I was very disappointed to read "Does negative press make you Sicko?" at the Google Health Advertising Blog, and the followup post didn't do much to ease my concerns. A large part of why I love working at Google is how seriously we take the philosophy of "don't be evil," and it's not hard to see how some people might conclude from those posts that we're backsliding on that. But what I see on the inside is very encouraging - lots of internal discussion about what the right course of action is, and a strong commitment from people all up and down the community to act on principles rather than just the profit motive.
Don't get me wrong, Google is in the advertising industry. It makes us a lot of money, and we are very good at it. In fact, I think that the type of ads that we do best -- connecting people who are looking for something specific with providers who offer it -- have lots of potential to improve the way healthcare is delivered in this country.
But I cannot agree with Lauren's claim that "advertising is a very democratic and effective way to participate in a public dialogue." I think that depends a lot on the kind of advertising we're talking about. At its best, it can indeed be democratic. Here's an example: it would be well within the reach of the yoga studio where my mom sometimes fills in as an instructor to buy some AdWords on "hypertension" for their local area. Then, when people search on that keyword, they'll see ads for the yoga studio mixed in with those for medications and high-tech hospital facilities for managing hypertension. Perhaps not quite as prominently based on the size of the ad buy, but good enough.
This type of scenario isn't even really competition. Most doctors would be thrilled to see their patients proactively making lifestyle changes to prevent the need for expensive medicines and treatments. At the same time, if you have a serious heart problem, my mom would definitely want you to get good diagnostics done, etc. Different story, of course, if your BP is just a touch high because you're out of shape and a little stressed out, but even in that case the pharmaceutical industry might concede the chase after that particular bit of revenue.
But when the insurance industry runs advertising campaigns to discredit Moore's film, that's not democracy. The imbalance of money is just too dramatic: the health industry runs somewhere north of a trillion dollars, and spends in the ballpark of three billion a year on advertising. By contrast, the production budget on Sicko was something like nine million. Even if you were to agree with every single point made by the insurance industry and disagree entirely with Moore, there's no way this system can be considered democratic.
I think we can all agree that we need a healthy debate about how to best restructure our healthcare system to better meet the needs of Americans. Moore is a master storyteller, and the way he shows the damage wreaked by the healthcare system in people's lives will make you weep. Getting people to sit up and care is an important contribution to the debate, but it isn't enough. As Lauren points out, anecdotes are not a great way to get to accurate information. To have a healthy debate, we need to be looking really intensely at the numbers. In a free society, the insurance companies absolutely should have the chance to present their case as well.
I also think it's just fine for Google to take their ad dollars, as long as we maintain the integrity of our search results. Those really are democratic, and our commitment to those principles runs deep at Google, from the original PageRank algorithm to the Founder's Letters filed with the SEC, through the actions of the engineers and support staff I work with every day.
But, back to ads, I personally do not weep for the insurance companies, and I frankly don't think they need that much help in getting their message across. This opinion is one of many; within the company, there are lots of people with lots of opinions, and a lot of thought about what it means to do the right thing. Where it gets interesting is when there is tension between all these goals, especially between running a company that is "trustworthy and interested in the public good" as well as profitable. In those cases, we have a spirited debate.
In fact, I am now going to reveal one of our most heavily guarded corporate secrets: within Google, Godwin's Law appears to be suspended. Conflicts, even on really sensitive and contentious topics, tend to get treated as misunderstandings and resolved, rather than degenerating into flamewars.
I don't know that we'll always do the right thing as a company, but I do have great faith that we will try our best to figure out what that is. I also know that when I see something wrong, I'll take a stand. This is not just me, but, believe it or not, is enshrined as principle I(d) in our Code of Conduct. For a moneymaking outfit in corporate America today, that's actually pretty amazing, and good enough for me personally. I'm also going to be spending some time over the next few weeks learning about healthcare initiatives within Google, such as Dr. Roni Ziegler's work.
I'd go so far as to say that if the public debates about important issues like healthcare were as well-informed and considerate as the internal discussions I've seen so far at Google, then Michael Moore probably never would have felt the need to make the film Sicko. That would have been something of a shame, because, like Picasso's Guernica, Moore has made great art from the raw material of human suffering on a large scale. Go see it. (*)
*Like everything else in this blog, the movie review represents my personal opinion and does not in any way represent Google's official corporate policy.