By Wendell Potter on July 29, 2009

The insurance industry, its business allies and its shills in Congress are doing their best once again to scare us away from real health care reform, just as they did 15 years ago. Using the same tactics and language they did then, insurers and their cronies are warning us that America will be sliding down a slippery slope toward socialism if the federal government creates a public insurance option to compete with the cartel of huge for-profit companies that now dominate the health insurance industry.

One of the false images they try to create in our minds is of long waits for needed care if our reformed health care system resembles in any way the systems of other developed countries in the world--systems that don't deny a single citizen access to affordable care, much less 50 million of them.

Here is a real image, and a very scary one, that I wish those overpaid insurance executives and members of Congress could have witnessed before dawn a few days ago: a thousand men, women and children standing for hours, in the dark, in a line that seemed to be endless, waiting patiently for a chance -- a chance because the need is so great many are turned away -- to get much-needed care from a volunteer doctor.

That is the scene they would have witnessed if they had bothered to come to the Wise County, Virginia, fairgrounds for the 10th annual Remote Area Medical (RAM) Expedition, a thee-day event in the southern Appalachians that grows larger every year as more and more Americans join the ranks of the uninsured and the underinsured.

Among those standing in line were people who thought they had decent health insurance until they really needed it. They found out the hard way that the policies insurers are forcing most of us into these days require us to put much more "skin in the game," as insurers say, so we will be more prudent "consumers" of health care.

When I came to the Wise expedition as a curious insurance company public relations executive two years ago, I was so shaken by what I saw that I knew immediately I was doing PR for the wrong side of the health care reform debate. A few months after that I walked away from a job that paid me very well to be one of the industry's mouthpieces.

When I returned to Wise last week, this time as someone trying to pull the curtain back on despicable insurance industry practices such as "purging" people from insurance rolls when they become sick, I was even angrier, even more outraged at what passes for a health care system than I was in 2007.

Knowing the industry as I do, it takes extraordinary callowness and heartlessness to surprise me. I didn't think I was capable of being shocked by insurers' greed.

I was wrong. What I learned is that many people who stand in those long lines at RAM events (the Wise expedition is the organization's 575th), are people who have been told by their insurance companies that they should call RAM if they don't have enough money to get needed care because they can't afford to pay their out-of-pocket expenses.

That's right, insurance company bureaucrats, who are under constant pressure from Wall Street analysts and investors to spend less and less of every premium dollar they receive from us to pay medical claims, are telling their policyholders to seek charity care. They are telling them to go stand in long lines, in the dark, at events held once a year, to get the care they thought their insurance companies would pay for just so they can put more of their premium dollars in the pockets of their executives and shareholders.

When I heard that I asked how much money RAM, a nonprofit organization that depends entirely on donations, has received this year -- or any year for that matter--from the insurance industry. I knew the answer but wanted to ask it anyway. If you guessed nothing, you guessed right.

Back in the early '90s, when the insurance industry was spending millions of dollars, as it is now, to scare us away from any additional involvement of the federal government in our health care system, one of the executives I wrote speeches for quoted 18th century economist Adam Smith's famous line about the ruthless "invisible hand" of the market in calling for less, rather than more, government regulation of the industry.

He was right: the invisible hand has indeed been ruthless. Fifteen years after he gave that speech, far more Americans are uninsured and underinsured. Millions of people have lost their homes or filed for bankruptcy because they couldn't afford to pay their medical bills. Thousands of our family members and neighbors have died needlessly because they didn't go to the doctor or pick up their prescriptions because they didn't have adequate insurance.

On behalf of the millions of men, women and children who will suffer the same fate unless Congress passes real reform this year, I am issuing this invitation to President Obama and members of Congress: join me at the next RAM event, which will be held over eight days next month in Los Angeles (August 11-18).

Congress, if you must take your August vacation, spend a day or two of it -- or a few minutes of it, if that's all you can spare--helping to register the many thousands of your fellow Americans who will be standing in long lines, in the dark, waiting for the doors of the Forum to open. Chances are you visited the Forum in years past to see the Lakers play. Be prepared this time to see it fulfilling an entirely different function, and be prepared to look those folks in the eye and explain why you needed to go on vacation before passing health care reform. And explain to them why many of you are saying we just can't afford reform, so let's just call the whole thing off and let the private market continue to work its ruthless magic.

Remember, Congress: while you are on vacation, 150,000 Americans will lose their insurance, many of them will file for bankruptcy because of mounting medical bills, and at least 1,500 will die because they don't have coverage that gives them access to care they need.

I'm looking forward to seeing you in L.A.


Wendell Potter is the Senior Fellow on Health Care for the Center for Media and Democracy in Madison, Wisconsin. A version of this article originally appeared on the Huffington Post.

Wendell Potter

Wendell Potter is CMD's honorary Senior Fellow on Health Care (since May 2009). He writes a regular column for the Center for Public Integrity.

Comments

Wendell, thank you so much for the good work you do. You've turned your experience in the belly of the beast into a valuable weapon in the fight for health care reform. I'm so glad you're out there.

I was amazed by your interview with Bill Moyers and at the end Iwas so disgusted and disheartened by the facts that the industry really does put profits over people.This is the biggest and best reason for reform to a single payer option.Thank you for being a real human being and for coming over to our side.

Thank you for sharing your perspective. I thought you were very effective in your testimony and in your series of recent media appearances.

Here is a piece from yesterday edition of The Commercial Appeal in Memphis.

It reminds us (as you did with your comments about RAM) that while there is a policy debate going on in Washington, there are real people behind this debate who are dealing with the issues of life and death everyday.

http://www.commercialappeal.com/news/2009/jul/29/let-down/

Hey Wendell,
I'm a CIGNA retiree and I'm so glad to see you out there speaking up.

I hope you can get on air somewhere to respond to Shawn Tully's July 24th article that's posted on CNNmoney site: 5 Endangered Freedoms. Most Americans covered by employer plans (or even individual plans) don't currently have any of the "freedoms" he/she is talking about. It's evident he/she is no expert on the subject, but he/she has written a piece that many lay people might believe.
They were talking about this article on CNN today. I believe it's meant to mislead people, so I hope you can read it and respond on air soon.

Thanks for all that you are doing.

Dear Mr. Potter -

I saw your interview on the Ed Show and just checked out your blog, which is moving to read. I hope that you will use all the skill you have acquired in communications to fight for proper access to health care for the many Americans who do not have or merely BELIEVE they have access now.

But, I am surprised that you were so unaware of the reality faced by so many. You mentioned meetings at CIGNA where you thought only of statistics and profits. You do not mention family or friends.

I have an MBA, a solid work history, and many friends with Master and PhD degrees, having worked many years at the director level in a research university. But, too many friends in their 50s and early 60s now face unemployment, dwindling or used-up COBRA, and little to no prospect of finding individual health insurance.

Of course, we lived in Cleveland, Ohio, which in 2007 lost more people than any other American city, according to US Census estimates. But that is not all that mitigating factor. As you drive around the US these days, look at all of the homes whose maintenance has been neglected for ages. We noticed this last week in NY State. We do not see this in Ontario, Canada, even in deeply rural areas or so-called inner cities (which do not really exist in Canadian cities). I would bet that many are not due to predatory lenders, but simply bankruptcy for medical reasons, which rose from 55 to 62% of personal bankruptcies between 2005 and 2006.

Your personal experience cannot be all that different from mine. Do you not have family members or friends who lost their professional positions, or began small businesses? Did you ever just ask them how they were coping?

One professor friend told me that years ago a friend of hers married her for just as long as it took her to get well after a catastrophic illness (due to which she had lost her job) before she entered academia and could sign up for insurance regardless of pre-existing conditions. Odd? Well, she is a lesbian who had already let everyone know by then. What a shame! My accountant lost his long-time faculty position--and benefits--when his university went belly-up; his wife took antidepressants after her parents' close-in-time deaths for a few months, and he is classified as obese, although he is in great shape and quite angular (heavy bones?), so they are uninsurable, even by AARP. I can go on and on... So, please start asking your nearest and dearest.

My husband and I are lucky. I moved the the US from Canada in 1983 at age 26, newly married, and I was shocked back then. I called the system barbaric when I visited home, said that combining where one works with how one accesses health care must have been dreamed up by someone on drugs.

Finally, we were in a position to move to Canada, so I sponsored my husband up here this year. What a difference! Don't let anyone tell you that this health care is terrible. It's not perfect, but here is what has happened to me so far:

January 2009: my official move, triggering a 90-day wait for the Ontario Health Insurance Plan (OHIP), the government provided insurance.

April 2009: received OHIP card; visit with family practitioner of my choice. (Which I scheduled in February, knowing when I would have insurance. She also had to accept me into her practice.) Blood, urine tests and EKG. Referrals to specialists, because I have pre-existing conditions, to bring info up to date.

May 2009: visit with chief cardiologist at major Toronto hospital (a top-ranked department in North America), with echocardiogram, EKG, more blood tests.

June 2009: visit with respirologist to ensure no drug interactions if I get lung infection, pulmonary function tests. Visit with family practitioner for skin problem that cropped up--seen on same day that I called(!). (Okay, that is rare timing.)

July 2009: overnight sleep study and follow-up with world-renowned sleep physician (somnambulist?) who specializes in treating heart failure patients. Referral to ENT for permanently enlarged tonsils. Regular densitometry test and my first-ever physical with the family practitioner.

August 2009: visit scheduled with colo-rectal surgeon preparatory to having regular colonoscopy.

September 2009: scheduled follow-up visits with cardiologist and sleep study specialist.

October 2009: regularly scheduled mammogram.

OHIP--the government plan--covers, without limits, deductibles or copayments: doctor visits, diagnostics, emergency clinics, hospital stays, inoculations, and much more. It does not cover prescriptions (though there is an excellent need-based government-run program), except for seniors (who pay only the dispensing fee), 25% of durable medical equipment, or purely cosmetic surgery. Private health insurance, included in many employers' benefits, covers these things.

And with all this, I am able to choose my own doctors. Patients do need referrals to see specialists, but then one can choose anyone in the province, which in this case, has over 11 million residents, so plenty of choice. In all this, my waits have been reasonable, and I could have seen these physicians sooner had I had the need.

Perhaps most important, doctors do not need to check with ANYONE before ordering a test, doing a procedure or anything else. They are presumed to be professionals and are in charge and all conversations between physician and patient are purely medical. There is little feeling of bureaucracy. I concede that their offices are not fancy, but they tend to have things like bottles of disinfectant everywhere for patient use, and face masks in doctors' and hospital lobbies. (They have learned much in Toronto from SARS.)

My only complaint: the parking is expensive in downtown Toronto where the specialists I have chosen are practicing! But I am interested in those who are doing research and publishing right now, alongside their practices, so big-city hospital/research university physicians are whom I need. So far, nothing else has cost me directly. I am seeking work, which is taking a while in this economy, but then I will begin paying for this health care out of my income tax--a great deal. And--yes, also so important!--my employer will not need to know anything about my health, as there is no information sent to employers about employee health care usage. There is simply no connection.

I could go on and on, but I do hope that you will read this and work hard for all those whom we left behind. All the best to you and I applaud and will follow your efforts.

Help! How can we get people mobilized to pressure our Congress men and women to be sensitive to the real needs of millions of people? I will write my senators and representatives tonight. We need everyone else to do the same!

Mr.Wendell Potter is truly a patriot who has the credibility to provide the OTHER SIDE of the story in these critical days!

Thank you for visiting Wise County and visiting with many of my friends and former colleagues.

Your July 31st interview with Bill Moyers on the Journal is a message that every American needs to hear.

You are a hero, Mr. Potter, in the sea of Profiles in Jellyfishism. I hope we can see the RAM on CSpan or here on CMD.

I write to people that you are the most telling spokesman possible against the bloodsucking Wall Street Health Scam Corporations with their odious medical loss ratios; RAPE (Rescind-And-Purge Evil); and fake insurance.

Do people really want Wall Street between them and their doctors? (Read up on medical-loss-ratios -- which means that anything they pay out to cover people is a loss to the stock-holders & punished by their Death-Star OverLords, Wall Street.) It disgusts.

You folks who still want Wall St. health scam insurance should go ahead and have your premiums pay Ron Williams' CEO Aetna's 24 million dollar annual compensation.

Urgent: To contact your representatives and leaders, you can go to http://www.congress.org/congressorg/directory/congdir.tt
for phone, fax, snail, etc.

For The White House, go to
http://www.whitehouse.gov/contact/
for email, phone, etc. Phone will be busy. You need to persevere and redial a lot. Other leaders (Pelosi, Reid, Baucus, etc) are a lot easier to contact. Always be extremely polite and have a tone of more in desperate sorrow than in anger. (I also call to quickly thank the good guys, Rockefeller, Sherrod Brown, Anthony Weiner, Barbara Mikulski etc.)

I've escalated to asking the volunteer to ask the President to say this single, plain sentence: "I will VETO any bill which does not include a robust public option."

My gratitude to Wendell is deep and wide. My head would have exploded if he hadn't stood bloody up. Governor Howard Dean is great too. (You can sign his petition here: http://standwithdrdean.com/) Watch The Ed Schultz Show on msnbc too. He's huge for health reform. He'll be on vacation this coming week reading the entire HELP bill, but he is very fiery for real reform for We The dear Sheeple. Wendell Rocks.

I work for a large US corporation that uses CIGNA ironically and I've watched our benefits and the quality of coverage decrease over time, especially in the last few years as the company struggles to maintain costs. And I'm one of the lucky ones who has coverage.

Congratulations on your decision to bring the wealth of your knowledge to the service of people in need -- and thank you. You add much needed credibility to the health care discussion.

Seriously -- is it possible you could work with President Obama to create a compelling narrative that most American's can easily understand about what is being offered and what is at stake? So far the narrative has been left to the Republicans and as the only clear story out there, as wrong as it is, it's working against us all.

Wendell Potter,

Let’s not dispair. Consider the Butterfly Effect:

“the idea that a butterfly’s wings might create tiny changes in the atmosphere that may ultimately alter the path of a tornado or delay, accelerate or even prevent the occurrence of a tornado in a certain location. The flapping wing represents a small change in the initial condition of the system, which causes a chain of events leading to large-scale alterations of events.

Wendell Potter, you are that butterfly. I cannot imagine President Obama and Congress declining to join you at the RAM fair in LA.

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