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
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
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,
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
(www.hiaa.org) 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
"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."