Facebook games lure players to campaign against public option

Promises of game rewards were linked to a coalition of health insurers. But the organization denies any involvement in the health reform lobbying effort.

By Emily Berry — Posted Dec. 28, 2009

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Someone in cyberspace has been offering virtual mob bosses and virtual farmers virtual cash to send letters opposing the very real public health insurance option.

Sometime during the week of Dec. 7, people playing popular online games hosted by Facebook were offered points and game currency in exchange for e-mailing Congress with concerns about losing employer-based health insurance should a public option pass as part of health system reform legislation.

Points or virtual dollars in games like "Mafia Wars" or "FarmVille," both popular applications on Facebook, are acquired by winning them through the game, buying them with real money, or completing offers from companies that offer rewards for taking marketing surveys or sharing personal information.

The offer of points in exchange for a letter appeared to come from Get Health Reform Right, a coalition of health insurance industry trade groups, including America's Health Insurance Plans and the BlueCross BlueShield Assn.

But the coalition denies ever paying for "incentive-based" ads online, leaving it unclear who was responsible for linking gamers with the letter-writing campaign.

The BlueCross BlueShield Assn., which handles the Web site, shut it down temporarily after learning about the ads offering game cash and prizes, said Blues spokesman Jeff Smokler.

In a statement released Dec. 12, the coalition said it learned its site had been associated with the offers and categorically denied any involvement.

Since launched this summer, 750,000 users have sent more than 2 million messages to members of Congress, Smokler said. But he said the coalition specifically had forbidden its advertising agency from using "incentive-based" ads to attract letter-writers.

The coalition is investigating what might have happened and has hired outside counsel to help identify any legal action it might take in response, Smokler said.

"I don't know that anybody was actually able to send any letters" through the giveaway offers, he said.

According to media reports, the e-mailed form letters said in part, "I am concerned that a new government plan could cause me to lose the employer coverage I have today."

Who was behind the ads is difficult to determine, because these kinds of offers often pass through several electronic middlemen before popping up on a gamer's computer screen.

Zynga, the company behind both "FarmVille" and "Mafia Wars," claims it has 100 million unique visitors each month, presenting a very large audience for advertising offers. Zygna did not respond to requests for comment by this article's deadline.

Facebook provides only a platform for games and typically has nothing to do with point offers. "It is the responsibility of both developers and ad networks to make sure the content running in third-party applications is appropriate," Facebook spokeswoman Malorie Lucich said in an e-mail.

"We have not seen the ad in question or received any user complaints about the issue," she said. "We can't comment on ads we have not seen, but we will take action against those that exploit political agendas for commercial use or receive significant negative user sentiment."

Dan Porter, chief executive officer of New York-based game development company OMGPOP, said he was approached by a company that "bundles" these kinds of offers from various companies. The company, whose name he did not disclose, tried to pay him to run a set of offers that included a survey linked to

He said typically a company that wants to gather up hundreds or thousands of e-mail addresses will pay a bundler a penny for every e-mail address it generates, and the bundler in turn will offer a fraction of that penny-per-address to a game site that allows the bundler to offer prizes to users.

Porter, who tests those type of offers before posting them for the people playing his games, said during his test run he was sent to a "survey," then redirected to, which automatically sent a letter to Congress on his behalf.

Out of curiosity, he found another route to by searching for a free K-Mart gift card and clicking through a series of surveys. These surveys, he said, are a common way for companies to do market research or advertise. But it was the first time he'd seen that kind of incentive-based lobbying online, and he wasn't interested in sending his gamers there.

"I thought it was weird, and pernicious," he said.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn