Ad campaigns, public health and the U. S. health care system

Whenever anyone begins seriously considering health care reform, a national health care system or universal health insurance coverage, critics will begin talking about the horrors of "socialized medicine." Someone else will begin to tout the superiority of the American health care system as the very best in the world--no matter what the hard data reveals to the contrary.

The fact is our health care system is the best in the world for those who can afford to access it fully.

The experience of the uninsured is quite different, and the effects on public health realities and outcomes is not what our current national investment should expect in return.

We get the results one might expect from a people who regard health care as a commodity, rather than a basic human right.

Now comes this report from The New York Times last Friday ("Cancer Society Focuses Its Ads On Uninsured," August 30, 2007, A1, 18). What follows is from the paper's on-line edition. The print version is even more exhaustive. Any objective reading of the current reality reveals that change is long, long overdue.

I find the report startling.

Please take the time to read on!
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ATLANTA, Aug. 30 — In a stark departure from past practice, the American Cancer Society plans to devote its entire $15 million advertising budget this year not to smoking cessation or colorectal screening but to the consequences of inadequate health coverage.

The campaign was born of the group’s frustration that cancer rates are not dropping as rapidly as hoped, and of recent research linking a lack of insurance to delays in detecting malignancies.

Though the advertisements are nonpartisan and pointedly avoid specific prescriptions, they are intended to intensify the political focus on an issue that is already receiving considerable attention from presidential candidates in both parties.

The society’s advertisements are unique, say experts in both philanthropy and advertising, in that disease-fighting charities traditionally limit their public appeals to narrower aspects of prevention or education.

But the leaders of several such organizations, including the American Heart Association, the American Diabetes Association and the Alzheimers Association, said they applauded the campaign’s message that progress against chronic disease would be halting until the country fixed its health care system.

As in the past, the heart association is using its advertising dollars these days to promote more rigorous exercise and healthier diets. The most recent cancer society campaign encouraged screening for colon cancer, including a memorable commercial in which a diner plucked — and then ate — a lima bean polyp from the intestinal tract he had carved in his mashed potatoes.

But John R. Seffrin, the chief executive of the cancer society, which is based here, said his organization had concluded that advances in prevention and research would have little lasting impact if Americans could not afford cancer screening and treatment.

“I believe, if we don’t fix the health care system, that lack of access will be a bigger cancer killer than tobacco,” Mr. Seffrin said in an interview. “The ultimate control of cancer is as much a public policy issue as it is a medical and scientific issue.”
The two 60-second television commercials that form the spine of the campaign make that point.

One features images of uninsured cancer patients, appearing hollow and fearful. “This is what a health care crisis looks like to the American Cancer Society,” the narrator begins. “We’re making progress, but it’s not enough if people don’t have access to the care that could save their lives.”

The other commercial depicts a young mother whose family has gone into debt because her insurance did not fully cover her cancer treatment. “Is the choice between caring for yourself and caring for your family really a choice?” the narrator asks.

Census figures released this week show that the number and percentage of people in the United States without health insurance rose last year, to 47 million and 15.8 percent. A 2003 study estimated that one of every 10 cancer patients was uninsured.

Other surveys have found that one of every four families afflicted by cancer, which is projected to kill 560,000 Americans this year, is effectively impoverished by the fight, including one of every five with insurance.

The cancer society plans to buy time on network and cable channels from Sept. 17 to Thanksgiving, said Greg Donaldson, the group’s vice president for corporate communications. There will also be advertisements in magazines and on Web sites.

With nearly $1 billion in revenues, the cancer society is the wealthiest of its peers and has spent about $15 million annually on advertising since 1999. By comparison, Geico, the automobile insurer with the “Caveman” advertisements, spent about $14 million on network advertising in the first quarter of 2007, according to TNS Media Intelligence, a tracking firm.

Advertising about the health insurance crisis is not uncommon among more broadly based medical organizations and other interest groups.

Last week, the American Medical Association kicked off a three-year campaign called “Voice for the Uninsured” that will begin with $5 million in advertising in early primary states. AARP, in conjunction with the Business Roundtable and the Service Employees International Union, recently began a similar effort called “Divided We Fail.”