Media: A Double-Edged Sword for Healthcare

One interesting theme arising out of the UnitedHealth murder aftermath is the power of media. Specifically, the power to hold UnitedHealth and other large healthcare corporations accountable to the public interest. As I discussed in my last newsletter, both social and traditional media channels have been flooded with expressions of public rage against the health insurance industry, whereas UnitedHealth’s PR response was surprisingly weak. Maybe this shouldn’t surprise us: direct confrontation of a public storm can be difficult if not impossible to pull off, even for the most resource-rich of modern corporations. It feels morally reassuring. Healthcare corporations might out there denying lifesaving care and extracting huge rents out of the American economy, but at least when they go too far they’ll get reined in by negative public sentiment.

But even if you believe this (and if we’re honest, it’s been a pretty weak reining-in so far), what happens after the storm has blown over? When public attention moves on to any other issue out of the unlimited pool of current crises? That’s when a lot of media’s real power is expressed these days. And ironically, the key action takes place behind the scenes rather than out in the open.

Consider the recent Blake Lively drama. In case you haven’t been following the story, here are the key points: Ms. Lively recently co-starred in the movie “It Ends With Us” with Justin Baldoni. Baldoni also directed the film. Following the film’s release, a flood of negative media coverage emerged, portraying Lively as a difficult diva who mistreated journalists and was “tone-deaf” about the movie’s theme of domestic violence. For a Hollywood celebrity whose career is dependent on their public image, this was a potentially disastrous turn of events.

Where did the negative coverage come from, and why did it emerge right when her movie was released (a period when actors are usually enjoying a wave of positive media attention)? Turns out that the negative stories had been planted by Baldoni's PR firm. Lively had complained about Baldoni’s behavior during filming, and Baldoni, worried about his reputation being harmed by sexual harassment claims, decided to pre-empt it by trashing Lively’s reputation first. We know all of this because Lively’s attorneys were able to acquire phone messages between the PR agents involved, including one saying, “You know, we can bury anyone.”

Now, planted stories about celebrities are nothing new. Between the gossip columns and the publicists and the talk shows, actors’ images have always been actively managed. Usually this goes in positive directions, but the Lively case shows that it can go negative as well. (Another example: Meghan Markle, esp. after the British royals soured on her).

Does press "engineering" take place in the healthcare industry? Absolutely. Former-health-insurance-PR-exec-turned-activist Wendell Potter has described the inner workings of Cigna’s PR department in detail in his Healthcare Uncovered substack as well as his recent NYTimes OpEd. For my part, I’m neither a journalist nor a PR agent, but I’ve learned some things about the media during my two decades working at a (nonprofit) national healthcare company, including a stretch in 2020 when I was the official press contact. All large corporations employ public affairs departments to protect their image, and healthcare companies are no exception.

Historically, professional journalists have served as a defence against planted stories. Journalists don’t like being told what they can and can't write, especially by outside companies. Fact-checking departments add another layer of defense. (Which is why most celebrity stories end up in tabloids rather than more mainstream outlets.) But the decline of local media has decimated the ranks of professional journalists, leaving behind smaller numbers of underpaid, overworked (and often junior) reporters who simply don’t have time to do proper investigation. Which can make planted (i.e., largely pre-written) stories hard to resist. I remember reading a healthcare news article in my local paper a few years back that turned out to be a thinly-disguised advertisement for a local back surgery practice. I emailed the reporter to share medical evidence that contradicted some of the claims in the article. She didn’t respond.

So back to UnitedHealthcare. If I worked in their PR department, I would probably be busy right now planning a reputation rehab campaign. One tactic would be to plant as many stories as possible that paint doctors, hospitals, and pharmas as the “real” villains driving up healthcare costs, leaving insurers as the only remaining good guys who can keep the system accountable. Stories such as this poorly researched hit piece in Vox about greedy anethesiologists, much of which is debunked in this episode of the 43cc podcast. (Note: I don't have any direct evidence that the Vox article was a planted story. But its one-sided defense of for-profit health insurers does create that impression.)

I expect to see a lot more of these kinds of stories in the next few years, along with counter-stories planted by health systems, physician groups, and pharma.

Fasten your seatbelts.