Health Care, Issues Management, and Transparency

The summer of 2009 has jump started the health care debate in the U.S.  People debate various plans to help provide health care to the millions in the U.S. who lack health insurance.  It is a vital issue that warrants public discussion.  Public relations can help build the marketplace of ideas (Chapter 3) by providing communication vehicles for various sides.  This is the realm of issues management.  The health care debate is issues management at its best and worst.  The worst comes in the form of front groups that hide their bias and provide information that can kindly be called misleading.  (See an earlier debate about twisting risk communication in this debate).

The Coalition to Protect Patients’ Rights sounds like group designed to help patients.  Here is a sample from their about section:

“The Coalition to Protect Patients’ Rights is a nonpartisan, grassroots coalition of patients, healthcare professionals, advocacy groups, and engaged citizens who are concerned about the current healthcare debate going on in Washington.

Agreeing that more must be done to reign in healthcare costs and provide affordable access to healthcare for uninsured Americans, the Coalition believes that the private sector can and must be involved in healthcare reform.  Recognizing that each of us are different and have different healthcare needs, we support choice and options in our healthcare – not a one-size fits all approach that simply provides everyone with the same level of substandard care.  The Coalition also believes that all medical decisions must be left to the patient and doctor.  We believe that allowing a government bureaucrat to exercise any authority over personal healthcare decisions would lead to diminished quality of life for all Americans.”
Now people might take” issue” that the about section implies that the U.S. government will take over healthcare and be the sole insurer in the U.S.  Of the plans being discussed, that is not at the top of the list or even a realistic option as of August 2009.  So there is some implied distortion.  What is problematic is the lack of transparency provided  by  The Coalition to Protect Patients’ Rights.  The group was developed by the DCI Group.  The DCI Group is a lobbying firm with a history of creating front groups (  As The Coalition to Protect Patients’ Rights sends out editorial and op eds, gains friend on Facebook, and has visitors at its web site, there is no indication who this group really represents.  What corporations or industry groups are paying the bill.  By definition, front groups lack transparency.  At best The Coalition to Protect Patients’ Rights is an example of astroturfing.  The organization was created to generate grassroots opposition to certain health insurance initiatives.  The organization was not a spontaneous development from constituents.  The organization was built by a communication/PR agency.  Here is how the DCI Group defines itself:

“DCI Group is a strategic public affairs and global issues management firm. We use a campaign-style approach to help corporations, trade associations, and nonprofit organizations address their most critical communications and public policy challenges.”


For the lighter side, see Steven Colbert discuss the Coalition to Protect Patients’ Rights as “the word” August 4, 2009 at—hippie-replacement.


Questions to Consider:

  1.  What are the ethical concerns for PR when engaging in astroturfing?
  2. Why does it matter who is funding The Coalition to Protect Patients’ Rights?
  3. How do front groups serve to undermine the issues management process?
  4. How does a demand for transparency protect issues management and the marketplace of ideas?
  5. What about the online environment (Chapter 7) makes it easier to create an effective front group?
  6. Does it seem odd that a PR agency with known connection to front groups is also Bronze Anvil award winner from the Public Relations Society of America? 
  7. How exactly might transparency be used to combat front groups especially in the online environment?
  8. Can The Coalition to Protect Patients’ Rights appear to be working as social marketing  (Chapter 8) and what advantage does that offer to its issues management efforts?

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