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Archive for April, 2010

In the News

Posted in Access to Medicines, Discrimination, Economics of Health Care, Ethics, Health Care Marketing, Health Care Reform, Health Insurance on 25 April 2010| Leave a Comment »

Drug Prices Rose 9.1% Last Year, Ahead of Federal Health Overhaul

Drug companies sharply raised prices last year, ahead of increased rebates they must pay to Medicaid and other expenses tied to the federal health overhaul passed last month.

WellPoint routinely targets breast cancer patients

Shortly after they were diagnosed with breast cancer, each of the women learned that her health insurance had been canceled….

………WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Pharmacy board approves small type for drug labels

The public sent more than 1,000 pages of letters to the board, urging the adoption of a larger text requirement on drug labels. It is the most letters the board has ever received on a topic, the panel’s executive officer, Virginia Herold, has said.

The California Board of Pharmacy had been poised, in January, to adopted the larger type size. But the day before the vote, Gov. Arnold Schwarzenegger appointed a drugstore executive to the panel, who cast the decisive vote to kill the plan, The Times reported.

The California Retailers Assn., a major Schwarzenegger donor, had lobbied heavily against the large type size, saying it would cause drug bottle to balloon, adding costs to consumers.

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KFC, Susan G. Komen, and Emesis Basins

Posted in Cause Marketing, Health Care Marketing, Promotions on 22 April 2010| 3 Comments »

Didn’t think that fast food cures cancer?  Well think again, as now there are pink buckets for the cure.

Last week another linkage between the promotion of unhealthy food for a big box health charity made headlines and generated buzz in the blogsphere.  This time it was KFC which launched its ” Buckets for the Cure”  promotion,  a fundraiser for Susan G. Komen Breast Cancer Foundation. The main company website now sports a hot pink background, and on the Buckets site, the Colonel is now pink, and there is an image of the  pink  serving bucket  The buckets feature photos of real life breast cancer survivors. Here’s  how the promo works :

Participating KFC franchise locations will be selling specially designed pink buckets of grilled and Original Recipe chicken. KFC has pledged 50 cents to Komen for every pink bucket ordered by its restaurant operators during the promotion period, with a minimum donation of $1 million and a goal to raise more than $8 million.

KFC Pink Bucket

Fine print at the bottom of the company website further explains that the funds to be donated to Komen come directly from the purchases of pink buckets  by KFC franchise owners,  who buy them for their stores,  between  April 5-May 9, 2010, and that “Customer purchases of KFC buckets during the promotion will not directly increase the total contribution.” The KFC  Pink Buckets website urges viewers to ” Help Make the Largest Single Donation to End Breast Cancer Forever “, and links to a Komen online donation form, which sports the pink Colonel Saunders logo. In other words, just buying a pink bucket of KFC chicken does not generate a donation to Komen, although consumers may think it does.

KFC materials do not explain exactly how the corporate donation to Komen will end breast cancer, merely  talks about need to raise awareness, and links out to the Komen site. Commentary about the promotion around the web ranges from  praise for a new way to help “the cause,” to  increasingly, critical analysis of why  promoting consumption of high fat, high sodium, high calorie food is problematic for health in  general, and for cancer prevention in particular, including breast cancer.

One of the most cogent deconstructions of what’s wrong with the campaign from both health and cause marketing viewpoints was an article by Scott Henderson entitled Cause Dissonance: KFC and Komen Buckets for the Cure, on his Rally the Cause blog. Using easy-to obtain data, Scott  explained a few facts:

Here’s what I learned from KFC.com (which currently features the Double Down wrapped in pink):

  • KFC lists its nutrition facts based on individual pieces of chicken, not the bucket.
  • Buckets come in 8, 12, and 15 pieces. You can choose between original recipe, extra crispy, spicy, or grilled. And you get wings, thighs,drumsticks, and breasts.
  • Assuming you like original recipe and buy a standard 8 piece bucket for your pink bucket, you’ll bring home 1,600 calories and 90 grams of fat. If extra crispy is more your style, say hello to 2,380 calories and 160 grams of fat.
  • If four people split the bucket, you’ll average 400 calories and 22.5 grams of fat (original recipe) or 595 calories and 40 grams of fat (extra crispy).
  • Calories from fat in the pink bucket is 49% (original recipe) and 60% (extra crispy).

Then I searched for daily nutrition guides and found this from the American Heart Association:

  • Without any sides or beverages, two pieces of chicken total 22-33% of the recommended caloric intake for women age 31-50.
  • For optimal health, total calories from fat should be 25-30% of your diet. Now compare that to the 49% and 60% that your pink bucket gives you.

As word of the pink bucket hype spreads, it’s encouraging to see that there is increasing awareness of  how inappropriate this campaign is, and that it’s not just about KFC finding a  new way to promote unhealthy food or improving its corporate image,  but that Komen is equally to blame for choosing this alliance.   Hopefully the critical reviews mean that the work of  groups like  Breast Cancer Action , one of the first to sound the alarm about  problematic pink cause marketing , is bearing fruit. BCA  has held its Think Before You Pink campaign each October ( Breast Cancer Awareness  Month)  since 2002, to educate the public about what’s really going on.  BCA is notable as one of only a handful of independent disease organizations–it accepts no industry funding– which also addresses social and environmental issues about the illness, plus offers patient  services. Visitors to the BCA website can now add their signatures to a letter  to Tell KFC and Komen to stop the pinkwashing!

This pinkwashing is especially egregious because KFC, like most fast food chains, is overwhelmingly present in communities that have poor health outcomes.  Susan G. Komen for the Cure knows that social inequities affect breast cancer mortality rates. Given this disconnect, we are especially disturbed by this partnership. It’s preposterous, and we have to tell them to stop.

Hat tip  for alerting me to this  new campaign goes to fellow Seattleite Jeanne Sather,  The Assertive Cancer Patient,  who  has been writing about the pink promotions for some time, and has held  “How LOW Will Komen Go” contests  for the past  3 years on her blog. Readers submitted entries with illustrating the most offensive pink products being hyped each October.  You can read the mind-boggling entries, many complete with photos,  for 2007, 2008, and 2009 plus extensive reader commentary.   While not all the products now on the market are tied to Komen campaigns, the organization is now synonymous with pink ribbon cause marketing, which itself has a controversial history.

And why my mention of emesis basins?  As a cancer survivor, the first thing that came to my mind when I heard about the pink buckets, was the image of those hospital puke pans ( taking a little liberty on the shape) which I’d used so often. And their large-sized cousins, the wash basins often needed for their greater volume, are frequently pink.  The pink buckets promotion made me feel sick to my stomach.

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For health’s sake, a dose of sunshine focused on the golden arches

Posted in Assistance, Cause Marketing, Discrimination, Ethics, Health Care Marketing, Language Access, Nutrition, Workers' rights on 11 April 2010| Leave a Comment »

More recent heartening news — literally and figuratively– was the March 31 launch of the “Retire Ronald” campaign by Corporate Accountability International.  CAI began work  in the late ’70s as INFACT ( Infant Formula Action Coalition) , to create global awareness  and action to curb the inappropriate marketing of baby formula in poor countries which caused devastating health and economic effects.  Today the organization campaigns to change harmful corporate practices in many fields. Health continues as a major focus, so mounting concern about the now-global problem of childhood obesity prompted its new Retire Ronald campaign. Fast food, today an international industry, is part of the problem;  McDonald’s business success its emblematic of its pervasive and detrimental reach.   Since its start almost 50 years ago, McDonald’s has utilized an array of multimedia marketing pitches, both overt and subtle, specifically targeting children.  The ubiquitous ads and events, in all their forms,  often feature Ronald in likeness or in person.  Detailed information about the Retire Ronald campaign, including  deconstruction of ads and  backgrounders on promotional  techniques used by McDonald’s , and a 28-page  report Clowning with Kids’ Health: The Case for Ronald McDonald’s Retirement, can be found the CAI website and the group’s Facebook page.  Readers also have the opportunity to sign an online retirement card to convey their messages to McD’s corporate office.

Companies the size of McDonald’s are able to utilize multiple venues and a range of techniques to disseminate their messages to potential customers of all ages: children,  youth, and adults. Of McDonald’s several websites, for example, its corporate site features a special section for students, which touts the many facets of its corporate social responsibility plus information on job and scholarship opportunities. In the FAQ section along with facts on company  operations,  item #14 in the Q & A  presents distorted information about nutrition :

Isn’t it healthier for me to make lunch for my kids rather than buy it at McDonald’s?

Actually, a 4-piece Chicken McNuggets with Apple Dippers and milk contains fewer calories and fat than a homemade grilled cheese sandwich, cup of tomato soup and glass of lemonade.

Not only is the question not answered (and seems to address parents, not students) only a single type of McDonald’s fare is compared to single type of homemade meal, hardly a valid analysis!  Parsing out comparisons between numerous McD items in contrast with a full array of possible home-prepared lunches could be the basis for an excellent lesson plan in independent living classes, for example.

Ronald McDonald has his own website directed at children with interactive online games, and messages informing parents that the activities help kids develop their fine motor skills . The main company site features products, nutrition information and special promotions along with “multicultural marketing” pages targeting at young African-American,  Asian American ( with sections in Chinese and Korean) and Latino customers, the latter version in Spanish.

Through my own work that spans involvement with Healthy Skepticism ( an NGO which aims to  promote health by countering misleading promotion of medicines) and my background as a nutrition educator and a mom of  children now grown , I was glad to learn of the Retire Ronald campaign.  My interest was further piqued because in the advocacy world too, I’ve been hearing other concerns related to Ronald, that make one wonder just how family-friendly he really is.

For starters, beyond just  problematic promotions,  is the fact that there are McDonald’s restaurants located in hospitals ,including in at least 30 in childrens hospitals around the country.  According to a 2006 study published in Pediatrics, some 30% of  all US hospitals had fast food restaurants located on their premises.  The researchers also found that:

…the presence of a McDonald’s restaurant in a children’s hospital was associated with (1) increased fast food purchasing by parents, (2) the belief that McDonald’s Corporation was a hospital benefactor, and (3) more positive perceptions of the healthiness of McDonald’s food.

And when hospitals try to put words into action with their own health messages to patients and families, by eliminating  fast food , they have faced corporate pushback.  This was the experience of a new CEO at the Cleveland Clinic ,which specializes  in cardiac care, when he tried to break a 10-year lease with McDonald’s.

The company’s clown mascot is further  known around the world through his namesake Ronald McDonald House Charities . RMHC sponsors Ronald McDonald Houses, which meet the vital lodging needs of  families of seriously ill children being treated at hospitals outside of their home communities. Reviews of  company history have revealed that McDonald’s got involved with charitable work not purely out of altruism as is commonly believed, but to enhance its own image and thus its bottom line,  through branding opportunities . According to research cited by CAI ( see pages 5 and 27 of the full report)  Fred Turner, former McD’s CEO and Chairman once told an interviewer:

We got into it [ charitable work] for very selfish reasons,  It was an inexpensive, imaginative way of getting your name before the public and building a reputation to offset the image of selling fifteen cent hamburgers. It was probably ninety-nine percent commercial.

RMH facilities are lodge-style  homes-away-from-home , usually situated adjacent to hospitals, in cities around the globe. The Houses in the US typically charge $10-$25 per night and RMHC Global has a universal access policy as part of its mission, stating that:

…..families either stay at no cost or are asked to make a donation up to $25 per day, depending on the house. The RMHC Global Policy is that families are never turned away; if its not possible to pay, the fee is waived.

There is a great need for this service, as in addition to the medical expenses, families also face enormous uncovered non-medical costs just at the time when income is decreased due to the sick child’s hospitalization and care needs.  With  hospital stays typically lasting  from weeks to many months, even paying for  subsidized temporary lodging ,while also paying rent or a mortgage back home, may be impossible.  As illustration of the  great demand  for lodging support are the facts that many RMHs keep waiting lists, and that many like the RMH in San Diego, report having had to turn away hundreds of families each year due to lack of space.

RMHC is  a 501(c)3, tax-exempt US charitable organization, separate from the McDonald’s Corporation, it’s principal corporate sponsor.  The RM Houses are run by local chapters of the  RMHC, and each chapter is incorporated as an independent  charitable organization in its home state, and conducts local fundraising, including at McDonald’s stores . For more about the links between McDonald’s and RMHC, see Our Relationship with McDonald’s.

There is the irony  of course that this essential healthcare support service is so heavily supported by the sales and promotion of unhealthy food.  But there are other issues too about the conditional welcome, or even exclusion, that some families may encounter at individual RMHC  facilities, and how RMH employees may be treated.

There seems to be some variability in the universal access policy, although the vast majority of the RMHC chapter websites that I reviewed– including  Springfield, MO,  Philadelphia, Minneapolis, Seattle,  Austin, TX,  Cleveland,  Los Angeles, just to name a few– explicitly state that no one is ever turned away because of inability to pay.  In New York City however, this does not seem to be the case, as their RMH website says only that There is a $35.00 fee per night, per room to stay at Ronald McDonald House of New York, and offers no information on flexibilities.

While Salt Lake City  RMH too has the open financial policy, published on its website is the stipulation that “For those who do not speak English an interpreter will need to accompany them on their first visit“. I’ve heard anecdotally that telephonic interpreting is not acceptable , although this service is commonly utilized by hospitals to complement live interpreter services.   Especially for families arriving after business hours, this requirement can be impossible to meet;  it resonates as mean-spirited and  exclusionary.  The Birmingham AL  RMH  website states that families can bring a friend or family member who can translate…..if you do not speak English.  (FYI,  interpretation refers to spoken or signed language, while translation is exclusively of written work; these terms are frequently confused). While I’m not an attorney, I do know that  these are the kind of policies which need to be reviewed for compliance with civil rights laws pertaining to  public accommodations.

The  validity of the warm, fuzzy, caring  attitude associated with Ronald in all his manifestations has at times been the subject of headlines regarding issues that have arisen at individual  RMHs  including:

  • a 2005 case in Baltimore, where a family of a child about to undergo heart surgery, was initially turned away by the facility because the patient’s blind mother was accompanied by a guide dog, in supposed violation of a RMH  “no pets” rule .
  • a 2007 case in Houston, where the mother of an infant who had just undergone surgery for a brain tumor, was admonished for nursing him  in a common area of the RMH, with implications made that if family wished to continue their stay , breastfeeding should be done only in the family bedroom.
  • a 2009 case in Miami, where the former assistant manager of RMH of South Florida has filed a lawsuit alleging violation of labor laws as she was often required to work off the clock, and did not receive  $20,000 in overtime  pay for  her customary 70-hour work weeks.

It’s important to know too that sponsorships by major corporations, which come product promotion ties, are not the only way to meet the housing needs of sick kids and their families. All around the country (and the world too) there are grassroots endeavors, by both organizations and individuals,  providing patient lodging. To learn more , visit the website of the National Association of Hospitality Houses.

Retiring Ronald could be a positive step to improving the health and well-being of our children, one meal at a time.

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