Behind the Veil of Healthcare Insurance USA

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Deadly Spin by former CIGNA VP, Wendell Potter, provides us with a detailed, well-researched, and credible resource for understanding how big for-profit healthcare insurance companies operate. Ultimately, a sad reflection on how susceptible we are to fear tactics and how shameful amounts of money consumers spend on premiums that cover not healthcare, but lobbying, front groups, and public relation salaries, all focused on deliberate deception.

This book is an important resource that weaves Potter’s personal awakening to his own contributions to manipulating public opinion with three compelling themes:

  • The story of 17 y.o. Nataline Sarkisyan who died while awaiting a liver transplant that CIGNA had denied coverage for.  (They eventually approved it, but she had already passed away).  And her mother’s subsequent mission to help consumers understand some of the hidden protection that ERISA has for insurance companies.  It is very complicated and I will devote some time to understanding it better myself and blogging about it.   But briefly, the Employee Retirement Income Act of 1974 (ERISA) originally passed by Congress to protect employee’s pensions (because corporate executives were stealing money from their employee’s retirement funds) also made it impossible for consumers to sue insurance companies in state courts for denial of coverage and efforts in federal courts are so limited that few lawyers will take cases.  Nataline’s mother, Hilda is working to help consumers understand how ERISA works, “In her view, it literally allows insurance companies to get away with murder”. (Video of Sarkisyan’s parents confronting CIGNA.)
  • The history of healthcare and reform in the USA.  Did you know that universal healthcare is available in every industrialized nation except one?  Guess who?  “America largely forfeited the development of its system to private, financially motivated interests from the very beginning.  Potter explains how Ronald Reagan spoke out against socialized medicine in the early 1960’s a propaganda campaign funded by the American Medical Association, and how some of the fearful language he used remains active today such as ‘ warning against the danger of encroaching on the relationship between patients and doctors, and of an attack on doctors’ freedoms’.   He takes us back into the late 1700s with then President John Adam’s signing of one of the worlds first government health programs that evolved into today’s Public Health Service.  He shares insights on the development of healthcare in Europe and differences in the USA that set the stage for profit-making insurance companies to gain a stronghold early on.  He discusses the healthcare reform efforts during from World War I up to the current Obama legislative changes.  Filled with political jockeying with a dizzying multitude of acronyms for real grassroots organizations and front groups made to look like them! It is not always easy to follow at times, because it is a complicated story.  Can you imagine what the agenda might be of a group made up of 50 CEOs from insurance companies, medical-device manufacturers, drug companies and hospitals? This group, the Healthcare Leadership Council (HLC), according to Potter, shared a single motivation, “…their general disdain for government regulation of their businesses”.  Healthcare insurance and other lobbyists spent over 300 million dollars to stop healthcare reform during the Clinton Administration.
  • How Public Relations (PR) has become a big business propaganda machine in many ways.  The author explains both ethical and unethical practices that are common place with the unethical ones becoming more prevalent.  He describes this “Playbook on How to Influence Lawmakers and Regulators Through the Manipulation of Public Opinion” originally developed by the tobacco industry.  I couldn’t find it on Amazon, but Potter tells us that it is carefully guarded by corporate users and gives several detailed and credible accounts of its use by tobacco, big oil, big banks and big soda companies in addition to the insurance industry!  Some of the fundamentals of the “Playbook” include:
  1. Hire a big PR firm that has a successful reputation for public deception and is is willing to ignore Public Relations’ Code of Ethics.
  2. Set up a coalition or front group with “American”, “Freedom” or “Choice” in its name.  Launder money through the PR firm to fund the groups efforts which will support you, but no one will know you are paying for it.
  3. Conduct a ‘bogus’ survey or slice and dice data with the intent of misleading or “lying with statistics”.

….and much much more including a great list of resources in the paperback edition!  It is no wonder that those of us trying to provide care are caught up in a web of agendas; make money, save money, work faster, work safer, that split our time and drain our energy.

The most hopeful part of the book is Wendell Potter’s story.  His ownership of wrongdoing and turning his work from being a participant in deceiving consumers for  corporate power and greed into one of educating us about the motives, strategies, and money-making intent of insurance companies is a tremendous source of power for change.  Doing the right stuff for the right reasons and as he puts it, after testifying before Congress during Obamacare debates, “Telling the truth is very cathartic.  I highly recommend it”.

Deadly Spin is a book I highly recommend, will read again, and refer to often.  In fact, in an upcoming blog, I’ll explain Medical Loss Ratios (MLR).  You may be receiving letters about them from your health insurance carriers as they scramble to maintain profits with capped MLRs instituted in latest healthcare reform. I suggest you read these letters with some skepticism!

You can learn a little more about Wendell Potter in the excellent movie “Escape Fire” or the this blog’s review of same.

 

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