The Health Care Industry vs. Health Reform
I'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
Congratulations!
Good for you to step up and speak out! I hope that you are successful. In addition to making sure that the political leaders get, understand, and act upon the real information, we somehow need to ensure that the general public also gets the message.
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.
The employer-based system we have for healthcare was once a useful benefit. Now that health insurance is essential, it needs to be something that is not tied to your employer.
We could use more transparency in how our insurance dollars are spent. Where can one find that information?
Thanks!
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.
Shill is as shill does. . .
Funny how all the 'Anonymous' comments on this thread all use health insurance shill tactics, like undermining sources and promoting emotional reactions instead of confronting the specific information and issues, isn't it? :^)
health care
How ever you feel about Mr Potter, the thing that made a big impression on me was, Instead of having a bureaucrat between me and my doctor an insurance exe is standing between me and my doctor. The myth that the govt can't run anything is garbage, I have been on medicare for 8 years and so far have had no problems, I know I am lucky, at least I have insurance, so passing the govt program has no relevance for me, but after hearing some of the horror stories of how some people were left to die because of and insurance exe makes me ill.
They should be wait for some
They should be wait for some years and they also get the good suggestions from the people who are working with the jobs which will effect this policy.
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
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.
"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.
Courage mon brave
Great to have you aboard the train leaving the station en route to universal health-care free at the point of delivery. That is your ultimate destination, isn't it? It's what I'm used to. My healthcare system allows me to see my doctor free of charge, and because I'm over 60 all my medicines are also free. If I have a prolonged episode of paroxysmal atrial fibrillation I can dial for an emergency ambulance (also free) which will have a paramedic and a defibrillator on board. Heart attack victims get taken straight to state of the art cardiac catheter labs at major Accident and Emergency Centres. My sister in law was diagnosed with age-related macular degeneration - she's had a course of treatment that has stabilised her condition, ensuring she doesn't lose her sight - each injection was worth about £14000 but they were free of charge to her. I live in England and my health service is the National Health Service. For all of its faults and inadequacies, I wouldn't swap what I've got for a health insurance model like that of the USA. You may have some of the best medical centres in the world, but the inequalities of provision that deprive the 'have-nots' of anything more than the very basic levels of healthcare provision is a situation that shames your country. I wish you well in your endeavours.
UK's National Health System
As a US citizen who has had treatment by the UK's NH system, I can double underline all the good Reg has to say about the NHS. I was in a clinic in Oxford to have a boil lanced and I was three days in the Radcliff Infirmary for what turned out to be a non-viral meningitis. The facilities were spartan, but the staff were people highly motivated to do medical work. I was also a month in an British organized hospital in Singapore following a near fatal accident in the offshore oil-fields, and I shall never tire of telling people how much it helped me to cope that the doctors considered me an active participant in my own treatment. I was consulted each time a medical decision was in the offing, and could ask questions, or be part of the decision making. At one point, when it was still a question whether my lower leg could be saved, I asked my doctor if there was a chance it would have to be amputated. He responded with an honest frankness that still takes my breath away: he said to me that sometimes it could be the wiser choice to loose the leg, get a prosthesis, and get back on my feet again rather than spend a long time on crutches and seeing my general body musculature weaken, not to mention being unable to reinsert myself in normal adult occupations. And, if there was a choice to be made, it would be made with my participation. I do think the health system in the UK works (some complain) because the British are unusually civic minded, and do not abuse the system. If the US changed to the same system overnight, I fear the masses of people heretofore left out of the health-care circuit would storm the system. All I want is the assurance of good basic care and a medical system committed to prevention and education about good personal hygiene. The private sector can offer luxury services to people with money to burn, and I'll be the first to wish them all the best.
The American Hospital in Paris serves the rich and famous, and the kings and queens from all over the planet, for unbelievable prices, and that's just fine by me; I can live with an " not all but something" choice.
Good Article.
It's really a good read. I must appreciate the time and effort you've put in. Keep up the good work.
David - Press release distribution
Courage
It takes courage to switch sides and put the public interest first over one's own personal success working for the private health insurance industry. You did a great service today for America in exposing the problems with private insurance and you should be commended for such courage.
Forcing Americans to purchase a defective product is a huge mistake and cannot be morally or politically justified. We need a single payer, national health insurance plan for this country. Let's hope your testimony as an insider brings courage to other insiders who can shed light on the state of private insurance, their motives, and why they should not be allowed to control our health care system. Please speak up. Bravo!
Health Care Profiteers
Welcome to you, Wendell Potter!
We need you and more like you.
Some years ago after having lingering health issues after an auto accident I made a decision to change careers, moving to the insurance and securities industry. How naive I was, but the education was quick. After struggling with all the required insurance and securities education and exams I foolishly thought I would be actually helping clients. When I started on the job I could not help but feel the SCORN for everyday people and their efforts to protect their families with insurance packages, establish retirement programs - potential clients were literally ignored. We were required to research obituaries, find out who owned substantial businesses, examine trust information in public records and find out who we could CONVINCE TO ROLL OVER THEIR WEALTH into our programs. When my first client came to me with $10,000 to establish a retirement account I was scoffed at by my manager and was told that wasn't the kind of client we would be dealing with. I can't tell you how devasted I was when I actually became aware how the insurance and securities industry really operates and what their true philosophy is. Within 6 months I left to go back to my business that I had started a few years earlier and worked very hard at re-establishing it.
After that hard lesson and returning to my own business for 5 years I was diagnosed with breast cancer. Fortunately I had had a solid - or so I thought - health insurance program for almost 10 years. During my treatment I was treated so badly I could not believe what they were doing to me - refusing to pay for my radiation after having sent me home in less than 24 hours with drain tubes and no one to help me since I live alone. Then they tried to cancel everything in the middle of the treatment by giving back all my premiums which certainly would not have covered all my treatment. I pleaded my case with out state insurance commission to no avail. I cashed in my retirement to pay my bills because the medical center harassed me causing me emotional distress. Ultimately I filed for bankruptcy and started from scratch in my life.
Some years later when I was dating a gentleman who was an independent insurance actuary I shared my experience with him. It was amazing! He knew exactly which insurance company that I was talking about even though I never mentioned who it was . He explained that they were only in this venture for the short term profits, made a lot of policyholders angry by refusing to pay claims, were sued successfully by all the states where they did business but not the one where I lived because that is where this investor group lived and were close friends of our governor. See why the insurance commission also gets involved?
The fraud and extortion in this industry is unbelieveable.
Currently I have a $450/mo premium and a $2,500 deductible for just myself. Of course there are many more details but surely you get the picture.
The irony of this all is that they continue to tell us that we need to 'take responsibility' - so why are we continueing to pay them our premiums? Mutual Insurance or some other NON-PROFIT SYSTEM is the way to go.
Health Insurance
I got my insurance premium down from 900 ish to around 300/ mo.
With the new 10k deductible it covers practically nothing but it was all I can afford.
Unless work improves, I may have to let it go.
I love my country and this situation is just horrible.
Hypocrisy
After working 20 years in the industry and getting stock, stock options, pension, and other benefits--during that entire time not having any qualms about the work he did and the communications he led--Mr. Potter now suddenly finds himself aghast at the insurance industry practices. Too little too late Mr Potter
Too little, too late?
We can only judge that in retrospect. You know, by results.
Bill Moyers was Lyndon Johnson's press secretary. Would you call everything he's accomplished since then too little, too late? (Assuming you're not a right-winger, of course.)
Welcome, Wendell. :-)
Lyndon Johnson
Sorry, bad analogy - President Johnson was one of our greatest - Medicare, Medicaid, Civil Rights Act - all under his watch. President Obama should be so fortunate to match Johnson's record!
Not really.
Bad analogy perhaps to civil rights, Medicare and Medicaid, but you've overlooked imperialism, militarism and war. Terrible enough in themselves, and in the long run they undermine everything good, as we're seeing played out right now.
How did you sleep then?
Didn't it occur to you over the twenty years you spent raking in the big bucks that your message was corruption? Just because you didn't break any laws didn't it cross your mind that elderly, children and others were at risk because of your snake oil routine. You were that clueless?
It's no wonder we are where we are. You have trained hundreds of others to take your place as health insurance lackeys.
Somehow I have a hard time wondering if you are really on our side.
Mr. Potter
Better late than never?
Ajit
Another former CIGNA employee
Hi Wendell,
New (corporate) “officers” in CIGNA were flown in for a three day orientation at headquarters in Connecticut. We were given a short presentation on your work. CIGNA thought most highly of you and apologized for your being away lobbying and thus unable to address our class yourself.
What I remember of that module was being told that we were expected to “tithe” 3-10% of our salary to the CIGNA lobbying group. The trainer explained it like a friendly grand-parent to a young child. This is how I remember it.
You see if we can influence legislation to benefit our business then we make more money, and you do too - through our generous profit sharing program. Our lobbyists are skilled at providing and presenting reasons for our duly elected representatives to support legislation that we sometimes write ourselves. Last year we had $3,000,000 in the lobbying budget. There are only a handful of senators and congressmen that we have to get on our side to get our legislation passed. We had one representative who was against one of the pieces of legislation we wanted to pass. We asked some questions and with only a $10,000 check, written in a completely legal way, he changed his vote.
Currently, we are working on influencing the legislature in Quebec, Canada to change the rules to open them up to the American style of health care. Our analysts have determined that once 15% of a population buys their own private health insurance the voters can be influenced to legislate the socialized system away. The reason the percentage is only fifteen percent is that those are the richest and most influential citizens. If you get that 15% to lead, then the herd will follow. Quebec is not that lucrative but once Quebec falls then Ontario will be open and that market is the size of Michigan!
After I flew home, I realized that I felt like I was working for Darth Vader. Something else occurred that concerned me.
Our Customer Service Representatives (CSRs) got bonuses (about 20% of their pay) for having better performance statistics in the current year as compared to the prior year. They were expected to deny more people the benefits that our subscribers expected year over year. The first year you may expect to deny benefits that our subscribers did not deserve. However, to have that same program year after year inevitably causes our CSRs to deny legitimate claims. When I raised this question it was suggested that I needed to pay more attention to being a “team player.”
After only eight months I left CIGNA. Self respect is worth more than a big paycheck.
so-called reform.
Well, sorry to disillusion you, guy, but I can tell you that up here in Canada the same type of sharks that are raiding your private insurance companies are a growing infection within the Canadian bureaucracies, giving themselves ludicrous bonuses and all. Because they control the system, no one can do anything about it, Like they say: It's virtually impossible to give sharks that sort of money and expect them to use it ethically.
support
I retired this month from a sales position with one of your former employers. I couldn't continue to do it anymore and sleep at night.
You are brave - I thank you for your article and will send it to everyone I know.
Wendell. You read the tea
Wendell. You read the tea leaves and are still spinning. Just from the other side.
Thank you
Wendell my simple thanks, for your grounded stand. If you would be so kind, I would appreciate if you would contact me and give me permission to email you my private newsletter to the community of practice I have launched called WeCare. I hope someday as you get to know me we can have a live conversation.
http://www.laviniaweissman.com
http://www.linkedin.com/in/laviniaweissman
http://aboutworkecology/typepad.com
http://twitter.com/WorkEcology
http://www.workecology.com
We travel in a similar trajectory woven by numerous of my mentors.
I left health care as a leader very young, only to open my eyes to what care has become in this country as a mother, daughter, patient, neighbor, medical advisor, ecologist who was inspired most of my life by a father who was a community leader, spinal injured Veteran of WWII, who understood and taught me the meaning of sustainability as it relates to health and the economy.
I need to have direct contact with more people like you ready and able to lead the change I see possible that is practical and not off the wall.
health care reform
I am a health insurance agent in Utah. I sit on the board of the Utah health underwriters as webmaster for http://www.bcbstx.info/ and http://www.utahinsuranceexchange.info/. I was heavily involved in designed a web connector to help Utah residents by pulling private and state sponsored insurance mechanisms together. It had a low budget of around $150k that virtually guaranteed health insurance coverage through either the private or state programs. Better yet all the local carriers agreed to split the costs. Our state insurance task force committee rejected the idea. They elected to go for a Massachusetts type connector program that isn't working well when you actually dig deep and check facts of where they are now. Our state approved H.B. 188 with a zero fiscal note attachment! My point is, I have been a fly on the wall in countless legislative meetings, insurance board meetings, hospital board meetings, the list goes on. The problem is conflict with the market demanding profit in all sectors of the system. Tough order to fill and keep costs down? You are absolutely right when you claim that healthcare is now unsustainable. I have been crying that a long time. Nobody listens.
Thanks for your courageous choice
In a world where too many take the easy way out, your choice is a real inspiration!
Way to go, Wendell
I worked for Wendell for seven years as a regional PR director. He was a great boss and I want to echo many of his comments. In California, where I worked, the industry spent millions of dollars in 1994 to defeat two single-payer health initiatives. One of the campaign directors who ran the HMOs campaign was Frank Shubert, who later went on to run the "Yes on Proposition 8" campaign in November 2008. If those same single-payer propositions were on the ballot today, I bet they would pass overwhelmingly.
Wendell Potter's Heroism
It takes courage to do what Mr. Potter is doing. Not magic, not wizardry, but courage. We should all share and learn in the lesson he is bringing all of us! The corruption in this industry should not shock us. It should not make us recoil in horror. This is us, this is America, and the lubricant that makes it all work is money. Enormous, enormous amounts of it. It makes the healthcare world go round, and it brings the healthcare world crashing down!
Let us shine all the light on this industry. It is our money, after all! The money for the healthcare industry is perhaps mainly spent in the private sector, but the clients, the millions and millions of healthcare clients in America, constitute a very large part of the mainstream American public. The mainstream American public, widely known as the middle class, is being royally screwed. And as goes the American middle class, so goes America.
Screwed. As Melissa sings so well, "I need to wake up!"
Wake up, America, it is time to wake up! They are here! They want it all, and they will take no prisoners! As the famous French revolutionary song, La Marseilleise, so eloquently calls out to its citizens, "Allons enfants de la patrie!" (Children of the nation, march!).
We must stand against these thieves, these corruptors! We must stand together, and rebuild our torn and embattled nation!
Since the time of Franklin Delano Roosevelt, the private sector corporate interests have toiled tirelessly to regain and maintain their supremacy in society through profit. They have sought to crush the power of the people. The power of the people was warned by the founding fathers against the large monied interests of privilege and power. Wherever people came together against these interests to form cooperatives, community and union halls from which they would take power over and for themselves, the corporate interests were ruthless and tireless in attacking and destroying these institutions of the people. The corporate interests have never slept in their incessant quest for more. More profits, more power, more influence, leading to more profits, more power...
Insatiable power and greed lust. Heady stuff.
Mr. Potter's liberation from that should be a celebration. We should wish that all Americans will one day be liberated from the clutches of these insatiable profit-seeking, destructive corporate interests, which are not truly interested in healthcare, as much as they are driven by the incessant demand for more and greater profits. It is no longer any fun to work in the healthcare field. The whole things has become monstrous!
We need Universal Medicare.
Now.
Health CARE vs Insurance
As a former employee of CIGNA, though far from an executive level capacity, I always felt that insurance companies have been ripping us off for years. It may have paid my bills for 6-1/2 years, but the basic principals under which they operated just seemed wrong.
The talking-heads are telling us that having "choices" of which insurance company we're going to buy our mandatory coverage from will bring prices down because of "competition", but car insurance never went down when states passed mandatory coverage. Why should we ever believe that the cost of health care will come down as long as insurance companies have control?
Maybe after they fix health insurance, Congress could pass a similar national car insurance system.
Time for Pay at the Pump Basic Auto Insurance
A couple of decades ago, the Michigan originators of the true "no fault" insurance proposed pay at the pump system. It would be a splendid way of encouraging fuel frugality without the impact that taxing would have. Since insurance has to be paid for, the use of pay at the pump would provide incentive for minimizing wasteful fuel consumption. Moreover, pay at the pump would see to it that unlicensed drivers and illegal immigrants were paying towards insurance.
So health insurers are
So health insurers are terrible people. This is new? And how does this justify national healthcare? You noted that lawmakers will do everything they can to discredit you, the same lawmakers that work for the government you want to take care of our health. So the government is corrupt but not when it comes to health care?
Further, crying socialism isn't a scare tactic just because some suits have caught onto the socialism scare and are trying to exploit it. There is nothing wrong with wanting to provide health care for all. But forcing everyone to pay for it is criminal and it is socialism--spreading the wealth when it's not yours to spend. If you want to spread the wealth, fine. Leave me out of it. Please, don't tell me I ought to support something I fundamentally disagree with because you feel bad. Respectfully sir, that seems to be your problem. Instead of thinking, you feel. You felt good about taking that money until you felt bad.
I appreciate your insight and think it is valuable, but I don't wish it to be used to dismantle the system we currently have. The government can't take care of anything, speaking as a military wife who had this so-called great government health care that everyone raves about. They screwed up our paychecks, screwed up all our moves (because the government only cares about the lowest bidder and hence low quality ), messed up reimbursements and just about anything you can think of.
Can't do anything right?
Elle, you say government can't do anything right, but I bet you support all its wars and interventionist foreign policy, don't you? I'm just guessing here, but I'm betting you as a military wife "support the troops" right down the line, including everything the Pentagon asks for and more. If government is so universally corrupt and incompetent, why would you support our military interventions and our bloated defense budget? You can't have it both ways.
Being a citizen
So you are ok with the services, but you don't want to pay? Do you think Wall Street has our best interests in mind where it comes to health care? I don't. This is a fundamental part of living in a society. You pay for fire departments even if you don't use them. Millions of people pay for schools, even when they don't have children... because it makes for a better society. It seems to me that the conservatives in this country are so paranoid that a penny of their taxes are going to go for something they don't benefit from. It is the same greed that got us into the current economic crisis.
My wife has an inoperable brain tumor. I'm scared to death of losing my job because of the economy. Put yourself, for once, in someone else's shoes. Ever heard of the term "pre-existing condition"? It is the first thought in an insurance company's list of ways to deny coverage. How fair is that???
What should I do?
Dear Wendel Potter,
I am a 55 year old Vietnam Era Veteran, who is permanently and totally disabled, but I currently have VA insurance for myself and Medical Mutual Insurance of Ohio for my wife and I. We are both disabled at 55 and 50 yrs.
I am worried that whenever Big Brother and Government steps into a free enterprised, they overstaff it with ignoramuses, who don't know a fig about health care, are more concerned about their next break from the break they call work, and over inflate our health care costs.
I do not want my health care managed by an HMO, PPO or Big Brother, so they can limit my health care, exclude new experimental drugsmedical treatments and procedures to make us well, and deny old people health care as we are too old to be of any good use to the society as a whole, so kill us off now as they can't afford us.
Now I have lived in Odessa, Ukraine, with my Russian wife of six years and I know first hand how this socialized medicine works. The doctors are not paid a living wage, which causes them to prioritize who gets health care on the basis of gifts, bribes or whatever you want to call it. Then you also need to give to the doctors a bottle of vodka or box of candy to pass out to their friends and family for such a privilege. You don't need a prescription to buy a drug, except narcotics, and can go to any drug store without such and pay $.50 to $2.00 for your favorite drug of choice.
The recent economic downturn has increased these costs in the last two years, since I was there. When you have a small medical problem, this system is satisfactory, but you have to wait all day in the hallway for the doctor to get to you, or pay a doctor to come to your house, yes they still do house calls.
However, if you have a heart attack, you will have a major health care & financial problem, as they have you by the shorts. None of your medical insurance works as they will not give to you a bill for a bribe, which means your 80/20 insurance card will not work in a socialist, low paid, medical plan.
Because of my beautiful daughter-in-law opera singer, I got to see the chief cardiologist of the President of Ukraine in Kiev, they said I should go to the US and have this done, bypass, angioplasty and stents or pay them $25,000 to $50,000 to do such there. They were trained in the US. Normal meds cost $2 a bottle, but heart meds cost so much, my wife had to borrow $500 for one month of foreign made meds like Plavix from Franceyour . So I came home, saw the VA and had my heart cath, angiography, angioplasty and stent done in Ohio.
Now I see this big problem about the proposed health reform. I can see the Canadians coming to the US to avoid rationing of health care for 2 to 3 years and do not like this prospect.
I do not like the idea of the government forcing me to pay for five jokers who have never worked a day in their lives and decreasing my access to advanced medical treatment and drugs to pay for them, when I have to pay $150 a month for such and will have to pay much more than I can afford, since I am $20,000 below the poverty level for 2 people as a disabled veteran without a military pension as of yet.
If any of my fellow medically insured change their plans from civilian to government covered plans, my Medical Mutual of Ohio will not be able to compete and throw me and all the others like me, who have earned their retirement benefits and full medical coverage into the new socialized medical plan. This threatens my health coverage, health, marriage, than and life as I am 55 years old. What young looking wife, wants a sick old man for a husband? Care takers of the family suffer from serious depression and that causes divorce.
So now my question is, what do I do? Pray to God the health reform fails? Go back to Ukraine, or emigrate to another non-socialist country?
The 10th Amendment stops the US Government from claiming rights that are not specifically enumerated in the US Constitution, and such legal rights belong to the Sovereign States and Individuals.
The Government will have denied my God-given right to contract with those medical insurance co and doctors, that I need to become healthy and remain so. Somehow, I am sure that all this control of our doctors and medical systems, will profit some fatcat bankster or politician down the line. What is your take on all this?
I too feel sorry for the hillbillies of the Appalachians, for I am one of them, and do not wish to join the lines of people to sick to get such coverage. Then I see that those who are already disabled, will be forced to pay a fortune for such care or be penalized for not having done so, in order to spread the costs, and I already go to the food pantry 4 times a month. Where is the line for the medical pantry? I have no huge financial largesse to afford more taxes or costs by gold digging politicians or banksters. I am not the only one. Three times, I have almost been killed by the pill pushing VA, who now gives me 22 types of pills a month at an additional $176/mo. Tell me they care about me. Hog slop.
The one thing I did like about the medical system of former Russian controlled Ukraine was that they used alternative, integrative, and complementary health care by incorporating the Eastern medical philosophies of acupuncture, herbs, and less potent pills, thereby allowing your body to heal itself, rather than poisoning you with counter-acting side effects, making your whole body a toxic waste.
My only hope is that Jesus will come soon and give to me and my wife a new, immortal and incorruptible body, because my faith in any health care system has failed due to greedy, ignorant, politicians, and the pharmaceutical companies.
If you have the time, please comment.
Yours,
David Harvey
David Harvey's VA Problems
As the spouse of a Viet Nam (yes he was there, not just an era) veteran, I can tell you that you are eligible for complete health care if it's service related. Even if you are disabled and it is NOT service related you can contact the VA hospital and most things ARE covered even if you are NOT RETIRED military! I am shocked that you have not been given this information. My son was in for 10 years, disabled and they pay all his meds. FTR, they go so far as to even cut your toenails if needed.
I am proud of my family's service and grateful for the health care we get. Neither my husband nor I are eligible for Medicare yet but I can tell you that the American military health care system is a good one and they DO negotiate with drug companies on price to enable vets to get their medicines either free or a $3 co-pay at any local pharmacy for generics. The government Medicare system has been barred from negotiating prescription drug prices, a real waste of health dollars. I advise you to get on the Internet and go visit the VA website or go to your nearest base pharmacy with your prescriptions. IF you are a military retiree you are eligible to get a 90 day supply of your prescriptions for $0.
BTW, for anyone that doesn't know, military retirees health care (referred to as Tricare) DOES come from Humana health care. If you don't get the answers that you want there are always people you can talk to, yep, real human beings that do care. My husband was not an officer or a "higher-up" when he retired, but a real person checks on him every couple of months to make sure his congestive heart failure is under control. We have several either retired vets or military disabled in my family, all, including spouses, treated with fairness and respect.
I hope that America will adopt a version of the military health care system that covers everybody. I was a claims analyst for RE Harrington (a 3rd part claims processor) 20+ years ago and was so disgusted by the corruption, paying claims for the VP's new step-daughter's cosmetic surgery while ordering me to deny a claim for a child that required maxilofacial surgery for birth defects, necessary for him to eat and breathe like a normal human being. I did complain way back then and nobody listened or seemed to care. One of their favorite ploys was to keep claims from being paid as long as possible. Why? Interest paid on the funds in their bank was far more than a few customer service reps paycheck:( Glad Mr. Potter got thru to some people, it was long overdue.
America is far from perfect and we do need a comprehensive health care system for everyone. If all the waste and corruption was cut, we could probably pay for it with just those savings. Contact your congresscritters and tell them to "move their butts" NOW!!
Mr. Harvey or anyone else that needs military retiree info, go to http://tricare.mil/
You can also write to Military Health System
Skyline 5, Suite 810, 5111 Leesburg Pike
Falls Church, VA 22041-3206
False dichotomy
The title of Mr. Potter's piece does him no service: "The Health Care Industry vs. Health Reform."
It's not a dichotomous choice. As a former employee of United Health Group, as well as Kaiser Permanente, I know the flaws in the system, as well as how for-profit insurance schemes are susceptible to abuse. However, absent from his post is any idea of how he would reform the current system.
Should we merely transpose a Medicare-like system onto 300 million Americans? Does anyone know how Medicare "balances" its fiscal obligations? By reducing payments to physicians and hospitals.
Succinctly stated, we have a cost problem based on over-utilization because the nexus between the consumer and the payment entity has been broken, which means I can obtain $275 worth of medical services from a visit to a specialist for about $50.
I could try, but I doubt an attorney or CPA would give me the same deal, so why should we expect that from our health insurance system?
Moreover, we don't have insurance for oil changes or tune-ups for our cars, so why do we have it for routine medical visits? How did this Faustian bargain begin?
It goes back to WWII when employers were circumscribed by wage restrictions, so they began providing health insurance to their employees. The rest is a muddled and admittedly imperfect system.
It does need to be reformed, and although the profit incentive must be controlled with oversight, if you excise that entirely, you'll merely have a Medicare-like system that strives on mediocrity. I know, because I live it on a daily basis and it simply doesn't work.
False accusations and spin
Another 'Anonymous' expert, I see, though this one took some more time to push some insurance industry talking points as well as attack Mr. Potter. Let's take this as an opportunity to go through some of them, a 'vaccination' against insurance-monger spin, if you will. :^)
"absent from his post is any idea of how he would reform the current system." - this could simply be a lack of understanding; this article is about how the Health Care Industry has put itself in the way of Health Reform and why it has been profitable to do so. Perhaps this writer is unaware that this is PR Watch, a watchdog group that points out false statements and spin, not a health care reform advocacy group. If the writer or anyone else would like to hear Potter's solutions, you can see him discuss this in more depth on his recent "Democracy Now!" interview.
"Does anyone know how Medicare "balances" its fiscal obligations? By reducing payments to physicians and hospitals." - Again, possibly just ignorance on the writer's part. First, let's establish a reasonable context: Medicare has been one of the most functional and efficient programs in the history of the US government. It has been so successful at handling its finances and taking care of its beneficiaries that it has been a cash cow for hundreds of other federal programs that have been dipping into its funds for decades. Having a central, consistent, single payer of benefits has meant enormous savings on the hundreds of billions of dollars of overhead costs that multiple insurance companies now incur and have burdened our healthcare system with, according to GAO findings. Medicare also has consistently higher approval ratings by doctors and other professionals than any private insurance company.
One small part of Medicare's success is the use of negotiated rates, a tactic used far more often by HMOs usual suspects like Kaiser Permanente. In fact, because groups like Kaiser negotiate individually instead of setting a consistent rate for all, insurance companies push the larger burden of costs onto smaller businesses and individuals who do not have the leverage to negotiate more advantageous contracts.
The statements that follow are similarly remarkably ignorant or radically disengenous; of course CPAs and lawyers give discounted services under negotiated contracts. Perhaps the writer has never owned a new car, but my last one came with a year of insurance for oil changes and tune-ups.
Much like the attempted accusation, the writer makes allusions to 'knowing the flaws' in the current system, but doesn't say what they are. The writer says "the profit incentive" can be controlled by oversight, but gives no indication why this would suddenly start working after several decades or why the insurance industry wouldn't fight this just as viciously. As someone who is supposedly an expert, why not add something useful into the discussion, rather than just attacking a known and recognized expert?
Repentance
Wendell has written some truth and that is great. Nothing pleases the Lord more than a sinner who has repented and works to change.
The information from Wendell ( Healthcare Greed) is not a revelation; we knew this already.
Christians will continue to take care of the sick and poor because it is our mission.
We will do the work we are commanded to do, regardless of the world.
Many non-Christian people carry the load as well and deserve recognition..
It's not the money; "The love of money is the root of all evil."
Way to go Wendell Potter !
The Neo-Bourgeoisie has come to help -- Look out!
Until Potter gives back all the money he made from the "big for-profit insurers [that] have hijacked our health care system," I don't trust him one iota.
This is always the scheme with the neo-Bourgeoisie: Build up huge wealth with deceit and greed. Then, once they've gotten theirs, they kick down the ladder and demand "reform" that, conveniently, destroys others but leaves them unscathed. I see Potter in my mind's eye sitting cozily in his Aspen lodge sipping wine, admiring the vistas and berating the "masses" as hicks and hillbillies, all the while rolling his blood-stained fingers over his ill-gotten booty.
He's got his money. Now he lusts power and a personal legacy.
One wonders what became of the more noble co-workers Potter shoved aside as he clawed his way to the top.
I note that this site proclaims to "remove personal attacks." This seems ironic, as Mr. Potter cites only his "personal" story as proof of the validity of his ideas. This site's tactic demands pro-propaganda conformity masquerading behind the facade of "free-speech."
Bitter and contemptible
Mr. Potter has a right to a change of heart and to live his life the way he sees fit. You say:
"...they kick down the ladder and demand "reform" that, conveniently, destroys others but leaves them unscathed..."
Just what "others" do you think that he is destroying? Your post is very odd, but your bitterness and rage are evident. It sounds like you yourself are clawing your way up the corporate ladder at an insurance company, perhaps denying claims and purging policyholders, and you worry that your own ambitions might fall victim to reform. That's the conclusion I drew from your vituperation..
Healthcare, Wendell Potter
Orwell's Avenger - Ii realize that this reply is pretty late relative to your comment and the article but I must comment. I have to wonder what makes a person think the way you do? There are millions of people who keep quiet about things they know are terribly wrong because of their paycheck and benefits. If your salary depends on you closing your eyes to certain things then it's very human to do that - we are after all, defective human creatures.
So Mr. Potter had his eyes opened to the point that he could not look away anymore - and you condemn him for this and attack him for this. Again, your anger at him seems misplaced. What would you have done in his situation? We all like to think that we would always to the right thing in all circumstances - I am grateful that he came forward and wish that many more had followed his lead - it would have made for an easier time reforming healthcare and we would not have had to pacify the insurance companies and their congressional mouthpieces of opposition. Bless you Mr. Potter, bless all the sick and suffering here in the good old USA, and may people like you OA have a change of heart, without having to learn the hard way with an illness for which the insurance giants toss you out. Peace.
Thank you
The current state of health care access in this country is a national disgrace. Thank you for adding your voice to the dialog.
How Do We Counter Fat-Cat Lobbying Groups?
Kudos!
You don't know how happy I am to see somebody like you speaking out. Thank you for doing so.
Any ideas on how to counter people who say "I don't want the government handling my health care"?
I think we won't see universal health care until we truly answer the concerns of those who are not outraged that their health is being treated like a business.
You're a PR pro, what to do?
Thanks again!
Health Reform
Mr. Potter:
Thank you!! Hear, Hear!! God bless you.
You know, much better than I, the duplicitous nature of these guys. But I ALWAYS suspected it, believed it, actually. So good to finally hear an insider speak out.
Are there more like you, still inside, who could provide information (evidence) on just how severely they're screwing the public financially, and essentially killing people? Do they have the same courage and integrity that you are now displaying??? I have physician friends who believe (they say KNOW) how screwed up things are and have some good ideas about how to fix it, but are afraid to speak out. They're scared! For good cause, no doubt.
Time to hear from them, not just in big HEALTH, Pharma, tobacco, etc., but how about agri-biz, control of drinking water, "clean" coal.
God bless!
Thank you for sharing your insight Wendell Potter
Just before reading your blog account on the health care insurance industry, I heard a very pointed attack on "socialized medicine" on a local conservative leaning radio station. An Arizona state representative has pushed through legislation to help "protect choice" and specifically counter any National Health Care plan operating in this state. The representative claims she has no ties to the insurance or health care industries, and that it is a proactive move to prevent Arizonans from suffering the harm of a Nationalized health care system, which she claims is a huge failure in Canada. She cited examples of people having to unreasonably "wait' for care in Canada, and other Canadians "flocking" to the US for care.
This past Monday, the Arizona State Senate approved the Health Care Freedom Act (HCR2014). This will put a proposal on the 2010 ballot which would constitutionally override any law, rule or regulation that requires individuals or employers to participate in any particular health care system.
Using the usual fear tactics of "socialized" medicine, and adding a Tenth Amendment state's rights argument into the mix, Arizona may have the issue on the ballot for public approval so that our less fortunate citizens also will not need to suffer through nationalized health care (They can just go without any care.)
Thank you Mr. Potter for standing up for what is right and honorable and helping expose the wrongs in our current for-profit medical care insurance system. The only "choice" available now, and as proposed by the right, is for those people with the money to go wherever they want ; to "choose." The rest of us must happy with their delayed or denied insurance claims, or go bankrupt. Nice choice.
Thank-you
THANK-YOU for speaking out. THANK-YOU! Don't stop. Don't slow down. Keep going.
Jean
Perfect post
I love your style too, I'm glad I found your blog. You made something from this boring day. Awesome keep up the good work.
Elizabeth writer at health blog
Cigna destroyed my life and cost me my home
Cigna destroyed my life and cost me my home. I am a +25 year survivor of HIV and my employer Apple eventually suggested that I stop working and apply for disability when my health deteriorated to the point that my job performance began to suffer. A variety of doctors and organizations acknowledged the reality of my health problems but Cigna declared that there was nothing wrong with me. I lost my supply of antivirals which fight HIV and I lost my home due to a lack of income......Cigna had contracted with Apple to provided Long Term Disability benefits to disabled Apple employees. I had a lot of health issues but Cigna declared there was nothing wrong with we. Then, a year later, Cigna lost a laptop computer with my name, address, SSN, medical information, and birthdate to theft. They informed that they had reason to believe the laptop was not encrypted when it was lost. If I could, I would hurt Cigna executives in any way possible. They are scum and I hope they all die painful deaths. Their children should be taken from them before they twist the kids' minds with their warped values and persistent greed and dishonesty. If there is a god and a heaven and a hell the executives of Cigna will spend their afterlives in hell suffering horribly. Good thing none of them live in my city or I would have taken action against them and picketed outside Cigna's offices to no end....and when that failed I would have killed a few. I hope they all die slow painful deaths.
Don't worry
Don't worry, Obama has re-assured us that if we like our private insurance we can keep it!
Yeah right! Most people hate their private insurance companies. I am sorry for what CIGNA did to you. I am afraid we are not making progress towards single payer. I also think Obama's effort to rush through a bill by this fall is more of an attempt to saddle us with a crappy mandate to buy private insurance with only a weak private option. We really need more time to get organized to fight for a single-payer plan.