Exposing the Insurers

By chance, I happened into BookPeople yesterday, mainly to sit out rush hour traffic on Lamar. I'm happy I did, because I got see Wendell Potter, the health insurance industry whistle-blower speaking about the insurance cartel's dangerous – and sometimes deadly – practices.

You may not know Potter's name, but it's likely you've heard his story: after serving in the insurance industry for over two decades, Potter had a change of heart and left his position to speak out. In his remarks, he recounted the story of Nataline Sarkisyan, a California teen battling leukemia. Potter's company, Cigna, had covered her medical procedures previously, but when it came time for a liver transplant, they balked at the cost, with a company doctor tens of thousands of miles away calling the practice “experimental.” Sarkisyan's family garnered massive media attention, and ultimately, Cigna caved, willing to pay for the transplant – but by that time, her overall health had so deteriorated, there was nothing to be done. She died soon after the transplant was approved. After that, Potter said he could no longer serve the industry in good conscience.

At the heart of the episode, if not for-profit insurers' general mission, Potter emphasized, was the industry's needs to meet profitability expectations. Countering the lies surrounding health insurance reform, Potter says fears of a “government takeover” are ridiculous when there's already “a Wall Street takeover of the health care system.” Instead of a government bureaucrat directing health decisions, we currently have “a corporate bureaucrat standing between you and your doctor.”

The profit motive is behind insurance companies' practice of “rescission,” canceling insurance policies for patients receiving expensive treatment. Potter also recounted the story of Robin Beaton, who testified before the same congressional panel as Potter investigating health insurance practices. Her insurance was canceled in the midst of cancer treatment because she failed to disclose she had previously been treated for acne.

Potter began by reading an excerpt from Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, the book he's on tour to promote. The passage, “Big Soda,” described how, threatened by taxes on sugary sodas, beverage conglomerates and distributors instantly created Astroturf groups with names like Americans Against Food Taxes to fight the proposals. Potter said he read the passage to illustrate how “the playbook” initially developed by tobacco companies to fight further regulation – creating front groups, clouding the issue, and preying upon fears of job losses – has been adopted by not only insurance reform opponents, but any company fighting additional safeguards.

But it's nowhere more evident than the sideshow attending President Obama's insurance reform package, as evidenced by House Republicans naming their repeal bill “Repealing the Job-Killing Health Care Law Act.” But the bill is just cover, Potter says. “'Repeal and replace' is just a smokescreen. That's political rhetoric, and it ain't gonna happen,” he says. The political theater of the repeal bill – which Potter predicts will die in the Senate – is to “hide the real purpose, which is to strip out the consumer protections,” like prohibitions against denying coverage. Once the bill fails, Potter expects Republican leadership to argue “'Now what we gotta do is take this apart piece by piece' – strip out some of the things they say are costing jobs. Watch the language over the coming months … there will be talking points that come straight from the insurance industry.”