If you can spot the difference between the two ads above, you know where this is going. But let me start by saying that free speech can be a pain in the butt. It’s amazing how fragile this most basic of American freedoms can sometimes be. Case in point: this creative Park&Co recently developed for Adelante Healthcare.

“We believe your health shouldn’t depend on having adequate coverage,” states the headline, superimposed over a photo of a man in a skimpy hospital gown. The image is meant to depict the chilly vulnerability of the underinsured. It’s a powerful image, and it should be. According to a recent study, 25 million Americans are underinsured.

Adelante Healthcare is passionate about making medical care available to everyone, regardless of their insurance situation. By approving this creative they demonstrated great courage. If only we could say the same for some of our local media companies. Taking exception to how much the gown revealed, a few of them refused to run the creative. Are you kidding me? Since when is the media interested in covering other people’s asses?

Having no other choice, we fired up Photoshop and inched the gown up. A few rounds of approvals later, the creative was blessed. The advertisement ran. And Adelante successfully delivered its message of sustainable healthcare. But within the greater victory a couple of battles were lost, and they weren’t small ones. As an agency, we lost the battle to speak freely and honestly on our client’s behalf. As consumers, our audience unknowingly lost a battle to decide for themselves what is objectionable and what is not.

Compared to the blatant censorship seen in places like China and North Korea, our tussle with Big Brother may seem small. Technically, it may not even be an issue of free speech in the strictest sense of the concept. Nonetheless, this experience serves as a reminder that, even in America, the difference between freedom and oppression may be smaller than we think.

In this particular case, that difference was only a matter of inches.