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Thursday, July 16, 2009 FULL SHOW | HEADLINES
2009-07-16

"They Dump the Sick to Satisfy Investors": Insurance Exec Turned Whistleblower Wendell Potter Speaks Out Against Healthcare Industry

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As the debate over healthcare reform intensifies on Capitol Hill, we spend the hour with a former top insurance executive who’s now exposing the industry’s dirty secrets. Wendell Potter once served as the head of corporate communications at CIGNA, one of the nation’s largest health insurance companies. We speak to Potter about his own transformation from industry mouthpiece to whistleblower, the healthcare industry’s extensive PR and lobbying machine, the campaign to discredit Michael Moore’s film Sicko, and the insurance industry’s most pressing task: the fight against a public option, let alone a single-payer system. [includes rush transcript]

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: As the healthcare reform debate intensifies on Capitol Hill, we spend the hour today with a former top executive from one of the nation’s largest health insurance companies who has begun exposing some of the industry’s dirty secrets. This whistleblower testified before the Senate Committee on Commerce, Science and Transportation last month.

    WENDELL POTTER: My name is Wendell Potter, and for twenty years I worked as a senior executive at health insurance companies. And I saw how they confused their customers and dumped the sick, so all they — so also they can satisfy their Wall Street investors.

AMY GOODMAN: Wendell Potter joins us today for the hour.

Up until last year he was the head of corporate communications at CIGNA, one of the nation’s largest for-profit health insurance companies. He served as CIGNA’s chief corporate spokesperson. He also once headed communications at Humana, another large for-profit health insurer. In 2007, Wendell Potter helped spearhead the healthcare industry’s campaign against Michael Moore’s movie Sicko. Today he is a fellow at the Center for Media and Democracy and is becoming one of the most prominent industry whistleblowers.

I sat down with Wendell Potter earlier this week.

    WENDELL POTTER: I worked for CIGNA for fifteen years, and I was a spokesman or spokesperson for CIGNA for all of that time, and probably the last four or five years I was the head of corporate communications and also the chief spokesman for the company.

    AMY GOODMAN: So why have you decided to speak out?

    WENDELL POTTER: You know, when I left, I left voluntarily. It was a little over a year ago. I just decided I didn’t want to keep doing that. I had no longer felt that what I was doing was the right thing. But I didn’t decide to start speaking out until just earlier this year, when I started seeing the evidence that the insurance industry’s PR and lobbying campaigns were apparently paying off, like they did in the early ’90s when they were leading the effort to kill the Clinton plan, and how they’ve killed every meaningful healthcare reform initiative since then.

    AMY GOODMAN: But you were a critical part of that, being in communications and then head of communications at CIGNA.

    WENDELL POTTER: I was. I was a person who was often speaking for not just the company, but sometimes the industry. I spent a lot of time working with my colleagues at other companies on task forces and trade association committees to help develop the strategy and the tactics. So, yes, I did a lot of that. So, as a consequence, I know pretty much the game plan that they have developed and used and the talking points that they use and send out to people who they think will say the things they want them to say.

    AMY GOODMAN: And what are those talking points? What is the game plan of the health insurance industry?

    WENDELL POTTER: Well, the game plan is based on scare tactics. And, of course, the thing they fear most is that the country will at some point gravitate toward a single-payer plan. That’s the ultimate fear that they have. But currently — and they know that right now that is not something that’s on the legislative table. And they’ve been very successful in making sure that it isn’t. They fear even the public insurance option that’s being proposed, that was part of President Obama’s campaign platform, his healthcare platform. And they’ll pull out all the stops they can to defeat that.

    And they’ll be working with their ideological allies, with the business community, with conservative pundits and editorial writers, to try to scare people into thinking that embracing a public health insurance option would lead us down the slippery — excuse me, slippery slope toward socialism and that you will be, in essence, putting a government bureaucrat between you and your doctor. That is — you know, they’ve used those talking points for years, and in years past they’ve always worked.

    AMY GOODMAN: What turned you? Why did you change?

    WENDELL POTTER: I changed because over the last two or three years I began seeing more than I’d ever seen before and became more knowledgeable of how health insurance — how health insurance companies make money, how they maximize profits.

    The companies that I worked for were two of the biggest for-profit health insurance companies. And over the past fifteen years, since the last time we had this debate, the health insurance industry has consolidated to the point that now there are about seven very large for-profit health insurance companies that dominate the market.

    They have begun shifting their business model away from managed care, which, frankly, I used to think was a great model, a great concept, for the delivery of healthcare. But they’ve moved — they’re moving away from that to what they refer to as consumer-driven or consumer-directed care, and it really is just a euphemism for shifting the financial burden from insurers and employers onto the shoulders of working men and women. I saw that happening. But I also saw how — you know, the things that they do to maximize their profit, which really boils down to dumping the sick.

    AMY GOODMAN: What do you mean, “dumping the sick”?

    WENDELL POTTER: Two different ways that they do this. In the individual insurance market, we’ve seen quite a bit of news coverage, especially in California. When insurance companies who are active in the individual market — and this means when you don’t get your insurance coverage through your workplace, about the only option you have is to buy it directly from an insurance company, and usually it’s much more costly than it is through — if you buy it or get it through your employer. Once you file a claim, if you are unfortunate enough to get very sick or have an accident and file a claim, you very often will find that your insurance company will go back and look at your application to see if there might be a chance that you either didn’t disclose something that you knew about in the past or inadvertently didn’t disclose something or might not have known about a pre-existing condition. They’ll use that as evidence that you were committing fraud, and they’ll revoke your policy, or they call it “rescinding” your policy, leaving you holding the bag, making you completely responsible for all the medical bills. That’s one way that they dump people who need insurance the most.

    Another is, if you are employed, particularly with a small business, and your insurance — your employer gets his or her insurance through one of the large insurers, and if just one person in your company files a claim that the underwriters think is too high, if it skews what they think is the appropriate medical experience or claim experience, when that business comes up for renewal, they very likely will jack up the rates so much that your employer has no alternative but to leave and leave you and all of your coworkers without insurance. Either that or they may cut benefits or try to shop for coverage somewhere else. But the end result is, you may find yourself dumped into the rolls and the ranks of the uninsured.

    AMY GOODMAN: Was there a seminal moment when you were head of communications at CIGNA that really made you start to look? And how were you isolated there from, well, most people in the country, you know, who were increasingly talking about the massive problems of healthcare and access to it and being cutting off, the dumping of the sick, as you put it?

    WENDELL POTTER: I was very isolated, along with most insurance company executives who deal with numbers all the time — profit margins and medical loss ratios and earnings per share and how many millions of members you have, or things like that. It’s just — they’re just numbers. And I didn’t really associate that with real people as much as I should and as much as most insurance company executives should, until I went to visit my relatives in Tennessee.

    And while I was there, I happened to learn about a healthcare expedition that was being held at a nearby town across the state line in Virginia. And I was intrigued, borrowed my dad’s car and drove up to Wise County to see what was going on there. And this expedition was being held at the Wise County fairgrounds, and it was being put on by this group called Remote Area Medical that got its start several years ago taking volunteer doctors from this country to remote villages in South America, where people really don’t have any access to medical care. The founder realized pretty soon, though, that the need in this country is very, very great, and he started holding similar expeditions in rural communities throughout the country. And this one was nearby. I decided to check it out.

    I didn’t have any idea what to expect, but when I walked through the fairground gates, it was just absolutely overwhelming. What I saw were people who were lined up. It was raining that day. They were lined up in the rain by the hundreds, waiting to get care that was being donated by doctors and nurses and dentists and other caregivers, and they were being treated in animal stalls. Volunteers had come to disinfect the animal stalls. They also had set up tents. It looked like a MASH unit. It looked like this could have been something that was happening in a war-torn country, and war refugees were there to get their care. It was just unbelievable, and it just drove it home to me, maybe for the first time, that we were talking about real human beings and not just numbers.

    AMY GOODMAN: And so, what did you do with that?

    WENDELL POTTER: Well, it took me a while to just really process it. I came back to work. I knew at that time that I couldn’t continue doing what I was doing. It just didn’t seem like it was ethically the right thing for me to do. My first career, I was a journalist, and I had been in PR, though, for many years. And I came to realize that much of what I was doing now — or then — in my PR career was just the opposite of what I was trying to do as a journalist. But still, you know, I had mortgage payments. I had other bills to pay. And it was just — it was difficult to work through this and figure out what do I do and how do I — what do I do next?

    But then, you know, just two or three weeks later, I was having to fly to a meeting, and I often would fly on one of the corporate jets. And while I was doing that, I was served my lunch on a gold-rimmed plate, was given gold-plated flatware to eat my lunch. I was sitting in a very spacious and luxurious leather chair. And it just dawned on me for the first time. I had done this many times. But because of the Wise County experience, I just realized for the first time that someone’s premiums were helping me to travel that way and were paying for my lunch on gold-trimmed china. And then I thought about those men and women that I had seen in Wise County, undoubtedly not having any idea that this is the way that insurance executives lived and how premium dollars were being spent. And that got me closer to making an ultimate decision that I had to leave.

AMY GOODMAN: Wendell Potter, the former chief spokesperson for the health insurance giant CIGNA. We’ll come back to this wide-ranging conversation in a minute.

[break]

AMY GOODMAN: We return to my conversation with the former health insurance executive Wendell Potter. He was the former head of corporate communications at the insurance giant CIGNA, now a fellow at the Center for Media and Democracy. I asked him whether he felt many of the journalists covering the health insurance industry are acting as PR agents for the industry.

    WENDELL POTTER: I do think so, maybe unwittingly in many cases, and probably mostly unwittingly. But also, just the way the mainstream media’s influence has changed and the — excuse me, the decline in newspaper circulation and just the way that people get their information, that has changed, and that has worked to the favor of people like I used to be — PR professionals and corporate executives. There aren’t as many reporters as there used to be. The so-called news hole isn’t as big as it used to be to have investigative pieces.

    Reporters who are still there are much busier, I think, than reporters were when I was there, and I was very busy. I think that they too often, or more often than they should, will just accept a statement that’s given to them from a corporate PR guy, like I used to be, and run with it and think their obligation is done, or just don’t have the time to explore it or do any in-depth stories. So, in that regard, I think they really are unwittingly helping the insurance industry.

    AMY GOODMAN: Can you think of an example of when you told a reporter something that you felt was not true, and that reporter did not investigate further?

    WENDELL POTTER: Two or three things. I think insurance companies and, well, anyone can — one of my favorite textbooks when I was in college was How to Lie with Statistics, and I think that we in PR often will throw statistics out that are true to a certain extent but are also misleading and don’t disclose the full story. That is what, more often than not, was what I was doing. I don’t recall intentionally or knowingly lying to a reporter; I wouldn’t have done that. But I think there are times when by withholding all the information or providing selective information or data, you definitely are misleading. And that’s what I did more often than not.

    AMY GOODMAN: Can you give us an example?

    WENDELL POTTER: One of the things you’ll see that insurance companies are doing these days, they do their own surveys of members. And one of the objectives they have right now is to try to persuade people that these consumer-directed plans are really popular with their customers and with the membership that they have. And the other data that we see that’s done by non-affiliated organizations show that people really don’t like these consumer-directed plans and are concerned about the cost shifting that is going on. But the insurance companies do their own surveying of their members, and they will — they’ll send out news releases with selective data about certain responses to certain questions, without disclosing the questions they ask or much of the methodology that they use. And as a consequence, they’re painting a picture that really is not necessarily the full picture. And I think that that’s an example. That’s one of the things I think people need to be very aware of and that journalists need to be very aware of, of the techniques that corporate PR people use to influence public opinion.

AMY GOODMAN: In 2007, CIGNA denied a California teenager, Nataline Sarkisyan, coverage for a liver transplant. Her family went to the media. This is her mother.

    HILDA SARKISYAN: The insurance company can’t decide who’s going to live and who’s going to die. Only doctors and nurses. Thank you.

AMY GOODMAN: The California Nurses Association joined in. Geri Jenkins is head of the CNA.

    GERI JENKINS: It’s just really atrocious that we let decisions be made based on money and not on human life and what’s necessary to keep people alive. The Sarkisyans had insurance. And that’s the telling thing here. They had insurance. They had done everything that was expected of them. They worked hard. They provided insurance. And yet, when they needed it, it wasn’t there for them.

AMY GOODMAN: Under mounting pressure, CIGNA finally granted coverage for the liver transplant. But it was too late. Two hours later, Nataline died.

    AMY GOODMAN: Wendell Potter, can you talk about — well, I’m sure this was a challenge for CIGNA — and how you dealt with this story?

    WENDELL POTTER: It was a challenge. And frankly, it was probably within a month or so after I first learned of Nataline Sarkisyan that I told the company that I worked for — pardon me — that I had come to the end of my career and had a long run at CIGNA, but it was time for me to go.

    Nataline Sarkisyan, as you know, was a seventeen-year-old girl in California when her doctors at UCLA suggested — or requested coverage for a liver transplant that was denied. That request was denied by CIGNA. And it was one of those things that became what we called a high-profile case. The Sarkisyan family reached out to the media, to the California Nurses Associations and others to help them put pressure on CIGNA to try to get the company to reverse its decision. Ultimately, the company did.

    It was a very, very difficult time for — I can’t imagine what it was like for the family. I don’t want to suggest that the difficulty that I had was anything close to what the family was going through. My heart went out to them and still does. But it was difficult to serve as a spokesman for the company during that time. And as you know, the company did make a decision to cover the procedure, but regrettably that decision came too late, because Nataline died just hours after that decision was communicated to the family.

    AMY GOODMAN: And how were you feeling at the time?

    WENDELL POTTER: Oh, just devastated. I have a daughter myself. And I — even though I was having to represent the company, and again was being as truthful as I could, I all the time was just thinking about the family and the grief that they were going through and the way their — you know, they were briefly optimistic that the decision to cover the procedure might save her life, and then so quickly for that hope to be dashed was just devastating for them, I know, and it was just crushing for me and a lot of people that I worked with at CIGNA, too. I want to make sure that that’s understood, that it, you know — I was so disappointed, and I was hopeful, too, that this might be something that actually would save her life. It was just a dreadful, dreadful experience for everyone concerned; there were no winners in that at all.

    And certainly, from a public relations point of view, CIGNA really suffered a black eye. And I, as the spokesman for the company — there were two people who really spoke for the company during this time. It was me and the chief medical officer. And I was — my name was on the website, and my contact information was on the website, CIGNA’s website, and so people were venting their frustration. I received — I can’t tell you how many emails, how many voicemail messages and calls from people who were just outraged. And it was a very difficult — very, very difficult thing to go through.

AMY GOODMAN: Wendell Potter was the former head of corporate communications at the insurance giant CIGNA.

I also asked him about the case of Thomas Concannon, the former head of the Federal Defenders of the Eastern District of the Legal Aid Society here in Manhattan. In 2002, Concannon was suffering from multiple myeloma, a rare form of cancer. His doctors planned to perform a bone marrow transplant, but as Concannon lay on the operating table, his insurance company, CIGNA, announced it would not cover the operation. Days later, Concannon came on Democracy Now! This is part of our interview seven years ago, on April 24th, 2002, with Thomas Concannon and Elisabeth Benjamin, supervising attorney in the Health Law Unit of the Legal Aid Society. This is Tom Concannon.

    THOMAS CONCANNON: On April 9th, they actually put me in the surgical — put me in an operating room, and through general anesthesia, put a tube in my chest that was — it’s called a catheter, a three-lumen catheter that’s meant to be the vehicle through which they extract for blood tests and where they put chemo, different forms, chemical cocktails in. And so, that was put in. And we thought, after a day of rest, that I’d get — begin two other days of certain kinds of photopheresis, other blood-cleansing processes and other things that would prevent grant-versus-host disease. And then, the following week, to get — I expected to get radiation and my sister’s transplant. In fact, last Friday, on my enchantress’s birthday here, that was the day that [inaudible] —-

    AMY GOODMAN: That’s your wife?

    THOMAS CONCANNON: Yes, that’s my sweetie here. She -— it was to be put in on that day. And that was the day we got the notice from — we got the letter from CIGNA saying we’re not — from Dr. Janet Maurer, saying we’re not going to — they were not going to approve that.

    AMY GOODMAN: What can people do, Elisabeth Benjamin, in a case like this?

    ELISABETH BENJAMIN: Well, if you want to help Tom, I think a good thing to do would be to call CIGNA’s vice president and corporate spokesman and express your utter dismay at their conduct in this case. His name is Wendell Potter, P-O-T-T-E-R. His telephone number is (215) 761-4450.

AMY GOODMAN: That was Elisabeth Benjamin. At the time, she was with the Legal Aid Society, giving out Wendell Potter’s office number on Democracy Now! It was seven years ago, on April 24th, 2002. At the time, Wendell Potter was the top spokesperson for CIGNA. As a result of our coverage, the company reversed its decision and paid for the surgery.

I asked Wendell Potter if he remembered the case of Thomas Concannon.

    WENDELL POTTER: Oh, I absolutely do. I mean, that case, the Nataline Sarkisyan case are two that I will never forget. I absolutely do.

    And it does speak to the influence that you have at Democracy Now!

    I came into work the next morning, and my inbox, my email inbox, was — I’d never seen anything quite like it, before or since. It was just phenomenal. I was just being inundated with emails and phone calls and faxes. It was just extraordinary. And I knew that the influence of the media was important in situations like this. And it just — I guess it just proves what I said before: it makes a big difference when someone can get the media or someone on their side to bring this — to make it a high-profile case. It was unforgettable.

    AMY GOODMAN: I want to stick with the media and the power of the media. You were the point person on Michael Moore’s film Sicko.

    WENDELL POTTER: I was.

    AMY GOODMAN: On refuting it.

    WENDELL POTTER: I was.

    AMY GOODMAN: Talk about what happened and how you organized against his film, and then how you feel about that today, or even how you felt about it at the time.

    WENDELL POTTER: Well, frankly, I was very conflicted, because when I saw the movie for the first time, I really felt that — well, I knew it was an honest film. The information that was contained in the film, it truly was a documentary, and certainly a documentary with a point of view, but that’s understandable.

    But the industry knew, from the moment that we heard that Michael Moore was going to be doing a film, a documentary, on the health insurance industry, that — or not just the health insurance industry, but the whole American healthcare system, that undoubtedly the American insurance system would not fare too well. And so, over the course of many months leading up to the premier of the movie, the industry was very active in trying to figure out how to blunt the impact of the movie when it did premier and was very careful to avoid any memos being written that had Michael Moore’s name or Sicko in the subject line, because there was this great fear that it would be leaked to Michael Moore, and he would use it as part of his publicity campaign. Apparently, such a memo was leaked from one of the pharmaceutical companies, and he used it to great advantage. So all of the memos would have the subject line "Hollywood," and all the conversations would be on very secretive conference calls.

    And then, when the movie was about to premier, the industry — it was premiered, as you may remember, in Cannes at the film festival in 2007, and the industry, through some connections that it had in the entertainment business, was able to fly someone to France to get a ticket and to sit in the theater during the first screening of the movie. And then, after that, this person got on the phone for a much-anticipated conference call. I’m sure there were dozens of us who were on the conference call waiting to hear the first reports about Sicko. And that was when we all knew which companies were mentioned in the movie and then what cases were being mentioned. And that gave the companies some time to prepare, to develop talking points to counteract the ultimate questions, the inevitable questions that would be asked when the movie was beginning to premier in the United States.

    AMY GOODMAN: And what were the buzzwords, the talking points, that you developed that you felt were most important to refute what he did? And then, your thoughts as the media repeated them?

    WENDELL POTTER: Well, two things. One is very consistent with what they’re doing now, the industry is doing now, to try to defeat or shape healthcare reform legislation to its benefit, and also consistent with what it did in ’93 and ’94 to kill the Clinton plan. Number one, with regards to Michael Moore himself, they knew that he could be a polarizing figure and that conservatives don’t like him, so they — the industry — part of the industry strategy was to recruit conservative pundits and editorial writers and members of Congress who were conservative and aligned with the industry’s agenda and point of view. And we would do media training with all of our executives, because there was the expectation that Moore would do ambush interviews, as he has done in some of his previous films. That didn’t happen, but if they had, we had our executives well trained with how to handle such an interview. We referred to him — we were prepared to refer to him in any interviews we did have as Michael Moore the movie maker, the entertainer, in an effort to diminish his importance as a documentary maker, to try to cast him as part of the Hollywood establishment and someone who was really making a fantasy, rather than a documentary. So that was part of the strategy.

    The other was to use the subject of what he was doing, which was — you know, as you may recall, he went to many different countries that have universal care, including Canada, the United Kingdom, France, and even Cuba, and some other places, to show how people can get care and have much better access to care than in the United States. The industry saw this certainly as a threat. They didn’t like seeing those countries’ healthcare systems depicted in a positive light, because they’d been fighting that kind of a system for many years. So the talking points were to demean a single-payer system or a government-run system. Government-run — whenever you hear someone who’s allied with the industry talk about a government-run system, they’ll use the term pejoratively, and they’ll say that it will put us on the slippery slope toward socialism, or it will put a government bureaucrat between you and your doctor. And you’re seeing that now in some of the ads that are running by — I think Conservatives for Patients’ Rights is one group that’s got ads running like that right now. So it was an effort to take advantage, actually, of the movie and to start the campaign against government-run healthcare once again.

AMY GOODMAN: This is Wendell Potter. He is the former healthcare industry spokesperson — health insurance industry spokesperson for CIGNA. We’ll have more of his interview after break.

[break]

AMY GOODMAN: Tomorrow on Democracy Now!, on Friday, we’ll be spending the hour with Howard Dean. Yes, the doctor, the former Vermont governor, the former head of the Democratic National Committee, and the former presidential candidate. He has a new book out. It’s called Howard Dean’s Prescription for Real Healthcare Reform. And if you have questions for him, you can send them to us at mail(at)democracynow.org or stories(at)democracynow.org.

Well, we’re going to return now to the end of our conversation with the former health insurance spokesperson Wendell Potter. Yes, he’s formerly head of corporate communications at the insurance giant CIGNA, now a fellow at the Center for Media and Democracy.

    AMY GOODMAN: Can you talk about the way the Senate now is dealing with healthcare, and Congress overall, and the power that the health insurance industry has over these politicians? I mean, you have people like Senator Max Baucus, who gets more money perhaps than anyone in the Senate from the health insurance, hospital, healthcare industry, and he’s head of the Senate Finance Committee.

    WENDELL POTTER: That’s right.

    AMY GOODMAN: Talk about that strategy the insurance industry has in dealing with politicians and your thoughts on this.

    WENDELL POTTER: Well, one thing to remember is that the health insurance industry has been anticipating this debate on healthcare reform for many years. They knew it was inevitable that it would come back. And they knew that if a Democrat were elected president, undoubtedly it would be on the top of the political agenda. So they’ve been positioning themselves to get very close to influential members of Congress in both parties, and Max Baucus is certainly someone they knew, a long time ago, was going to be critical for their interests. So, yes, they — the insurance industry, the pharmaceutical industry and others in healthcare — have spent, have donated lots and lots, millions of dollars, to his campaigns over the past few years.

    But aside from money, it’s relationships that count. And that’s why the insurance industry has hired scores and scores of lobbyists, many of whom have worked for members of Congress and some who are former members of Congress, to lobby on their behalf. Some of Max Baucus’s former staff members work for — in the health insurance industry as lobbyists these days. That is very important. It helps to open the door, and it enables people who are aligned with the industry, who have good associations or close associations with members of Congress, to pass along the talking points or to express the industry’s points of view.

    For example, one of the companies hired a very influential lobbyist who has connections on the Democratic side. And one of the things that the industry has been doing is engaging in what’s referred to as "grasstops lobbying.” And that means the top executives go to Washington and meet with members of Congress and try to persuade them, or at least make them see, that they don’t have two heads and that they’re reasonable people, and you should listen to us. One of the companies that I used to work for was able to get my former CEO in an audience with Hillary Clinton. And Hillary Clinton certainly — this was when she was still senator and was running for president, and her platform was very similar to Barack Obama’s platform on healthcare reform. And she, undoubtedly more than almost anybody else in the Senate, knew the power and influence of the insurance industry, but she was willing to meet with the executives. So that just gives you an example of how doors can be opened for some of the most influential people on Capitol Hill. And most people can’t imagine having that kind of access or that kind of entree to the power and leadership on Capitol Hill.

    AMY GOODMAN: Was that when you were working for CIGNA?

    WENDELL POTTER: It was, it was. And one of the industry’s lobbyists is Heather Podesta. Heather has her own company now. She used to be with another big firm called Blank Rome, which also is doing a significant amount of lobbying. But her husband is Tony Podesta. They are a power couple in Washington, if there ever was one. Tony is John Podesta’s brother. And they, themselves, have contributed thousands and thousands of dollars to candidates over the past several years. So, having someone like that on your team makes a huge difference in being able to get the foot in the door and to present your points of view.

    AMY GOODMAN: Well, what about that, Tony’s brother being John Podesta, who is seminal for the shaping of Obama policy, and the people who are — most significantly, the people who are put into the Obama administration? What is your understanding of how much influence he has on his brother?

    WENDELL POTTER: You know, I don’t know, and I think that would be something that would be very interesting for some reporters to ask, to call up both Podestas and just explore that and find out if they have conversations. And I would — I don’t know. I would be speculating, and I haven’t been a part of any conversations that would suggest that there is anything untoward there. But I think it would be — it’s something that I think would be appropriate for the media to take a look at it and just to do stories about the connections in Washington and how the insurance industry and others who have gained so much power and influence shape legislation, as it very likely will be shaping healthcare reform legislation this time.

    AMY GOODMAN: The Washington Post recently had a piece about the nation’s healthcare industry hiring more than 350 former government officials and members of Congress to sway healthcare reform on Capitol Hill. According to lobbying records, three out of every four major healthcare companies have at least one former government insider on the payroll. Nearly half held positions under key committees and lawmakers, including Senators Max Baucus, as you mentioned, and Charles Grassley. Baucus, chair of the Senate Finance Committee, of course, which is largely steering healthcare reform. Baucus’s aides, as you mentioned, recently held a meeting with a group of lobbyists that included two of his former chiefs of staff. The Washington Post says the healthcare industry is now spending $1.4 million a day on lobbying, totaling $126 million in the first fiscal quarter, I guess spending the money of the premiums of people. Perhaps a number have been denied. Wendell?

    WENDELL POTTER: Well, there’s no doubt that the money that insurance companies have to do their lobbying comes from premium income. One thing that people, I think, need to understand, that I’ve been talking about as part of my testimony, was how less and less of a person’s premium dollar is being spent actually to cover claims these days. Back when Bill Clinton was president and he and Hillary Clinton were trying to reform the healthcare system, back in 1993, 95 — on the average, 95 cents of every premium dollar was being spent to pay claims. Last year, it was down to just around 80 cents. So we’ve seen that much of a change in fifteen years. And that coincides with the consolidation of the insurance industry and the industry becoming much more dominated by for-profit insurance companies.

    AMY GOODMAN: What do you think of single payer? And first, explain it, as you understand it. I think that’s critical, because most people don’t even understand the idea of government-paid-for healthcare. And compare it to a public plan. And then, where do you see us going now, and where do you think we have to go?

    WENDELL POTTER: Yeah, I think one of the ways for people to understand how a single-payer system works is to look at our Medicare program, which is a single-payer program. The government runs the program. So we have a very popular government-run program in this country, and have since the 1960s. And it has been — it has made enormous difference in the lives of people who are elderly and disabled. And, in fact, the satisfaction ratings of people who are enrolled in Medicare — and these are people who are elderly and disabled, who have a much greater chance of needing care than people who are younger and who are enrolled in private plans — the satisfaction ratings of people in Medicare is higher than it is for people who are in private plans.

    In Canada, their system there is called Medicare, and it is a system that essentially has taken our Medicare program and expanded it to include or be available to all their citizens. And in Canada — it’s probably the ultimate single-payer system — there are no private insurance companies that compete for business. In the UK and some other countries in Europe, there are government-run programs, but some allow insurance companies to operate. So there are different kinds of government-run programs or programs that are essentially financed largely by the government.

    But even in a single-payer system like in Canada and our own Medicare system, the care is delivered by the private sector, by doctors and nurses who are in private practice and by private hospitals. So it is not a government takeover, as some in the industry and its allies would like us to believe. It is not a government takeover of the healthcare system, by any means. In a single-payer system, doctors and nurses and hospitals deliver the care. And people have a broad choice; they’re not restricted to certain doctors and nurses and hospitals.

    AMY GOODMAN: Are you for single-payer healthcare in this country?

    WENDELL POTTER: It works in Canada. There are people in Canada — I think the satisfaction ratings in Canada, people are much happier with their system there than Americans are here. In fact, more people in this country are uninsured than the entire population of Canada. And if you take into consideration the people who — the number of people who are underinsured now — and that is a number that is growing because of the new health plans that are being sold, these so-called consumer-directed plans that are really high-deductible plans — when you add those people in, there are more people who are either uninsured or underinsured than the entire population of the United Kingdom. So, you know, we are at a point where some fundamental reform is absolutely necessary. We can’t let another opportunity go. We can’t go another fifteen years before we have some meaningful reform.

    AMY GOODMAN: Should there be for-profit health insurance companies in this country?

    WENDELL POTTER: You know, interesting. One of the big champions of the so-called consumer-directed plans is a woman named Regina Herzlinger. She’s a professor at Harvard and is kind of considered the guru of consumer-directed plans. She often talks about the Swiss system as something that the US might look at as a model, because they presumably have something like a consumer-directed care there. They do have private insurance companies that operate there. The interesting thing is that she doesn’t mention too much, or at all, for that matter, is that while there are insurance companies that operate there, for-profit insurance companies are illegal in Switzerland, and they are very highly regulated. And they all have to offer standard benefit plans. And so, there’s nothing like the kind of system that we have here.

    I think, in many ways, it might not be a bad model to look at, because there are no for-profit companies that operate there. Some of the companies even in this country do sell supplemental products in Asia and Europe. But I kind of think the Swiss are onto something. If they don’t allow for-profit insurance companies to operate, there must be some good reasons why they think that should be the way it is.

    AMY GOODMAN: Wendell Potter, as you look back on your life and look forward about what your plans are now — you voluntarily left as the chief of corporate communications at CIGNA — would you do things any differently?

    WENDELL POTTER: You know, I’ve said that in the twenty years I’ve spent in the health insurance industry, looking back at it now, I feel like I was a journalist undercover for twenty years. And that helps me sleep at night to look at it that way. Yeah, I think there are some things I would do differently. But on the other hand, if I hadn’t done what I did, I wouldn’t know what I know now, and I wouldn’t be in a position to be able to speak out and to disclose and describe what really goes on. So, you know, you can’t really look back and say, “I wish I’d done this,” because it doesn’t do a bit of good. I think you just have to do what you can do in the present moment, and hopefully that it will make a positive difference. And that’s what I hope to do, going forward.

    AMY GOODMAN: And finally, as the push for healthcare reform continues, it looks like President Obama is having a mutiny within his own party. What they call the conservative Democrats, or the Blue Dog Democrats, look like they might even be backing away from a public plan. In fact, Rahm Emanuel, President Obama himself seems to have backed off somewhat, saying that may not be the first step in healthcare reform. Does this concern you? And what advice would you give to them right now, when you have a population that’s overwhelmingly for a public plan, if not single payer, and a filibuster-proof Democratic majority in the Senate?

    WENDELL POTTER: I think it would be absolutely disastrous for the administration to even consider signing legislation that doesn’t include a strong public plan. You’re exactly right. And I think many, many people voted for Barack Obama because of his healthcare platform and the things that he said he felt were vital in terms of reform. The inclusion of a public insurance plan is paramount, it is absolutely necessary, and I would hope that people who voted for him and people who are uninsured, who are underinsured, will make sure that he understands that.

    I think what Rahm Emanuel said, let’s hope it was a trial balloon to see just what kind of reaction it might get. And I think it was swift. People who are supporters of the President, from what I understand, were very, very quick to say, you know, “That dog won’t hunt. You’ve got to — a public plan is important, it is something that we expect. And we expect that you will get behind it in a strong way.”

    I think that the President’s influence may be seen more toward the end of this process. There will be a House bill that’s hopefully passed, a Senate bill that will be passed. They will be different, because they always are, and there will be a conference committee that will need to be held to iron out the differences. And I think that will be a time when the President’s influence will be especially needed to make sure that a public plan, and a strong one, is included in the final legislation that reaches his desk.

AMY GOODMAN: Wendell Potter, the former chief spokesperson at CIGNA, one of the nation’s largest for-profit health insurance companies.

Friday on Democracy Now!, Howard Dean will be our guest, as we continue to look at healthcare in America. His new book is called Howard Dean’s Prescription for Real Healthcare. If you have suggestions for questions for Howard Dean, you can email us at stories(at)democracynow.org, or for any other stories. Or if you’re a whistleblower, well, let us know.

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