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Context of 'June 2007: Health Care Executive Shocked at Sight of Americans Being Treated in Livestock Stalls, Tents'

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Wendell Potter, a senior health care executive with the insurance giant Cigna, visits a “health care exposition” in Wise, Virginia, not far from his home town. Potter is shocked at what he sees at the Wise County Fairgrounds. As he will later recall (see July 10, 2009), he assumed he would see booths set up for people to get their blood pressure checked and so forth. What he actually sees is doctors providing a range of care in livestock stalls and tents. Some patients are treated while lying on gurneys, under a rainy sky. “And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care,” he will later say. “People drove from South Carolina and Georgia and Kentucky, Tennessee—all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth. There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.… It was absolutely stunning. It was like being hit by lightning. It was almost—what country am I in? I just—it just didn’t seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me.” Potter will describe himself as “insulated” from the harsh reality of American health care before visiting the expo. “I had a great job. And I had a terrific office in a high-rise building in Philadelphia. I was insulated. I didn’t really see what was going on. I saw the data. I knew that 47 million people were uninsured, but I didn’t put faces with that number.… [W]hen you’re in the executive offices, when you’re getting prepared for a call with an analyst, in the financial medium, what you think about are the numbers. You don’t think about individual people. You think about the numbers, and whether or not you’re going to meet Wall Street’s expectations. That’s what you think about, at that level. And it helps to think that way. That’s why you—that enables you to stay there, if you don’t really think that you’re talking about and dealing with real human beings.” Potter finds it difficult to reconcile his executive lifestyle with relatives and neighbors being treated in livestock stalls. He will eventually resign his position with Cigna. [PBS, 7/10/2009]

Entity Tags: Wendell Potter, Cigna

Timeline Tags: US Health Care

Wendell Potter (r) being interviewed by Bill Moyers (l).Wendell Potter (r) being interviewed by Bill Moyers (l). [Source: PR Watch (.org)]Former health care executive Wendell Potter, who left the insurance giant Cigna after fifteen years, appears on “Bill Moyers’ Journal.” He was formerly the head of corporate communications before he resigned his position, a post he calls “the ultimate PR job.” He says he was not forced to leave the company, and was extremely well compensated for his duties. He left after realizing that the health care industry is using underhanded and hurtful tactics to undermine the drive towards health care reform. He never went to his bosses with his observations because, he says, “for most of the time I was there, I felt that what we were doing was the right thing. And that I was playing on a team that was honorable. I just didn’t really get it all that much until toward the end of my tenure at Cigna.”
Health Care Expo Changed His Perceptions - In June 2007, Potter recalls, his perceptions were drastically changed by his visit to a health care exposition in Wise, Virginia (see June 2007).
Changing Plans - The industry shifted from selling primarily managed care plans, he says, to what they call “consumer-driven plans.” Despite the name, they are health care plans with high deductibles and limited coverage.
'Highlight Horror Stories' - Moyers shows Potter a copy of an “action plan” devised by America’s Health Insurance Plans (AHIP), the industry’s trade association. In large gold letters, the plan tells lobbyists and industry representatives to “Highlight horror stories of government-run systems.” Potter says that AHIP and other industry representatives try to paint government-run health care as socialism, and as inevitable failures. “The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them,” he says, “that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.” Moyers also notes that the AHIP plan targets the film Sicko, a 2007 documentary by leftist filmmaker Michael Moore that portrayed America’s health care industry in a dismal light. AHIP’s action plan is to “Position Sicko as a threat to Democrats’ larger agenda.” Potter says that was an effort to discredit the film by using lobbyists and AHIP staffers “to go onto Capitol Hill and say, ‘Look, you don’t want to believe this movie. You don’t want to talk about it. You don’t want to endorse it. And if you do, we can make things tough for you.’” If they did, AHIP would retaliate by running negative ads against the lawmakers in their home districts or other electoral punishments. AHIP focused strongly on the conservative Democratic Leadership Council. Another tactic, as delineated in the memo: “Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status.” Moyers says that AHIP attempted to “radicalize” Moore and portray him as an extremist who could not be believed. Many politicians used AHIP talking points in discussing Moore and his film. “So your plan worked,” Moyers observes. Potter agrees: “It worked beautifully.” The lesson that was lost from Moore’s film, Potter says, was that Americans “shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.”
Conservative Counter-Strategy - Moyers then displays a memo from Republican strategist Frank Luntz, who in the spring of 2009 wrote a strategy memo for health care reform opponents. The memo reads in part: “First, you have to pretend to support it. Then use phrases like, ‘government takeover,’ ‘delayed care is denied care,’ ‘consequences of rationing,’ ‘bureaucrats, not doctors prescribing medicine.’” He then shows film clips of House Minority Leader John Boehner (R-OH), Senate Minority Leader Mitch McConnell (R-KY), Senator Jon Kyl (R-AZ), and others using Luntz’s talking points in discussions on the floors of Congress. Potter says that many conservatives—Democrats as well as Republicans—“are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don’t understand from an insider’s perspective like I have, what that actually means, and the consequences of that to Americans. They parrot those comments, without really realizing what the real situation is.” He notes that Representative Zach Wamp (R-TN), who grew up very near Potter’s childhood home in Chattanooga, told reporters that half of America’s uninsured don’t want health care, they would rather “go naked and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.” Potter notes that the word “naked” is an industry term for people who choose not to buy health insurance. He calls Wamp’s comment “ridiculous” and “an example of a member of Congress buying what the insurance industry is peddling.” Moyers cites conservative Democrat Max Baucus, the chairman of the Senate Finance Committee, as another politician central to the health care reform process who is heavily influenced by corporate lobbyists—two of whom used to work on his own Senate staff. Potter says: “[I]t does offend me, that the vested special interests, who are so profitable and so powerful, are able to influence public policy in the way that they have, and the way that they’ve done over the years. And the insurance industry has been one of the most successful, in beating back any kinds of legislation that would hinder or affect the profitability of the companies.”
Fierce Opposition to Public Option - The “public option,” the idea that the government would extend a non-profit, government-run health care alternative for citizens, is fiercely opposed by the health care industry. Potter says the reason why is “[t]he industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate.” Government programs such as Medicare and the Veterans Administration’s medical providers are far more efficient than private, for-profit health care providers, and the industry fears that having to compete with such a program will slash their profits. Medical companies will do whatever it takes to keep their profit margins—and shareholder returns—above a certain threshold. They will deny more claims, kick more people off their rolls, purge employer accounts, whatever it takes. Potter, evidently bemused, says, “You know, I’ve been around a long time. And I have to say, I just don’t get this. I just don’t understand how the corporations can oppose a plan that gives the unhealthy people a chance to be covered. And they don’t want to do it themselves.… I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.” A public option would help “keep [health care corporations] honest,” he says, and they would inevitably lose profits.
Predictions - Right now the industry is primarily involved in what Potter calls a “charm offensive,” where it is attempting to give the perception that it, too, is for health care reform. But once Congress begins putting out specific legislative language, the industry and its flacks will begin attacking specific provisions. Moyers says the upshot is for the industry to either “kill reform” or prevent lawmakers from agreeing on a bill, just like what happened in 1993-94 under the Clinton administration. No matter what they say—favoring the elimination of pre-existing condition restrictions, for example—the industry will adamantly oppose reform of any kind. “They don’t want a public plan,” Potter says. “They want all the uninsured to have to be enrolled in a private insurance plan. They want—they see those 50 million people as potentially 50 million new customers. So they’re in favor of that. They see this as a way to essentially lock them into the system, and ensure their profitability in the future. The strategy is as it was in 1993 and ‘94, to conduct this charm offensive on the surface. But behind the scenes, to use front groups and third-party advocates and ideological allies. And those on Capitol Hill who are aligned with them, philosophically, to do the dirty work. To demean and scare people about a government-run plan, try to make people not even remember that Medicare, their Medicare program, is a government-run plan that has operated a lot more efficiently.… [T]hey want to scare you into thinking that through the anecdotes they tell you, that any government-run system, particularly those in Canada, and UK, and France that the people are very unhappy. And that these people will have to wait in long lines to get care, or wait a long time to get care. I’d like to take them down to Wise County. I’d like the president to come down to Wise County, and see some real lines of Americans, standing in line to get their care. [PBS, 7/10/2009]

Entity Tags: John Boehner, Frank Luntz, Cigna, Bill Moyers, America’s Health Insurance Plans, Zach Wamp, Wendell Potter, US Veterans Administration, Senate Finance Committee, Michael Moore, Medicare, Max Baucus, Mitch McConnell, Jon Kyl, Clinton administration

Timeline Tags: US Health Care

America’s Health Insurance Plans (AHIP), the health care industry’s trade association, distributes “talking points” for use by opponents of health care reform that specifically target the so-called “public option” for alternative government-provided health care. AHIP has been heavily involved in orchestrating and facilitating the recent spate of raucous anti-reform protests (see July 10, 2009 and August 2, 2009). The talking points, entitled “August Recess Talking Points,” include the following: “Health plans strongly believe that now is the time for comprehensive, bipartisan health care reform that enhances affordability, improves quality, covers all Americans, and puts the health care system on a sustainable path. However, we also share the concerns that employers, providers, and patients have raised about the significant unintended consequences of a new government-run plan. A government-run plan would dismantle employer-based coverage, thereby violating the shared commitment to ensure that those who like their current coverage can keep it. The government-run plan would also add significant liabilities to the federal budget.” Reporter Greg Sargent notes that like any other lobbying group or citizens’ organization, AHIP has the right to “encourage… participation and distribut[e] talking points.” However, he notes that the industry AHIP represents “has a tremendous financial stake in whether a public plan becomes a reality. And the industry is not only telling people to go to town meetings, but also telling them how to voice their opposition to a public option. Bottom line: It’s indisputable that the industry is orchestrating public opposition to one of health care reform’s most important components.” [Plum Line, 8/6/2009]

Entity Tags: Greg Sargent, America’s Health Insurance Plans

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Former health insurance executive Wendell Potter (see July 10, 2009), who formerly headed the PR division at Cigna, says that the skyrocketing profits of health care corporations and their executives are directly driving the industry’s opposition to health care reform. According to filings with the Securities and Exchange Commission, the profits of the US’s 10 largest health insurance companies rose 428 percent between 2000 and 2007. In 2000, those 10 companies made a combined profit of $2.4 billion. In 2007, those numbers had risen to $12.9 billion. During that seven-year period, the number of Americans without health insurance rose 19 percent. The CEOs of those 10 firms made an average of $11.9 million in 2007 alone. MSNBC’s Rachel Maddow notes that the health insurance industry “bankrolled efforts to kill the last effort at health care reform” in 1994 (see Mid-January - February 4, 1994). In an interview with Maddow, Potter blames the insurance industry for much of the recent spate of “town hall” disruptions that have helped derail debate over health care reform (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, August 5, 2009, August 5, 2009, August 6, 2009, August 6, 2009, August 6-8, 2009, August 8, 2009, and August 10, 2009) “and a lot of the deception that’s going on in terms of disinformation that many Americans apparently are believing.” Potter goes on to note that health insurance firms are making tremendous profits on the steady erosion of paid premiums going to fund medical claims. In 1993, the industry paid out roughly 95 percent of the premiums they took in to claims. In 2007, that number had dropped to 80 percent. Insurance firms also routinely “kick sick people off the rolls when they do get sick or when people get injured.… [A]nd also, they’re paying fewer claims.” The health insurance industry is dead set against the so-called “public option,” Potter says, for the simple reason that a publicly run alternative to private insurance would cost its members profits. [MSNBC, 8/11/2009]

Entity Tags: Wendell Potter, Rachel Maddow

Timeline Tags: US Health Care

Wendell Potter, a former health insurance executive with CIGNA who has now become a whistleblower against the industry (see July 10, 2009 and August 10, 2009), says that the raucous and contentious protests at health care “town halls” are the result of what he calls “covert,” or “stealth” efforts by health insurance companies. Potter says he lacks the specifics for the current campaign, but he witnessed and actually took part in similar efforts in earlier years. This year’s efforts follow similar patterns to the ones he was familiar with, he says. “The industry is up to the same dirty tricks this year,” Potter says after meeting with House Rules Committee Chairwoman Louise Slaughter (D-NY), who supports the Democrats’ health care reform initiative. “When you hear someone complaining about traveling down a ‘slippery slope to socialism,’ some insurance flack, like I used to be, wrote that,” Potter says. He notes that during his 20 years in the industry, he watched—and participated in—the industry’s funneling money to large public firms who would create “Astroturf,” or fake grassroots, organizations (see April 14, 2009, April 15, 2009, May 29, 2009, July 27, 2009, August 4, 2009, August 5, 2009, Before August 6, 2009, August 6, 2009, August 6-7, 2009, and August 10, 2009) and use friendly conservative media voices. Slaughter says, “[T]he notion that this is going to be something devilish comes from the people who would lose money on it.” [The Hill, 8/12/2009]

Entity Tags: Wendell Potter, Louise Slaughter

Timeline Tags: US Health Care, Domestic Propaganda

Within minutes of the release of a new study by health insurance lobbying firm America’s Health Insurance Plans (AHIP) that claims health care reform would drastically raise costs to American families (see October 11, 2009), critics from different sides of the political divide dispute the study’s accuracy and question its impartiality.
White House: Study Ignores Key Elements of Reform - White House assistant press secretary Reid Cherlin says the study “conveniently ignores critical policies that will lower costs for those who have insurance, expand coverage, and provide affordable health insurance options to millions of Americans who are priced out of today’s health insurance market or are locked out by unfair insurance company practices.” [MSNBC, 10/12/2009]
'Blowback' from Study Possible - White House and Senate officials say that the insurance industry may suffer “blowback” over the report. Democrats may well close ranks behind either the Senate Finance Committee (SFC) bill or another version of the legislation, and liberal lawmakers may go after the insurance companies, maybe by proposing a cap on premiums or solidifying support for the government insurance plan. “They have opened themselves up,” says a senior Senate Democratic aide. “It is an incredibly stupid strategic blunder. If you are going to fire a shot like this, you fire a good shot.” Former industry executive Wendell Potter, who has become an industry whistleblower (see July 10, 2009), says AHIP is responding to critical analyses from Wall Street that the legislation will hurt private insurers. “Karen [AHIP official Karen Ignagni] had no alternative because the CEOs were so determined to do something to try to sway the committee to back off the reductions,” he says. “She didn’t have an alternative. They are obviously doing this on the eve of the vote in the Senate Finance Committee, hoping enough members of the committee would be concerned, to restore it. I think the strategy will backfire.” [Politico, 10/12/2009]
Economist: Study Fundamentally Flawed - MIT economist Jonathan Gruber analyzes the PWC study and concludes that it is fundamentally flawed. He writes: “The nonpartisan analysis based on information from the CBO [Congressional Budget Office] shows clearly that for those facing purchase in the non-group market, the SFC bill will deliver savings ranging from several hundred dollars for the youngest consumers to over $8,500 for families. This is in addition to all the other benefits that this legislation will deliver to those consumers—in particular the guarantee, unavailable in most states, that prices would not be raised or the policy revoked if they became ill.” On MSNBC, Gruber notes: “If the report had came out and said, ‘look we need stronger penalties, or premiums will go up,’ that’s a very valid point to make. But what the report says is that it went too far. It said with the current structure, premiums will be much higher than they are today. And that’s just wrong. I mean, the nonpartisan Congressional Budget Office has came out and said that for this bill, premiums in the exchange will be lower than they are in the none group market today. So they just drew the wrong comparison.” [Massachusetts Institute of Technology, 10/12/2009; Think Progress, 10/13/2009]
Democrats: Proof that Industry Needs Further Regulation - Representative Anthony Weiner (D-NY) says, “[T]he health insurance lobby today fired the most important salvo in weeks for the public option,” and adds that the study proves the industry needs further regulations imposed on it by Congress: “If you have the health care industry complaining that we’re going to raise costs because of these changes, it is them putting us on notice that we haven’t put enough cost containment in the bill. You know, the health care industry themselves is putting out a whole report saying that. That should be a tell to the [Senate Finance Committee] that you know what, maybe it’s time for them to go back and revisit the public option. In a strange way, and look, obviously they didn’t mean this, the health insurance lobby today fired the most important salvo in weeks for the public option, because they have said, as clear as day, left to their own devices, according to their own number crunchers, they’re going to raise rates 111 percent.” [Think Progress, 10/12/2009] Senator John D. Rockefeller (D-WV) charges the insurance industry with releasing a false study for political purposes. “The misleading and harmful claims made by the profit-driven insurance companies are politicking for corporate gain at its worst,” he says. “Their recent statements only further highlight that our focus here in Congress must be on the inclusion of a public health insurance option in the marketplace to protect families and put more money back in their wallets by creating greater competition and driving down costs.” [Politico, 10/12/2009]
Washington Post: 'Industry Hit Job' - The Washington Post’s Ezra Klein calls the report “deceptive” and “a predictable industry hit job,” and notes that the study was produced by accounting and services firm PriceWaterhouseCoopers (PWC), which in the 1990s was commissioned by the tobacco industry to do a study on the economic catastrophe that would result from taxing tobacco products. That study was found to be unreliable, and, perhaps not surprisingly, made all of its errors in favor of the tobacco industry. Klein writes that the same effect can be observed in this report on health care. He concludes: “But if the [study] doesn’t offer much in the way of trustworthy policy analysis, it is an interesting looking at the changing politics of the issue. In short, the insurance industry is getting scared. After many months of quiet constructiveness, they’re launching a broadside on the week of the Senate Finance Committee’s vote. The White House, which had a pleasant meeting with the industry’s leadership last week, was shocked by the report, and so too was the Senate Finance Committee. The era of cooperation seems to be over, and they weren’t given much advance warning. But the report might have another impact, too: The evident anger and fear of the insurance industry might do a bit to reassure liberals that this plan is worth supporting, after all.” [Washington Post, 10/12/2009]
New Republic: 'Questionable Assumptions' - The New Republic’s Jonathan Cohn chastizes PriceWaterhouse for deliberately, and explictly, choosing to believe that all the new factors included in the study will raise costs, when other analyses show that many of those factors will actually drive costs down. Cohn writes that the study is based on a plethora of “strange [and] questionable assumptions.” [New Republic, 10/11/2009]
Progressive Columnist: 'This Is News?' - Progressive columnist Josh Marshall wrote before the study was released: “Let me get this right. The big news tomorrow is that ‘America’s Health Insurance Plans’ (AHIP, aka the health insurance lobby) has commissioned a study by PriceWaterHouseCoopers that comes to the conclusion that the Senate Finance Committee bill is a bad, bad thing and would lead to health care costs going up even faster than they are under the current system. This is news?” [Talking Points Memo, 10/12/2009]
Washington Times: Defending the Study, Attacking the CBO - The conservative Washington Times defends the study as essentially accurate, and instead attacks the Congressional Budget Office, whose own figures differ dramatically from the PWC study. The Times editorial board calls the CBO’s estimates “fanciful” and “grandly overoptimistic,” and accuses the Democrats of adding opportunities for consumers to “game the system”—“It’s a mystery how the CBO can make its evaluation without once mentioning that individuals easily will be able to go without insurance while they are healthy and then buy insurance after they get sick.” The entire proposal allows Democrats to “avoid electoral accountability over the urgent health care needs of the people they say they’re trying to help but won’t.” [Washington Times, 10/12/2009]
AHIP Defends Study - Ignagni defends the study and says the lobbying firm did not release it to undermine the Finance Committee’s attempt to craft an acceptable reform bill. She says the industry’s main concern is getting everyone involved in health care to work together to bring costs down. There is a strong need, she says, to “encourage all the other stakeholders to participate in a broader effort so that they can too lend a hand and get costs under control in a much more effective way than we would.… We don’t see comprehensive cost control in any legislation.” [MSNBC, 10/12/2009]
PWC Backs Off from Study - Late in the evening, PWC issues a statement noting that the study only examined “a small slice” of the health care reform initiative, and saying that if other provisions in the reform package succeed in lowering costs, then the estimates of cost increases claimed in the study would be inaccurate (see October 12, 2009).

Entity Tags: America’s Health Insurance Plans, Anthony D. Weiner, Jonathan Gruber, Congressional Budget Office, Ezra Klein, Jonathan Cohn, Wendell Potter, John D. Rockefeller, PriceWaterhouseCoopers, Karen Ignagni, Washington Times, Obama administration, Joshua Micah Marshall, Reid Cherlin, Senate Finance Committee

Timeline Tags: US Health Care

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