ANALYSIS: Healthcare - HMOs fight tide of public and media Hillopinion

Are HMOs really the bad guys in the country's healthcare


Maybe not. Allen Houston takes a look at how the companies are battling

to get their messages out

The latest salvo in the battle for a patients' bill of rights, the

McCain/Kennedy bill, battered its way through the Senate by a 59-36 vote

before the July 4 holiday, presenting a new set of headaches for

beleaguered HMOs.

Although the bill must still travel through the House of Representatives

and past the desk of a skeptical President Bush in order to make it into

law, the damage has already been done for the health management


By even proposing that consumers should be allowed to sue their HMOs in

the case of fatalities or other catastrophes, the bill has given

semi-official recognition to an issue that has been picking up pace in

the media for years.

Healthcare spin doctors

HMOs have not taken the assault on their image lying down, and have

sought to influence the debate, both at a media level and by lobbying on

the Hill. Smoke screens have been put up by both camps, with HMOs

seeking to deflect blame by pointing out the respective roles of the

media and legal professions in the debate.

Leading the charge for the HMOs has been the Health Benefits Coalition

(HBC), a Porter Novelli client for the last four years. This group is on

the forefront of arguing against the bill; one of its prime arguments is

that making HMOs more liable will hurt consumers in the long run because

the cost of healthcare will have to rise.

HBC represents more than three million employers, and provides coverage

to more than 100 million employees and families. The coalition was

formed out of concern that mandates proposed in Congress would increase

costs, resulting in millions of people losing their coverage.

"When Daschle said that the first thing he was going to bring up was a

patients' bill of rights, we had to immediately shift gears and mount a

challenge," says Todd Irons, account supervisor for Porter Novelli.

"Our challenge was to break through all the HMO horror-story anecdotes

that have been getting play in the media, and explain to the public what

was really in the bill, a large part of which is liability and


Porter Novelli is responsible for communicating with the Hill, and has

been flooding HBC's message to Congress. PN's group has been sending out

press releases, fielding interviews, and sending the results of polls to

the Senate to get the HBC's point across. For the last month, the agency

has been developing and rolling out new print, TV, and radio ads

criticizing the patients' bill of rights.

Joining the fight

The HBC is not the only group running a PR campaign against the

patients' bill of rights. Two other groups - the Health Insurance

Association of America (HIAA) and the American Association of Health

Plans (AAHP) - have also been running their own campaigns to let people

know what they believe are the fundamental flaws with the bill.

Although the HIAA concedes that HMOs are often seen as the bad guys, the

group believes that much of the problem can be accounted for by lazy

journalism and the greed of the legal profession.

"We're well aware of the poor image that HMOs have in the public


There has been a push of negative media by healthcare providers and

trial lawyers - very formulaic," explains Richard Coorsh, the HIAA's

vice president of communications. "(It) usually begins with a story

about a victim, and then enters into the slanted perception (to which)

the media relates.

Meanwhile, when we're given the chance to speak, we are put on the

defensive and immediately refuted."

Coorsh asserts that most people are satisfied with their healthcare, and

they are only unhappy with the system as a whole because of the

negativity that the media shows.

A March 2001 Harris Interactive survey backs up Coorsh's assertion. The

poll found that 69% of those polled gave their healthcare plans an A or

B rating, while only 8% would give their plans a failing or

below-average grade.

Media bias

Coorsh cites a recent story that ran on the CBS Evening News "Eye On

America" segment - that aired April 30 and May 1 - to highlight what he

sees as the media bias. In the story, CBS examines allegations contained

in civil lawsuits filed by the Connecticut State Medical Society. The

piece, which was supposed to take a critical look at the healthcare

industry, was basically a one-sided representation of the discussion,

says Coorsh.

He fired off a four-page memo accusing CBS of not being objective, and

he pointed out holes in the story. CBS never responded to Coorsh.

The HIAA regularly holds press conferences and has a Web site

( through which the organization communicates its position

on the patients' bill of rights. A study that the HIAA released in mid

June, "A Pot of Gold for Trial Lawyers," was picked up and quoted by the

St. Louis Post-Dispatch, Houston Chronicle, The Dallas Morning News, The

Hartford Courant, and National Underwriter, among others.

"Our goal is to hit a core audience in the beltway and around the


We have a couple of different methods that we use," says Mohit Ghose,

manager of media relations at the AAHP (a trade association representing

more than 1,000 health maintenance organizations that care for 140

million Americans).

"We have a target list of doctors, journalists, and people on the Hill,

and every two weeks we tell them our perspective," says Ghose. "The

object is to hit the opinion leaders and get the message out of the


The AAHP also has a list of 50,000 doctors that it contacts


The organization's messages encourage activism, and ask doctors to call

their congresspeople to communicate their opinions. The AAHP also sends

weekly tracking polls to people on the Hill, and has just started

running national TV commercials.

"We have been working this issue like a political campaign," says


"The media is looking for a hook to sell its stories, but we are

continuing to batter our message across that we are a thoughtful,

helpful industry trying to assist people."

Todd Irons of the HBC says that he began to notice a change in the

discussion about the patients' bill of rights a week before the bill was


"Getting the media to change the tone of its discourse, which before

seemed focused on criticizing the healthcare industry, to a discussion

on what was inside the bill was difficult," says Irons. "Just breaking

through the initial reaction was complicated. That change was how we

knew that we were making headway."

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