April 9, 2009

Thom Hartman interviews Russell Mokhiber about the Frontline controversy.

In response to my earlier post quoting Russell Mokhiber from Corporate Crime Reporter on the dispute over Frontline's "Sick in America" (which in turn quoted T.R. Reid, the journalist who worked on the story), Frontline sent this letter (you'll have to read all the way through to see Reid's response):

FRONTLINE takes a strongly different view of the characterization of its editorial disagreement with T.R. Reid as presented by Mr. Reid and Russell Mokhiber in the recent blog entry, “Something is Rotten at PBS” (Counter Punch, April 2, 2009).

That blog entry describes the dispute about FRONTLINE’s “Sick Around America” as a disagreement about the correct health care policy for the United States and says that FRONTLINE “had a point of view — they wanted to keep the for-profit health insurance companies in the game.” Those claims are not true and falsely characterize the reporting in the film.

“Sick Around America,” in fact, made no assertions about the path health care reform should take, but simply reported on the current state of health insurance in the country, focusing primarily on how inadequacies in the current private health insurance system, both for-profit and non-profit companies, were negatively impacting many Americans. Our reporting revealed that both non-profit and for-profit insurance companies were concerned with keeping costs down and maximizing their market share. As a result, both write policies that can be changed yearly based on the experience of the particular business in the case of employer-based coverage and both use medical underwriting (in all but five states) to reduce the number of sick or potentially sick individuals they cover. Both employ the practice of rescission, as we reported.

In his blog entry, Mr. Mokhiber makes this erroneous critique of one portion of the film:

During that segment, about halfway through Sick Around America, the moderator introduces Karen Ignagni, president of America's Health Insurance Plans, the lead health insurance lobby in the United States.

Moderator: Other developed countries guarantee coverage for everyone. We asked Karen Ignagni why it can’t work here.

Karen Ignagni: Well, it would work if we did what other countries do, which is have a mandate that everybody participate. And if everybody is in, it's quite reasonable to ask our industry to do guarantee issue, to get everybody in. So, the answer to your question is we can, and the public here will have to agree to do what the public in other countries have done, which is a consensus that everybody should be in.

Moderator: That's what other developed countries do. They make insurers cover everyone, and they make all citizens buy insurance. And the poor are subsidized.

But the hard reality, as presented by Reid in Sick Around the World, is quite different than Ignagni and the moderator claim.

Other countries do not require citizens buy health insurance from for-profit health insurance companies – the kind that Karen Ignagni represents.

But Mr. Mokhiber made a factual error that seriously undercuts this critique. His argument rests on the assumption that Ms. Ignagni represents only for profit health insurance companies. In fact, her organization, America’s Health Insurance Plans, represents both for-profit and non-profit companies. FRONTLINE rejects Mr. Mokhiber’s assertion that we were misleading viewers in this section of the film.

I normally wouldn't butt into a response letter, but since Frontline's editors say this factual error "seriously undercuts" Reid's critique, I'll point out a few things. The first is, AHIP was the result of a merger between the Health Insurance Association of America (HIAA) and American Association of Health Plans (AAHP) - in other words, it's the lobbying arm of the health insurance industry. The HIAA ran the "Harry and Louise" advertisements that helped kill the Clinton health care reform.

It's also disingenuous (while an accurate legal distinction, it's misleading) to identify health insurance companies as non-profit when it's industry-wide practice for the non-profits to form for-profit subsidiaries - with which the non-profit then contract to provide its profitable services. (My local Blue Cross has at least nine for-profit subsidiaries.)

In fact, in a later section of the film the narrator explicitly says that other developed [countries] require health insurance companies operate on a non-profit basis:

Narrator: Other developed countries bar health insurance companies from making profits on basic care and cap their administrative costs.

FRONTLINE sees the dispute with Mr. Reid as one not about for-profit vs. non-profit health insurance or health care policy, but instead about journalism. The dispute with Mr. Reid centered on a decision to include a section on the recent attempts by Massachusetts to reform its health care system. Mr. Reid objected to the inclusion of Massachusetts, the only state to require its citizens to purchase health insurance, and to require insurance companies to sell them policies with an adequate standard of coverage.

Reid repeatedly told FRONTLINE that including Massachusetts in the program at all, was to advocate for that kind of reform as opposed to Reid’s preference of a “Medicare for all,” one-payer system for the entire country. FRONTLINE’s position was that simply reporting on the state’s plan was not advocacy and, in fact, our reporting would focus not only on the benefits, but also on the problems with the Massachusetts plan. We think any objective viewing of that sequence in “Sick around America” will confirm FRONTLINE’s view that it was a piece of reporting not advocacy.

Editorial disagreements are common in the making of documentary films, but for more than twenty five years, FRONTLINE has been able to find a way to resolve those differences with a wide variety of producing and reporting teams. We were surprised to be unable to find consensus with Mr. Reid and found him resistant to working through the problems with us. He refused to travel to Boston conduct a critical interview with the Massachusetts Secretary of Health or to have requested face-to-face meetings on his editorial differences with the FRONTLINE team. Instead, Mr. Reid demanded that he be completely removed from the film and FRONTLINE reluctantly honored his request.

We would also note that on March 17, just three weeks after he asked to be removed from the film, a Denver magazine reported that T.R. Reid said he was interested in being appointed to a vacant seat in the Colorado House of Representatives, citing that his concerns about health care reform in the U.S. were “enough to push him from the reporting side over to the policy-making side. And he thinks Colorado would be a perfect testing ground.” FRONTLINE’s editorial guidelines explicitly state that “when working on any politically controversial programs the producer [or correspondent] should engage in no personal political activities…and should not lobby for or against any specific piece of legislation.”

In the end, FRONTLINE believes the dispute centered on a conflict between FRONTLINE’s journalistic commitment to fair and nuanced reporting and its aversion to policy advocacy and Mr. Reid’s commitment to advocacy for specific health care policy reforms, for positions he apparently advocates in his forthcoming book.

One last point: Mr. Mokhiber writes that Mr. Reid “did the reporting for the film.” In fact, as is true in most FRONTLINE films, virtually all of the detailed reporting for “Sick Around America” was conducted by the film’s producer, Jon Palfreman, and his co-producer Kate McMahon. Mr. Reid consulted with Mr. Palfreman and conducted some of the interviews. However, Mr. Palfreman conducted many of the other interviews in the film. As is always the case, this was a collaborative journalistic effort. We regret that the collaboration had such an unfortunate conclusion.

Reid responded via email:

I've had the highest regard for FRONTLINE and its producer, Jon Palfreman. We made some good films together. We've had some honest differences over health policy, but that shouldn't lead us into ugly personal attacks.

So I won't try to correct all the errors in your "extended comment." But I should point out that I do not see "Medicare for all" as the solution to our health care mess. I'm searching for --and I think I've found -- a more politically viable route to the goal of universal coverage at reasonable cost.

I appreciate your mention of my forthcoming book, "The Healing of America. A Global Quest for Better, Cheaper, and Fairer Health Care." (Penguin Press, 2009). I bet FRONTLINE viewers will find it more informative, and more engaging, than the nasty, defensive tone of your extended comment.

Best,

Tom Reid

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