Washington Post goes Minitrue

In Orwell's Nineteen eighty-four, Winston Smith works in the Ministry of Truth ('Minitrue') rewriting past pronouncements to fit the facts to the party's doctrine and to efface any traces of potentially embarrassing statements. If he were in DC today, Smith might be working instead for the Washington Post.

Over at the outstanding health-care reform blog of Physicians for a National Health Program, Dr. Don McCanne has caught the Post rewriting one of its stories seemingly in order to eliminate information embarrassing to Blue Cross Blue Shield Association (BCBSA). The original version of the story pointed out that BCBSA had commissioned a study by the Lewin Group research firm but, since BCBSA was dissatisfied with the results, the study never was released to the public. Later the WaPo revised the story and posted the new version on line – without however noting that it had been altered. The revised story completely eliminated the information about the suppressed BCBSA study.

Health-care analysis by the Lewin Group has been widely cited by Congressional Republican opponents of reform. Lewin claims that it provides independent and objective analyses of policy options.The Post story, by David Hilzenrath, demonstrated that Lewin has a considerable conflict of interest in health-care research. It is owned by Ingenix, a subsidiary of UnitedHealth Group, which is one of the largest insurers in the US. Furthermore, both the parent company and subsidiary were exposed by the New York Attorney General for having generated skewed medical data that was used to pad the insurer's bottom line.

Here is a part of the Post's story that was rewritten. First, the version as posted on line at 6:46 PM on July 22, 2009. The emphasis is mine.

Lewin's clients include the government and private groups with a variety of perspectives, including the Commonwealth Fund and the Heritage Foundation. A February report contained information that could be used to argue for a single-payer system, the approach most threatening to private insurers, [Lewin Vice President John] Sheils noted.

But not all of the firm's reports see the light of day. For example, a study for the Blue Cross Blue Shield Association was never released, Sheils said.

"Let's just say, sometimes studies come out that don't show exactly what the client wants to see. And in those instances, they have [the] option to bury the study -- to not release it, rather," Sheils said.

Asked to comment, Blue Cross Blue Shield Association spokesman Brett Lieberman said, "We're still working with Lewin on a study, and, you know, we don't talk about our studies until they're done."

In testimony last month to a House committee, Lewin disclosed its affiliation with UnitedHealth and Ingenix in its written submission, but in his oral testimony he did not bring it up until asked, according to a transcript.

"The Lewin Group is committed to providing independent, objective and nonpartisan analyses of policy options," the firm said at the front of its written submission to the Energy and Commerce Committee. "To assure the independence of its work, The Lewin Group has editorial control over all its work products," the firm added.

Notice that there are 262 comments on that version of the article at the WaPo website. The comments slow to a trickle after about 8 AM on July 23.

Now here is a rewritten version of that story, dated to July 23 but with no time stamp. This version has only 5 comments attached to it (beginning in the wee hours of the morning). Two sections of the story (bolded in the earlier version) have simply been excised. The excisions eliminate embarrassing revelations about (a) the non-publication of the study sponsored by Blue Cross Blue Shield (some of whose affiliates are in strong opposition to the Democrats' health care reform proposals), and (b) the seeming reluctance of Lewin Group to disclose its corporate ownership to Congress (though UnitedHealth has a vast stake in any reform proposals under consideration).

Lewin's clients include the government and groups with a variety of perspectives, including the Commonwealth Fund and the Heritage Foundation. A February report by the firm contained information that could be used to argue for a national system known as single-payer, the approach most threatening to insurers, Sheils noted.

But not all of Lewin's reports see the light of day. "Let's just say, sometimes studies come out that don't show exactly what the client wants to see. And in those instances, they have [the] option to bury the study," Sheils said.

"The Lewin Group is committed to providing independent, objective and nonpartisan analyses of policy options," the firm said in a recent submission to the House Energy and Commerce Committee. Though it is owned by UnitedHealth, the Lewin Group "has editorial control over all its work products," the firm added.

Neither version at the Post mentions that the story has been revised; that an alternate version exists; or that any 'corrections' needed to be made.

Although the PNHP blog doesn't notice this fact, another three paragraphs toward the end of the first version of the story were eliminated in the Post's rewrite. The eliminated paragraphs cited examples where the Lewin Group had positive things to say about the "public plan" under consideration. Here is what was deleted in the rewrite:

Lewin's findings have been somewhat distorted in the political debate. The firm's analysis of the public option is far from one-sided.

As Sheils explained it to the Energy and Commerce Committee, people would opt for the public plan because they would find it more attractive -- mainly because it would charge much lower premiums.

Politicians have argued that the public plan would place bureaucrats between patients and doctors. However, Lewin wrote that, like traditional Medicare, the federal program for the elderly, a public plan would do less than private insurers to restrict medical care.

Why this additional information also needed to be excised is far from clear to me.

Earlier in the article, a single word was changed. Here is the original sentence:

Ingenix supplied its parent company and other insurers with data that allegedly understated the "usual and customary" doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

The later version changes "usual" to "reasonable". No doubt this was just a matter of tidying up facts, but again, the Post can't be bothered to acknowledge the correction.

crossposted from unbossed.com