| Number 217 | August 8, 2003 |
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This Week:
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Greetings, Did somebody publish a good review of Nygaard Notes somewhere? Over the past couple of weeks I have gotten a flurry of new subscribers and pledges of financial support. Anyway, WELCOME to the new readers, and THANK YOU to the new contributors! Boy, I can use the support right now. Summer is a financially “challenging” time, to put it politely. Which reminds me... The next Nygaard Notes Pledge Drive will be coming up here in a couple of months, but you don’t have to wait for a Pledge Drive to send in a donation. If a particular edition reminds you of how much to like the Notes, or of how useful this independent newsletter is to you in understanding and organizing around the issues of the day, then let that be the impetus to send in your check, or maybe to send me the addresses of people who you think should be subscribing. YOUR actions are what make this thing work. I don’t have a Marketing Department, y’know. The Notes this week is all about health care, and really about how the media (mostly unconsciously) decides which issues are “hot” and which are not. I didn’t actually write much this week, I mostly spliced news reports together. But I think, after you read it, you’ll see how important a good “editor” can really be. To DO something about health care, contact the Universal Health Care Action Network (UHCAN!) at http://www.uhcan.org/ or Physicians for a National Health Program, at http://www.pnhp.org/index.html. Solidarity, Nygaard |
You most likely didn’t hear about this poll, since it was only reported in two newspapers in this country, and both are “regional” newspapers, not “agenda-setting” ones. The Milwaukee Journal Sentinel mentioned it in paragraph 35 of a story about the Democratic presidential candidates on July 27, and the Pittsburgh Post-Gazette reprinted that article on August 3. |
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One of the ways to give items in the media a new and often different meaning is to hunt down other, related, items from different days or different pages, and put the items right next to each other. When you then read the items together, otherwise out-of-context “factoids” will often go from having almost no meaning at all to being very illuminating indeed. This week I do some of this simple moving and placing, splicing together items from the nation’s newspapers published during the past month. The focus is on health care news, where I found that the papers have reported quite a bit on both sides of the story, one side being the Sad World of human suffering, the other side the Happy World of corporate profits attained from the management of that suffering. The Happy World: July 18, Star Tribune (Newspaper of the Twin Cities!), Business section, page 2. Headline: “UnitedHealth Earnings up 35%, Growth Likely for Rest of Year.” Here are three quotations:
The Sad World (several sources):
The Happy World: July 29, New York Times (“All The News That’s Fit To Print”), Business section, page 4. Headline: “2nd-Quarter Earnings Increased $24 Million at Insurer.” Lead sentence: “Humana Inc., the biggest operator of health plans for United States military families, said yesterday that profit rose 53 percent in the second quarter as it raised premiums and cut costs.” More Happy World: August 5, New York Times, Business section, page 4. Headline: “Health Net Reports Increased Profits.” Lead sentence: “Health Net Inc., a leading provider of health plans for the United States military, said yesterday that quarterly profit climbed, beating Wall Street forecasts, as it raised premiums to stay ahead of soaring medical costs.” Bonus sentence: “With the notable exception of Cigna's net loss last week, all the major health insurance companies posted profit gains, many by double digits.” The Sad World: July 15, Los Angeles Times, page 18. Headline: “Va Health System Failing, Survey Says; Veterans Have to Wait up to Half a Year for an Appointment, the American Legion Reports. Clinics Can't Keep up with Demand.” Lead sentence: “Veterans are waiting six months or more for medical care as a severely overburdened Veterans Affairs health system fails to keep pace with growing demand, a report to be presented to Congress today concludes.” The Happy World: July 31, New York Times, Business section, page 6. Headline: “Aetna Profits Are Up 28% As Health Insurers Prosper.” Lead sentence: “Riding a wave of growing prosperity in health insurance, Aetna reported a 28 percent increase in profit in the second quarter, joining three other industry giants that have reported better-than-expected results in the last two weeks.” The Sad World: July 23, New York Times, Business section, page 2, headlined: “Fewer Retirees Are Receiving Drug Benefits From Employers.” Lead sentence: “The number of people retiring with health insurance from their employers has dropped significantly since 1996, according to a new study, leaving many recent retirees without coverage for prescription drugs.” It is testimony to the power of PLACEMENT, EMPHASIS, and TONE in reporting the news that, despite the above facts being known and reported, it isn’t a major, headline-grabbing scandal in this country that the health industry is seeing record profits at a time when the health of United Statesians—especially poor ones—lags far behind that of other industrial nations. To illustrate, consider that all of the above quotations appeared within the past month. Nowhere during that period was it even mentioned in the news section of any major paper in the United States—according to the Lexis/Nexis database search of the period I did—that, yes, we still have 41 million people in the United States without health insurance and, yes, this does mean that untold numbers of people suffer needlessly from preventable and treatable illnesses. Imagine if this simple and undisputed fact were routinely included in the frequent reports on record profits in the “health care” industry. Then imagine that these reports were moved from the Business section to the front pages. Same story. Different understanding. The power of the media. |
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I have pointed out many times that there are two very good reasons to read the Business pages of the daily papers. One reason is that the audience of the Business pages is businesspeople. Businesspeople demand—and have the power to get—real and substantial information about how the world works from the newspapers. This is different from the mass audience, which demands, for the most part, entertainment and, to a lesser extent, individualized “News You Can Use.” This is because businesspeople are very aware that they have some power to shape the larger world in which they live, and most “ordinary citizens” believe that they do not. The second reason to read the Business pages is that, precisely because businesspeople are so powerful, it is important to know what they are thinking. For a variety of reasons, these people seem to speak much more freely and with greater candor when they are talking to Business reporters than when they are talking to “regular” reporters. They don’t seem to worry as much, in the Business press, about revealing their anti-social attitudes and actions. Why not? Maybe they think people like us aren’t listening? Or, maybe they think that we can’t crack their codes? Who knows? In any case, the following case study will show what I mean. |
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The news article that I quote in this piece appeared in the New York Times (“All The News That’s Fit To Print”) of July 31, 2003, on page 6 of what the Times calls the “Business/Financial Desk.” The headline was, “Aetna Profits Are Up 28% As Health Insurers Prosper.” It’s true that I quoted the very same article in a separate essay in this issue of the Notes, but I thought it was deserving of more attention, so that’s why I bring it up again. I’m not just forgetful! The following words, drawn from just this one story, illustrate the value of the Business pages to those of us who want to understand how the world works. The corporation that is the subject of the story, referred to here simply as “Aetna,” is a 20-billion-dollar-a -year insurance company, although it doesn’t like to use the word “insurance” — they like to say that they “provide” health care “products.” They are “one of the nation’s leaders” in doing so, they add. The lead paragraph I quoted elsewhere: “Riding a wave of growing prosperity in health insurance, Aetna reported a 28 percent increase in profit in the second quarter, joining three other industry giants that have reported better-than-expected results in the last two weeks.” Now let’s go to paragraph 5 and note this: “Shares for the health care companies have been thriving. As a group, the health companies’ shares are up about 30 percent since the beginning of the year, compared with about 12 percent for the S.& P. 500-stock index.” “‘We're in a sweet spot right now,’ said Charles Hill, the director of research at Thomson First Call.” [Thomson is a “global research network” with offices on five continents, providing “information and technology solutions” — including something they call “competitive intelligence” — to the “worldwide financial community.”] Paragraph 7: “The improvements for the industry have resulted from steadily increasing prices at a time when the companies have managed to slow the rate of increase in their costs. Much of the savings have come from shifting costs to patients in the form of higher fees or co-payments for visits to doctors, higher deductibles, increased use of generic rather than brand-name drugs and higher charges to patients for many drugs.” Paragraph 12: “Since Dr. [Jack W.] Rowe, the former chief executive of the Mount Sinai Medical Center in New York, became chief executive of Aetna nearly three years ago, the company has been aggressively reducing the ranks of its least profitable customers, Kenneth S. Abramowitz [a managing director of the investment firm The Carlyle Group] said.” (Editor’s Translation: Corporatese = “least profitable customers” English = “human beings who are actually sick or have disabilities”) Paragraph 13 describes the “win/win” situation for the corporate bottom line, as follows: “The technique [used by Aetna] has been simply to confront customers with higher prices. Some are driven away, Mr. Abramowitz said, and that reduces losses. Those who stay and pay the higher prices contribute to higher profits. In 2001, Mr. Abramowitz said, Aetna was providing insurance for nine million people; today the number is about half that. ‘Aetna would prefer the customers stay,’ he said, ‘but in either case it is better for Aetna. On the one hand they are losing less money, on the other they are making more.’” There is a Big Lie that is at the heart of the increasing privatization of health care in this country. That Big Lie goes like this: The private health care industry is more “efficient” than the public sector, so the more they control health care delivery, the more they will “rein in” systemwide health care costs. You don’t have to read too much between the lines in the above article to understand the reality that these “Business” people state freely: They profit from health care not by reducing systemwide costs, but by SHIFTING costs, as the reporter frankly says in paragraph 7, away from themselves and their stockholders and onto sick people and, if necessary, taxpayers. To use Aetna as an example again (I don’t think they’re unique), listen to what the Los Angeles Times reported on July 8: “Aetna Inc. [is] attempting to break away from the industry to settle a class-action lawsuit filed by an estimated 700,000 doctors who claim HMOs meddle in doctors' care of patients by arbitrarily denying specialist referrals and cutting short hospital stays to trim costs.” Not all of the “customers” to which Mr. Abramowitz refers—the ones that are “driven away” when “confronted with higher prices,” that is—just disappear. Some of them do die prematurely, of course., which saves everyone a lot of money. But the rest end up in one or another of our remaining public programs, most likely Medicaid or Medicare. I plan to chronicle the attacks on these programs in these pages within the next month or two. |