Health care ad audit: 'Health Reform Testimonials'

Kaiser Health NewsJuly 14, 2009 

Editor's note: This is one of a series of features analyzing advertisements sponsored by organizations that are engaged in the debate over health care.

AD TITLE: "Health Reform Testimonials."

SPONSORS: Families USA along with Pharmaceutical Research and Manufacturers of America (PhRMA).

SUMMARY: An unusual collaboration between a prominent liberal group and the prescription drug industry uses heartrending vignettes of "real people" to press for affordable, comprehensive health insurance. Yet some of the people profiled in the ads might not get much relief under the main proposals that are pending in Congress.

Families USA says it purchased three weeks of time on the three major national cable networks, MSNBC, CNN and Fox. There are two versions of the ad. The total TV time purchase is in the multimillion-dollar range, but the groups declined to say how the cost is being split between them.

DESCRIPTION (ad No. 1): A sad piano tune plays in the background as a series of people speak directly into the camera. Their names and hometowns are displayed on the screen.

Ken Colen, a New Jersey business owner: "After fighting cancer, my health insurance company left me over $90,000 in the hole."

Summer DeMichael, an uninsured Florida resident hospitalized for a colon infection because she couldn't afford medication: "I couldn't work because I was sick, and I couldn't get better because I didn't have health insurance."

Mark Derbyshire, the owner of a moving and storage company in Maryland: "I want to provide health care to my employees. They deserve it. But it's getting harder and harder and harder to do."

Mary Smalls, a South Carolina resident who lost her employer-provided health insurance when she was laid off: "If I get sick, really sick, and got to be hospitalized or something, I stand a chance of losing everything." She fights back tears.

DeMichael: "I think Americans deserve better. This is one promise the politicians have to keep."

Text appears: "Every American should have quality, affordable health care." Then: "Health Care Reform," followed by "Now."

POLITICS: For PhRMA, the ads are good public relations and good business for an industry with an image problem. By running these ads — and agreeing recently to help finance a health care overhaul through $80 billion worth of concessions, primarily in discounts on medicine for the elderly — the industry is striving to portray itself as an agent of change, rather than an impediment, in the health care debate. More people with health insurance also would translate into more customers who could afford prescription medicine. For Families USA, a relationship with the deep-pocketed PhRMA — one of the most muscular trade groups in Washington — gives the overhaul message extra reach.

POLICY: The difficulty in obtaining affordable health insurance is at the heart of Democratic prescriptions for change, but it isn't clear that the major congressional proposals would resolve the problems of all the individuals in the ad.

Derbyshire, the Maryland employer who complains about the costs of insuring about 30 workers, would qualify for tax credits under the Senate Health, Education, Labor and Pensions Committee's bill, which would provide credits to businesses that have fewer than 50 full-time employees. He might not qualify under the House of Representatives' plan, however, which would limit subsidies to companies with fewer than 25 workers. The Senate Finance Committee is considering limiting subsidies to employers with 10 or fewer workers. However, all the proposals envision creating more competitive marketplaces in which small businesses could shop for insurance, which proponents argue would help reduce the costs of policies.

Colen's large medical bill occurred because he went out of his insurer's preferred network for treatment for a rare form of cancer. Colen claims that his network didn't have a specialized treatment center in its network, but the insurer declined to pay for a portion of the hospital charges that it thought were too far above market rates. While Congress is considering placing annual limits on the maximum amount that patients must pay in network, neither the Senate Health, Education, Labor and Pensions measure nor the House bill explicitly guarantees that the limits will apply to out-of-network providers, analysts say. Even if they did, those safeguards might not apply to the portion of the charges that insurers think is above "reasonable and customary" amounts. The Democratic proposals would require insurers to have adequate networks of doctors and hospitals, which might have helped Colen avoid having to go out of his network in the first place.

The congressional proposal drafts probably would help the two women in the ad who lack insurance, either by subsidizing private insurance or by permitting them to enroll in Medicaid, the state-federal health program for the poor.

(Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy-research organization that isn't affiliated with Kaiser Permanente.)

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