“Hi I’m Flo! I want to thank the thousands of seniors who have written urging Congress to help seniors in need get Rx drug coverage. Please keep urging your Member of Congress to join hands with Citizens for Better Medicare to support bipartisan plans for Rx coverage. It’s the best way to ensure seniors get the medicine they need and still keep Medicare financially sound.”

But Flo didn’t pay for that ad, and neither did Ann and Fred. Citizens for Better Medicare, an organization funded almost entirely by drug companies deathly afraid of government controls, did. Yet you wouldn’t know that from the ad or even the organization’s Website. In fact, ads like this are beginning to reappear—just in time to misrepresent issues during the election cycle—and if the media does as bad a job deconstructing them as they did during the health-care debate of 1994, we won’t be able to sort through their distortions, or even know who paid for them.

Interest groups have been running issue ads for years. When U.S. steelmakers found themselves under pressure from imports they ran ads claiming that foreign makers were unfairly dumping their products. When Congress took up the North American Free Trade Act, labor, business, and other interests tried to influence the debate through ads. But issue ads really came of age in 1994 when those who supported and opposed President Bill Clinton’s health-care initiative spent over $100 million dollars, more than what Clinton and former President Bush spent combined in the 1992 election, says Kathleen Hall Jamieson, Dean of the Annenberg School for Communication at the University of Pennsylvania.

The most prominent ads, featuring the famous “Harry and Louise”—sponsored by the Health Insurance Association of America (HIAA), a vehement opponent of Clinton’s plan—consciously sought to disguise their big business backing by featuring actors posing as a middle-class couple in their home. In a series of print and TV ads, Harry and Louise voiced vague but powerful fears about the plan that ended up having an important influence on its eventual scuttling. With opponents of the plan outspending proponents by two to one, a study by the Kaiser Family Foundation, a non-profit, independent health-care philanthropy, found that slightly over half of the lawmakers who responded said that interest-group advertising “had a great deal of impact on the [health-care] debate.”

Mark Crispin Miller, a professor of communications at New York University, and issue ad watcher, emphatically agrees. “That campaign was really instrumental in shooting down Clinton’s plan. The ads seemed to have come from the grassroots but were really bogus grassroots organizations.”

While the Clinton health plan might never have flown, the ads prevented an honest debate. A study headed by Jamieson looked at 125 print and 73 broadcast ads on the health-care debate, run between January and October 1994, and found that they were “more often unfair than fair, more focused on fear than on fact and more often engaged in attack than advocacy.” Indeed 28 percent of the print ads and 59 percent of the broadcast ads were deemed unfair, misleading, or false.

Even more appalling was the lack of a role that the media played. The study found that “reporters did a poor job of contextualizing ads, assessing their fairness and accuracy and identifying their sponsors.” For example, most broadcast reports on the ads aired them with a full-screen, a move that “magnified their power and increased the likelihood that viewers would confuse them with news.”

Issue ads surely have some place in a society that encourages the free exchange of political ideas. But they subvert the democratic process because, unlike ads by political candidates or commercials, it’s not easy to figure out who is sponsoring the ads or what their motives are. Take the ads by Citizens for Better Medicare. Who would know from reading them or from any news report in the media that drug makers underwrite them? Who would know their motives? Who would know that, until this year, drug companies have worked ceaselessly to keep drugs from being covered under Medicare out of the fear that the government would then be able to dictate prices? Who would know that their plan seeks to derail the White House’s plan to reform Medicare?

Examining the truth of issue ads and who’s behind them is particularly timely and critical. Interest groups are poised to release a barrage of ads during the upcoming presidential election cycle and upcoming debates on Capitol Hill over the uninsured, patient rights, and drug coverage. On January 24, for example, a full page ad featuring Harry and Louise in their kitchen appeared in The Wall Street Journal:

“Look out Washington. It’s been six years since we’ve heard from Harry and Louise, but they’re back,” the ad proudly proclaims. The ad, part of a $1 million campaign, touts the HIAA’s plan to cover the country’s 44 million uninsured—deftly calling the plan InsureUSA. But the plan isn’t a real solution to solving the problems of the uninsured: it’s just a way to impede the progress of major health-care reform proposals.

Or take the radio ads from the (possibly intentionally) obscure group calling itself Americans for Economic Growth. The organization, which has no Website and no phone number or address in the Washington, D.C. area as most advocacy groups do, sponsored radio ads in the districts of four vulnerable freshman House Democrats, accusing them of trying to steal Social Security funds to pay for government spending. The ads strongly resembled TV ads by the National Republican Campaign Committee, which targeted vulnerable Democrats in late September 1999.

Crispin Miller freely concedes that “propaganda per se is a fact of modern life and doesn’t always require unmasking.” But when such campaigns are well funded, “democracy is simply not viable if the masquerade (of who and what interests are behind the ads) goes undisturbed.”

What’s the solution? Miller says that news organizations simply have to do a better job than they did in 1994. That means consistently analyzing the ads for accuracy and finding out who is behind them. The media should not only make coverage of issue ads a regular part of their campaign analysis, as some outlets do with occasional ad watch columns for political candidates. Media organizations should also maintain areas on their Websites where visitors can look up ads, and the news organizations’ corresponding analysis. Jamieson says that makers of issue and political ads and campaign strategists admitted to her, off the record, that ad watches have affected their behavior—at times making them tone down misrepresentations and sometimes making them pull ads altogether.

If journalists do their jobs better this time, it will be much easier for Americans to make headway in honestly solving some very serious issues.

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