By Merrill Goozner, The Fiscal Times
This story comes from our partner 

Julie Grabow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer.

Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors.

The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have generated a lot of excitement among cancer patients and oncologists in recent years.

Drugs that target just the cancer cells promise the same or better results as toxic chemotherapy, but with far fewer side effects.

There was a catch, though. Like many of the latest cancer drugs, Novartis is charging exorbitant amounts for the treatment – in this case, $10,000 per month.

That quickly put an end to that possibility for Grabow’s patient. Her monthly co-payment, even after her insurance company agreed to pay its share of the off-label use the drug (the Food and Drug Administration has only approved Afinitor for kidney and pancreatic cancer, not breast cancer), was $2,900.

“She can’t afford this, even though it’s potentially a less toxic and potentially equally effective regimen,” Grabow said. “Chemo will help her, and it’s a reasonable choice. But that choice is 100 percent driven by economics.”

Over the past year, official Washington and candidates on the campaign trail have locked horns over the best way to curb rising health insurance costs. The public has been bombarded with dueling slogans – Republicans vowing to fight the “death panels” and “rationing” of Obamacare while Democrats promise “guaranteed access” and “affordability” with the Affordable Care Act.

But an economic drama that neither side wants to confront is playing itself out in cancer wards and oncologists’ offices across the country.

Unaffordable new drugs, even when they’re covered by insurance, are being rationed by price as patients, doctors and hospital officials struggle with what is likely to be the most pressing problem for the nation’s health care system over the next decade: how to pay for the spectacular rise in the cost of cancer care, especially drugs and diagnostic tests.

“In the real world of private practice where most care is delivered, it would be a mistake to say rising costs haven’t affected care,” said Eric Nadler, a head, neck and lung cancer specialist at Baylor University Medical Center.

The growing cost of cancer care will impose its greatest burden on the nation’s Medicare system, since 55 percent of all cancers are diagnosed in individuals 65 or older.

A recent study by the National Cancer Institute projected the cost of treating the 29 most common cancers in men and women will rise 27 percent by 2020, even though incidence of the disease is going down due to successful public health campaigns like the war on smoking.

The study pointed out that its projections were based on 2006 Medicare claims data, which predated the development of most of the latest targeted therapies.

There’s no doubt that there will be many new therapies for cancer coming to market in the years ahead. The nation’s $150 billion public investment in understanding the biology of cancer – the science side of the War on Cancer launched by President Richard Nixon in 1971 – is beginning to bear fruit.

The pharmaceutical industry, which draws on that publicly funded science to develop drug candidates, now has 887 new cancer drugs in development, over 30 percent of its total portfolio of new drug candidates, according to the Pharmaceutical Research and Manufacturers of America, the industry trade group. That’s up from 646 or 26 percent of the total devoted to cancer in 2006.

The industry is pouring increased research and development resources in cancer therapeutics in hopes that it will replace the revenue being lost from the expiration of patents on blockbusters like Lipitor.

However, since there are fewer cancer patients than there are people with chronic conditions like elevated cholesterol, and many don’t live very long, the prices needed to support the industry’s current size and structure, and profits must be substantially higher.

“They’re trying to maximize profits given their incentives,” said Peter Neumann, director of the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, which receives funding from the drug industry.

Possible solutions, he said, include letting Medicare set prices based on the medical value of adding extra months to life. That’s a variation on Great Britain’s cost-effectiveness model, which has been roundly condemned by most U.S. politicians and the press.

The other path is to turn to a bundled payment for every for every episode of cancer care and let the health care delivery organizations and private insurers sort it out. (Bundled payments account for all medical services associated with a given episode of care—doctors, nurses, technicians, etc.) That approach, in essence, would force the marketplace to execute the rationing.

“Bundled payment isn’t a panacea, but it does create incentives,” Neumann said. Some private insurers are experimenting with bundled payments for cancer care.

A quick review of the new cancer drugs approved by the Food and Drug Administration last year reveals how fast drug prices are rising.

Most of the older chemotherapy regimens for cancer, some of which have been around since the 1950s, are generic and relatively inexpensive.

But among the six new drugs approved in 2011, the cheapest – Johnson & Johnson’s Zytiga for advanced prostate cancer – cost $44,000 a year. The drug extended life by an average of less than 5 months to 16 months, according to a company spokesperson.

At the high end of the spectrum was Adcetris, a biotech product from Seattle Genetics that treats recurrences of Hodgkin’s lymphoma. A highly curable disease when initially treated in the 8,830 mostly middle-aged patients who get the disease every year, it is usually fatal if a drug-resistant strain emerges later in life.

Adcetris, the first new treatment to come along since 1977, kept the cancer in check for nearly 7 months in the single small trial that led to its quick FDA approval. It’s price tag: $216,000 for a full course of treatment.

Skin cancer specialists had a lot to cheer about in 2011 with two new therapies coming on the market for metastatic melanoma, which is fatal within one year for about 75 percent of the 10,000 people stricken each year.

But Roche/Genentech’s Zelboraf cost $61,400 a year and Bristol-Myers Squibb’s Yervoy, which nearly doubled the one-year survival rate from 25 percent to 46 percent, cost $120,000 for a four-month course of treatment.

“We price our medicines based on a number of factors including the value they deliver to patients and the scientific innovation they represent,” said Sarah Koenig, a spokeswoman for Bristol-Myers. “We have one of the most robust patient assistance programs for cancer patients in the industry.”

Most drug companies have patient assistance programs for poor or struggling patients, but many only come into play if patients are poor or families have exhausted their savings.

And since many of the latest therapies, like the older chemotherapies they are replacing or supplementing, extend life for brief periods of time, patients wind up weighing whether they want to deplete their children’s inheritances for a couple extra months of being very, very sick.

A study released at last June’s annual conference of the American Society of Clinical Oncology, which represents the nation’s 25,000 oncologists, revealed that patients with co-payments over $500 a month were four times more likely to refuse treatment than those whose co-payments were under $100 a month.

“The price of drugs can’t be set so outrageously high,” study author Lee Schwartzberg told Reuters. Schwartzberg is the chief medical officer at Acorn Research, which conducted the study.

“All stake holders have to get together and compromise to translate this great science into great patient care without breaking the bank.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Jon Cohn

McKinsey and Company has finally released the details of its controversial paper on the likely effects of health care reform. And it looks like the paper’s critics (including yours truly) were right to raise questions about it.

Based on what the company has said, the paper offers no new reason to think Americans with employer-sponsored insurance will lose that coverage because of the Affordable Care Act.

Politically, that’s good news for President Barack Obama, since he told insured Americans that the law wouldn’t take away the coverage they already had.

But what does it mean in terms of policy? Should we be happy that health care reform is unlikely to reduce substantially the current system’s dependence on employer-based insurance? That’s another, much more complicated question.

Let’s start by looking closely at the paper, which suggested that as many as half of all employers would seriously readjust their employee benefits and as many as a third would drop coverage altogether once the health law took full effect in 2014.

The theory behind the claim was that employers would find it financially advantageous to stop offering insurance because workers could instead get subsidized coverage through the new insurance exchanges.

Even though firms that employ more than 50 employees — which account the majority of American jobs – would have to pay a penalty for failing to offer health benefits, the McKinsey consultants said, the financial advantages of dropping coverage would more than offset that cost.

But the basis for that prediction was a survey of high-ranking corporate officials. And it turns out the survey had a few weaknesses.

For one thing, a quarter of respondents didn’t know the salary breakdowns of their companies — in other words, how many workers were making high salaries and how many were making low salaries.

In addition, more than half of respondents weren’t even aware of what their companies spent on health benefits.

The survey didn’t ask respondents about the ages of their employees. Were they relatively old? Young? A mix of the two?

And when survey administrators “educated” respondents about the health law, they didn’t remind them about the effects of the employer tax exclusion, which makes job-based health insurance worth a lot more to employees.

Surveys asking employers to predict behavior are never that reliable. But these issues make the McKinsey study a particularly poor forecasting tool. In general, younger and poorer workers might be better off getting insurance through the new exchanges, because they will get bigger subsidies from the government and because they benefit less from the tax exclusion. It is a different story for older and richer workers.

Sure enough, these studies have consistently shown a very different result: that the majority of employers will continue to offer health insurance, even after health care reform.

In fact, just this week, new analyses by Avalere Consulting and the Robert Wood Johnson Foundation came to the same conclusion. (The basis for the Robert Wood Johnson prediction was another projection from the Urban Institute’s model.)

While these predictions could be wrong, obviously, their findings are consistent with what happened in Massachusetts, where a similar coverage scheme actually bolstered employer-sponsored insurance.

Indeed, even McKinsey itself now acknowledges that its study couldn’t make projections as reliably as these other efforts. In its official June 20 press release, it stated flatly that its prediction was “not comparable to the health care research and analysis conducted by others such as the Congressional Budget Office, RAND and the Urban Institute.”

Private, employer-based coverage became the norm in the U.S. in the 1940s and 1950s because the arithmetic of health insurance works only with large groups of relatively randomly selected people, and large businesses naturally create such groups.

But employer-based coverage makes workers too dependent on their bosses while saddling employers with a financial liability over which they have only partial control. More importantly, it leaves out people who don’t have steady, full-time work.

An ideal health care system would not merely include everybody. It would also give everybody access to the same set of coverage arrangements, regardless of their place of employment (or lack thereof).

It would also liberate employers from the responsibility of administering health benefits for workers, allowing them to concentrate on other, more productive activities.

Let the car companies make cars and the grocery stores sell groceries and the software firms design software. They don’t need to be running health insurance plans, too.

A single-payer system, with a combination of basic government insurance and private supplemental coverage, would be a much better alternative.

So would a “competition” system that looks like what is currently in place in the Netherlands or Switzerland, or what Sen. Ron Wyden, D-Ore., first proposed back in 2007.

The Affordable Care Act could evolve into such a system, particularly if the new insurance exchanges work well and workers feel comfortable the insurance available there is as good as what they’d get from employers.

But that transition would probably take a lot of time, no matter what corporate officials were telling the survey-takers at McKinsey.

Jonathan Cohn is a senior editor at The New Republic .

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Jonathan Cohn, Senior Editor of The New Republic

This column is a collaboration between KHN and The New Republic.

For the better part of two years, the debate over how to control health care costs had a certain one-sided quality to it, because the Democrats had a plan and their critics did not. Democrats were forced to put their ideas on paper, with specifics, and subject them to nonpartisan accounting. All the critics had to do was attack.

Rep. Paul Ryan

And attack they did. Sometimes they said the Democrats’ plan, which eventually became the Affordable Care Act, did too little. (It’ll blow up the deficit! It’ll bankrupt the government!) Sometimes they said it did too much. (It’ll stop innovation! It’ll create death panels!) Sometimes they even said the two things simultaneously, which is the kind of neat rhetorical trick politicians can pull off only when they have no plans of their own.

All of that changed this month, when House Budget Committee Chairman Paul Ryan, R-Wis., released his budget proposal and included within it radically conservative reforms of the nation’s major health care programs.

Ryan would repeal altogether the coverage expansions of the health law. He also would increase the eligibility age for Medicare and then turn it into what most of us would call a “voucher scheme,” eliminating in 2022 the traditional government-run insurance plan for everybody who retires in that year and replacing it with a fixed financial subsidy that seniors can apply toward the cost of regulated private insurance policies.

Last but not least, Ryan would transform Medicaid into a block grant. Instead of guaranteeing federal funds to cover everyone that becomes eligible for the program, Washington would simply give the states a pre-determined, lump sum of money — and let states figure out how best to use it.

On paper, the Ryan plan saves the government a lot of money, at least in the long run. But upon closer inspection, the savings turn out to be illusory, cruel or some combination of the two. In fact, far from proving the superiority of conservative health reforms, Ryan’s plan validates what his political adversaries have said all along.

The Affordable Care Act represents a serious and realistic approach to controlling the cost of medicine — one that would be even more serious and realistic if the long-term budget changes President Barack Obama just recommended become law.

Although privatization has its own ideological appeal to conservatives, the real reason Ryan’s program would reduce government spending and deficits dramatically, at least over the long term, is that it substantially reduces the amount of insurance people would get. Repealing the health law would deprive more than 30 million people of insurance and leave others with more limited benefits.’

Meanwhile, the fixed formula Ryan would use to calculate the Medicaid block grants and Medicare vouchers would cause the value of each to rise far more slowly than the cost of health care. States would end up reducing enrollment or scaling back benefits or both. And, according to the Congressional Budget Office, seniors would end up individually responsible for more than two-thirds of their medical costs.

The theory behind this effort is that, by making individuals more conscious of the cost of health care, they will act more like consumers — thinking twice before getting extra treatments and shopping around for insurance policies that provide better value at lower costs.

But Republicans take this argument, which has some truth, way too far. The Medicare Advantage program, which already offers seniors the option to enroll in private insurance, hasn’t produced vast savings. Experiments with high-deductible coverage suggest it causes beneficiaries to skimp on useful care, including preventive treatments that prevent most costly, acute episodes later on. As Len Nichols, an economist at George Mason University, puts it, Ryan and his allies are “substituting algebra for health care policy.”

And that’s to say nothing of the political perils in Ryan’s strategy. As presently structured, his plan envisions a seismic shift away from traditional Medicare to a voucher worth considerably less money. Older voters are famously sensitive to even modest alterations in government benefit programs for the elderly. The idea that lawmakers would stand behind such an abrupt change, and then let it evolve in a way that so drastically reduces the federal contribution toward retiree health care, is difficult to accept.

The alternative is to control health care costs a bit more gradually, which is what the federal health overhaul does. Like Ryan’s plan, the Affordable Care Act attempts to restrict the federal government’s contribution toward health care expenses, via constraints limiting the growth in Medicare (although not Medicaid) costs as well as the tax subsidy working-age Americans get for employer-sponsored insurance. But the constraints are looser.

For example, unlike Ryan’s plan, which uses a fixed-value voucher to set Medicare spending, the health law sets less restrictive growth targets (which the president’s debt plan would further tighten) and then calls upon an independent commission — the Independent Payment Advisory Board — to recommend reforms when Medicare costs exceed those targets. IPAB’s recommendations can change what Medicare pays the providers of care, but the board, by law, cannot alter Medicare benefits or eligibility.

In addition, the health law’s formula doesn’t attempt to reduce spending by focusing exclusively on direct cuts to individual beneficiaries. On the contrary, the law distributes spending reductions across the health care system, affecting virtually everybody — whether it’s reducing Medicare payments to hospitals, eliminating extra subsidies for private Medicare Advantage plans or demanding greater rebates from pharmaceutical companies that contract with government insurance programs.

Most important, the Affordable Care Act doesn’t merely limit health care spending, in the faint hope that consumers, on their own, will produce a more efficient market. The law also introduces reforms that will put in place technological infrastructure and financial incentives to promote higher quality care. To some extent, that means sweeping, system-wide changes like the introduction of electronic medical records or the creation of an institute that will determine which treatments work better than others. But it also means dozens of more narrowly focused efforts, like a new public-private partnership to promote patient safety or pilot programs in “smart malpractice reform.” The idea is to experiment with virtually every payment reform experts have tried successfully on a small scale, in the hopes of replicating the successful ones across the country.

In short, the Republican vision for health care reform, as expressed by Ryan, is to limit federal spending on medical care, at levels far below what we spend today, and then let individuals make the best of the situation. By contrast, the health law calls for more gradual, more shared sacrifice by everybody involved with health care — with a focus on promoting efficiency so that lower spending needn’t result in lesser care. That’s not only a more realistic approach to controlling costs. It’s also a more humane one.

Jonathan Cohn is a senior editor at The New Republic .

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

The Republicans insist they want not just to repeal the Affordable Care Act but also to replace it. But replace it with what, exactly? It’s not an easy question to answer.

Republicans have yet to embrace a specific proposal and, rhetorically, they have made contradictory arguments about what they want.

They have, for example, criticized the new law for reducing Medicare spending. B

ut they’ve also applauded proposals, like the one offered by House Budget Chairman Paul Ryan, R- Wis., which would reduce spending far more dramatically.

Still, there are a few key ideas that virtually all Republicans endorse. One in particular tells you everything you need to know about the GOP’s vision of health care reform — for better and, mostly, for worse.

The idea is to allow the purchase of health insurance across state lines. Today, if you buy coverage on your own, you can only buy a policy from within your state.

Jon Cohn

The Republicans would change that rule, so that somebody in Minnesota could buy a policy from, say, Alabama.

Republicans like this idea because, they maintain, it would help move health care toward a truly free market. As individuals shopped more aggressively for policies, the argument goes, they’d force insurers and, eventually, the whole health care system, to provide better quality and lower prices.

But cross-state purchasing would do more than merely unleash consumer power, the Republicans claim. It would also prevent regulations from driving up the cost of insurance.

Right now, states have rules about what insurance plans must cover and how insurers must behave. And the rules vary by state. States like New Jersey have lots of them — states like Oklahoma, not so much.

On the whole, regulations, where they exist, tend to make health insurance more expensive. The more insurers must cover, the more it’s going to cost consumers.

It all sounds very sensible, until you start to think through the implications. Many people can’t even get insurance on the individual market, because of pre-existing conditions. And many of those who do get insurance end up with coverage that is, frankly, just plain lousy.

The people with these policies are known as the “under-insured.” Many if not most of them believed they were getting insurance when they purchased the policies. They discover the gaps only when they file claims and it is too late.

The main reason this problem isn’t worse right now is that some states have regulations forcing insurers to make insurance available to at least some people with pre-existing conditions and to cover at least some services. (The health overhaul strengthens these standards substantially, making insurance effectively available to all, and imposes them nationally.)

But the Republican proposal on cross-state purchases would decimate those regulations, opening the door for young, healthy people — whom insurers covet and who are frequently willing to risk flimsy coverage — to start buying the most minimal policies sold from the states with the least regulations.

Eventually the insurers would likely move, as well — congregating in those states in much the same way the credit card industry migrated to low-regulation states like Delaware and South Dakota. Offering more comprehensive insurance or making coverage available to people with serious medical conditions would become financially untenable, since there wouldn’t be enough premiums from healthy people to offset the costs of the sick.

You don’t have to take my word for it. When John McCain embraced this idea as part of his 2008 presidential campaign, the Urban Institute’s Linda Blumberg analyzed it and concluded that it would leave “many more people with health problems unable to purchase private coverage at any price … . The typical coverage would become less comprehensive as well, with benefit exclusions and limitations becoming the norm across the country.” Other experts have reached similar conclusions.

To be sure, allowing the purchase of insurance across state lines is just one part of the Republican agenda. But it reflects the same basic impulse as the other ideas Republicans frequently embrace. Ending the tax break that encourages employers to provide insurance, offering inducements for individuals to buy high-deductible coverage, turning Medicare into a voucher scheme that doesn’t guarantee comprehensive benefits — all of these ideas would make health care expenses less of a collective responsibility and more of an individual one. It’s a lousy deal for people who are sick, many of whom would have to forgo medical care or face financial ruin.

The only ones who benefit are the relatively young and healthy — well, at least until they get old and unhealthy, as everybody inevitably does.

Earlier this week, Republican aides told Politico that they plan, after the repeal vote, to start hearings on crafting a formal alternative to the health law — but that the work might, um, take some time.

“They won’t be rushing to push their own vision of health care through the House anytime soon,” the article explained. Given what that vision looks like, is it any wonder why?

Jonathan Cohn is a senior editor at The New Republic .

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

If last year’s attacks on the health-care reform law seemed familiar, it’s because you’ve seen same the tactics before, writes Wendell Potter in his new book Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans (Bloomsbury Press).

They are the same tactics used by the tobacco industry against anti-smoking initiatives, by the fossil fuel industry campaign against global warming research, and by the food and beverage industry against taxes on high-sugar snacks and soda pop, he writes.

Indeed, not only are the tactics the same, Potter writes, they are often orchestrated by the same alliance of well-connected PR firms, industry-funded front groups, right-wing think tanks and supportive conservative media outlets, all following a time-tested playbook of PR spin.

Potter is in a good position to know: he was part of that spin machine, a master of the dark arts of PR, serving for 20 years as a communications officer major health insurers, most recently as the senior PR executive for the industry giant CIGNA.

It was a job, Potter writes, that for many years he enjoyed: he enjoyed the work, the pay, the perks and the prestige.

Disillusionment

But as Potter recounts in his book a series of events led him to question the morality of that work, among them: watching Sicko, Michael Moore’s scathing documentary exposé on the U.S. health insurance industry (“Moore had gotten it right,” Potter writes); visiting a health-care charity event in rural Virginia where he saw thousands of uninsured men, women and children standing in line in the rain to get basic health services (“I felt as if I’d stepped into a movie set or a war zone.”, and finally finding himself using his PR skills to defend his company’s decision to refuse to pay for a young girl’s liver transplant, a decision that may well have led to her death (“Just thinking about it caused me to ache.”).

Wendell Potter Photo by Emily Potter

These and other experiences led him to conclude that the  primary interest of his employers and other health insurance companies was to boost profits and stock prices even at the expense of patient welfare

“It became clearer to me than ever,” he writes, “that I was part of an industry that would do whatever it took to perpetuate its extraordinarily profitable existence.”

Ultimately, in 2008, he quit is high-paying job at CIGNA, because, Potter writes, he “could no longer serve in good conscience as a spokesman for an industry whose routine practices amount to a death sentence for thousands of Americans a year.”

Shortly, afterwards, as the debate of health-care reform heated up and he began to see opponents to reform mouthing talking points that he had written, Potter felt compelled to speak out and he soon began writing, giving interviews and testifying repeatedly before Congress about health insurance industry practices.

Potter dedicates a portion of his book to telling the story of how he gradually became disillusioned with his work but most of the book focuses on the art of PR spin and how various industry groups–including insurers, drug companies and the American Medical Association (AMA), for example–have skillfully used PR to block health-care reform for decades.

In the 1960s, for instance, the AMA enlisted an actor named Ronald Reagan to produce a record in which Reagan describes Medicare as a sinister socialist plot. (You can listen to that recording below.)

How-to manual

Potter’s book could serve as a handy “how-to” book for anyone who wants to manipulate public opinion and isn’t too bothered by ethics.

Potter lays out the key elements:

• First, hire an well-connected PR firm, one that has cultivated friendly relations with influential politicians, journalists and pundits;

• then launch a “charm offensive” emphasizing your company’s desire to work with its opponents to find solutions, while at the same time creating “front” organizations (which should always have the words “American” or “Freedom” in their names, Potter notes) that can go on the attack;

• and, finally, enlist the help of conservative think-tanks, columnists and television personalities to give those attacks an air of legitimacy.

This was the exact playbook was followed by the health insurance industry during the debate over the new health-care legislation, Potter says: Publicly, it pledged to work with President Obama and the Democrats on reform, while at the same time behind the scenes supported front groups that alleged reform would bring rationing, death panels and socialism.

Fox News

Leaked emails from Fox News published online yesterday support Potter’s charge that conservative news organizations actively collaborate in these PR initiatives.

In the email, Bill Sammon, Fox New’s Washington managing editor, instructs the network’s reporters to use the phrase “government option” when referring to the “public option”, which at the time was being promoted by the Democrats.

Bill Dimiero, a reporter for MediaWatch, a left-leaning media watchdog group, included the email in his story Fox boss caught slanting news reporting.

From: Sammon, Bill
Sent: Tuesday, October 27, 2009 8:23 AM
To: 054 -FNSunday; 169 -SPECIAL REPORT; 069 -Politics; 030 -Root (FoxNews.Com); 036 -FOX.WHU; 050 -Senior Producers; 051 -Producers
Subject: friendly reminder: let’s not slip back into calling it the “public option”

1)      Please use the term “government-run health insurance” or, when brevity is a concern, “government option,” wheneverpossible.

2)      When it is necessary to use the term “public option” (which is, after all, firmly ensconced in the nation’s lexicon), use the qualifier “so-called,” as in “the so-called public option.”

3)      Here’s another way to phrase it: “The public option, which is the government-run plan.”

4)      When newsmakers and sources use the term “public option” in our stories, there’s not a lot we can do about it, since quotes are of course sacrosanct.

Dimiero points out that just a few months before Republican PR consultant Frank Luntz coached Fox News’ Sean Hannity on just this point:

Potter fears that as traditional news sources, newspapers in particular, contract, more and more of our information will be generated by PR firms and transmitted to us unfiltered without the analysis that professional journalists can bring to bear.

So now it is more important than ever for all of us to be more savvy PR professional works, Potter argues. “To understand why you believe some of the things you believe and do some of the things you do, it’s important for you to understand what PR people do and how they do it.”

His book is a good primer for anyone interested in learning about the science of spin, whether it comes from the right or the left.

Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans. Bloomsbury Press. Hardcover $26.00 288 pp. Kindle $14.30. Bloomsbury Press.

Ronald Reagan on the threat of Medicare:

To learn more:

• Listen to Ross Reynold’s interview with Wendell Potter on KUOW.

• Read Ben Dimiero’s article on MediaWatch: Fox boss caught slanting news reporting

• Visit the websites of Center for Media and Democracy, a liberal PR industry watchdog that reveals who is behind the spin at www.prwatch.org and their wiki site  www.sourcewatch.org

• Read PR consultant Frank Luntz’s memo to Republican on how to couch their attack on health-care reform: The Language of healthcare 2009