Molly Ivins July 12

AUSTIN, Texas — They fooled you once on the tobacco bill with a $40 million public relations campaign — all those TV ads claiming the tobacco bill was about "new taxes" and would create "40 new government bureaucracies." Shame on them.

Now, they're fixing to fool you again with another TV ad campaign calling the Patients Bill of Rights "the politicians' new game ... new laws and regulations could cause nearly 2 million hard-working Americans to lose their health coverage." If they fool you this time, shame on you.

The health insurance industry has taken a page straight out of the tobacco playbook. The ads are almost carbon copies of Big Tobacco's strategy to shift the discussion from the real subject to big government, to bureaucracy, to politicians — to anything we like even less than we do tobacco or the insurance industry.

Former Surgeon General C. Everett Koop, one of the real heroes in the anti-tobacco fight (although he has been described by Senate Majority Leader Trent Lott as "Dr. Kook"), did an ad for the American Cancer Society during the fight over the tobacco bill in which he said: "When you see advertising from the tobacco industry, consider the source. These people are experts at manipulation and have been lying to the American people for decades."

Unfortunately, the American Cancer Society doesn't have anything like tobacco's money, so you may not have seen the ad, but it's still good advice for the coming battle on health insurance. When you see advertising from the health insurance industry, consider the source.

These are the friendly folks who brought us "drive-through delivery" of babies, gave us drive-through mastectomies, told their doctors they couldn't prescribe all the range of treatments for a given illness to a patient — only the least costly. These are the outfits that won't let patients see specialists — and some people have died because of it. These are the people who won't let you choose your own doctor. And they've got the system rigged so you can't sue health plans for improperly denying coverage.

These are the folks who have been pulling out of managed-care programs for the poor and the elderly. Aetna U.S. Healthcare, Pacificare, Oxford Health Plan, Kaiser Permanente, and Blue Cross and Blue Shield have shut down Medicaid services in 12 states, and the withdrawals are spreading to Medicare programs for the elderly, primarily in rural communities, according to The New York Times.

Same old same old: The Center for Responsive Politics reports that the health insurance industry gave $1.6 million to federal candidates and parties in 1997 and the first part of 1998.

Close to 70 percent of those funds went to Republicans, who usually oppose health-care regulation. First, they buy the politicians; then, they put on a PR blitz to fool the people.

But in this case, a lot of the pols are not staying bought. The Democrats, led by President Clinton and Sen. Ted Kennedy, have been pushing for a Patients Bill of Rights for months now. Meanwhile, the R's found out through their polling that it's a "hot" issue. According to a recent Time/CNN poll, 75 percent of Americans think the health insurance system needs reform and 40 percent think it's in "crisis"; according to the Los Angeles Times, 59 percent of doctors in California reported that HMO quality-improvement programs were either "poor" or "very poor." The R's have now come up with their own bill, which is not only weaker than that of the D's but also contains some extraneous bad ideas.

Just to show you how unradical the D proposal is, the Texas Legislature passed its own Patients Bill of Rights last session, allowing HMOs to be taken to court for medical negligence. And you know our Lege is no bastion of progressive thought.

The main points of reform are: giving patients access to more doctors, the right to appeal a managed-care organization's decision to an impartial panel, and the freedom to sue the organization for malpractice. If you canvass your friends and acquaintances, you're almost sure to come across someone who has had a hideous problem with an HMO.

Alicia and Steve Autrey of Austin had to raise the money to pay for part of his liver transplant — he would have died without it — when their HMO refused to cover the $32,000 cost of the removal of the liver from the donor (procurement). They are also worried about other future expenses. (They have a web site: www.ccms.net/~element/autrey.)

Naturally, the health insurance industry is claiming that any fixes to the system will raise costs and "force" them to cancel people's insurance. These are the same companies that are already cutting off old and poor people. According to The Washington Post, one of their ads features a "Congressman Frankenstein" conducting a mad operation: "Remarkable, you've stitched together hundreds of new government mandates, putting Washington in control of everyone's health care," says his crazed assistant.

Remember, consider the source.

Molly Ivins is a columnist for the Fort Worth Star-Telegram. To find out more about Molly Ivins and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate web page at www.creators.com.

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