Contributor Trudy Lieberman has been tracking the progress of the 21st Century Cures Act through Congress. She’s previously written about how the bill would relax consumer safety protections related to medical devices. In a future post she’ll be examining how current FDA regulations are already allowing many faulty, unproven devices on the market — and how those devices are harming patients. Here she looks at the well-oiled public relations machinery that is propelling the industry-friendly bill toward passage.
In late August Sue Darcey, senior reporter for the The Gray Sheet, a trade pub that covers medical devices, noticed she was receiving e-mails almost every day from the House Energy & Commerce Committee, whose work this summer resulted in swift House passage of the 21st Century Cures Act. As I noted in a previous blog post, that legislation at its core would weaken FDA regulation of medical devices so they can come to market without any clinical trials. Darcey told me the committee generally sends out communications from its press office, but the latest crop seemed a bit unusual. “Literally I get one or two a day,” she said, adding “Upton (Rep. Fred Upton, a Michigan Republican who chairs the committee) is really, really pushing passage of this bill. Michigan is a huge medical device state.”
Of course, there’s nothing wrong or unusual about members of Congress cheerleading for their hometown industries, but given that the Cures Act has received so little critical media coverage, I followed up on Darcey’s tip. What I found was a steady stream of slick communications from the press office, including blog posts and messages labeled “ICYMI” (In Case You Missed It) to build momentum for passing the House bill and to create the appearance of inevitability of its passage in the Senate this fall or early next year. Since the end of May the committee has sent dozens of messages that recycle existing media stories about the Cures Act or that encourage new positive coverage that will propel it further along toward a White House signing ceremony.
“It wouldn’t surprise me if the industry had a heavy hand in all this,” said Vijay Das, the health advocate for Public Citizen, the Beltway’s premier consumer group, adding it’s striking “how corporate and well put together this effort has been.” If PR professionals working for medical device manufacturers did help create the messages, they were careful to downplay the obvious financial benefits that would accrue to their clients. The messages are designed to generate sympathy for sick children and others stricken with deadly diseases while leaving the matter of company profits to the foot soldier lobbyists who walk the halls of Congress. Media lobbying with a heavy emphasis on social media and coupled with old-fashioned arm-twisting have so far brought extraordinary results.
It’s hard to say whether the committee’s media efforts on behalf of this bill are the new norm in Congress. Das told me he didn’t think it was unusual. Committee staff members, he said, often worked for members of Congress and are used to making their bosses look good. Still, I checked the recent press output from the House Agriculture Committee and the Financial Services Committee and found it didn’t come close that from the Energy & Commerce Committee. Since May 28, the Agriculture Committee has posted only a couple of times on its blog and put out 2 ICYMIs, while Financial Services has posted on its blog 11 times (no ICYMIs). Compare the leisurely output of those committees to the relentless pace set by Energy & Commerce, with its 23 blog posts and 84 ICYMIs — the vast majority of which are devoted to promoting the 21st Century Cures legislation. Another important committee that seems to come close is Ways and Means, which posts at least a couple of times each week with messages promoting a very conservative agenda.
I wanted to talk to the committee’s press secretary Noelle Clemente, about all this, but she didn’t respond to my e-mail. Clemente once worked for the American Action Forum and the Heritage Foundation, conservative policy shops that know a thing or two about messaging. Indeed, some of the committee’s press outreach reminded me of that used by Heritage two decades ago when it began a media campaign to privatize Medicare, an issue very much alive today.
One tool perfected over the years calls for recycling previous media stories or op-eds, sometimes planted by a bill’s supporters or opponents, and the committee has done a lot of that lately. For a recent ICYMI, it dusted off a Forbes piece that noted, “Over the past 20 years, research at NIH has been making slow progress against cancer, increasing survival rates by about 1% per year…through a new initiative called 21st Century Cures Act, we have a chance to accelerate that progress.” When the Cleveland Plain Dealer published an op-ed, “Today’s Innovations are Tomorrow’s Cures,” by Energy & Commerce committee member Bob Latta of Ohio, it was attached to an ICYMI on August 17. Another ICYMI released August 12 recycled a piece, “A local push, in a sister’s name, for new cures,” in the Cincinnati Enquirer, about a local woman who was advocating on behalf of her sister and others who died of pancreatic cancer. The woman had written a guest blog on House Speaker John Boehner’s website. In September an ICYMI, “Groundbreaking Research Offers the Best Hope,” featured a piece from the Dallas Business Journal which reported, “It’s too expensive and takes too long to move medical discoveries to the patient’s bedside,” adding federal funding for biomedical research has dropped more than 22 percent in inflation-adjusted dollars since 2003.
Sometimes only quotes are recycled in blog posts labeled “What They’re Saying.” These present comments from newspapers, trade associations, disease advocacy groups, and sometimes serve up comments from important people like Francis Collins, the head of NIH. Several sent out since January give the committee another chance to reinforce its message.
The power of recycled stories and op-eds is obvious, but other themes laced through the committee messages are just as powerful. It’s hard to beat stories of sick kids, and there are plenty of them in the committee’s portfolio. “Our Friend Max” is one. Young Max, who suffers from Noonan Syndrome, a rare genetic condition, got to see the committee approve the bill 51-0. A blog post shows Max sitting in Chairman Upton’s seat and notes, “the legislation will help our good friend Max” whose mother, the blog post says, is vice president of the RASopathies Network USA, a disease group that advocates for cures for genetic syndromes.
Another post features Michigan twins Brooke and Brielle who “battle Spinal Muscular Atrophy (SMA) with bright smiles and the motto ‘I can and I will.’” Readers learn “their powerful voices helped pave the way for #Cures 2015,” the hash tag used for social media. A post sent out after the House passed the bill told of Gabe and “The Lost Boys,” who suffer from Duchenne Muscular Dystrophy, “the number one genetic killer of all boys in the world.” According to the post, they get the name “Lost Boys” because of “the lack of funding and awareness of this deadly disease.” The point of these stories: Failing to adequately fund research and delaying new treatments steals the only hope these kids have.
Tugging at the proverbial heart strings usually works. So do descriptions of the Act that create one-sided positive images that make their way to the public via media stories. When Roll Call features a commentary from a former associate FDA commissioner claiming that the Act would create “’a more streamlined drug approval system by revolutionizing procedures for clinical trials,’” who wouldn’t think the Act is good for them? Of course, neither the Roll Call piece nor the committee news release that it spawned mentioned that the author, Peter J. Pitts, in addition to being a former FDA official, has also been a high-ranking executive at global public relations firms that serve clients in the pharmaceutical industry. Phrases like the Act has “the potential of being one of the most transformational pieces of legislation that has come along since the National Cancer Act of 1971” and it “seeks to strengthen and modernize our health care system to help generate more cures” don’t come with an explanation of the downsides that might harm patients — like allowing medical devices on the market based on anecdotal evidence instead of clinical trials.
Another thread runs through the messaging—the cloak of bipartisanship—that has worked its way into the mainstream media. The Atlantic.com heralded the bill’s passage in the House as “A Bipartisan Victory for Medical Research in Congress.” The New York Times weighed in with “Bipartisanship Produces a Health Bill that Passes the House.” The Act provides additional funding for the NIH, the carrot to attract Democratic support. The $8.75 billion boost restores the agency funding to 1990 levels and was enough for Colorado Democrat Rep. Diane DeGette “to drag huge numbers of Democrats to vote for the bill,” says Sidney Wolfe, founder and now senior adviser to Public Citizen’s Health Research Group. “All you needed was a good Democrat to accomplish this.”
And, of course, you need money. Some of the funds to boost the NIH budget come from reducing Medicare payments to physicians who use old, outdated, X-ray machines. The idea is for them to buy new digital imaging technology or face steep financial penalties. It’s a good bet a lobbyist for some medical imaging company inserted that provision into the bill. Who did it? How much money will the client firm make by forcing docs to upgrade? Now that’s a story! But don’t look for a news release from the Energy & Commerce Committee to tip you off.