A Look at the Underside of Health Care Today

A Look at the Underside of Health Care Today

"Deadly Spin" is must reading for anyone who wants to understand the nature and cost of health care in America today.

Written by Wendell Potter, a newspaper reporter who later served as a top PR executive for Humana and then CIGNA for almost 20 years, it is a first-person account of how the major health care insurance companies combined to influence the Congress and the American people about health care reform and legislation.  In the process, they helped to kill health care legislation during the Clinton Administration and tried very hard, but unsuccessfully, to do the same thing with the Affordable Care Act (ACA).  However, the misinformation campaign waged earlier continues to this day, as can be seen by statements from congressional leaders and those from our own state and area, who have referred to the ACA as a "train wreck."

Potter knows what he's talking about because he was involved in all of the misinformation campaigns until he resigned from CIGNA in May of 2008. I won't go into all of the reasons Potter resigned from CIGNA. You should read the book — but not before going to bed because you'll be too upset to fall asleep.

In a recent "Fresh Air" interview with Dave Davies on WHYY, the NPR affiliate in Philadelphia, Potter explained how he became disillusioned with the tactics of the health care insurance companies, in which he participated, and the harm it had done. As he put it, "I realized that what I was doing  was in many cases the exact opposite of what I was doing as a newspaper reporter — trying to present information in as unbiased a way as possible, to not selectively disclose information to mislead. But I was often doing that in my job." So he ultimately quit CIGNA, wrote "Deadly Spin" and is now a senior analyst at the Center for Public Integrity and a contributor to the Huffington Post.

One of the things Potter stressed in the "Fresh Air" interview was the comparability of one plan with another under the exchanges created by the ACA. "Some states will be operating the exchanges themselves," he said. "Others will be doing it in partnership with the federal government. Others are just saying to the feds, 'You do it.' But regardless of that arrangement, all the states and the District of Columbia will have a place where people can finally go to get coverage and be able to compare one health plan with another — to get information in plain language that enables them to figure out what it is they're actually buying, to get some idea of how much they'll have to spend out of pocket if they choose one plan versus another."

Potter said he knows from personal experience "that insurance companies profited a great deal from consumers being uninformed and not being able to get the information they really need or understanding the information they're given when they buy health care coverage. So this is a very, very important first step."

Potter made three other very important statements in the interview. "Insurance companies will no longer be able to hide the most important elements of what is covered and what's not in fine print," he said. "Some health plans, the so-called limited benefit plans, often don't even cover hospitalization. But a lot of people buy these plans without realizing just how skimpy the benefits are. Those plans, by the way, won't be legal after the first of next year" (when the ACA goes into effect).

"There are junk plans that are out there today and some of the biggest insurance companies sell them," Potter said. "And they're very profitable for insurance companies. A lot of people don't know they're in junk plans until they get sick or injured and then they find out when it's too late that they're not adequately covered."

In  response to Davies' question concerning whether the recent increase in insurance rates is attributable to Obamacare, Potter said, "Very little can be attributed to Obamacare. What people often don't know and the critics of the law would like us to forget is that between 2000 and 2010 private insurance premiums increased 131 percent. And this is in the employer market. That's significant. In almost every year there was a double-digit increase in premiums." In effect, he said, the insurance companies were "making sure that they have a certain profit that's built in over and above what they expect to pay in medical premiums."