“Where Do You Get Your Ideas?”

Writers, story-tellers, song-writers, and artists are among those who are asked this question, and often they have no more clue than anyone else. “What made me think of that?” one might muse. Is the creative mind simply more open, more receptive, to its own emerging phantasms? Where do our dreams come from—and where they go when we wake?

How about more practical ideas—an idea for a new business or even an idea about what would be good or bad legislation for Michigan or the United States?

The deeply held ideas we call our “beliefs”? Where do they come from? From our parents, our education, television, friends, the Internet, newspapers, politicians, “spokespeople,” the air we breathe, our own independent philosophical investigations? What think you?

The best public relations is invisible. While it’s easy to spot advertising—the stuff that blatantly urges you to go buy something—PR subtly convinces you to change the way you think. Advertising urges you to do something now; PR is patient. Advertisers pay for the time and space devoted to their messages. Good PR usually gets free media space because it is presented as unbiased information.
 - Wendell Potter, Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans (Bloomsbury Press, 2010)

Read that last sentence again, please. Here, I’ll repeat it: “Good PR usually gets free media space because it is presented as unbiased information” [emphasis added]. So what our politicians tell us, what we hear and read in news media, what we pass along to each other, and even our own belief-forming thought—all that is constantly being shaped by well-bankrolled, behind-the-scenes forces. Now please look again at the subtitle: This is more than a book about the health care so-called “debate,” and the author is more than just another pundit urging his opinion on you. Wendell Potter worked for 25 years in public relations.

This book is also a lot more than just another exposé. The author tells of a very personal journey, beginning with his parents’ and his own origin in a poor rural Appalachian mountain community. He also traces from its origins the development of public relations in this country—who first came up with it, where the first college class was taught, what kind of ethics restrained early practitioners, and where PR has come in less than a hundred years. For example, “crisis management” was first developed by Ivy Lee, cofounder of the Parker & Lee agency in New York, who counteracted bad publicity about industrial massacres and strike-breaking with carefully written and distributed press releases. Press releases, he discovered, did reporters’ jobs for them, and reporters were happy to hand in a release rather than investigating a story for themselves.

A contemporary of Lee, Edward Bernays, enterprising son of Jewish parents, Potter tells us, is “generally credited with coining the term ‘public relations counselor.’” It was Bernays who came up with a wildly successful campaign to attract more women to smoking cigarettes, equating smoking with equality and calling cigarettes “torches of freedom.” Why do I mention his Jewish heritage? Because according to a citation Potter’s to Bernays’s autobiography, in 1933 the noted public relations counselor was disturbed to be told by a guest in his home, a guest who had recently been a guest in the home of Joseph Goebbels, that Goebbels had “at least one of Bernays’s books” on his shelves. Hitler’s use of slogans and manipulation to move crowds was well know, also, and Potter says that Bernays “fretted publicly about ethics later in his life.”

Looking back, he said that had he known the dangers of tobacco, he would not have accepted the American Tobacco account. “No reputable public relations organization would today accept a cigarette account since their cancer-causing effects have been proven,” he wrote in 1986. Also late in life, Bernays appealed to the PRSA [Public Relations Society of America] to police its ranks, arguing that circumstances allowed unethical behavior without any sanctions, legal or otherwise. “There are no standards,” he said.

“No standards.” What does that mean? Anything goes. There are, you may object, legal limits, but let’s look closer at that idea, too.

As Americans, we treasure our freedom of speech. At the same time, we hold onto the idea that “what’s good for General Motors,” i.e., more generally, Big Business, is good for us all. Enter a new American entity, the front group. A front group is created by PR people but not identified with an affiliation to any particular corporation or political party. PR people begin with focus groups, private citizen volunteers, and they test phrases with these groups to see what responses are evoked by certain words and phrases. Say that you find, as PR folks did, that the phrase “government takeover” generates a high fear response. A front group is then organized under some intentionally vague name, chosen because the words have positive focus group response. A website is set up, and the “group” begins to issue statements warning about, say, “a government takeover” of health care. The phony group also buys advertising but never in the name of the industry or any particular business or corporation: the point of PR is to make it look like some group of public- and like-minded citizens just got together in a grassroots kind of way.

Here’s a personal backtrack: I remember in the 1970s when my employer, Western Michigan University, announced that we were going to be given a choice between our old, traditional insurance and a new health maintenance organization (HMO). What surprised me was the high correlation of features shared by the HMO alternative and “socialized medicine” as the fear-mongers had presented it. Why, I wondered, were these features (e.g., limited list of approved health care providers) nightmare outrages if part of a government program but reasonable and desirable if offered by a for-profit private company? I have never had a satisfactory answer to the question. Only slogans come back: “government takeover” and “socialized medicine” vs. “the American way.”

The best example of the industry’s secrecy is the medical-loss ratio, which, as I mentioned previously, is the measurement of the share of premium spent on actual health care. The trend since Clinton’s plan failed has been unmistakable. In 1993, the leading insurers used about 95 percent of premium dollars on medical benefits, according to the consulting firm of PricewaterhouseCoopers. The merger wave and the new philosophy about health insurance pushed MLRs down sharply, so that by 2007 the number was 81 percent. By contrast, Medicare has consistently had a ratio greater than 97 percent since 1993.

What Americans pay in and what they get back: that’s what the MLR measures, and there are the numbers. What about increasing health care costs and inflation in general?

If the [insurance] industry had chosen to raise premiums at the exact pace that it increased spending on health care from 2000 to 2008, insurers would still have made substantial profits without pushing millions of people to go without health benefits. But during those years, insurers raised family premiums 2.5 times faster than the rate of medical inflation, 3.3 times faster than that of wages, and 4.6 times faster than that of general inflation.

Insurance was costing more at the same time that those buying it were getting less, and many could not afford to buy it at all.

The picture that emerges in this book is the clear subversion of the democratic process, but Potter’s examination of the insurance industry (“Industry”? What do they make? Why is every business these days called an “industry” and every income-generating plan called a “product”?) is one case study in a much larger economic development. We all recognize that politics is rife with public relations specialists, doing all they can to shape candidates to our fears and desires. The greater truth is that every important issue that comes before those politicians, once they are in office, has also been manipulated in similar ways. What do “the people” really want? Which voices are theirs? Have we all been hoodwinked before we even open our mouths?

For example, one justly deep fear of the American people has always been the invasion of personal privacy by government. Is the parallel to socialized medicine and HMO’s obvious to you? The greatest threats to the privacy of Americans here at the beginning of the 21st century, as far as I can see, come not from our government but from private interests against which the government is able to offer little protection. Again, please look up your own sources on privacy and data mining. Do you view your concerns for privacy and for freedom as contradictory?

In 1963, in his justly famous “I Have a Dream” speech, Martin Luther King, Jr. warned of “the tranquilizing drug of gradualism” in the struggle for human rights, insisting that the present was a time of “fierce urgency.” For Wendell Potter, the present is a time of fierce urgency in the war of independent thinking against public relations. The problem is that the enemy is invisible. We have already been infiltrated. We may even be unknowingly complicit, unpaid soldiers on a side we never chose.

Potter does not tar all PR with the same brush. Like any tool, PR can be and is often used in the service of good. He does, however, end his introduction with these words:

...I believe that unless we do fight back—and with urgency—the twenty-first century will be dominated by the retrenchment of democracy and the unbridled growth of corporate power, enabled by increasingly unchallenged propaganda.

Who were “Citizens United”? Did you unite with them? Isn’t it ironic that putting the government of the United States up for sale was accomplished without any need for a bloody coup, that it was put on the auction block by our own Supreme Court (three dissenting), reasoning on principle?