The emails appear to show extensive outside involvement in the Montana lawmakers’ op-eds. In a Microsoft Word document, MacDonald removed three paragraphs from a draft of Kelker’s op-ed that pointed out that the United States “clearly spends significantly more on health care per capita than other developed nations.” He also deleted a table from the lawmaker’s original draft showing that the United States has higher health-care spending per capita than France, Germany, Norway and Switzerland.
The columns were published this summer in the Missoulian, a newspaper published in Missoula, and the Billings Gazette.
“I know most newspapers are going to have trouble formatting the graphic you provided and will likely ask us to hold off on that,” MacDonald told Kelker in a June 12 email. “The client had trepidations that it might also come across to the ‘less-discerning’ reader that because foreign single-payer markets cost patients less, they are superior.”