The Health Care Industry vs. Health Reform

Share/Save Share this

Wendell PotterI'm the former insurance industry insider now speaking out about how big for-profit insurers have hijacked our health care system and turned it into a giant ATM for Wall Street investors, and how the industry is using its massive wealth and influence to determine what is (and is not) included in the health care reform legislation members of Congress are now writing.

Although by most measures I had a great career in the insurance industry (four years at Humana and nearly 15 at CIGNA), in recent years I had grown increasingly uncomfortable serving as one of the industry's top PR executives. In addition to my responsibilities at CIGNA, which included serving as the company's chief spokesman to the media on all corporate and financial matters, I also served on a lot of trade association committees and industry-financed coalitions, many of which were essentially front groups for insurers. So I was in a unique position to see not only how Wall Street analysts and investors influence decisions insurance company executives make but also how the industry has carried out behind-the-scenes PR and lobbying campaigns to kill or weaken any health care reform efforts that threatened insurers' profitability.

I also have seen how the industry's practices -- especially those of the for-profit insurers that are under constant pressure from Wall Street to meet their profit expectations -- have contributed to the tragedy of nearly 50 million people being uninsured as well as to the growing number of Americans who, because insurers now require them to pay thousands of dollars out of their own pockets before their coverage kicks in -- are underinsured. An estimated 25 million of us now fall into that category.

What I saw happening over the past few years was a steady movement away from the concept of insurance and toward "individual responsibility," a term used a lot by insurers and their ideological allies. This is playing out as a continuous shifting of the financial burden of health care costs away from insurers and employers and onto the backs of individuals. As a result, more and more sick people are not going to the doctor or picking up their prescriptions because of costs. If they are unfortunate enough to become seriously ill or injured, many people enrolled in these plans find themselves on the hook for such high medical bills that they are losing their homes to foreclosure or being forced into bankruptcy.

As an industry spokesman, I was expected to put a positive spin on this trend that the industry created and euphemistically refers to as "consumerism" and to promote so-called "consumer-driven" health plans. I ultimately reached the point of feeling like a huckster.

I thought I could live with being a well-paid huckster and hang in there a few more years until I could retire. I probably would have if I hadn't made a completely spur-of-the-moment decision a couple of years ago that changed the direction of my life. While visiting my folks in northeast Tennessee where I grew up, I read in the local paper about a health "expedition" being held that weekend a few miles up U.S. 23 in Wise, Va. Doctors, nurses and other medical professionals were volunteering their time to provide free medical care to people who lived in the area. What intrigued me most was that Remote Area Medical, a non-profit group whose original mission was to provide free care to people in remote villages in South America, was organizing the expedition. I decided to check it out.

That 50-mile stretch of U.S. 23, which twists through the mountains where thousands of men have made their living working in the coalmines, turned out to be my "road to Damascus."

Nothing could have prepared me for what I saw when I reached the Wise County Fairgrounds, where the expedition was being held. Hundreds of people had camped out all night in the parking lot to be assured of seeing a doctor or dentist when the gates opened. By the time I got there, long lines of people stretched from every animal stall and tent where the volunteers were treating patients.

That scene was so visually and emotionally stunning it was all I could do to hold back tears. How could it be that citizens of the richest nation in the world were being treated this way?

A couple of weeks later I was boarding a corporate jet to fly from Philadelphia to a meeting in Connecticut. When the flight attendant served my lunch on gold-rimmed china and gave me a gold-plated knife and fork to eat it with, I realized for the first time that someone's insurance premiums were paying for me to travel in such luxury. I also realized that one of the reasons those people in Wise County had to wait in long lines to be treated in animal stalls was because our Wall Street-driven health care system has created one of the most inequitable health care systems on the planet.

Although I quit my job last year, I did not make a final decision to speak out as a former insider until recently when it became clear to me that the insurance industry and its allies (often including drug and medical device makers, business groups and even the American Medical Association) were succeeding in shaping the current debate on health care reform. While the thought of speaking out had crossed my mind during the months leading up to the day I gave notice, I initially decided instead to hang out my shingle as a consultant to small businesses and nonprofit organizations.

I decided to take the shingle down, though, at least for a while, when I heard members of Congress reciting talking points like the ones I used to write to scare people away from real reform. I'll have more to say about that over the coming weeks and months, but, for now, remember this: whenever you hear a politician or pundit use the term "government-run health care" and warn that the creation of a public health insurance option that would compete with private insurers (or heaven forbid, a single-payer system like the one Canada has) will "lead us down the path to socialism," know that the original source of the sound bite most likely was some flack like I used to be.

Bottom line: I ultimately decided the stakes are too high for me to just sit on the sidelines and let the special interests win again. So I have joined forces with thousands of other Americans who are trying to persuade our lawmakers to listen to us for a change, not just to the insurance and drug company executives who are spending millions to shape reform to benefit them and the Wall Street hedge fund managers they are beholden to.

Take it from me, a former insider, who knows what really motivates those folks. You need to know where the hard-earned money you pay in health insurance premiums -- if you lucky enough to have coverage at all -- really goes.

I decided to speak out knowing that some people will not like what I have to say and will do all they can to discredit me. In anticipation of that, here are some facts:

  • I am not doing this because my former employer was pushing me out the door or because I had become a disgruntled employee. I had not been passed over for a promotion or anything like that. As I noted earlier, I had a financially rewarding career in the industry, and I'm very grateful for that. I had numerous promotions, raises, bonuses, stock options and stock grants over the years. When I left my last job, I was as close on the corporate ladder to the CEO as any PR person has ever climbed at the company. I reported to the general counsel, the company's top lawyer, whose boss is the chairman and CEO, a man I like and worked closely with over many years.
  • The decision to leave was entirely my own, and I left on good terms with everybody at the company. In fact, I agreed to postpone my last day at work by more than two months at the company's request. My coworkers gave me a terrific going-away party, and I received dozens of kind notes from people all across the country including friends at other companies and at America's Health Insurance Plans, the industry trade association.

I still consider all of them my friends. In fact, the thing I have missed most since I left is working as part of a team, even though I eventually came to the conclusion that I was playing for the wrong side. Being a consultant has its advantages, but I have missed the camaraderie. After a few months, I thought that maybe I should consider working for another company again. At one point, a former boss told me that another insurer had posted a PR job and encouraged me to contact a former CIGNA executive who worked there about it. Against my better judgment, I did, but I immediately decided not to pursue it. The last thing I wanted to do was to go from one big insurer to another one. What the hell was I thinking?

I'm writing this because, knowing how things work, I'm fully expecting insurers' PR firms to quietly feed friends of the industry (which include a roster of editorial writers and pundits, lawmakers and many others who fall under the broad category of "third-party advocates,") with anything they can think of to discredit me and what I say. This will go on behind the scenes because the insurers will want to preserve the image they are working so hard to cultivate -- as a group of kind and caring folks who think only of you and your health and are working hard as real partners to Congress and the White House to find "a uniquely American solution" to what ails our system.

I expect this because I have worked closely with the industry's PR firms over many years whenever the insurers were being threatened with bad publicity, litigation or legislation that might hinder profits.

One of the reasons I chose to become affiliated with the Center for Media and Democracy is because of the important work the organization does to expose often devious, dishonest and unethical PR practices that further the self interests of big corporations and special interest groups at the expense of the American people and the democratic principles this country was founded on.

After a long career in PR, I am looking forward to providing an insider's perspective as a senior fellow at CMD, and I am very grateful for the opportunity to speak out for the rights and dignity of ordinary people. The people of Wise County and every county deserve much better than to be left behind to suffer or die ahead of their time due to Wall Street's efforts to keep our government from ensuring that all Americans have real access to first-class health care.


Wendell Potter is the Senior Fellow on Health Care for the Center for Media and Democracy in Madison, Wisconsin.

Comments

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.

I have not seen any mention

I have not seen any mention of the public health system aims to make customers out of insurance companies, reducing their spending due to unnecessary layoffs and reduced bonuses paid to executives due to decreased benefits. My point is, nothing works, unless insurance companies to be part of the solution. The debate has been all about the government, the uninsured, and cost savings from suppliers, including recados para orkut pharmecuticals. When insurance companies have been in this debate? strangely silent, I would keep. In my opinion, their piece of the market must be significantly eroded achieve real savings. Have to make significant cuts to the structures of their earnings, or anything else of this work.

i totally agree with

i totally agree with you.Health insurance is necessary  for the employers benefit.saying the (vague) language of the law is more important than what the people who wrote it intended.    <A HREF="http://www.prlog.org/10354498-cell-phone-spy-software-free-mobile-spy-15-only.html">cell phone spy software</A>

I Agree

"I am saddened whenever I hear my good, although conservative friends describe changes to the system as socialism. I'm tempted to say "if that's socialism, then bring it on!", but I know this would only feed the fire."

I agree with you here. It does seem like every time we have a new proposal from Obama, we get everyone screaming socialism. Well, to me its all just word labelling. What we should look are is how the proposals affect the future and as long we could see a benefit I don't see why it should not be implemented. Using socialism as fear mongering is just hindering change.

"Reacting to the surprise

"Reacting to the surprise announcement that congressional budget referees now predict healthcare reform could top $1 trillion, the Obama administration threatened Wednesday to veto parts of its own healthcare bill.

The politically explosive revelation, which is likely to give new impetus to the GOP?s repeal movement, came after the Congressional Budget Office (CBO) said the law potentially could add at least $115 billion to government healthcare spending over the next 10 years."

That is how an ill conceived idea ends up.

Are you serious, I mean this

Are you serious, I mean this is the guy that thought Sicko was truly a documentary. See the interview quote below. He is a shill. Too bad he can't bring credibility to the table rather than contrition...

WENDELL POTTER: Well, frankly, I was very conflicted, because when I saw the movie for the first time, I really felt that—well, I knew it was an honest film. The information that was contained in the film, it truly was a documentary, and certainly a documentary with a point of view, but that’s understandable.

Sicko?

Why? what's wrong with Sicko? I love that documentary and really opened my eyes on the current state of America. The part about the people who helped with the world trade center incident.. That almost made me cry.

Mike Moore's film Sicko

Sicko was a good movie, marred by the usual Michael Moore excesses. The concluding mendacious material about Cuba did blot an otherwise good film. I wish Moore would hire a good editor, because he opens himself up to unfair criticism of his many valid and compelling points about evils in the American health care system

I thought Sicko was a great

I thought Sicko was a great film and it DOES make me sad that people can't look past Mike to see the point of the entire thing: our health care system needs to be fixed. I remember becoming irate when I saw the volunteers of 9/11 denied any sort of health help because they were not on CONTRACT by the govt and decided to help out of the goodness of their hearts. Is there no decency left in this country?

I agree with you

I thought Sicko was a great film and it DOES make me sad that people can't look past Mike to see the point of the entire thing: our health care system needs to be fixed. I remember becoming irate when I saw the volunteers of 9/11 denied any sort of health help because they were not on CONTRACT by the govt and decided to help out of the goodness of their hearts. Is there no decency left in this country?

Thanks for taking the time

Thanks for taking the time to post such a detailed and informative article. It has given me a lot of inspiration and I look forward to more sajoo like this in the future.