August 16, 2009, New York Times

Competing Ads on Health Care Plan Swamp the Airwaves
By KATHARINE Q. SEELYE

By the time President Obama left Montana on Saturday, the Bozeman media market had been saturated with an advertisement opposing his health care plan - hard for anyone to miss since it ran 115 times in 36 hours on network and cable television channels.

“Say no to government-run health care,” a narrator says in the advertisement by a conservative group that particularly went after the idea of a government insurance option.

The spot, timed in advance of Mr. Obama’s visit, is part of a cascade of advertising swamping the airwaves across the country as the health care fight has become a full-blown national political campaign, replete with battleground states, polling, leafleting, fractious town-hall-style meetings, op-ed articles, talking points and videos. He held one of those public meetings in Colorado on Saturday .

Interest groups on all sides of the debate have spent more than $57 million on television advertisements in six months, most of it in the last 45 days, said Evan Tracey, chief operating officer of the Campaign Media Analysis Group, which tracks television advertisements.

“It’s the most we’ve seen this quick,” Mr. Tracey said. “If it goes on all year, we’re looking at one of the biggest public policy ad wars ever.”

Supporters of Mr. Obama’s plan to overhaul the system have outspent opponents, with $24 million worth of advertising, compared with $9 million from opponents. An additional $24 million has been broadly spent in support of overhauling the system without backing a specific plan.

Geoff Garin, a Democratic pollster who is advising several Democrats on Capitol Hill, said whoever defined the debate would win it. “Opponents are trying to cement the notion that this is all about government-run health care,” Mr. Garin said, “while supporters want to cement the notion that this is about fixing a badly broken system.”

Advertisements in favor of Mr. Obama’s effort mostly seek to reassure those who already have insurance that they will benefit because insurance companies will not be able to drop them if they are sick or deny them coverage for pre-existing conditions.

But at times, Democrats in favor of remaking the health system have been attacking fellow Democrats who are undecided or oppose an overhaul, which may partly explain why support for Mr. Obama’s effort has been eroding, even though his side has spent more money.

Opponents’ advertisements are sharper in tone. They are intended to fire up the conservative base and appeal to independents who may share conservatives’ concerns about a government takeover of the health system or excessive spending.

One commercial shows a red balloon that expands as the narrator warns that an overhaul would increase deficits, taxes and government control. Eventually, the balloon pops.

Other advertisements from opponents make more emotional but unsubstantiated assertions that an overhaul would ration care and deny treatment to older people.

Mr. Tracey said that, generally, the advertisements in favor of an overhaul had been “cheerleading” up to this point, while those against it had successfully raised doubts about it. “People may favor health care reform,” he said, “but if you can pull out end-of-life issues or taxpayer-funded abortions or rationing care and dictating lifestyle, those fit really well into 30-second spots.”

White House aides concede that Mr. Obama, who is stumping the country for his health care plan, has lost some ground; they chalk it up partly to misleading advertisements suggesting that the government will ration health care or that senior citizens will be denied end-of-life care.

Both sides are broadcasting their message in many of the same battleground states - including Arkansas, Colorado, Louisiana, Maine, Nebraska and North Carolina - to reach conservative Democrats and moderate Republicans who may determine the fate of the bill.

In a $12 million advertising buy that began last week in 12 states, a coalition of drug companies, doctors, for-profit hospitals and union members defended overhauling the system. With piano music playing over pictures of patients with health care workers, the commercial portrays the overhaul as providing “quality, affordable care you can count on.” The coalition calls itself Americans for Stable Quality Care.

“It’s very carefully drafted,” Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, one of the biggest players in the debate in support of an overhaul, said of the commercial. “We don’t want to fan the flames; we want to calm people down.”

The pharmaceutical industry has also resurrected “Harry and Louise” from 1993-94, when the fictional couple, like the drug industry, was against President Bill Clinton’s health reform proposal. But now, both the drug industry and the couple, still at their kitchen table 16 years later, have had a change of heart and are promoting an overhaul.

The commercials range from the macro to the micro, with some aimed at tiny demographic slices. One ad by an autism awareness group urges viewers to tell Congress that any plan that does not prevent autism insurance discrimination “is unacceptable.”

Both parties have also gotten into the act. The Republican National Committee has run radio advertisements in more than 30 states aimed at Democrats in conservative and swing districts.

“If Barack Obama and the Democrats get their way, the federal government will make the decisions about your health care,” the narrator says. “And their plan costs a trillion dollars we don’t have.”

The Republican committee also created a Web advertisement that received much attention for its humor but that has been called misleading by critics. Reminiscent of commercials for male potency drugs, it shows carefree couples in various settings but warns of “side effects,” like being denied coverage “based on patient age.”

The Democratic National Committee has tried to capitalize on recent town-hall-style meetings with raucous protesters. In one Web advertisement, it warned that “the right-wing extremist Republican base is back” and is “organizing angry mobs, just like they did during the election.” (Last week, however, Gallup found that voters, particularly independents, said they were more sympathetic to town-hall protesters than not.)

And in a highly unusual move, the Democratic committee even broadcast advertisements intended to put pressure on senators of its own party - Kent Conrad of North Dakota, Evan Bayh of Indiana, Bill Nelson of Florida, Mary L. Landrieu of Louisiana, Blanche Lincoln of Arkansas and Ben Nelson of Nebraska - who have been skeptical of an overhaul or of the public option. The spot shows average voters with tales of woe who say “it’s time” for an overhaul.

Organizing for America, the reconstituted Obama campaign team, is working hand in hand with the Democratic National Committee and features the “it’s time” commercial on its Web site.

Liberal groups like MoveOn.org are presenting more personal attacks against conservative House Democrats, including Representatives John Barrow of Georgia, Jim Matheson of Utah and Charlie Melancon of Louisiana, all of whom voted against a Democratic health bill in committee. The advertisements tell viewers in those districts that their congressman “sided with the special interests and insurance companies.”

The commercial in Montana that urged Mr. Obama to drop the public option dogged him as he headed to Colorado, where it ran 50 times in the Grand Junction media market over 24 hours. It was sponsored by Conservatives for Patients’ Rights, started by Richard L. Scott, the former chairman and chief executive of Columbia/HCA, a large hospital chain. Mr. Scott was ousted in 1997 amid a fraud scandal, though he was not directly implicated.

More prominent nationally is the “red balloon” commercial, sponsored by the United States Chamber of Commerce. R. Bruce Josten, executive vice president for governmental affairs at the chamber, said his group started advertising in Arkansas, Colorado, Louisiana, Maine and North Carolina to bolster lawmakers who had expressed opposition to a government-run insurance option. The chamber expanded its multimillion-dollar advertising campaign last week to 15 more states.

“I’m up against a dozen groups running ads that will spend between $50 million and $80 million to promote a public plan and promote an employer mandate, regardless of the cost,” Mr. Josten said. “We’re trying to create a dialogue rather than cede the ground.”