Last Tuesday, a week after the Supreme Court's ruling upholding Obamacare, Sally Pipes appeared before the House Oversight and Government Reform Committee to enumerate the evils of the law. The president of the Pacific Research Institute, a San Francisco-based free-market think tank, Pipes warned members of Congress that if they didn't act quickly Americans would soon suffer the rationed care and long waits supposedly plaguing her native Canada. The country's health care system, she insisted, had killed her mother by refusing to test her for colon cancer, which she later died from.
Pipes' appearance on Capitol Hill, days before the House voted for the 33rd time to repeal Obamacare, capped a busy two weeks for the prominent critic of the president's health reform law. In just the 24 hours following the Supreme Court's Obamacare decision, Pipes churned out thousands of words of outraged copy, publishing columns in the National Review Online, the Orange County Register, the Daily Caller, Human Events, and elsewhere—all while running her small think tank and keeping up her typically frenetic schedule of media interviews. All of this cemented her status as a leading voice of Obamacare opposition. Along with a constant stream of op-eds and TV appearances in recent years, she has also authored three books since 2008 lambasting health care reform.
If Pipes seems supernaturally prolific, there's a good reason. To assist with her written output, PRI employs a DC-based ghostwriting and PR firm with drug and health care industry clients. That firm, Keybridge Communications, researches, drafts, and edits much of Pipes' published work in an arrangement that's unusual for someone at a supposedly independent think tank.
Several former PRI staffers tell Mother Jones it was well known within the organization that Pipes relied heavily on Keybridge, particularly for her books, and did far from all of her own writing. (Pipes thanks Keybridge and specific staffers there in her last three books.) In recent years, PRI has spent large amounts of money on Keybridge's services. Between 2008 and 2010, the think tank paid Keybridge nearly $1 million—$400,000 alone in 2010.
Keybridge's services for PRI have included drafting and editing Pipes' op-eds, including her online column for Forbes, "Piping Up."
It's a significant expenditure for a nonprofit of PRI's size—the think tank's annual budget is close to $4 million—especially one that until recently had about a dozen well-compensated marketing and research staff in-house. (Last summer, experiencing financial problems, PRI laid off about a third of its employees; several others left last year without being replaced.) But unlike other scholars at PRI, research for Pipes' work wasn’t handled by PRI's in-house research team, say former employees; it's been done by Keybridge.
Keybridge's services for PRI have included drafting and editing Pipes' op-eds, including her online column for Forbes, "Piping Up." A Keybridge invoice from June 2011, obtained by Mother Jones, details more than $17,000 worth of charges to PRI for, among other things, services related to drafting four Forbes columns for Pipes, operating her Twitter feed, and pitching op-eds on behalf of Pipes and a couple other PRI staffers.
Christine Hughes, a PRI spokeswoman, insists that Pipes writes all her work herself and that Keybridge only does the "initial drafting, researching, and editing" of Pipes' Forbes columns and other op-eds. Hughes says the fact that Keybridge has pharmaceutical or health care clients—and that much of Pipes' commentary centers on subjects of interest to these companies—does not pose a conflict of interest for PRI. She directed questions about whether Pipes' work may be influenced by the positions of Keybridge's clientele to the PR firm.
Sam Ryan, Keybridge's CEO, told Mother Jones he was restricted in what he could say about his firm's work because Keybridge signs confidentiality agreements with its clients. But he did confirm that Keybridge edits and drafts "rough copy" for Pipes, though, like Hughes, he maintains that the ideas for the columns and the final products are Pipes'.
"Our services include editing, drafting rough copy, earned media outreach, and booking radio and television interviews," he explains. "All of Sally's books are authored by Sally. It's no secret that we assisted Sally with her books, as we're acknowledged in the credits, but we would never claim authorship of any written material we helped draft or edit. That would be akin to a bricklayer taking credit for an architect's design."
It's an open secret in Washington that well-known public figures often use the services of ghostwriters for op-ed pieces and books published under their names. When President Obama writes an op-ed for the Washington Post it's a safe bet that he had some help from one of his speechwriters. But it's unusual in the think tank world, where scholars or fellows are considered more like academics than advocates. While think tankers may have an assistant or research help in-house, they are typically expected to do their own work.
Laurie Boeder, a spokeswoman for the Brookings Institution, says Brookings scholars do not outsource their writing. "We have a very academic atmosphere here," she says, noting that she can only speak to what's done at Brookings, not at other organizations. "Scholars hold themselves to the same standards that you'd find in an academic institution. Obviously they work with research assistants, but every author here is responsible for work written under his or her name."
Conservative lawyer Ted Frank is a regular contributor to the Wall Street Journal's op-ed page who's worked as a fellow or scholar at the American Enterprise Institute and the Manhattan Institute. While not commenting specifically on Pipes or PRI, he echoes Boeder's sentiment about think tank work. He says he once rejected a PR firm that approached him about ghostwriting op-eds. While he says he expects high-profile people like Bill Clinton to use speechwriters and others to help prepare things he writes, "I expect a Ted Frank op-ed to be written by Ted Frank."
Pipes' op-eds, especially her Forbes column, often read like advertorials, frequently addressing obscure health policy topics and touting specific big companies by name. For instance, in December and January, she published a pair of Piping Up columns bashing an attempt by the federal Center for Medicare and Medicaid Services (CMS) to cut costs by conducting a competitive bidding auction for medical equipment. In one column, she named a medical device called "wound-vac," made by a company called Kinetic Concepts, as an example of a product that might become inaccessible due to the auction process.
The mind-numbing ins and outs of the CMS auction process have not been in the news much of late, but it's a big deal to Kinetic Concepts, which has spent more than $1.1 million since 2009 lobbying Congress and CMS over exactly the issues Pipes raises in her columns. Kinetic Concepts' parent company, KCI, has been a PRI donor. Keybridge also has clients in the medical-device industry, according to Ryan. But Pipes doesn't disclose any of that in her op-ed that name-checks wound-vac technology. (Hughes says that Pipes sometimes does disclose PRI's donors in her writing, as she did in this article for the Palm Beach Post.)
In August 2011, Pipes published a Forbes column that advocated making Lipitor, a cholesterol-lowering drug manufactured by Pfizer, available without a prescription. Pfizer is about to lose its patent on the multibillion-dollar-a-year blockbuster drug, and is pushing the FDA to make it available over-the-counter, despite the objections of many doctors. Pfizer has been a longtime PRI donor. The drugmaker has also been a Keybridge client. (Ryan says Pfizer has not been a client of the firm since 2010, but the company is a member of PhRMA, the pharmaceutical industry's lobbying association, which is a Keybridge client.) Pipes didn't disclose any of these relationships in her piece. When asked about whether Forbes was aware of Keybridge's role in Pipes' columns, a Forbes spokeswoman side-stepped the question, saying, "Our contributor network is held to the highest standards. All content is attributed to the individual contributor."