They then mentioned an ally that most of us had never heard of,
Health Care America. It had been created by AHIP and APCO for the
sole purpose of attacking Moore and his contention that people in countries
with government-run systems spent far less and got better care
than people in the United States. The sole reason Health Care America
exists, they said, was to talk about the shortcomings of government-run
Unlike the Galen Institute and AEI, Health Care America was a
front group, funded by money from the health insurance industry and
other special interests, that APCO would set up and run out of its offi
ces. Although Schooling didn't disclose this at the meeting, the person
who would serve as the media contact for Health Care America
would be APCO employee Bill Pierce, a man who had served in the
top communications job at the Blue Cross and Blue Shield Association,
another insurance trade group, and as a public affairs officer at the
Department of Health and Human Ser vices during the George W.
Bush administration, before joining APCO as a senior vice president.
Creating Health Care America - which would spring into action as
soon as Sicko hit theaters in the United States - was deemed necessary
because of the steady and alarming erosion in Amerians' opposition to
government-run systems, as borne out by McInturff's research. Health
Care America would lead the effort to restore Americans' fear of
government-run health care.
While Health Care America and the industry's allies would be doing
the fearmongering, AHIP and insurers would try to persuade the
public as well as lawmakers that the industry had a legitimate reason to
exist. One of the key messages AHIP would stress in every media interview
about health care reform during the coming months was that
this time the industry would be "bringing solutions to the table," and
would be willing to make certain concessions when Congress began
drafting reform legislation. This would be the part of its PR charm offensive
that insurers would want the public to see.
The part they would not want the public to see, however, was their
effort to depict Moore as such a polarizing figure - loved by leftwingers
and liberal activists but viewed with suspicion by more conservative
voters - that Democrats would talk positively about Sicko at
their own peril. The goal was to make Moore radioactive to centrist
Demo crats in particular. The plan included recruiting political pundits,
including some Democrats, to articulate that threat. AHIP and
APCO would also reach out to political reporters and try to frame the
movie as an effort on the part of Moore and other liberals to drive the
agenda to the political left.
Tuffin and Schooling wrapped up their presentation with a "worstcase
scenario" plan. If Sicko showed signs of being as influential in
shaping public opinion on health care reform as An Inconve nient Truth
had been in changing attitudes about climate change, then the industry
would have to consider implementing a plan "to push Moore off the
cliff." They didn't elaborate, and no one asked what they meant by that.
We knew they didn't mean it literally - that a hit man would be sent to
take Moore out. Rather, an all-out effort would be made to depict
Moore as someone intent on destroying the free-market health care
system and with it, the American way of life.
Too Bad the CIA Isn't This Efficient
A few days later, my assistant brought me a one-and-a-half-inch-thick
unmarked three-ring binder. The only indications that it came from
AHIP were a few references in the table of contents to a white paper
the organization had produced on the Canadian health care system
and a few other documents on AHIP's reform proposals.
The binder contained responses to just about any conceivable
question a reporter might ask about the movie or government-run systems,
but in keeping with AHIP's ban on even mentioning Moore or
Sicko in writing, there were no specific references to either. AHIP sent
the binder to all of the PR chiefs who participated in the Philadelphia
meeting to equip us with negative anecdotes and statistics about any of
the health care systems depicted in Sicko and to remind us to always
mention in our conversations with anyone about the movie that Americans
do not want a government takeover of their health care system.
The phrase "government takeover" is one that has tested extremely
well over the years and has been central to every campaign
the industry has conducted in recent de cades to defeat reform efforts,
including the Clinton proposal in 1994. The industry has paid Mc-
Inturff and other consultants and pollsters millions of dollars to craft
and test such phrases in focus groups and surveys. Knowing from that
research that many Americans react negatively to more government
involvement in their lives, particularly if it involves higher taxes, AHIP
ensured that a warning against a government takeover was included
in the briefing packets for lawmakers in Washington, the industry's
business allies, and conservative pundits, talk show hosts, and editorial
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