Wendell Potter's News Articles

Insurers' Cost of Doing Business Costs Us Dearly

Since you likely don't pay as much attention to the behavior of insurance companies as I do, you probably are not aware that CIGNA, my last employer, was fined $600,000 by the North Carolina Department of Insurance earlier this week for, among other things, not charging its customers correctly.

It was the second largest fine ever levied by the state's regulators, the largest being a $1.8 million fine in 2003 against Blue Cross Blue Shield of North Carolina for underpaying claims for emergency care. The news about the CIGNA fine was picked up by a few media outlets in the state, but not many, and it got almost no press coverage outside of the state. In addition to the fine CIGNA has been ordered to pay, the company will have to shell out several hundred thousand dollars in refunds to North Carolina employers whom regulators say were charged too much over a three-year period.

Making a Killing on "Mini-Med" Plans

One of the reasons I left my job as a PR executive for the health insurance industry was because I could not in good conscience be a pitchman for the sort of fabulously profitable benefit plan that often provides little more than the illusion of coverage.

Known as "mini-meds," these plans have become popular among businesses like fast-food chains that have many low-wage employees. The common features of these plans: high deductibles, modest benefits and low annual caps on medical coverage. Some of these plans provide as little as $2,000 worth of care each year.

Consumer advocates call these plans "junk insurance." That's because what workers get in these plans for their hard-earned money may actually put them at risk of going bankrupt or losing their homes if they get seriously sick or injured.

Reform Already Saving Lives of Many Americans

Is the health care reform law a good deal for Americans, or is it so badly flawed that Congress should repeal it? Now that the measure is one year old -- President Obama signed the Patient Protection and Affordable Care Act to law on March 23, 2010 -- I humbly suggest we attempt an unbiased assessment of what the law really means to us, and where we need to go from here.

To do that in a meaningful way, we must remind ourselves why reform was necessary in the first place. I believe the heated rhetoric we've been exposed to since the reform debate began has obscured the harsh realities of a health care system that failed to meet the needs of an ever-growing number of Americans.

Death Panels: Fact and Fiction

"Death panels" are back in the news and Congress is turning its attention to them once again. The problem is, lawmakers are looking in all the wrong places.

The proposed provision would have allowed Medicare to pay doctors to counsel patients about their end-of-life medical wishes. That idea originally had bipartisan support, but when the provision was brought to Sarah Palin's attention, she accused Democrats of wanting to create "death panels" that would decide when to pull the plug on granny and grandpa. The House Energy and Commerce Committee, now headed by Republicans, sent a letter to Health and Human Services Secretary Kathleen Sebelius last week demanding to know how a controversial provision that was excised from last year's health reform bill wound up -- briefly -- in a government "rule" on physician reimbursement.

Reframing the Debate to Make Health Insurers Look Poor

In 2010, the U.S. Census Bureau delivered the troubling but hardly shocking news that almost 51 million Americans -- nearly one out of every six of us -- had fallen into the ranks of the uninsured. If you think that news would also be troubling for health insurance companies, think again. While the country was struggling to emerge from a recession, and more and more of us were struggling with no medical coverage, the big for-profit insurance companies were rolling in dough.

Over the past few weeks, UnitedHealth, WellPoint, Aetna, CIGNA and Humana reported fourth quarter 2010 earnings, and all but Humana exceeded Wall Street's profit expectations, most by wide margins. The combined earnings of just those five companies were more than $11.7 billion last year, which was 17 percent more than they made in 2009. Since the end of 2008, their earnings have increased a Wall Street-pleasing 51 percent. Just imagine how much more they would have been able to reward their shareholders if the economy had been running on all cylinders.In fact, 2010 will go down in the history books as one of the most profitable ever for the five biggest for-profit health insurers.

Vermont May Lead U.S. to Single Payer Health Care

Montpelier, Vermont — Chances are you've never heard of Peter Shumlin, who last month was sworn in as the 81st governor or Vermont. That's about to change. If Shumlin makes good on a signature campaign promise, he might end up as well-known and beloved in the United States as Tommy Douglas is in Canada.

OK, maybe you've never heard of Tommy Douglas, either. A former Baptist preacher and member of the Canadian parliament, Douglas is considered the father of Canada's popular government-run medical insurance program.

If you're surprised to learn that Canadians like that system, it's probably because you've been convinced otherwise by a years-long propaganda campaign from American insurers -- a campaign I used to help carry out as an industry PR executive.

Don't Buy Insurance Industry's "Objective Analysis"

Connecticut residents who believe their state should be the first in the nation to set up a public health insurance option to compete with private insurers should brace themselves for what will be a beautifully packaged, seemingly well-researched study from the insurance industry to convince them otherwise.

America's Health Insurance Plans (AHIP), a big Washington-based lobbying group, last week told Connecticut lawmakers (pdf) that -- surprise, surprise -- they would be making a very big mistake if they approved funding to get the public option, called SustiNet, up and running. AHIP said it had hired "a well-known consulting firm" to produce a study that would support the conclusions the industry had already reached about SustiNet. AHIP even had the audacity to claim that said study would be an "objective analysis."

An Illuminating Expedition to the World of the Uninsured

As Congressional Republicans seek ways to starve the new health care reform law of necessary funding -- and Democrats try to keep that from happening -- it's easy to lose sight of the reasons why reform was pursued in the first place.

For a reminder, lawmakers might want to spend a few hours in Nashville this weekend. I'm betting they would behave differently when they got back to Washington on Monday.

If they arrived in Nashville by Friday afternoon, those legislators would see an ever-growing line of cars and trucks outside a locked gate at McGavock High School. At midnight, the gate will be opened, enabling the occupants of those cars and trucks to camp out in the parking lot for hours, maybe even days. Many of these folks will have driven hundreds of miles to receive care from doctors and nurses and other caregivers volunteering their time to treat as many people as possible before they all pack up and go home Sunday evening.

Obama: Not A Lot Left to Debate in Health Care Law

By devoting just two minutes to health care reform in his State of the Union address -- and not mentioning it until half way through the remarks -- President Obama was signaling Americans that he believes the health reform debate is over, that Republicans would be wasting precious time by "refighting the battles of the last two years."

While noting that "anything can be improved" and that he would welcome ideas to improve the bill he signed into law last March, Obama offered only two subjects that might warrant renewed attention -- and one of those is sure to set off alarms among consumer advocates and trial lawyers, though changes seem unlikely.

"How Everybody Exists" Doesn’t Have To Be

If you want to know how things really get done in Washington -- or don't get done, depending on the desires of America's corporate executives -- all you have to do is read a couple of paragraphs in a January 23 story in the Philadelphia Inquirer.

Reporter Joe DiStefano quotes a vice president at APCO Worldwide -- one of DC's most powerful and influential PR firms -- in response to questions about my book, Deadly Spin. Throughout the book, I disclose the previously secretive work APCO did for the health insurance industry to manipulate public opinion on health care reform, in part by trying to scare people away from a movie, Michael Moore's 2007 documentary "Sicko".

The surprising gem in the Inquirer piece was that APCO VP Bill Pierce essentially agreed with me. He acknowledged that interest-funded pressure groups "are all over the place" in Washington. "That's how everybody exists here," Pierce said.

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