Friday, August 28, 2009

Mr. Potter's Lullaby

After reading Nick Kristof’s column in the New York Times yesterday (available here), I was moved to investigate his chosen subject, former insurance industry executive Wendell Potter. After a quick Google search, I found an interview of Mr. Potter conducted by Bill Moyers that I thought might be good viewing. So last night, my wife and I sat down after getting our daughter to bed and began an evening of emotional distress.

The video (from PBS’s Bill Moyers’ Journal) with Potter (available here) was, to say the least, unsettling. In it, Mr. Potter describes how the largest insurance agencies in the country deplore competition and have worked tirelessly over the years not only to consolidate their hold on the market by buying up smaller companies, but to convince the public that any insurance not offered and provided through them is a wrong headed and un-American idea.

He talks specifically about the insurer’s aggressive pursuit of profits and the lengths to which they go to maintain them. Two such practices described were the canceling of policies as soon as holders are diagnosed with conditions that are expensive to treat, and increasing premiums on smaller business whose employees file expensive or too frequent claims so that the small business is priced out and forced to cancel coverage.

He describes the industry organization, Americas Health Insurance Plans (AHIP), and their concerted efforts in the early 1990’s to control the messages and talking points that most Americans would see and hear on the news or TV commercials. He is blatant in his descriptions of pressure being applied and bribes offered to legislators by the industry and their lobbyists. The goal was to direct the conversation away from fact and towards ideological lines, thus obfuscating any real attempt at conversations about reform. Quite simply, they wanted things to stay just as they were and they used every way possible to portray anyone who suggested reform as a danger to our society.

Potter’s description of the AHIP’s response to Michael Moore’s film, “Sicko” in 2007 is nothing short of astonishing. The coordination and logistics utilized to try and cut off debate about health care reform and blunt the impact of Mr. Moore’s film illustrate just how desperate the industry is to remain in control of health care in this country. Their companies are at stake, as well as the fortunes of the executives who run them, and they fight as though they have everything to lose – because they do.

The information gleaned from the video was not surprising. Neither my wife nor I were shocked to hear that Cigna and other insurers don’t want competition and that they are willing to lie and manipulate the message through media to maintain the status quo. What was surprising, and disturbing to watch, was this man – who has worked in the industry for decades and helped design the PR responses to such threats to their crystal towers – sit there and explain why he now decides to come forward and let the rest of America know just what he has been doing for the past 15-20 years. He claims he was moved when he attended a health fair in Virginia at which thousands of people sought care because they had no insurance and no access to affordable care because of it.

His descriptions of what he saw and how it moved him only served to infuriate me. He had never seen people suffer and go without because they had no ability to pay for care. It had never dawned on him that people who were removed from his company’s roles would be left with no way to pay for care they needed. He had lived in that ivory tower and had never bothered to look down and see what was under him. I was nauseous as he described flying on the Cigna corporate jet, eating a meal on a gold rimmed plate with gold plated utensils while his company worked diligently at not paying for the care of policy holders who had dutifully paid in their premiums.

I don’t know what to make of all of this yet. I’m still too unsure and unconvinced of this man’s motives to be sure he’s telling us all that we need to know. I don’t doubt anything he said, but I suspect that there’s much more and worse that we should have heard.

One thing is very clear though - the insurers have attempted to make their own actions invisible as much as possible. They have levied accusations of rationing and denying care against an as yet unexisting government run insurance plan, yet they themselves conduct these practices. It’s like Fox News accusing another network of bias while denying their own.

The former administration taught us all that if you accuse your opponent of something you yourself are doing, they spend lots of time and effort trying to disprove a negative and you are free to do whatever you want. Advocates of universal health have been defending the idea from almost everyone; meanwhile Cigna and its brethren are hiking rates and dropping expensive policy holders.

It’s enough to make me sick.


  1. I, too, was taken aback by most of what Mr Potter said. Three observations come to mind.

    1) Not all insurers are stock companies. Some are mutual companies, which means that the policy holders are the owners of the companies. If policy holders allow the management of a mutual insurance company to "get away with murder," they are being derelict in their fiduciary responsibility to themselves.

    One of the weaknesses in much of the talk about health care "reform" appears to be the absence of having names named. Now, I may have missed something, but Cigna and United Health Care are the only companies I recall having been mentioned. I'd feel more comfortable knowing exactly which companies are "making out like bandits."

    2) Michael Moore has done some (perhaps even a lot; I've seen only three of his films) good, but like all of us he has his faults. A group of Canadians made a documentary about Mr Moore and how he produces his documentaries. (I wish I had the coordinates, but a Google search should turn up the necessary information.) The Canadian documentary on Mr Moore was at least as enlightening as the three by Mr Moore that I have seen. My point: I'd take a big lick off that salt block by the fence and think through carefully at least twice any of the evidence that Mr Moore presents.

    3) I would feel far more sanguine about Congress' attempt to effect health care reform if (a) members of Congress had to declare their conflicts of interest. As it is, I have to find out who's taken how much from which insurance companies or associations; (b) Congress would not exempt itself and federal employees from whatever program(s) it devises; (c) I thought that the vast majority of members of Congress truly had the interest of the majority of Americans at heart. I would prefer not to be a cynic, but I've seen too many of Congress' good intentions in and of themselves and as examples of the law of unintended consequences not to be one.

    Thank you for your thoughtful piece.

  2. Richard -

    I'm glad you enjoyed it. I am also happy that it has provided food for thought.

    Keep reading.