Monday, March 14, 2011

PR, Sock Puppets, and the Ways of Corporations

This rather incoherent post arises from a conjunction of two events--first, seeing the following post--http://www.cbo.gov/ftpdocs/88xx/doc8891/MainText.3.1.shtml-- on our fellow blog, Health Care Renewal; and second, being in the process of reading Wendell Potter's book, Deadly Spin, as recommended by HCR's Dr. Roy Poses in his comment to my March 7 post (http://brodyhooked.blogspot.com/2011/03/and-another-defense-of-medicine-pharma.html).

HCR's Dr. Scot Silverstein, their regular blogger on matters relating to health information technology and electronic records, using technology that is far beyond my poor powers, was able to track down an anonymous person who regularly left disparaging, ad hominem comments about any criticism of the HIT industry or its products. He found that the messages originated in a computer located in the headquarters of an HIT firm in Massachusetts. As soon as he "outed" the source, the comments from that anonymous individual ceased.

Dr. Silverstein thereby introduced me to the useful term "sock puppet"--a shill who is in the employ of or sympathetic to a moneyed interest, and who attacks opponents of that interest with misdirection, obfuscation, or ad hominem invective, all the while concealing the link between the attacks and the moneyed interest.

Back to Wendell Potter. His book reviews how the health insurance industry has responded to all attempts at health reform in the US with well-financed and highly effective PR campaigns either to defeat reform outright (as with Clinton), or else to be sure that reforms take whatever shape will best preserve the profits of the private insurance industry (as with "Obamacare," that supposedly socialist program). The primary tool of these PR compaigns is the creation of phony organizations fully funded by the insurance industry but supposedly made up of grass roots supporters ("astroturf"), that can parrot the talking points that the insurance poobahs have refined and field-tested, but while making it appear that the statements come from anywhere except the insurance companies. The goal is to make it seem as if "everyone is saying that" when "that" in fact was deliberately invented and promulgated by the insurance folks.

It is instructive to compare the standard PR procedures of the insurance industry with those of the drug industry. While there are some differences, the basic approach seems to be the same. As anthropologist Kalman Applbaum (see previous post, http://brodyhooked.blogspot.com/2010/06/how-does-drug-industry-exert-power.html) shows, the special insight that Pharma has added is the notion of a drug "channel," the entire collection of events that must occur between the time a new drug is discovered and when it is sold to patients. The drug industry has become adept in creating marketing strategies that manage to control an entire channel. This serves the same purpose as insurance industry PR. To the average spectator, it seems simply inconceivable that the drug companies could control all these disparate players--scientists, physicians, the FDA, celebrities who mention a new drug on TV, etc. Therefore the sheer audacity of the industry strategy renders it invisible, in a sense--it simply does not seem possible that all those inputs could be deliberately orchestrated.

Potter W. Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans. New York: Bloomsbury Press, 2010.

4 comments:

Scot M Silverstein MD said...

It is instructive to compare the standard PR procedures of the insurance industry with those of the drug industry. While there are some differences, the basic approach seems to be the same. As anthropologist Kalman Applbaum (see previous post, http://brodyhooked.blogspot.com/2010/06/how-does-drug-industry-exert-power.html) shows, the special insight that Pharma has added is the notion of a drug "channel," the entire collection of events that must occur between the time a new drug is discovered and when it is sold to patients

It seems the health IT industry has learned the same approach. Thanks for the link to the post about Applbaum's work.

Scot M Silverstein MD said...

See my new HC Renewal post How Lousy Health IT (And Other Healthcare Refuse) Gets Pushed on Naïve Physicians, Hospital Executives and Governments.

-- SS

Roy M. Poses MD said...

I would also not be surprised if at some point we discover that pharma (and device and biotech, and probably health care IT, hospitals and every other type of big, wealthy health care organization) use PR tactics similar to those described by Potter to promote their health policy objectives (as distinct from their marketing objectives.)

JPB said...

I am sure that you are right, Dr. Poses!