Jackie Judd:  I’m Jackie Judd with Ad Audit, a feature of Kaiser Health News that takes a close look at the advertising campaigns about health care reform.  Joining me is Jordan Rau of Kaiser Health News.  Jordan, welcome.  You’ve been covering this beat for some time now.  Just how saturated have television markets become with these commercials?  How much money is being spent?

Jordan Rau:  About 60 million dollars has been spent so far, which is, if it ramps up when Congress comes back, is an enormous amount of money and could even be setting a record.  Until this summer, most of the money was being spent, or a large portion was actually being spent inside Washington for people who play here on national cable shows.  But the money and ads have followed the lawmakers back to their districts for the August recess and particularly in a lot of the swing states – Arkansas, Louisiana, Colorado – and places where lawmakers live who sit on committees that have a direct role in crafting this legislation. 

JJ:  You said a moment ago, it could set a record.  A record for the amount of money spent on a particular issue?

JR:  Right, on a particular campaign.

JJ:  You’ve been following this for a while, as I’ve said – are there general things you could say about the themes in these commercials?

JR:  I think that you see a couple of trends with both of those.  First of all, it’s been about two to one spending in favor, as opposed to against, which is sort of surprising because usually we associate TV ads with attack ads.  But actually, most of the money has been in support.  A large part because the industry players have been on the side of, at this point, of getting some sort of legislation through, so pharmaceutical companies and the AMA and unions are all spending a large amount of money.  So, on their side, the themes have largely been two-fold: one is attacking insurers, because that polls very well with the public; and the second is focusing on catastrophic situations in the current system to argue that it’s unsustainable and needs to be changed.  So you see testimonies of people talking about how their cancer wasn’t covered; talking about how they got billed some exorbitant amount.  Also, you see some arguments that basically the government has to step into the marketplace.  The flipside, the negative ads criticizing them, which have been done by a whole bunch of conservative groups, as well as the Republican National Committee has put in some ads as well, are pretty much what you would expect there as well.  They are making comparisons to other countries, such as Britain and Canada, and holding their systems, which have more government intervention, in a negative light, and then also basically saying that this would badly impact other areas of the country, such as the federal budget deficit. 

JJ:  In recent days, there has been a new campaign that’s been started, I think you told me before we started taping, a 12 million dollar buy.  Let’s look at that commercial and talk about it afterwards. 

[“Mean For You” from the Americans for Stable Quality Care]

JJ:  Who is behind that ad?

JR:  That is a group called the Americans for Stable Quality Care. 

JJ:  And I ask again, who is behind that ad?

JR:  Exactly, actually I have to check my notes, because I keep forgetting what order those very safe words go in.  Quality first or stable first?  The AMA, which is the American Medical Association, Families USA, which is a consumer group that is supporting reform, PhRMA, which is the drug lobby and which has said they are willing to spend as much as 150 million dollars on advertising, SEIU, which is one of the major unions, and then the American Hospital Federation.

JJ:  In a way, it’s a commercial that’s neutral.  It doesn’t really tell you what to think about specific ideas.

JR:  Yes, there are a couple of themes that you see because of these odd bedfellows coalitions.  And the first thing is, that they can’t get too specific without making one partner who is funding it mad or another.  So, you can’t go against the doctors and the hospitals for spending too much or for providing inadequate care when they’re picking up some of the bill.  It’s quite unseemly.  And so that’s one of the reasons that it’s soft.  But the other reason that it’s soft – and this is one of the big problems that the pro side has had – is that right now they really need to make the case to people who already have their insurance, largely through their employer, so the case they are making is sort of a catastrophic, ok this will help you in broad ways that we can’t actually be that specific about , like controlling costs now, but what you really need to worry about is down the road, if something dreadful happened and you were kicked out of your insurance and then you were thrown into the individual marketplace.

JJ:  The message just seems to be: this status quo can’t be maintained. 

JR:  Right, a lot of the message is that way, but the problem is, the people that they want to influence right now aren’t that unhappy with the status quo, because they do have insurance.  Now obviously, if you have no insurance, you’re going to be much more likely to be supporting this.  So, they’re really aiming at that Middle America swath of people that have coverage, their costs may be going up every year, but still, if something dreadful happens to them, and they’re in a car accident or whatever, they are going to be taken care of.  So, that’s one of the reasons it has a calming tone.  The other thing too, in tone, is that when you’re advocating in favor of a change, you don’t want to make people too jittery.  So, you sort of want to have them a bit sedated or relaxed, because you want them to have faith that, yes, while things are bad now, we’re confident enough to make a change in a way that will be better for you. 

JJ:  Let’s take a look now at a commercial that was run by organizations that oppose changes in the current system. 

[ “Where Does It End?” from the Club for Growth]

JJ:  Now that was Senator Harry Reid, the leader of the Senate Democrats in Nevada.  Who was behind that?

JR:  That was the Club for Growth, and they are a conservative anti-tax group that’s been around for a while in Washington.  And you see in this ad, what has been happening increasingly, the ads are targeting specific lawmakers in specific districts. 

JJ:  And the theme is fairly representative of other commercials that have run that oppose some of the reform ideas on Capitol Hill? 

JR: Yes, it is, again, raising a lot of doubts on the government role and then making an invidious comparison.  In this case, the comparison is sort of interesting, because it’s to Wall Street, which by some accounts, certainly Obama and other people argue, you needed the government to step into because it’s broken.  But here, they’re basically trying to twist that argument and say, well, we’ve already spent so much money bailing out these unworthy companies and people who took out too-large mortgages, and now government wants to just hike up the deficit even more by expanding into this other area of the economy that it has not played as big a role in.

JJ:  As you’ve mentioned earlier, we’ve seen a flood of commercials during the August recess.  The Kaiser Family Foundation tracking poll that just came out showed that back in June, only 21 percent of Americans had seen, heard or read an ad like the one’s we’ve shown today.  Now we’re up to 45 percent.  What is the expectation about what may happen in September when Congress returns?

JR:  Well, so far, most of the actual legislative decisions are being made in particular committees, and the ads have, to some extent, been limited to those states where the lawmakers are.  And I think that it’s very likely that, should legislation progress in Congress, and come out and hit full floor of the Senate, come before the full House of Representatives, that you would see many more ads in many more states because there are more constituents that the various sides will want to activate.  The second thing, and I think one of the interesting things about the ads are, usually I associate, a lot of people associate, television political advertising as shrill and nasty, and actually, I think that these ads so far have probably been a bit more temperate than some of the scenes you’ve seen at the town hall meetings.  So, I think there’s a good chance, that just historically speaking, that the tone and the direct assault on particular players and lawmakers will get stronger as this goes on and people feel that the stakes get higher. 

JJ: Ok, we will check back with you.  Jordan Rau, thank you very much.  Thank you for joining us, I’m Jackie Judd.