Playing Footsie With Fascists-- Will Obama Ever Learn?

Maybe you read the NY Times editorial over the weekend, The War Over Health Care Exchanges.

To their shame and discredit, Republicans are trying to block efforts to inform people about the law and are using scare tactics to keep them from enrolling. The Republican mantra is that the nation will face economic and medical catastrophe-- a “train wreck,” they say-- unless health care reform is stopped in its tracks.

Their tactics are despicable. When Kathleen Sebelius, the secretary of health and human services, revealed that she was talking with the National Football League and other athletic organizations about ways to inform their fans about insurance on the exchanges, the two highest-ranking Republican senators wrote a threatening letter that caused the league to back off.

Crossroads GPS, a conservative group co-founded by the Republican strategist Karl Rove, has been running a video comparing the law to a tornado that will produce “a rising tide of health care costs” and leave “nobody safe from its wrath.”

Top officials in Ohio and Indiana who oppose the law have issued dire, misleading forecasts-- roundly debunked by analysts — that the law will raise premiums to astronomical levels. And the House Republican Conference is advising its members on how to organize “emergency health care” town hall meetings during the August recess to denounce the law. The goal is to ignite passionate opposition to the measure, like that stirred up by Tea Party activists at town hall meetings in the past.

In virtually no case do Republicans ever mention that millions of people who lack health insurance or have lousy policies could obtain comprehensive coverage on the exchanges and that most of them would qualify for federal subsidies to lower the cost.

Many states, mostly governed by Republicans, have refused to set up their own exchanges and have left the job to the federal government. (Many states also have refused to expand their Medicaid programs to cover more of the uninsured, but that is a separate issue.)

And, if course, the neo-fascist wing of the GOP, led by nihilists like Mike Lee (R-UT) and Ted Cruz (R-TX), are hoping their threat to shut down the government and bankrupt the country if they don't get Obama to halt all progress on the implementation of the Affordable Care Act. But it's worth going back and looking at a little recent history to understand why we're still in this mess over healthcare.

The system, alas, was designed with some serious flaws in order to placate implacable foes, Republicans and the special interests who finance their cushy careers. Playing footsie with fascists never works. It never has and it never will, though wishy-washy conservative Establishment Democrats-- like Obama-- seem incapable of ever learning that lesson. Recently, many progressives were dismayed by two Obama nominees that far right Republican senators eagerly supported: Penny Pritzker as Secretary of Commerce and pro-outsourcer Michael Froman as U.S. Trade Rep. Many people see them as his two worst, most corporate appointments. He seems determined to outdo himself though. See the execrable Larry Summers rearing his ugly head down the road apiece? What do weak Democrats who fear the progressive agenda think they're going to accomplish by kissing corporate butt? In his new book, The Machine, investigative journalist Lee Fang used the health care debate to show just what they do get when they make common ground with the enemy. Hint: the enemy doesn't bother using any K-Y.

When Michael Moore’s award-winning documentarySiCKO came out in 2007, the insurance industry devised a detailed public relations plan to blunt Moore’s argument that profit-based health insurance is both unnecessary and inefficient. The industry understood that it suffered a negative public perception even before Moore’s movie. So the industry, according to a PowerPoint presentation obtained by Bill Moyers of PBS, orchestrated an elaborate campaign to position Moore as simply an “entertainer” and “out of the mainstream.” The PowerPoint indicated that the industry worked with centrist Democrats and Republicans to cast Moore as too much of a “polarizing figure” for the Democratic Party, and to threaten Democrats aligned with him with the prospect of “returning to a minority party.” According to their industry’s own research, they believed that arguing that America should simply improve its own health system rather than move to government-run health care would be a “debate we can win.” To shift the dialogue, one slide in the presentation recommended that the industry worked with various conservative think tanks, such as Heritage and the Pacific Legal Research Institute, as well as with conservative blogs and media, to produce a series of stories on the “horror stories of govt.-run systems” and positive steps industry could make to improve itself without the government involvement. Before the movie even premiered, the industry blasted the media with its own message. The PowerPoint, developed by the public relations firm APCO, demonstrated a preemptive plan to “reframe the debate” and “define the health insurance industry as the solution.”

As the industry prepared to enter the debate under Obama, the insurance companies came to the conclusion that they were particularly unpopular and a vulnerable target for comprehensive reform. Out of all of the major industries involved in health care, the public hates and has long hated insurance companies, and there has always been wide consensus supporting some type of reform. Politically, President Obama, with his massive majorities in Congress, seemed more likely than any president in the past to enact sweeping changes. Adding urgency to the situation, when Obama was sworn into office, approximately 14,000 Americans were losing their health insurance every day because of the recession.

Taking a page from the strategy they used against Moore, the industry tried to flank the Obama administration, coming out quickly to announce that the industry would not fight reform as it had under the Clinton administration. The insurance industry’s chief lobbyist, karen Ignagni, made headlines when she told Obama, “You have our commitment to play, to contribute and to help pass health-care reform this year” at his health reform summit at the outset of the reform process. This, Wendell Potter explained, was part of the “charm” side of the duplicitous campaign. In public, the industry would commit to working proactively for reform. “They will talk about, in broad terms, how supportive they are of health care reform,” said Potter, adding, “but they will be working behind the scenes to kill very, very crucial parts of reform legislation like the public option.” Just as soon as the charm campaign kicked into high gear, with pundits and editorials praising the insurance industry for changing its ways, the “dirty,” underhanded campaign began.

In March, shortly before Obama’s health reform summit announcing the beginning of health reform negotiations, a group called Conservatives for Patients’ Rights (CPR) was launched to smear the effort. The group, managed day to day by Creative Response Concepts Public Relations, the Republican-friendly PR firm which had handled the “Swift Boat Veterans for Truth” campaign to smear John Kerry’s war record in 2004, hosted a website, but had no grassroots support. Creative Response Concepts had worked in the past for health insurers, managing the Coalition for Patient Choice front group in the nineties. CPR immediately raised $20 million dollars for ads, in part funded by millionaire Rick Scott, who was forced to resign as the head of the Columbia/HCA hospital corporation amid Medicare fraud charges in the nineties, and in part from a group of mystery donors. The ads disparaged reform with token catchphrases, accusing the public option of placing “a bureaucrat in between you and your doctor.” Curiously, the Washington, D.C., address listed for CPR was a mailbox on the floor of an office building level owned by APCO public affairs, the same mega-PR firm that Potter said handled the strategy for the insurance industry’s campaign against Moore. Representatives from CPR denied any relationship with APCO. A document later obtained from the health insurance industry revealed that insurers had funneled over $3.8 million to APCO in 2009.

Almost every day of the summer of 2009, the insurance industry pumped out two simultaneous messages. Starting in July of 2009, the insurance industry trade association began sponsoring millions of dollars’ worth of feel-good ads promising to fix the health care system. “We’re America’s health insurance companies, supporting bipartisan reforms that Congress can build on,” said the narrator in one ad called “Illness.” Starting around the same time, the U.S. Chamber of Commerce launched ads smearing reform, erroneously alleging that reform would kill jobs and would “make a tough economy worse.” “Let’s stop the new health care tax. Tell Congress to keep their hands to themselves and out of our pockets,” said another chamber ad. The chamber spent more than $10 million on various attack ads against reform on television and on the radio. Well after health reform was signed into law, Bloomberg reported that the health insurance industry had channeled over $107 million to the chamber for the attack ads in 2009 and 2010. Companies such as Aetna, Cigna, Humana, Kaiser Health Plans, UnitedHealth Group, and Wellpoint all participated in the donation.

Potter explained that despite the industry’s promise to support reform, it still fed talking points and attack lines to right-wing radio and the larger propaganda chamber of the right, such as Fox News and the Washington Times. In February 2009, only weeks after Obama took office, the health insurance trade association AHIP conducted a secret poll to find the best language to defeat reform, particularly the public option. The best way to sour opinion over the public option, the poll found, was to brand it as the “government-run health insurance plan.” AHIP lobbyists sent the polling memo to Republican staffers, and eventually, to right-wing media. In October, Fox News vice president Bill Sammon sent a stern warning e-mail to all Fox News reporters instructing them only to use the term “government-run health insurance” or “government option” when describing the public option In the weeks preceding critical votes in both the House and Senate, front groups like Americans for Prosperity, 60 Plus Association, Independent Women’s Forum, the Susan B. Anthony List, and American Future Fund ran millions of dollars’ worth of ads attacking the legislation. Like CRC, none of the groups would reveal their backers. It is difficult to imagine that doctors’ groups or hospitals were secretly funding these anti–health reform fronts.

...With the American Medical Association supporting reform legislation, the insurance industry turned toward PR operatives to manufacture its own doctor groups that would oppose reform. A new doctors’ group formed in 2009, the Coalition to Protect Patients’ Rights, began organizing press events and running ads of doctors saying they opposed any form of government-run health care, especially a public option. After meeting several of the group’s staffers at the National Press Club, I was handed a business card with a newly registered telephone number and post office box. On the publicly available calendar for the Press Club, however, I noticed that a woman from the infamous DCI Group had registered the coalition’s event. After calling the DCI Group and speaking with the staffer, I was able to confirm that the DCI Group had helped create the coalition and was managing its daily affairs.

The DCI Group, which came into prominence after working for the tobacco industry to create fake “smokers’ rights” groups to lobby against tobacco regulation, had worked for the insurance industry in 2002 to build opposition to the Patients’ Bill of Rights legislation. Similarly, an investigation I conducted into an outfit called the Center for Medicine in the Public Interest, which had been running online ads attacking the public option and calling to kill the bills in Congress, revealed that the group was secretly run by the PR firm Porter Novelli, which has long served the health care industry.

As corporate front groups and right-wing media fought to bring down the popularity of health reform throughout the summer, many still trusted the health insurance industry’s charm campaign, despite clear evidence that they were lying For instance, insurance industry lobbyists, including Karen Ignagni, spent the summer claiming that the industry was “the first to step up and offer real change,” such as ending the practice of rescinding coverage after an applicant files a medical claim. But in a hearing under oath on June 16, 2009, executives from unitedHealth, Assurant, and WellPoint specifically refused to “commit” to ending that practice, undercutting the public promises from their trade association.

As a pivotal vote in the Senate Finance Committee neared in October 2009, it became more difficult to believe the industry’s charm campaign. Shortly before the Finance Committee vote, health insurance lobbyists distributed a report-- funded by the insurance industry-- falsely accusing the bill of raising premiums. According to he Huffington, health insurance lobbyist Steve Champlin declaredten days later that bipartisan reform was dead, and he urgedGOP lawmakers to refuse to help pass the bill. "So when they vote for a health care reform bill, whatever it is, they are giving comfort to the enemy who is down,” said Champlin at a closed-door meeting for insurance executives.

In the end, the insurance industry successfully removed the public option by spreading misinformation about it. Conservative Democrats, persuaded by an avalanche of ads and angry constituents, removed the public option before the Senate passed the bill on Christmas Day in 2009.

...After the bill passed, front groups, many of them funded by health insurance companies, began pummeling legislators with attack ads in a bid to replace them with lawmakers who would repeal or weaken the bill. But as they had during the legislative debate over the bill, the companies hid their identities while funding the ads. It wasn’t until June 2012 that Aetna, in what appeared to be an accidental regulatory filing, revealed that it poured some $7 million into undisclosed nonprofits, like the American Action Network, to help elect Tea Party Republicans promising to repeal health reform.

The vast majority of the rotten Democrats in the House who either conspired with the Republicans or were too stupid to know they were being played, were defeated in the Great Blue Dog Apocalypse of 2010. Two years later, DCCC Chair Steve Israel, himself a "former" Blue Dog, engineered a restocking of the Democratic caucus with an equally bad bunch of ConservaDems. Particularly odious are the ones claiming to be progressives because they are-- unlike the Blue Dogs-- pro-Choice and/or pro-gay. Some of the worst of the lot are Kyrsten Sinema (New Dem-AZ), Patrick Murphy (New Dem-FL), Sean Patrick Maloney (New Dem-NY), Scott Peters (New Dem-CA), Joe Garcia (New Dem-FL), Raul Ruiz (CA), all of whom ran as progressives and instantly turned into conservative voters as soon as crucial roll calls started being called-- often at the insistence of the DCCC.