From our friends at Health Justice Monitor:
Health insurance industry opponents of universal coverage have invested heavily in social media to sow doubt about the benefits of health policies and to undermine public trust in government and evidence. Effective response requires understanding the public’s values and a multi-pronged communication strategy.
Generating Opposition to universal healthcare policies the United States: An analysis of private health industry advertising on Meta platforms
PLOS Global Public Health
July 16, 2025
By Kendra Chow et al.Abstract
In 2019, the Partnership for America’s Health Care Future (PAHCF), a private health industry lobby group, launched a campaign across Meta platforms (Facebook, Instagram) to generate opposition to universal health care policies in the United States. This study investigates the content and the themes prevalent in PAHCF’s campaign and how these might shape public discourse and perceptions around universal health care policies. Using qualitative content analysis, 1675 advertisements were examined on Meta platforms within PAGCF’s campaign. Inductive methodology was applied to develop a coding framework. Details of campaign spend and number of impressions advertisements received were also collected. The qualitative coding strategies identified three overarching foci: policy targets, claims and themes, and targeted appeal groups. These elements were found to strategically and mutually reinforce one another to generate the narrative that proposed universal health care policies will be detrimental to public health, the economy, and society. Analysis identified that PAHCF engages in strategies common among unhealthy commodity industries. Social media in this instance powerfully perpetuated PAHCF messages that undermined universal health care efforts and contributed to the commercial determinants of health impacts of this industry. These findings indicate that the private health care industry is participating in wider commercial determinants of health activities, acting to protect their profits to the detriment of public health. Like other campaigns by unhealthy commodity industries, PAHCF’s campaign is designed to increase doubt in the benefits of health policies, undermine public trust in government and evidence, and promote public alignment with their own messaging and preferred solutions. To counter such tactics, public health professionals need to gain a better understanding of the strategies unhealthy commodity industries utilize to deflect attention from their underlying health-harming intentions, especially through more novel platforms like social media.
Comment by: Don McCanne & Jim Kahn
This study shows that anti-insurance reform forces are aggresively exploiting the power of social media, our era’s central tool for disseminating ideas. The Partnership for America’s Health Care Future social media campaign cleverly crafts negative (and misleading) perceptions of a universal health care system.
Those of us advocating for universal, comprehensive, affordable health care have faced intense opposition, often from organizations like PAHCF. Such opposition has not relied solely on social media. Other avenues include political parties (both Republican and Democratic) and large media networks such as Fox News. These strategies have been all too successful at creating resistance and fear about an insurance approach that is functioning and appreciated around the world.
Support for universal health programs derives from a belief in social justice: everyone should have access to comprehensive health care that is kept affordable through progressive taxes. Opponents place a high value on each person being individually responsible for funding their own care, with a minimized role of government. The centrist consensus (GOP & Dem alike) is that free market dynamics and limited government programs like Medicaid will assure efficiency and (limited) generosity. However, anyone who has studied recent US health policy knows that the market model fails – neither efficient nor generous. The current system increases the wealth of investors by depriving lower-income individuals of needed care.
Could individuals across the political spectrum assemble to calmly devise a system that works of all of us? It appears not. Those supporting single payer, which requires funding based on the ability to pay, will never win the support of individuals who deem it unfair to require them to pay more, no matter how wealthy they are. In an age of billionaires, there seems to be rising inflexibility on this issue.
Ok, much education and persuasion is needed before we can gather to devise a functioning universal approach. Could we build this support through expanded social media? It certainly must be a central part of the strategy.
However, before we dive into persuasive techniques, let’s explore what substantive arguments might work. Both of us really like AI LLMs (large language models) for the ability to frame issues. Thus, to structure our thinking, we asked ChatGPT.
Let’s all ponder and critique this framework. In coming weeks we’ll refine these AI comments and build the persuasive arguments.
Prompt:
What factors make a person decide that society should support an equitable, universal financing system for health care that enables everyone to receive the health care that they should have, as opposed to the view that each person should be individually responsible for providing the funds that are needed to pay for their own health care, whether by direct payment or payment through insurance?
ChatGPT said:
The decision to support an equitable, universal financing system for health care versus an individual responsibility model is shaped by a mix of moral, cultural, economic, and practical considerations. Here are the major factors that influence which viewpoint a person adopts:
- Moral and Ethical Values
Belief in health care as a human right: People who see health care as a fundamental human right often favor universal systems, believing that access should not depend on wealth or employment.
Empathy and social solidarity: Those who place a high value on community welfare, fairness, and compassion tend to support systems that ensure no one is left behind.
Views on individualism vs. collectivism: In cultures or families that emphasize individual responsibility, people may lean toward self-financed health care. Conversely, collectivist values emphasize shared responsibility.
- Economic Perspectives
Risk pooling and efficiency: Some recognize that universal systems spread risk across society, lowering overall costs and avoiding the inefficiencies of fragmented, for-profit insurance systems.
Concerns about personal cost: People who believe they can afford their own care (or have good insurance) may resist universal systems because they fear higher taxes or subsidizing others.
Awareness of market failures: Those who understand that health care markets don’t function like regular markets (due to emergencies, unequal information, and lack of consumer choice) may see universal financing as more rational.
- Personal Experiences
Encounters with medical bills or gaps in coverage: A personal or family experience with medical bankruptcy, denial of care, or lack of insurance often shifts people toward supporting universal care.
Positive or negative experiences abroad: Exposure to universal health care systems in other countries can strongly influence perceptions.
Trust in existing insurance or employer coverage: People satisfied with their private insurance may feel less incentive to support systemic change.
- Knowledge and Awareness
Understanding of how health care is financed: People who learn that even private care is heavily subsidized (through tax breaks, public programs, etc.) may be more open to universal financing.
Evidence of better outcomes elsewhere: Awareness that countries with universal health care often achieve better health outcomes at lower costs can sway opinions.
Misinformation or myths: Some oppose universal systems due to beliefs that such systems mean “rationing,” poor quality, or lack of choice, even when evidence suggests otherwise.
- Political and Ideological Beliefs
Role of government: People who trust government and view it as a vehicle for public good are more likely to support universal systems. Those who distrust government often favor private solutions.
Perception of fairness: Some believe it’s unfair to require healthy or wealthy individuals to pay for others’ care, while others see universal care as a fair use of shared resources.
Influence of political parties and media: Political messaging significantly shapes opinions, with universal care often framed differently depending on ideological leanings.
- Social and Cultural Factors
Sense of social safety nets: In societies where public education, roads, and policing are accepted as communal goods, people are more likely to see health care in the same way.
Cultural attitudes toward poverty and illness: Societies that view illness as a personal failing may favor individual responsibility, while those that see it as largely random and unavoidable lean toward shared financing.
- Fear of Economic Insecurity
Job-based insurance concerns: People who fear losing health coverage due to unemployment or changing jobs may prefer universal financing for stability.
Desire for protection against catastrophic costs: Recognition that anyone can face unexpected illness can lead to support for collective risk-sharing.