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By Matthew Holt
Spot On Blog | San Francisco
Nov 6, 2006

Back in the day when there was some vague interest from Democrats in fixing our health care system, a kindly millionaire gave a pile of money to a lobbying pressure group that had quite some influence behind the ill-fated Clinton Health Plan. Not too much has been heard since from Families USA and its leader Ron Pollack. Sadly, those of us of a certain age felt that its day in the sun had come and gone.

But what was interesting about Families USA was that, unlike other Capitol Hill groups with “friendly” names, it actually lobbied for things that might make pretty good sense to families, especially poor ones. Namely national health insurance coverage that couldn’t be taken away if the breadwinner got sick. Those of us in the now majority who live in households that are no longer inhabited by traditional families, might wonder why health care needs to be specially designed just for them, given that it’s not just people in traditional families who get sick (and in fact many of the most sick are not in traditional families). But families are important because families tend to be richer and more likely to vote than other households, and what’s good for them is generally what’s good for America.

However, you might think that 13 years after its heyday that Families USA may not be very important any more. But it is. How do I know this? Well the health care industry and a few of its zealot fellow traveler ideologues have set up a knock-off “astroturf” movement to counter its work. I’d missed the formal launch but, no worries, into my inbox popped a very nice looking email from someone called Sandra Berk who claims to be the head of Health Care America. And Health Care America’s web site address is, get this, fightingforfamilies.org. No confusion there. Nope. Not a speck.

You know this has got to be special – presumably fighting forfamiliesmotherhoodandapplepie.org was taken. But then I read down in the email and it was full of all the nutty health care theories that proliferates from certain right wing think tanks. I know these people well enough and have had long interviews with two of their leaders Grace Marie Turner and David Grazter over on my site, THCB. Their basic premise is that no one should be forced by mandate or taxation to buy health insurance. They know and cheerfully admit that this will continue the current scenario in which millions of Americans will remain uninsured, and consequently in which many of them have extreme problems with medical costs – often leading to bankruptcy.

Turner, Gratzer et al basically think that this is the price we pay for getting slightly better survival rates for cancer than Canadians, and we should thank our lucky stars that we’re not like them – as in forced to pay into a social insurance pool that puts some limits on care for the virtually dead, but makes sure that no one goes to the poorhouse purely because they’re sick. Whether or not you agree with them, that’s what they think and I suppose it’s a point of view.

But I don’t see how it’s a point of view that “families” are particularly keen on. Which raise a basic question. Which families are supporting fightingforfamilies.org? Well it becomes pretty obvious when you look at their web site:

Health Care America is supported by a broad spectrum of consumer choice advocates, including employers, individuals, hospitals, pharmaceutical manufacturers, pharmacy benefit managers, health care professionals and others.
So the families we’re discussing are the McGuires, the Frists, the Crawfords, et al. Families that look just like the other 50 odd million in America, apart from their bank accounts.

But you won’t find out from the site who’s running the show. There is no page for “management” or “sponsors”. The Washington Post reported that the head was “Sarah Berk, a former lobbyist for the American Hospital Association and earlier an aide in the leadership office of Sen. Rick Santorum (R-Pa.).” She wants to “produce research papers and be a free-market ‘counter-voice’ to Families USA, a group that she said promotes a ‘liberal health-care agenda.'”

Well you didn’t know that 13 years after its glory days promoting the Clinton plan – which today is even repudiated by the person who lead it – Families USA needed to be combatted. So how will HCA help finish it off?

Health Care America is a tireless advocate for American families and is a vocal critic of policies that restrict consumer choice in the health care system. We participate actively in the media, produce groundbreaking research and provide Americans with the information they need to help improve our nation’s health care system.
And even if they don’t tell you on their web site who their management or funders are, a quick search shows the site’s address is registered to geofffreeman@cox.net who sounds suspiciously like this Geoff Freeman:

Geoff Freeman, executive director of the Discover America Partnership, is an expert in managing complex issue campaigns and developing innovative outreach strategies to increase support among unlikely allies.
And who is he really? A Republican PR operative returned from a tour in Iraq at the Coalition Provisional Authority with ties to the big drug companies.

As a Vice President with APCO Worldwide, a global public affairs firm, Mr. Freeman managed a wide array of issue campaigns, including the Partnership for Prescription Assistance (PPA). The PPA, supported by America’s pharmaceutical companies, is the largest effort ever created to connect uninsured Americans with free prescription medicines. The campaign succeed in helping more than two million Americans in its first year of operation, driving over 5,000 news stories and repositioning the pharmaceutical industry.

Prior to leading the PPA, Mr. Freeman managed a multi-million dollar campaign to inform millions of Americans on some of the many “untold stories” from America’s liberation of Iraq. The campaign featured dozens of Iraqis touring the United States to express their gratitude for the sacrifices made by American soldiers as well as the release of a groundbreaking film titled “Voices of Iraq.” The film empowered Iraqis to share their personal stories and won rave reviews from critics across the country. The campaign included over 200 speaking engagements in targeted markets and earned more than 325 television and radio appearances and over 250 newspaper placements.
What Iraqis have in common with bedraggled American families and their health care needs escapes me. But they’re not the only ones who’s labels are in question. There’s also Consumers for Health Care Choices, run by Greg Scandlen – a man who cut his teeth working for the Blue Cross plans – and Stormy Johnson – a former President of the American Medical Association. You might think that a health plan executive and a proponent of organized medicine aren’t exactly most likely to be the standard bearers for the down-trodden consumer. And you’d be right.

But that’s all OK. This is America – you can call yourselves what you like and there’s no penalty for misleading the public. But the skeptics might ask cui bono. And while they’re lacking a bunch of PR flacks on the payroll, there are some organizations who are what they claim, The poor saps at Physicians for a National Health Program are actually what they say they are – a bunch of physicians in favor of a national single payer plan.

Sadly, no one told them that you need to be a “family” to run the world.

By David R. Francis
The Christian Science Monitor
November 6, 2006

The healthcare system in the United States is eroding. Costs are rising too fast. More and more people lack health insurance. Companies are dumping or shrinking employee health plans. Deductibles and copayments on medical services are rising.

That’s the widely agreed-upon scene.

Yet chances are slim that Americans will go for a far less expensive “single payer” health system, as in Canada, Britain, or Australia, anytime soon.

“The issue is not likely to be given a fair examination,” says Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health, Boston. “There is a cultural resistance to even considering this very serious option.”

Since the healthcare system is “sort of collapsing,” Stephanie Woolhandler, co-founder of Physicians for a National Health Program (PNHP), expects “a lot more discussion” of a single-payer system after the congressional elections Tuesday, especially if the Democrats win at least one house in Congress. In such a system, the government pays the bills from hospitals and physicians.

Doctors Woolhandler and Blendon basically agree on why change is resisted.

Many Americans are cynical about government, distrusting its ability to provide a competent healthcare system. They prefer a market-based system with a high degree of individual choice.

Moreover, self-interested groups have political clout. Health insurance companies, pharmaceutical firms, private hospitals, and Wall Street investors in the healthcare industry “aren’t going to go quietly into the night,” says Blendon.

The drug industry usually ranks as the most profitable. In 2002, it made a 14 percent return on assets; the Fortune 500 made a median of 2.3 percent.

When voters in California and Washington considered single-payer systems for their states in the 1990s, opponents outspent proponents 12 to 1, and the proposals died by a huge majority.

Students from other industrial nations tell him that the US is unique in the degree of power that moneyed interests wield in politics, says Blendon.

“A single-payer system is inevitable,” holds Dr. John Geyman, president of the 14,000-member PNHP. “It is just a matter of time.”

Polls find at least 60 percent of Americans want public financing of the $2 trillion healthcare system, something that would work the way Medicare does for older citizens. Government would foot much of the bill from private hospitals and physicians.

But in opposition are many of the 1,500 private insurance firms. They seek to make more money for shareholders by cherry-picking healthy customers and avoiding those with costly chronic illness, Dr. Geyman charges. He cites a former editor of the New England Journal of Medicine, Dr. Arnold Relman, who warned in 1980 of the “medical-industrial complex” and its hold on Washington, echoing President Eisenhower’s reference to a “military-industrial complex.”

Those in the healthcare industry fear more government regulation, more interference. They don’t want the government to restrain prices for drugs or other medical services, as systems in other industrial countries do.

The US spends 15 percent of its gross national product on healthcare, of which 31 percent goes for administrative costs. Canada spends about 10 percent of GDP on a universal healthcare system, 1.3 percent of it for overhead..

Woolhandler is hopeful about a single-payer system because of what she calls a “slow-motion collapse” of employee-sponsored health coverage as health costs rise and competition in a globalized economy increases.

Blendon, though, figures it will take a major healthcare crisis, perhaps including hospital closings and doctors becoming unavailable to many patients, before the political powers will launch an effort at real reform.

“Will the situation get so bad we have to do something about it?” asks Daniel Callahan, international programs director at the Hastings Center, a bioethics research body in Garrison, N.Y. “We have not yet reached that point.”

There is no strong leadership in Congress or the White House for radical change in the healthcare system. Further, some 80 to 85 percent of Americans today get decent medical healthcare, Mr. Callahan estimates. Those who are satisfied with the system are unlikely to urge reforms to help the less fortunate.

Despite polls indicating sympathy for the plight of 46.6 million without health insurance, the majority “is not willing to put their wallet where their mouth is,” says Callahan.

But the system continues to weaken.

Over the past six years, family health insurance premiums have risen on average about 69 percent, more than six times the increase in the median earnings of workers (about 11 percent), finds Families USA, a Washington group championing healthcare consumers.

“This is not sustainable,” says the group’s executive director Ron Pollack. “More and more people are being driven out of healthcare insurance…. More and more people find it unaffordable.”

What may move the issue onto the front burner again is that in 2020 there will be about twice as many elderly in the nation, forcing up healthcare costs.

Healthcare will be a top issue in the 2008 election, Mr. Pollack predicts.