Posted by Wendell Potter on January 12, 2011

Advocates of health care reform who are fearful -- or hopeful, as the case may be -- that Republicans will be able to repeal the Patient Protection and Affordable Care Act (aka "Obamacare") need to understand that the GOP has no real intention of repealing it.

The rhetoric of repeal is just a smoke screen to obscure the real objective of the "repeal and replace" caucus: to preserve the sections of the law that big insurance and its business allies like and strip out the regulations and consumer protections they don't like.

The rhetoric is necessary, of course, to keep fooling the people they fooled in the first place (with a corporate-funded campaign of lies and deception) into thinking that repeal would be in their best interests. For the same reason, it will be necessary for the Republican-controlled House to pass the two-page bill their PR consultants drafted to repeal the law. (Calling it the "Repealing the Job-Killing Health Care Law Act" is a tactic that comes straight out of the playbook I describe in my book, Deadly Spin.)

By now, lobbyists for the insurance industry undoubtedly have met behind closed doors with every one of their new members of Congress to make it clear what insurers really want. Those meetings were necessary because it's likely that some of the newly elected representatives of the insurance industry, who told us that the law was a "government takeover of health care," had actually begun to believe their own talking points. You know the old adage: Tell a lie often enough and you'll begin to believe it.

The real concern for advocates of reform should not be repeal. What we will wind up with, if the insurers' demands are met, is much worse.

Insurers got what they needed out of the reform debate: a requirement that all of us who are not eligible for a government-run program like Medicare will have to buy their increasingly inadequate products. That was job one. Job two was to get the public option, which they knew would be a formidable competitor, excised from the bill. The insurers were desperate to have the individual mandate included in the bill because their current business models are not sustainable. They cannot continue raising premiums and shifting more costs to their customers through ever-increasing deductibles and expect employers and regular folks to buy what they're selling.

Shifting costs is now the only way the for-profit insurers can ensure Wall Street of the expected return on investment. The problem, of course, is that you can't keep shifting costs to consumers indefinitely and expect them to buy your products -- unless, of course, the government forces them to.

Insurers helped finance the "government takeover" fear-mongering campaign not because they wanted the law repealed but because they hoped it would enable the GOP to regain at least one chamber of Congress. They fare much better when Republicans are in control. They also are not too worried about the challenges to the law's constitutionality because insurers had a hand in writing the individual mandate provision to ensure that it could ultimately withstand a court challenge.

What insurers don't like are the provisions of the law that restrict their ability to shift costs to us and that require them to spend at least 80 percent of premiums on our medical care. They also don't like being told they can't charge women and older people a lot more than men and younger people. And they are not at all happy that Congress finally outlawed some of their most anti-consumer practices, like dumping sick enrollees and refusing to sell insurance to people with pre-existing conditions. So the GOP's real agenda is to restore those "freedoms" to insurers and keep the individual mandate in place. We can only hope that reform advocates figure how to counter the lies -- the deadly spin -- and that Democrats in Congress will protect our best interests.

Comments

As a Canadian citizen, and someone who spends winters in Florida, I would like to thank you for speaking out on the horror of American health care for the average citizen. You may not be aware that the Canadian system is under constant attack, so we really appreciate any documentation on the subject of privitized health care.

With all good wishes for 2011 and KEEP UP THE GOOD WORK!

Why ramble when no facts or GOP are quoted? You only prove how blindly led the liberal party is. Observe all the facts and be willing to change your tune if unbais facts point you in the opposite direction.

I have been a healthcare professional for years. I also spent several years working in medical insurance (although not in as exalted a position as Mr. Potter), and I'm here to tell you that what Wendell Potter says is absolutely spot on. Those of us who were working inside the healthcare industry have known for years that if something didn't drastically change that we would end up with exactly the problems we are facing now. And don't try to tell me that the industry isn't lying to the public to protect their position, because I KNOW they are. I've seen it up close, and I could fill several pages with stories of the chicanery from the industry I've personally seen.
For-profit insurance(at least in its current incarnation)does not make economic sense. It benefits NO one but the ones profiting from it, and the last thing they want is for the public to figure that out. If there is going to be for-profit insurance then it should at least be stringently regulated because the industry has already proved that they certainly can't be trusted to police themselves.
I applaud Mr. Potter for having the courage to speak out on this issue. The man should be considered a hero for his efforts to make the general public aware of what a lot of us have known for years.

I wonder about the Center for Medicare Advocacy which is a group that allegedly supports health care reform and his even quoted you Mr. Potter. However, look at what their doing with the money they receive in donations. Their not suing the insurance companies. Their suing the government over regulations that cut into physician and perhaps insurance company profits http://www.medicareadvocacy.org/Litigation/LITIGATION_ActiveCases.htm . Rather, odd behavior I would say for a group that claims to advocate for health care. A closer look at the testimony of some of their allegedly advocates includes statements like "he appropriate government role is not coaching facilities in how to provide
good care. The federal law recognizes that market forces are not sufficient to assure high quality of care. Nor, I would add, is technology, important as technology is. “Pay for performance,” or its new name, “value-based purchasing,” is promoted as another panacea to quality problems, but promotion of this untested concept deflects time and attention from what is known to be necessary for high quality care, namely staff." In other give us money but don't regulate us(see http://docs.google.com/viewer?a=v&q=cache:ae0hNg62au8J:www.qualitylongtermcarecommission.org/meetings/722PH/pdf/txstmtAMPUBLICCOMMENTedelman07-19-05.pdf+%22toby+edelman%22+testimony&hl=en&gl=us&pid=bl&srcid=ADGEESh_xsEJOnzTUflOKMpUCnAqqrgMiuIom8COsYdmvafsvcy9jHVUYDFX0tdlXfYruA6NadRfFCmlkwKZUNmE4AARr-nRYZPxwOb-NLv9cCCjYBUvUvPQvr51UaAil_FgGYtEhtes&sig=AHIEtbTg12A5vHA5-8CpIbhV3GWOpdjjCQ)." They seem to want Medicare to pay more but without any oversight which seems to me to be highly inconsistent with their public statements. I also find their focus on nursing homes at the expense of looking at what's going on in hospitals to be a red flag. Of course, nursing home advocacy is important unless it used to divert attention away from the recent OIG research which shows that 2/7 medicare patients are harmed, http://www.thecre.com/blog/2010/11/hhs-oig-1-in-7-medicare-beneficiaries-harmed-in-hospital/ which in my view begs for more regulation and not less.

Keep up the good work Mr. Potter!

Time is overdue to start Class Action lawsuits against insurance companies. The only thing insurance companies will respond to is the possibility of losing money!

All Republicans and Democrats should be required to use the average American's health insurance because unless and until they have the FULL EXPERIENCE OF DEALING WITH THE INSANITY OF HEALTH CARE BUREAUCRACY they just won't EVER get it. Even then they I doubt they would anyway. All the more reason for CLASS ACTION LAWSUITS!! If you can stay healthy then you have a fighting chance - if you get sick you will get beaten up financially by your insurer one way or another.

My family has personal experience with his so we know it's a FACT!

The U.S. needs a public option. Insurance companies can go straight to h___.

Wendell, your observations are very correct about the influence of profiteers and investors in the health insurance debate, and how they are spreading huge untruths about health care. As a former Republican with a family member who led Eisenhower's campaign...I am amazed how gullable and corrupt the party has become since the Nixon Administration. Also, most Republican officials have no idea what they are doing to harm our American people and our country, and neither do the voters. Some Democrats are the same.
please keep putting forth your efforts to educate the public, and lawmakers as well.

Best regards
PB

Almost done w/ this excellent book - and I'm HOPPING mad. But, then I have been so about the insurance industry for years already! This just added fuel to the fire..
So, now I want to know why no one has sued health insurers for practicing medicine without a license? Oh, right, they have shills with MDs working for them making "medical decisions" in review cases.
As long as we in the US have an insurance industry AND health care provision industry that is profit driven we will never have equitable, affordable health care for all. (Notice, I did NOT say health insurance.)
I pray everyday that my husband doesn't get sick or have a serious accident right now. We can't afford the $400 plus to add him to my employer provided health insurance plan.