That time a Koch-backed group spent millions to propagate an invented tale about a brain tumor
As a fresh debate takes place on the Affordable Care Act, it is worth taking a look at the multi-million dollar ad campaign a Koch-backed group broadcast across eight states in 2009 to promote a false story of a woman in Canada being denied treatment for a brain tumor.
The “Survivor” ad was sponsored by “Patients United Now,” an offshoot of “Americans Prosperity Foundation,” a conservative political advocacy group founded by billionaire chemical magnate David Koch. In the ad, seen above, Shona Robertson-Holmes (listed as “Shona Holmes”) narrates her story as follows: “I survived a brain tumor. But if I had relied on my government for health care I would be dead. I am a Canadian citizen and as my brain tumor got worse my government told me I would have to wait six months to see a specialist. In six months I would have died.”
None of those four statements are true, according to subsequent media coverage. Holmes never had a brain tumor. As Julie Mason reported in the Ottawa Citizen, “On the Mayo Clinic’s website, Shona Holmes is a success story. But it’s somewhat different story than all the headlines might have implied. Holmes’ ‘brain tumor’ was actually a Rathke’s Cleft Cyst on her pituitary gland. To quote an American source, the John Wayne Cancer Center, ‘Rathke’s Cleft Cysts are not true tumors or neoplasms; instead they are benign cysts.’ There’s no doubt Holmes had a problem that needed treatment, and she was given appointments with the appropriate specialists in Ontario. She chose not to wait the few months to see them. But it’s a far cry from the life-or-death picture portrayed by Holmes on the TV ads or by McConnell in his attacks.”
Describing herself as a “self-employed” patient advocate, Robertson-Holmes has since gone to make a career out of attacking public health insurance programs. Interestingly, her website, shonaholmes.com, has Sean Noble of DC London listed as the registrant contact. Noble is a former congressional aide who distributed $137 million on behalf of the Kochs in political spending during the 2012 election, according to ProPublica, and has a long back story (see more below). Six weeks before the 2012 election, she visited Ohio on behalf of the 60Plus Association, another Koch-backed group. Holmes’ Twitter feed, maintained from 2013 to 2015, details her many media appearances and is filled with blasts against Canadian health care. In 2014, she spoke at a CPAC panel that also featured then Oklahoma attorney general (now EPA Administrator) Scott Pruitt.
National Review reports on the “Surivor” ad’s success in setting the tone for debate about the Affordable Care Act: “The ad blanketed the airwaves on Fox News; CNN’s Dana Bash flew to Ontario to interview Holmes and tell her story; and Jake Tapper, then of ABC News, took questions about her case to Canadian prime minister Stephen Harper.”
Showing the ad to viewers on Fox News before an interview with Robertson-Holmes, a gullible Megyn Kelly said, “That is incredible. That warning is a part of a new ad campaign predicting the perils of state-run health care.”
She then asks Robertson-Holmes, “Your doctor in Canada diagnoses a brain tumor because you’re having vision problems. So you went in, you got checked out, they diagnosed the brain tumor and after they know it’s a brain tumor they say you have to wait months before you have to wait months before you can get to a neurologist?”
Robertson-Holmes doesn’t correct Kelly’s description of the diagnosis as a brain tumor and instead says, “This is exactly what happens and unfortunately I’m not just one story. There’s so many out there like me.” She repeated this tale again before the House Energy and Commerce Committee in June 2009 stating, “If I had relied on my own government-run health care system in Canada, I would not be sitting here before you today.”
Coupled with Tea Party protests- also receiving heavy Koch network financing– the anti-ACA ad campaigns flooding the airwaves in 2009 and 2010 helped to shift Congress, while completely distorting the actual legislation contained in the Affordable Care Act. CBS News reported on Nov. 3, 2010, “Congressional Democrats suffered their worst electoral defeat in decades, losing more than 50 seats in the House of Representatives.”
Unwilling to take on the popularity of most provisions within ACA (allowing children to remain on a parents’ insurance until age 26; requiring that insurance be offered to people with so-called ‘pre-existing conditions; ending lifetime limits; mandating that large companies provide health care, etc.), the Koch network resorted instead to propagating a lie that President Barack Obama was instituting “Canadian-style” health care which would lead to long wait times and denial of care (bracketing aside the question of whether this assessment of the Canadian system is even a correct one). The Affordable Care Act is based around private insurers and an individual mandate, making it similar to the health act enacted earlier by then-Governor Mitt Romney in Massachusetts and bearing little resemblance to Canadia’s province-operated single-payer system.
Calvin Woodward wrote for the Associated Press, “[Robertson-Holmes] never had cancer — a fact routinely omitted by the advocates who have seized on her case. Technically, she didn’t have a tumor, either. She had a benign cyst that was apparently threatening her eyesight. Holmes’ decision to come to the U.S. exposed her both to the best of American health care and the worst: its capacity for prompt, advanced treatment for complicated conditions, and its staggering expense… There’s no question many Canadians wait for care they’re anxious to get. A trade-off of guaranteeing coverage for all and paying medical bills mostly through taxes is that people often wait to be treated for conditions that may be serious but — rightly or wrongly — are not judged urgent. Even so, across a range of diseases monitored in Canada, the average waiting time before seeing a specialist is typically measured in days or a few weeks, not the four to six months reported in Holmes’ case.”
The Koch-backed group Patients United Now followed up its 2009 ad with a 2012 sequel called “We Must Replace President Obama,” also featuring the Canadian Robertson-Holmes, this time spending $6.2 million to broadcast it in eleven swing states. For this ad, the cyst was not depicted as a “brain tumor” but as a “life-threatening brain condition.” After Robertson-Holmes discussed having deteriorating vision and being forced to seek care at the Mayo Clinic because of wait times in Canada, a text is displayed on screen stating, “But under President Obama, America’s health care is becoming more like the Canadian system that failed Shona.” Why a Canadian would be so engaged in America’s health care debate is not exactly clear.
National Review wrote of the AFP ad campaign, “The ads themselves, which have inflamed Democrats this election season, represent five years of knowledge, accumulated through polls and focus groups, about how to use the health-care issue to pull Americans into the GOP camp. With AFP having spent over $30 million so far this year to bring down sitting Democratic senators, the ads also symbolize the changing nature of American politics. Since the Supreme Court’s 2010 Citizens United decision, unlimited outside spending by 501(c)(4) social-welfare groups has finally allowed Republicans to match the political muscle of labor unions, whose spending was also blown open by the decision, but which have long poured money into Democratic coffers.”
Noble distributed money channeled by the Koch brothers and partner donors through the “Center to Protect Patient Rights,” since renamed American Encore– some of it illegally funneled into direct electioneering, resulting in hundreds of thousands of dollars in FEC fines.
Frank Luntz– who invented terms like “death tax” (for estate tax) and “energy exploration” (for oil drilling)– and Larry McCarthy, producer of the 1988 Willie Horton ad, were brought in to help craft and produce the ads.
National Review outlines CPPR’s origins:
The Koch network’s anti-Obamacare assault began in 2009 with Sean Noble, a former chief of staff to Arizona congressman John Shadegg and then an adviser to the Koch brothers, and Randy Kendrick, the wife of Arizona Diamondbacks part-owner Ken Kendrick and a prominent donor to the Kochs’ formidable fundraising network… The result of Kendrick and Noble’s efforts was the Center to Protect Patient Rights (CPPR), which was incorporated in April 2009 and funded largely through donations from the Koch network… With that largesse, CPPR produced dozens of ads that targeted hundreds of Democratic congressmen in the 2010 midterm elections, when Republicans regained 63 seats and recaptured the House majority in the largest midterm romp since 1938… CPPR funneled money to multiple groups, Noble says, both to protect the anonymity of donors and because IRS regulations prohibit any individual ©(4) group from spending more than 50 percent of its time on candidate-related political activity. In 2010, though, the activity of the groups was extraordinarily well-orchestrated, with no two groups airing ads in the same congressional district. Attack ads against Democratic incumbents blanketed the country: The 60 Plus Association spent to air ads in Arizona’s 1st congressional district, Florida’s 2nd and 24th, Indiana’s 2nd, Minnesota’s 8th, New York’s 20th, Ohio’s 16th, Pennsylvania’s 3rd, and Wisconsin’s 3rd and 8th, for example, while Americans for Job Security put up ads in New York’s 24th, North Carolina’s 2nd and 8th, Ohio’s 18th, and Virginia’s 9th. The American Future Fund put up spots in Alabama’s 2nd, Colorado’s 7th, New Mexico’s 1st, and Washington’s 2nd.
BillMoyers.com reports, “The Koch network is better understood not as a labyrinthine tangle of funding flows, but as an evolving set of core organizations directly created and funded by the Kochs and run by their close associates. Our research has documented a complementary and tightly coordinated set of entities, each of which performs important functions in the overall Koch political operation.”
Kim Barker and Theodoric Meyer provided a 2014 update on a disgraced Sean Noble for ProPublica:
Noble appears to have lost his central position in the Koch empire, undone by poor election results and a California investigation that shined an unwelcome light on some of the Center’s inner workings, insiders say. But his story shows how the Supreme Court’s landmark 2010 Citizens United ruling has given rise to a new breed of power brokers who control a growing pool of money raised in secret and spent to influence politics in ways that voters can’t always trace.
Much of Noble’s work in 2012 remained invisible to the public until the Center and dozens of other Koch-backed nonprofits released their tax returns late last year. An examination of those tax returns, along with court records and filings with the Federal Election Commission, shows that the Center to Protect Patient Rights bent state election laws and federal tax rules governing how such groups are supposed to operate. Millions of dollars the Center told the Internal Revenue Service it gave to other groups only for “tax exempt education and social welfare purposes” were actually spent on election ads and other political activities. Experts on nonprofit law said it’s the donor’s responsibility to follow up on grants if they were not spent as required.
Meanwhile, together with a network of conservative donors, many of them fellow billionaires, the Koch brothers have continued their efforts to remake American politics, leading (arguably) to the Trump age.
The Associated Press reported back in 2015, “Officials for the Koch Brothers’ political organization announced Monday that the group has budgeted a whopping $889 million for the 2016 presidential campaign. That is more than double the approximately $400 million it spent in 2012… The Kochs inherited their father’s company in Kansas, and turned Wichita-based Koch Industries into the second-largest privately held company in the nation. The conglomerate makes a wide range of products including Dixie cups, chemicals, jet fuel, fertilizer, electronics, toilet paper and much more. William and Frederick cashed out in 1983 and no longer have a stake in the company… With a fortune estimated at $41 billion each, Charles and David tie for fourth on Forbes’ list of the richest Americans, and tie for sixth on Forbes’ worldwide billionaires list.”
Uncomfortable with Trump’s nomination and some of the economic policies he proposed (e.g., spending billions on a border wall), the Koch brothers later dialed down their plans to spend on the presidential campaign, focusing their money on other races. But they were hardly incidental to Trump’s surprise victory– especially given the Republican nominee’s own failure to invest in a ground game. Talking Points Memo reports:
Despite loud pronouncements from Charles Koch that his network would not support Trump, the Kochs’ massive political operation worked over many months to turn out Republican voters in key states. Above all, AFP was deeply involved in get-out-the-vote efforts, especially in the critical swing states of Florida, Wisconsin, Pennsylvania, and North Carolina.
Publicly available numbers suggest that AFP’s grassroots organizing made a real difference — and indirectly helped Trump, who had little campaign capacity of his own. In Wisconsin, for instance, AFP claims that it reached over 2.5 million voters in phone banking and canvassing efforts. In North Carolina, AFP claimed over 1.2 million calls and 120,000 door-to-door efforts, or nearly the entire reported margin of victory for Trump. And in Pennsylvania, AFP claims it made over 2.4 million phone calls and knocked on over 135,000 doors, more than twice Trump’s margin of victory in that state. AFP’s grassroots efforts were especially pronounced in Florida, where AFP boasts that its people knocked on a record-breaking one million doors throughout the state to help re-elect Senator Marco Rubio. Hillary Clinton lost the state by just over 100,000 votes. In all four of these states AFP helped to re-elect the incumbent Republican Senator and make important down ballot gains. Obviously, given what we know about the decline of split ticking voting, most of the same citizens AFP mobilized for state and Congressional contests also cast ballots for Donald Trump.
Beyond AFP’s mobilization in the run-up to Election Day, Trump and other Republicans were likely buoyed by longer-term efforts pursued by the Koch network across the states. Enacting voter ID laws and legal measures to eviscerate the organizing and bargaining rights of labor unions have been two of ongoing efforts of the Koch network — which always prioritizes steps to undercut the fundraising and organizational capacities of liberals and progressives. AFP and other Koch groups have worked closely with other right-wing allies to enact “right to work” measures and laws that make it hard for unions to hold members or wield organizational capacities in elections and policy battles. Their efforts have paid off handsomely in the form of abrupt declines in union membership and clout in Wisconsin and Michigan, two states that Trump won by a hair on November 8. Observers also believe that Wisconsin’s voter ID law had a significant impact in lowering black voter turnout in Milwaukee.
While the Koch brothers did not back Donald Trump (Charles Koch famously said that choosing between Hillary Clinton and Donald Trump was like choosing “cancer or heart attack”), it did not take them long to sink their tentacles into his administration. The Center for American Progress reported last month, “As of January 12th, 342 people have joined Trump’s transition team to fill 390 positions. Of those 342 people, 107 are associated with the conservative billionaire Koch brothers. This means almost a third of Trump’s team is part of the Koch’s elitist establishment that Trump promised to distance himself from when he was campaigning.”
On Thursday, Vice-President Mike Pence told attendees at the annual CPAC conference, “”Let me assure you. America’s ObamaCare nightmare is about to end.”
For many, though, the “nightmare” may just be beginning.
As many as 32 million Americans will lose health insurance if Republicans repeal the Affordable Care Act, according to the Congress Budget Office. That will be a lot of people losing access to treatment for cancer, brain tumors or anything else.
In a series published in Glamour called “The Affordable Care Act Saved My Life,” health care survivors wrote of the difference Obamacare has meant for them.
A woman named Abby S. wrote:
When I was 10 months old, I was diagnosed with congenital toxoplasmosis, a parasitic infection that a mother can pass to her unborn child without even knowing she has the parasite. It’s a rare disease, and few people have heard about it. Not long after my diagnosis, I had my first brain surgery to place a shunt that would help drain fluids. Luckily, my parents were able to insure me through their business before it became clear that this would be a chronic illness. If that had not been the case, I’m not sure where I would be.
I was pretty healthy until I was about 14 and started having problems related to the toxo. I began losing vision in my left eye and eventually lost almost all of it. When I was 16, I had my first shunt failure. I had multiple eye surgeries. I also somehow managed to pick up E.coli — to this day, I still don’t know how. Because of my surgeries and the E.coli, I was put on Daraprim for over a year and a half. At the time, this medication was about $13 per pill; today it costs $750 per pill (we can thank Martin Shkreli for this price hike).
Because I was having so many surgeries, my parents soon sat me down to tell me a hard truth: Insurance plans came with both annual and lifetime limits for the coverage they offered. If I kept having surgeries, it was quite possible that I would hit those limits and we would have to figure out how to pay for my care. I went through most of my life not really thinking about the consequences of having a chronic illness. I didn’t really understand what pre-existing conditions or lifetime and annual limits meant. I didn’t know that I would have to find a new health plan once I turned 22. I come from a working-class family. They own a small manufacturing company. Paying my premium every month was an enormous financial burden — and it was just for me. I began thinking about what it would mean if I couldn’t have health insurance. It was frightening…
Because of the ACA, and the sheer luck that I hadn’t hit my lifetime limits, I was able to stay on my parents’ plan till I turned 26. They’re on Medicare now, but I have insurance through my employer. If Congress repeals the ACA, it will only mean bad things for my care and coverage. My shunt can fail at any time — just like it did last October. It comes out of nowhere: I’ll be fine and then, all of a sudden, I’ll be really sick. I won’t know where I am or who I am. I’ll need emergency surgery. I could lose my other eye within a matter of 24 hours. The only medicine that treats my disease is $750 a pill. I couldn’t afford that without health insurance. If insurance companies go back to refusing to cover certain medications, treatments, or pre-existing conditions — or if they return to high-risk pools — I’ll be out of luck. This doesn’t work for me. It doesn’t work for anyone with a congenital or serious chronic illness. Not everyone is as privileged as I am to have employer-based coverage. If Congress repeals the ACA, we’re looking at a future in which millions of people are going to be very sick.
Another woman, Chinelo O. wrote:
I was diagnosed with Hodgkin’s lymphoma about three weeks after graduating from college. I was given nine rounds of chemotherapy, but they didn’t work. Usually, that treatment does the trick, so my doctors switched me to another treatment. I had a stem cell transplant, because usually, without that, the cancer has a 90 percent chance of returning. My transplant decreased that to about 40 percent. I had several surgeries and 16 more rounds of another chemo. I then was given a preventive chemo treatment to further decrease the chances of my cancer coming back. Because my first treatment didn’t work, my doctors gave me this more aggressive one to knock the cancer out. With three of those, I was in remission.
For my stem cell transplant alone, I was in the hospital for about 20 days and racked up a bill of almost $1 million. Because of the Affordable Care Act, I was able to stay covered under my mom’s work insurance, even though I had graduated from college. We were still paying for my treatments, but they were much less than they would’ve been without insurance. Actually, I would’ve died without the ACA. No one can really afford multimillion-dollar cancer treatments.
Yet another, Mina S., wrote:
I was 25 when I was a graduate student at the University of Missouri and had health insurance through the university. Following graduation, I planned to join the Peace Corps. The Peace Corps didn’t start for another nine months, so I had time to kill in between. I planned on taking a temporary job to pay the bills, but that job did not provide health insurance. My parents foresaw this gap in coverage and told me there was a new law — the Affordable Care Act — that would allow me to be on their insurance until I was 26. They asked if I wanted to join, and I said sure. I was young — and healthy — and hadn’t thought about my insurance ending. Then, a few weeks after graduation, when my insurance would have ended, I received a cancer diagnosis. It was an aggressive bone cancer mostly found in kids and teenagers. I was a little old to have it, so it was pretty shocking.
I had five surgeries and a year of mostly in-patient chemotherapy. My insurance basically saved my family from bankruptcy. I could be dead if it weren’t for access to health care during that time. I got a lot out of the ACA, and it didn’t cap my benefits. There are out-of-pocket limits for how much I could be charged, so most of my medical care was covered. Without the ACA, my family and I would have been taking out loans and potentially filing for bankruptcy.
Those are the survivor stories we should be hearing.
