Who won the Twitter war of words--Aetna or patients?

As a war of words recently broke out on Twitter between a patient suffering from Stage 4 colon cancer and the chief executive of Aetna, it's unclear who more effectively harnessed the power of social media. The answer, I suspect, lies within the future actions of all insurers.

Aetna faced a potentially damaging image problem as Arijit Guha took to Twitter last week to complain about his insurance company's failure to fully cover his cancer treatments. As an Arizona State University doctoral student, Guha is covered through the school's Aetna health plan, but his cancer treatments already exceeded the plan's $300,000 lifetime cap, leaving him more than $100,000 in debt--and counting.

Just one day later, Aetna CEO Mark Bertolini jumped into the fray, using his personal Twitter account, no less, to tell Guha that the insurer would cover his cancer costs in full. I commend Bertolini for stepping in and paying the medical bills, although you could easily argue that if he hadn't taken that unusual and somewhat extraordinary step, Bertolini would have had a much larger PR nightmare on his hands.

Yes, Guha used Twitter to criticize Aetna for denying $118,000 in claims while reaping $2 billion in annual profits, the Huffington Post reported. Yes, he questioned Aetna's commitment to fixing the broken healthcare system since it took the reform law to compel the insurer into offering a "decent, human plan." And yes, Bertolini rose to the challenge, quelling what could have become a public uproar about the insurer's policies.

But here's the larger question: what's next? Did Bertolini just squelch one blaze while igniting a whole other fire? By admitting in a Twitter post that "the system is broken, and I am committed to fixing it," did Bertolini unintentionally spur other patients to use social media, or any other public forum, to shame health insurers into submission, offering a financial answer their prayers?

Of course, Aetna and other insurers aren't going to grant patients' requests willy-nilly, but that won't necessarily stop patients from asking for gigantic monetary favors (and maybe even form a coalition of sorts) to gang up on insurance companies. We all know it's not hard to find one, or two, or 20 people who hate their health plan.

So what's to keep anyone from doing about 5 minutes of online research to uncover less-than-pleasant insurance industry policies and essentially blackmailing companies with the threat of destroying their public images?

That's where insurance companies have to step up their game. It's good that Bertolini responded, but it's also the problem. He was reactive, not proactive.

Insurers need a much more prominent social media message. They should, for example, create a comprehensive social media policy that directs a strong, positive presence throughout all social outlets. Take to Twitter, Facebook, YouTube and Google+ to proactively spread a positive message and humanize themselves to their customers. Maybe if Aetna already had garnered a favorable public opinion, Guha wouldn't have felt compelled to attack the company or at least not make those disparaging comments in such a public manner.

Perhaps Guha summed up the situation best himself. "It's great this all worked out. Those who don't engage in a Twitter war with Aetna's CEO might not be so lucky," he told The Washington Post. "The bigger issue is that it's so absurd that I should have to be doing this. It speaks volumes to how broken our healthcare system is."

Yes, indeed. #healthcare broken. Need real #healthcare solutions. --Dina (@HealthPayer)