Back then, a different public relations counseling firm was running the show—Democracy & Data Communications, whose suburban Washington address was the same one given for the Coalition on its Web site. (There’s now a different address on the Coalition’s Web site.) The firm’s clients included AHIP and two companies, Humana and United Healthcare, which have profited from Medicare Advantage plans.

Johnson says he gets tons of Astroturf letters—like the ones from the Coalition—each day, and they’re usually easy to spot. These, he said, were written in a “corporate marketing department style.” If they’re easy to spot, then why do PR firms keep sending them? Because they’re effective, Johnson explained, noting that when he checked with Google, he found that lots of small papers were running them. His advice for editorial page editors and others inclined toward gullibility: “Be vigilant and don’t let people use your letters columns as a marketing tool.”

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.