Who Will Be at the Table? Part III

Special interest groups masquerade as ordinary citizens

During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is a good time to take a look at just what kind of seats special interest groups will have at Obama’s table, and what they’re doing to bring the public around to their ways of thinking. This is the third of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.

It was good to see Robert Pear of The New York Times writing again about health care the other day. Back when he was regularly writing on the topic, Pear could always be counted on to deliver the inside scoop about the latest Washington think on health reform. He did so during the 1993-94 debates, and it looks like he may be doing that again.

His Wednesday story had a lot to say about who will be at Obama’s table. Obama and his health chief Tom Daschle are encouraging ordinary citizens to hold community discussions—a kind of Tupperware party for health care. The Obama team will provide a moderator’s guide, and promises that Daschle might even drop in on some of the parties. That’s one way the president-elect is making good on his promise to bring every stakeholder to the table—but the effort may be co-opted by the special interests.

The trouble, according to Pear, is that those interest groups are urging their members to attend and even lead some of the discussions. Insurance trade association AHIP, the American Medical Association, state medical societies, and the Health Care Leadership Council—an organization of large corporations that played a role in defeating the Clinton health care plan—are all organizing sessions or sending representatives to attend them. Group Health of Puget Sound, a managed care organization, has sent e-mails to 35,000 members (aka patients), urging their participation. One of its doctors is even going to lead a session. AHIP is mobilizing its grassroots coalition, presumably all those folks it met in places like Detroit and Albuquerque on its listening tour this summer as part of its Campaign for an American Solution.

OK, you can argue that insurance company reps and doctors are ordinary citizens. But they also represent important special interests that are invested in the reform efforts that might upset the way they do business. Which hat do these people wear when they speak at one of Obama’s sessions? Attendees aren’t required to disclose their employers or their affiliations, Pear reports. This under-the-table lobbying reminds me of a common PR trick that calls on employees of a particular business to write to local newspapers in order to advance a corporate point of view. While the letters appear to be written by average Joes or Janes, they are really crafted by a PR agency. It’s also reminiscent of the AMA’s campaign in 1948 that helped defeat the national health insurance plan proposed by President Harry Truman. That time, the AMA called on doctors’ wives to get involved in community discussions.

Reporters usually don’t attend Tupperware parties, but we’d like to encourage them to go to these. They end on December 31. Look at who is doing the talking. Where are they from? What are they saying? What is the major point of view? Are the uninsured represented? How will they fare under the solutions discussed? Localizing what is fast turning into a national story is sometimes hard. But Obama’s effort to bring everyone to the table may be just the entrée journalists need.

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Trudy Lieberman is 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. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.