of the Obama Administration] will limit your choice of doctors, dictate your treatment decisions, and ration care.

Facts: The health plans now before Congress indicate that the health insurance industry will continue to dictate your treatment decisions, ration care, and limit your choice of doctors. Furthermore, U.S. medical care is already rationed in the worst possible way—based on income. All industrialized countries are grappling with the need for rationing based on cost-effectiveness (e.g., a treatment may be marginally effective but not worth the high cost — see cancer drug example below).

Poor Care Implied: Canada and the U.K. provide “government-run healthcare.”

Facts: Both systems are taxpayer funded. Of the two, only the U.K.’s is government-run because the government provides and pays for medical care. Most hospital doctors are on salary and GPs are paid on the basis of how many patients they see. Canada has a socialized medical insurance system, otherwise known as single-payer. The provincial governments pay the medical bills, but delivery of care remains largely private. Most doctors are in private practice and their fees are paid by the government. Fees are set by negotiations between the provincial governments and the medical associations.

Canada vs. U.S.: Subtext of the ads is your life will be terrible if Congress passes a health plan similar to that of Canada.

Facts: Canada’s health care system is similar to the U.S. Medicare system but without the need for Medigap or other out-of-pocket expenses. Surveys show that most elderly Americans are satisfied with Medicare. A recent national Commonwealth Fund survey compared Medicare beneficiaries with younger Americans covered by private health plans. The Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored private plans.

Doctor Choice: A government-run healthcare system will restrict your choice of doctors.

Facts: As with Canadians, elderly Americans on Medicare can choose their own doctors. Many non-elderly Americans with private health insurance do not have this option.

Tragic Stories: Anecdotes from patients and doctors are offered as proof of how bad things are in the U.K. and Canada. For example: “If you have cancer in the U.K., you will die quicker than any other countries in Europe.”

Facts: The U.K. does have a lower cancer survival rate than other European countries, according to a 2007 study that also showed the highest cancer survival rates are in Sweden, which has a single-payer health insurance system. See Michael Moore’s 2007 movie “SICKO” for tragic stories from Americans dumped by their insurance companies once an expensive illness was diagnosed.

Drugs Rationed: In one ad a British woman says, “There are expensive new drugs coming up for cancer and other things. It’s hard to get hold of them without a big struggle…. It’s heartbreaking, especially when people can’t afford to buy the drugs.”

Facts: Costly cancer drugs are a worldwide problem no matter the type of health care system. Too often effectiveness is not fully addressed, just as it isn’t in this ad. A recent issue of the U.S. Journal of the National Cancer Institute published a cost/benefit analysis of a drug for non-small cell lung cancer, Erbitux (generic name: cetuximab), which has been hailed as “practice changing”. It concluded, “18 weeks of cetuximab treatment for non-small cell lung cancer, which was found to extend life by 1.2 months, costs an average of $80,000.”

Rationing by Delay: Government-run healthcare will lead to long waiting lists for care.

Facts:
There is truth to this charge in some countries for certain tests and procedures, as well as visits to specialists. In Ireland, however, a country with both private and public systems, people who paid more to be in the private system reported longer delays in getting care than the people in the public system. According to a 2008 PBS Frontline show (see end of this article), the British government has instituted reforms expected to alleviate the problem of delayed care.

More accountability and competition: Prices of medical treatments should be up front and people should be rewarded for good health behaviors. “These ideas will lower costs without taking away your right to make your own medical decisions.”

Fact: No well-designed studies back up the cost-lowering benefit of these worthy suggestions.

CPR’s Driving Force: Health care entrepreneur Richard Scott, the former CEO of Columbia/HCA Healthcare, who made millions in the for-profit hospital industry.

Fact: Scott was forced to resign amid fraud charges against this giant health care company in 1997, according to Forbes magazine.

Scott’s Defense: “[My detractors] are running TV ads attacking me personally because they don’t want to debate the substance of what we believe vs. the substance of what they want, which is government-run healthcare.” Choosing his words carefully, Scott says, “I was never charged with any wrongdoing.”

Facts: True. His company settled. According to a June 26, 2003, U.S. Department of Justice press release, “HCA Inc. (formerly known as Columbia/HCA and HCA—the Healthcare Company) settled in 2003 and agreed to pay the U.S. $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs.” In an April 1, 2009 New York Times article about Scott’s role in the scandal, reporter Jim Rutenberg wrote, “Though Mr. Scott was not directly implicated in the fraud scandal — with whistle-blower suits filed against some hospitals before his acquisition of them — critics said his drive for profits had created incentive for fraud.”

Information About Other Health Plans:

-Sixty percent of U.S. physicians favor a single-payer health insurance system. Go to Physicians for National Health Program to learn why. Here’s one reason from the organization’s Web site: “The term socialized medicine is often used to conjure up images of government bureaucratic interference in medical care. That does not describe what happens in countries with national health insurance where doctors and patients often have more clinical freedom than in the U.S., where bureaucrats attempt to direct care.”

-“Sick around the world: Five Capitalist Democracies and How They do it.” The excellent 2008 PBS Frontline program is freely available online.

Maryann Napoli, Center for Medical Consumers(c)
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