Checking In With Consumer Union’s Jim Guest

This week, Consumers Union, the nonprofit organization that publishes Consumer Reports magazine, stepped into the fray of the congressional health care debate by airing a 30-second television ad supporting reform. Although the group is known for taking very public — and sometimes controversial — positions on a range of consumer products and services, it has never before broadcast a television commercial on a public policy question. In the TV spot, which began airing Monday in Washington, D.C., and will continue for two weeks, Jim Guest, the group’s president and CEO, said a health care overhaul is needed to limit consumers’ burden from rising health care costs.

Consumers Union also released this week the results of a national telephone poll in which respondents expressed significant concerns about the health care system. For instance, 59 percent of the 1,002 adults surveyed said that during the past two years they had experienced increases in health care costs beyond that of other expenses. For 73 percent of respondents, the greatest health care worry was that illness or an accident would cause a major financial loss. Seventy-three percent were anxious about not being able to afford health care in the future. Another 73 percent feared that insurance companies could deny them coverage.

KHN’s Jaclyn Schiff spoke with Guest about the poll results and Consumer Unions’ ad. He described the current debate as the “crunch time” for what may be “one of the biggest consumer issues” in the U.S. ever. Excerpts of the interview follow.

Q. What were some of the most surprising findings in Consumer Reports National Research Center recent poll?

A. The poll underscored that Americans are really being badly affected by the health care system today and they’re worried about the future. One really strong finding is that half of Americans, 51 percent, say they have actually put off medical care. They haven’t filled prescriptions. They’ve cut pills in half. They have not done follow up visits or medical procedures that were recommended by their providers. That’s half the population being affected right there.

Q. This is the first time that your organization has run a TV ad supporting a public policy position. Why now? Did the poll factor into the decision?

A. We made the decision to run the ad before we even had the poll [results]. We’ve been engaged in the health care arena going back to our founding in 1936. In the last few years we’ve been even more active. What is dramatically clear is that reform … is absolutely vital to getting costs under control, getting quality improved and providing consumers with care they need in an affordable fashion. This is the year for action. This is the year when we can actually achieve health care reform, which we first recommended back in 1939. So now it’s 70 years later.

We’ve seen it in our polling and we’ve seen it in other work that we do in terms of what’s on the minds of the American public. Clearly this is a very, very big issue. We also feel that this is a unique and one-time opportunity. That is part of why we’re saying the consumer voice has to be very much in the conversation and in the minds of legislators. [This issue] affects consumers and that is why we’re doing this and ramping it up even more than our normal active advocacy.

Q. A lot of angry comments about the ad have been posted on the Consumer Reports Health Blog. Are you concerned about how the decision to run it might affect your group’s reputation as an independent, unbiased consumer advocacy organization?

A. No, I’m not. Since we started, we’ve been public about our positions. We’ve never pulled punches before. No matter what we say — whether we’re saying Japanese cars are finishing higher than American cars — some people criticize us. [The criticism] is not going to hold us back from saying what we believe.

Q. Your ad calls on policymakers to act and pass a comprehensive health reform bill. What components should be included in the legislation?

A. First, absolutely, it has to cut health care costs. There are a variety of ways to do that. One is to have more competition among the health insurance plans. Another, over time, is to set some things in place that can really change the reimbursement system. … Right now doctors and hospitals get paid on volume and quantity not on quality. So the incentives are wrong. We also think that consumers need better information so that they can make informed decisions about hospitals, doctors, medical treatments, drugs or health plans. The other part of it is we really believe that health reform needs to cover everyone.

Q. What about the public option? Is it a necessary component of the legislation?

A. Yes absolutely. … There has got to be competition and competition among the health plans and health insurers. That is the best and most immediate way to achieve it.