WellPoint, the nation's largest health insurer, has launched what could be the start of a campaign for the hearts and minds of the American public as the country prepares for debates over reshaping its much-maligned health care system.
The company, which operates in California as Anthem Blue Cross, made 3 million computer-generated phone calls last week to gauge the public's appetite for overhauling health care - and to enlist, critics say, a grass-roots army to voice concerns about the sweeping proposals developing on Capitol Hill.
"This was our first step," said WellPoint spokeswoman Cheryl Leamon. "Obviously, the debate over health care reform is heating up."
Health care leaders in the U.S. Senate said the work on legislation will begin in early June.
California's largest insurer with 8.3 million subscribers, WellPoint is expected to take a prominent role in the debate over health care - much as it did in the state two years ago.
The company's critics say it may be taking a page out of its playbook here to counter some of the sweeping health care proposals now circulating in Washington, including a government-backed insurance plan that would compete against private insurers.
WellPoint spent $2 million on an advertising blitz in 2007 that helped defeat Gov. Arnold Schwarzenegger's campaign to require all Californians to obtain health insurance and force insurers to issue policies to anyone, regardless of health.
His program also would have required insurers to spend 85 percent of the premiums on patient care. At the time, WellPoint said it objected to the proposed regulations and to what it said was the increased cost of implementing the rules.
The Governor's Office criticized WellPoint's marketing campaign then - and did so again this week for its recent telephone survey.
"We don't need to make telemarketer phone calls to know what Californians think about health care reform," said Lisa Page, a spokeswoman for the governor. "They want it."
Other groups also found fault with the governor's plan two years ago, including the California Nurses Association. But Anthem Blue Cross stood alone in opposition among the state's major insurers, who signed onto the proposal or remained neutral.
"The other major health plans deserve credit for going out of their comfort zone," said Daniel Zingale, one of the architects of Schwarzenegger's plan and now vice president for policy at the California Endowment, a nonprofit health care foundation.
Elizabeth Hall, WellPoint's vice president of public policy, defended the company's effort to reach out to its 35 million subscribers nationwide.
"The public is not always well informed," Hall said.
She said WellPoint wants to make sure that its customers are aware of its positions.
Of the 3 million phone calls WellPoint made last week, the company connected with 140,000 people - 66,000 of whom expressed interest in receiving information and willingness to take part in WellPoint-sponsored town hall meetings, if any are to be convened, said Leamon, the company spokeswoman.
Joel E. Miller, senior vice president for operations at the National Coalition for Health Care, said WellPoint must tread carefully, particularly in engaging a public wary of doctors, pharmaceutical firms and health insurance companies.
"The industry has been under fire, and that's no mystery," said Miller, whose nonpartisan group represents insurance companies, business groups, labor unions and health advocates.
"It really is amazing that they would make all those phone calls," he said. "Looks like they're putting together a giant focus group."
With $2.24 trillion spent on health care in 2007 - including $775 billion spent on private insurance - the stakes are undoubtedly high.
WellPoint could have the most to lose, particularly if the government decides to offer its own health plan, because the company's profits depend heavily on individual health insurance policies. Those policies often have low premiums and high deductibles, and WellPoint has been among the most aggressive in pursuing healthy customers who are less likely to use benefits to pay for medical care.
Insurance companies, while embracing universal insurance, are resisting a government-run plan similar to Medicare. There appears to be little interest among policymakers to implement a single-payer system, which some see as socialized medicine and that insurers say threatens the lifeblood of the nation's 1,300 health insurance companies.
Joan Pirkle Smith of Glendale was among the Californians called by WellPoint.
"They asked me if I was aware of the health care debate happening in Washington right now," Smith said. "Then they asked me if I cared enough to get involved."
Smith, who is a board member of the advocacy group Health Access California, responded in the affirmative.
"Sure, I'd love to give Anthem Blue Cross my opinions about health care reform," said Smith, who supports a single-payer system.
It's no surprise that WellPoint and other stakeholders would want to take the pulse of the American public, said Jacob Hacker, a professor of political science and co-director for the Center for Health, Economic and Family Security at the University of California, Berkeley.
"At the moment, there are good signs that insurance companies will play ball," Hacker said.
But it remains to be seen, he said, how willing the industry will be to make concessions as the debate moves forward.
"Most people are skeptical of insurance companies," Hacker said. As a result, the industry "may well be hoping they can find sympathetic allies in their subscriber base."