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Whistleblower Tells of America's Hidden Nightmare for Its Sick Poor
When an insurance firm boss saw a field hospital for the poor in Virginia, he knew he had to speak out. Here, he tells Paul Harris of his fears for Obama's bid to bring about radical change
Wendell Potter can remember exactly when he took the first steps on his journey to becoming a whistleblower and turning against one of the most powerful industries in America.
Patients without health insurance get dental care at a free clinic in Wise, Virginia, held every July for the past three years. More than 25,000 were treated in a weekend (Photograph: John Moore/Getty Images) It was July 2007 and Potter, a senior
executive at giant US healthcare firm Cigna, was visiting relatives in
the poverty-ridden mountain districts of northeast Tennessee. He saw an
advert in a local paper for a touring free medical clinic at a
fairground just across the state border in Wise County, Virginia.
Potter, who had worked at Cigna for 15 years, decided to check it out. What he saw appalled him. Hundreds of desperate people, most without any medical insurance, descended on the clinic from out of the hills. People queued in long lines to have the most basic medical procedures carried out free of charge. Some had driven more than 200 miles from Georgia. Many were treated in the open air. Potter took pictures of patients lying on trolleys on rain-soaked pavements.
For Potter it was a dreadful realisation that healthcare in America had failed millions of poor, sick people and that he, and the industry he worked for, did not care about the human cost of their relentless search for profits. "It was over-powering. It was just more than I could possibly have imagined could be happening in America," he told the Observer
Potter resigned shortly afterwards. Last month he testified in Congress, becoming one of the few industry executives to admit that what its critics say is true: healthcare insurance firms push up costs, buy politicians and refuse to pay out when many patients actually get sick. In chilling words he told a Senate committee: "I worked as a senior executive at health insurance companies and I saw how they confuse their customers and dump the sick: all so they can satisfy their Wall Street investors."
Potter's claims are at the centre of the biggest political crisis of Barack Obama's young presidency. Obama, faced with 47 million Americans without health insurance, has put reforming the system at the top of his agenda. If he succeeds, he will have pushed through one of the greatest changes to domestic policy of any president. If he fails, his presidency could be broken before it is even a year old. Last week, in a sign of how high the stakes are, he addressed the nation in a live TV news conference. It is the sort of event usually reserved for a moment of deep national crisis, such as a terrorist attack. But Obama wanted to talk about healthcare. "This is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades," he told the nation.
Obama's plans are now mired and the opponents of reform are winning. The Republican attack machine has cranked into gear, labelling reform as "socialist" and warning ordinary Americans that government bureaucrats, not doctors, will choose their medicines. The bill's opponents say the huge cost can only be paid by massive tax increases on ordinary Americans and that others will have their current healthcare plans taken away. Many centrist Democratic congressmen, wary of their conservative voters, are wavering. The legislation has failed to meet Obama's August deadline and is now delayed until after the summer recess. Many fear that this loss of momentum could kill it altogether.
To Potter that is no surprise. He has seen all this before. In his long years with Cigna he rose to be the company's top PR executive. He had an eagle-eye view of the industry's tactics of scuppering political efforts to get it to reform. "This is a very wealthy industry and they use PR very effectively. They manipulate public opinion and the news media and they have built up these relationships with all these politicians through campaign contributions," Potter said.
Potter was witness to the campaign against Michael Moore's healthcare documentary Sicko. The industry slammed the film as one-sided and politically motivated. Secret documents leaked from the American Health Insurance Plans, the industry's lobby group, detailed the plan to paint Moore as a fringe radical. Potter now says the film "hit the nail on the head". "The Michael Moore movie that I saw was full of truth," he admits.
Potter was also working for Cigna when it became embroiled in the case of Nataline Sarkisyan, whose family went public after Cigna refused to pay for a liver transplant that it considered "experimental" and therefore not covered by their policy. Cigna reversed this decision only hours before the Californian teenager died. "I wish I could have done more in that case," Potter said.
Such sentiments are rare in an industry that has given America a healthcare system that can be cripplingly expensive for patients, but that does not produce a healthier population. The industry is often accused of wriggling out of claims. Firms comb medical records for any technicality that will allow them to refuse to pay. In one recently publicised example, a retired nurse from Texas discovered she had breast cancer. Yet her policy was cancelled because her insurers found she had previously had treatment for acne, which the dermatologist had mistakenly noted as pre-cancerous. They decreed she had misinformed them about her medical history and her double mastectomy was cancelled just three days before the operation.
Last month three healthcare executives were grilled about such "rescinding" tactics by a congressional subcommittee. When asked if they would abandon them except in cases of deliberately proven fraud, each executive replied simply: "No."
To Potter that attitude has a sad logic. The healthcare industry generates enormous profits and its top executives have a lavish corporate lifestyle that he once shared. Treating patients for their expensive conditions is bad for business as it reduces the bottom line. Kicking out patients who pursue claims makes perfect economic sense. "It is a system that is rigged against the policyholder," Potter said. The congressional probe found that just three firms had rescinded more than 20,000 policyholders between 2003 and 2007, saving hundreds of millions. "That's a lot of money that will now go towards their profits," Potter said.
A lot of that money also goes into contributions to politicians of both parties - $372m in the past nine years - and in lobbying groups to run TV ads slamming Obama's plans. Many of these ads deploy naked scare tactics. One report said that the industry was spending $1.4m a day on its campaign. In the face of that, it is perhaps no wonder that the Senate has delayed its vote, dealing a massive blow to Obama. "I have seen how the opponents of healthcare reform go to work... they are trying to delay action. They know that if they keep the process going for months, and turn it into a big mess, then the political impetus behind it will lessen," Potter said.
Potter, who now works at the Centre for Media and Democracy in Wisconsin, says the industry is afraid of Obama's reforms and that is why it is fighting so hard. It wants to deal him the same blow as it did Bill Clinton when it scuppered his attempt at reform in the 1990s. Potter admits that he is worried the industry might win again. "I have seen their tactics work. I have been a part of it," he said. He knows he has no chance of ever working again for a major firm. "I am a whistleblower and corporate America does not tend to like that," he said. But there is one thing Potter is not sorry about: leaving the healthcare industry and speaking out. "I have absolutely no regrets. I am doing the right thing," he said.
Comprehensive healthcare reform in the US has been an ambition of many presidents since the early part of the 20th century. None has succeeded in creating a system that gives all Americans the right to coverage. Barack Obama, below, is desperate to avoid the same fate.
Finding a cure
What is the current system? It is a complex mish-mash of systems. Millions of Americans have their own private healthcare plans, either individually or through their employer. About 47 million Americans have none. However, systems do exist to cover the very poor and the old. The system is fiendishly complex and full of loopholes, so even those with coverage can have it withdrawn.
How bad is it? US hospitals are the best in the world if you can afford them. Many cannot, and an accident or sudden illness can often bankrupt someone.
How does it compare with other countries? It depends how you measure things. The US spends about 16% of GNP on healthcare, far more than France and Germany, which spend 11 to 12%. Yet those countries provide universal care.
What is the biggest problem? Critics say the biggest issue is the profit motive that drives US healthcare. This ensures that costs are always rising as the incentive is there to provide expensive treatment. It also gives health insurers the incentive to refuse treatment to claimants, by seeking to withdraw their cover.
What is Obama's solution? Obama has asked Congress to draw up a government option, allowing all Americans to get some sort of cover. The sheer size of the state plan should theoretically allow it to drive down costs by economies of scale.
What's happening now? Obama has put his reputation on the line to persuade wavering Democrats and moderate Republicans to vote on legislation by August. The Senate has said this will not happen. That's a major blow, as it puts off the debate until September and could see the political momentum stall.
- Posted in
54 Comments so far
Show AllThe saddest thing about his article is that it's telling us nothing new.
Still, the horror of healthcare financing in the US is such an affront to humanity that even stories that we read a dozen time bear repeating and should be repeated as long as Americans are allowed to die for Wall Street profits.
q
Mr. Potter is correct. The major problem with our health care are the insurance companies. That doesn't mean making a profit on health care is bad. Canadian companies and hospitals make profits on health care. The difference is they have a single payer system and there is no opportunity for insurance companies to deny care or charge huge fees.
By real (the same) measurements our health care is on a par with others in many areas and better than some in other areas. But everyone doesn't get that care.
The problem I have with this article is that it favors the bills now in Congress which are absolutely terrible. Their is no endemic or systematic reform in these bills. They are shite.
In Canada most hospitals are public. Doctor and laboratory services are privately owned, but the government sets reimbursement rates for consultations and tests.
Exactly. All this stuff about "costs are high because US doctors order fancy diagnostic tests" still doesn't explain the $10.00 apririn on a hospital bill.
Costs need to be firmly set. If this creates shortages, the govt. can subsidize medical education and equipment purchases - although in most cases, such shortages are due to investor-tantrums than being forced into the red by the reimbursement rates. Water gas and electric rates are (or in many places, were) regulated, and the only shortage that ever occurred was when electricity was deregulated and given by all those smart-guys capitalists at Enron.
It was a really good asprin.
Must be true since we have the best healthcare in the world. (sarcasm)
We're number one! We're number one!
And so it goes;no news,no outrage no nothing from dc as America goes into the pockets of TARP recipiants.So proud to be an american.Tony
Wendell Potter has become the Smedley Butler of the US "health care" industry. Unfortunately, he is receiving the same amount of underwhelming attention from the American corporate media (whom are addicted to that same industry's advertising dollars) that Butler did. It is no surprise that the article which is being commented upon appeared in a UK media outlet, The Guardian.
Exactly, all the impotant news about my own country, I learn from media outlets on the other side of the Atlantic, or sometimes from a little Arab Emirate on the other side of the Red Sea!
Human compassion is against the rules for Christo-Republicans and other Bloodsucking Leachmen.
Human compassion is just as against the rules for the Democrats. Get over the concept of the lesser evil---both political parties are rotten to the core and have no interest 'cept increasing the profits of the already wealthy.
It is almost too late for us to miss this important point. We the people want and need Single Payer and neither the Democrats nor the Republicans will let us have it. There is NO CHANCE to realize any hope for a government that works in the interests of the people of this nation if you vote for either of the corporate parties.
In the mean time, you must harrass your so called 'Representative' to vote yes on HR 676. And watch the vote. He/she votes no, you vote no on them when they come up for re election.
Jeevee
RIGHT!
As long as we have a "Power Elite" whose two purposes are: The Accumulation of Wealth and The Centralization of Power, there is nothing we can do but live out our lives the best we can.
Human life has only one value to "The Power Elite": human life is expendable and there are variables of monetary value: An Iraqi has "0" value, An Afghan has "0" value, A low income American Soldier $500,000, a victim of 9/11 three million dollars, and an uninsured poor person "0" value.....
The headline seems to suggest that none of these problems were known until Mr Potter "Revealed them".
They have been known about and talked about for decades. The MSM simply defers to the Elites as more credible then those tens of thousands of voices speaking up against the issue for many years.
This speaks to a systemic problem inside the society in that in order for your message to be "credible" where topics of foreign or domestic policy are to be examined, you must be part of that ELITE group.
Being born to money and privilege or for that matter acquiring it on your own through means either fair or foul , hardly means you have more INsight or knowledge towards forming a freer and more perfect society.
This no slam on Mr Potter coming forward. It a slam on how the "Truth" is "revealed" only after one of THAT small segment of people speak.
It is a waste of time although quite satisfying to sit around and think of juicy acts of retribution. Even if you succeeded in the painful extinction of the last administration and many that still rule today you would still live within a system that is speeding all of us to horrid little unacknowledged deaths.
Financial devastation,pending destruction of mediocre health care systems that many have no access to and climate change leading not to the destruction of the earth but humans that live on it overwhelm our lives.
The biggest crisis is not lack of knowledge of or discussion of the crisis that we face but the total inability to act in the face of that crisis. It's not about who you going to call but what YOU are going to DO about it.
W4D August the 1st for Single Payer health care for all!. Show your power, support W4D!
The most important function of government needs to be keeping the capitalist attack dog on a short leash. That can't happen until we get money out of politics.
Hi Eze, it occurs to me that politics is an industry just like any other. You know how they say, "well, the insurance industry is 20% of the GDP" ? I wonder what % of the GDP is "politics"? Counting all the lobbying/bribe money, all the TV commercials, Country Club fundraisers, jet-set "business" trips, lawyers on retainer, mistresses in penthouses, interns under the desks, er, I mean manning the phones, printers, tailors, car services and security guards, not to mention drug dealers and prostitutes, it adds up to a big chunk of the GDP. Getting the money out of politics would leave alot of people unemployed, but this time it would be the right people! I'm for it.
Eisenhower warned us of the rise of power of the military-industrial complex. Those were the good old days. We now have the military-industrial-political-media complex, all owned by corporatists and run for the love of money.
Money will not leave politics (or anything else) as long as the corporatists are breathing in their boardrooms. Arranging the peons while leaving the jackals at the top in place will not do a thing.
One of the major fallacies of the entire debate is an economic one that lies in its tacit acceptance of the data that is put forward for the total cost of U.S. health care. The insurance industry "skim" has nothing whatever to do with health care and should NOT be assigned as a part of health care's true costs.
Insurance industry profits, unlike actual medical services costs, are unearned income with absolutely no medical value added and a considerable amount subtracted. In other words, they provide absolutely no health care benefit and should not be charged to that item in the public ledger. So long as the two very different costs continue to be confused and conflated, all related arguments (affordability, compensation, etc., etc.) are inevitably distorted -- not accidentally of course.
Let's put the blame where it really belongs - on the greedy workers who wanted 'free healthcare' - especially during WWII when there was a wage freeze. Americans brought this on themselves - they thought by letting their employers pay for their healthcare 'insurance' that they were getting something for nothing. Surprise surprise - there is no Santa Claus. When insurance companies lost their asses in Latin America, we knew they'd have to find a way to screw somebody else instead of going belly-up (for bad bets) - and they did. "Free" health 'insurance' became the national hue-and-cry - and now you all have what you wanted, and even fought for, for decades. Hope you're enjoying your 'free' benefits. Aren't you lucky you don't have to pay taxes on them? Wow.
Perhaps those "greedy workers" thought that their contributions to the war effort should entitle them to some of the same benefits as the troops they supported. But you're certainly right about the absence of Santa Claus -- save and except the Coca Cola commercial advertisements version of course.
World Health Organization ranks US healthcare in 37th position among nations in study released in 2000. Nine years later millions more are without insurance or with totally inadequate insurance, totalling near 1/3 of the US population. Wonder how many notches it would fall if the data were done again? Sadly it seems ever more likely that the Dimopublican party "solution" will create even more of a mess to ensare the US people and keep making the drug, insurance and hospital chains ever richer. Clearly the healthcare profiteers have bought the majority of the corrupt Congress which will do its will. Unless and until a large part of the US population is ready and willing to take to the streets and threaten to or actually shut down major parts of the system, as the French do, the people's needs will be ignored.
The ruling elites have two central projects: maintaining, funding and extending the US global military empire for control of resources and funding and sustaining the operations of US global finance capitalism, short-handed as Wall Street. These twin headed dragons of destruction are first and foremost. All else, including basic needs of the citizens, is secondary or as in healthcare 37th or lower.
Why do the republicans keep saying "socialism" like that's such a dirty word? Why are people so afraid of it? Socialism and socialised care in the US could actually HELP the people who are rallying against it.
You might as well ask how capitalism itself came to be equated with "freedom and democracy", especially the latter, when they are actually diametrically opposed in many respects. In much of what passes for political discourse in the U.S. and in other so-called "western democracies", semantic distortions abound.
The primary reason is simply that the societal benefits once claimed for capitalism on its own merits (e.g., its alleged "free market competition") no longer apply very convincingly in the larger reality. It's therefore necessary to invent fictional associations and linkages with other "good" and "evil" concepts that are more universally accepted as such. Thus, anything lacking those inculcated "good" associations is inherently "evil" by definition.
I wonder how leaders or people hoping to work towards economic justice might be able to promote and explain the clarity of a simple idea that describes Capitalism:
IT IS FAR from being democracy or freedom. in FACT , capitalism IS a DICTATORSHIP of profiteers.
that ought to be repeated to everyone. the problem is to show ordinary people how this REALITY and TRUTH in fact HARMS them and their own children and the generations to come as it has harmed everyone , even the profiteers in destroying their humanity and conscience for generations through history.
Capitalism IS HARMFUL . it harms humans, creatures, nations, economies , individuals , populations and the planet - it is a DICTATORSHIP of profiteers.
"Potter admits that he is worried the industry might win again."
The bigger question is:
Are Americans going to do nothing if the industry "wins" again?
I say: Not this time.
If we do not fight for UNIVERSAL Single Payer HEALTHCARE now, we are doomed. Private insurance forced on everyone will not work, just asked the people of Massachusetts....
According to Republican Senator Chuck Grassley President Obama said to him privately that he's willing to drop a robust public option.
http://thinkprogress.org/2009/07/25/grassley-obama-public-plan/
No, he did not say that.
The Think Progress headline says that.
I am not defending Grassley the republican. But those were not his words.
Actually, Cygnus-X1-isaHole July 26th, 2009 5:31 pm, I heard it was Rahm Emmanuel who said that, not Obama. Aside from that, why would you trust anything a Republican had to say in this matter?
There is only one change America needs to make.
That one change would make this nation a 'shinning success and THE primary example of a Democracy'.
That one change need only be to move from the Plutocratic Oligarchy that the USA has been from the beginning to a Democracy.
That one change would be all that would be needed.
The American people have never known a 'Democracy"--it might be a 'refreshing change' from the Plutocratic Oligarchy that has proven to be ineffective for the majority; but very good for the minority in 'control'.
Good Luck America, you really need it.
The Quarterback is T O A S T. He will give you a "Public Option" (if he gives you anything at all) that is born crippled and doomed BY DESIGN. Master does NOT Share. Remember this: Master does NOT Share. Master does NOT Share. This means feudalism. Dress up the chains but you are all supposed to have NO health care, NO stable employment, NO food security, and NO life outside your job on one of the corporate Plantations, if you got one...and kiss Master's feet for letting you nibble the crumbs from his golden plates. Feudalism. Overseers on the Plantation don't have a color or a gender, they have a job description: Xfer all wealth to the top 1% and degrade and debase the general population into compliance, conformity, and obedience...couldn't be simpler...and he's doing a heckofa job, isn't he? Yeah, it's all just 3-dimensional chess...aka, "Watch the birdie!"
Peace.
"...and he's doing a heckofa job, isn't he?"
From my admittedly limited perspective, I haven't quite decided that yet. Clearly he's following the script with great dedication and considerable subtlety. His problem may be that the script itself is increasingly tattered and transparent. Or maybe that's just my own wishful thinking.
Third World West Virginia...behold our future.
If 100 of the top editors in our Newspapers and media were all refused health care claims for some incurable, non-life threatening but chronic and high treatment cost disease like leprosy, I'm sure the Insurance crooks would be given a run for their money.
Hey, God, send them a plague of hemorroids!
Oh, you did that already? So that's why they think that God is a pain in the ass.
Okay God, how about an encore with some real ugly acne thrown in? It's in the mill, you say? I see, ten years after botox is first applied, it morphs into severe pimples. Great! Now that's what I call targeting the greedy, arrogant, narcissistic, elite.
AGG July 26th, 2009 7:24 pm, their fate was settled long ago when they sold their puny souls to be 'Beltway Journalists.' You'll never see a collection of more miserable weasels than a roomful of Washington Media Insiders -- they sweat deceit and indifference, revel in petty gossip and backstabbing, and live in a perpetual high school popularity contest desperately vying for 'access' and invitations to the right A-List parties, and they are always afraid they might write or say the wrong thing and offend the wrong person and it will all vanish in a snap. No one gets off without paying a price in this life, not even the elite who feed us what they laughingly call 'the news.'
Just as it takes INDIVIDUALS with so much accumulated power and wealth to CAUSE suffering for so many -- it can also take INDIVIDUALS who - having HAD that power , such as Mister Potter - to have their consciences open and PERHAPS , with their own knowledge of how that power has worked against people, help to correct what is clearly EVIL.
one can only hope that Mister Potter - just like "harry potter" - in the movies - who had , with his growing power , EVERY CHANCE to "become one of the Dark Powers" - will be adding his voice AND abilities to help in making the USA and this world a BIT more humane.
One should highly commend someone who ALLOWED himself to FEEL and SEE what his own industry and people like him (as he WAS) with such power -
DO with such CRUELTY to so many others for generations...and after opening himself up to his own humanity - is trying to do something about it.
I find it most distressful to learn from Mr. Potter that no President or Congress have ever been able to successfully or even substantially reform healthcare. The statistics cited by other posts ignore the causalities of such a predicament. Essentially, the health insurance companies are running our government, not only usurping the power of the people, but at their expense: at the expense of their very lives.
This is no longer a matter of a majority vote: not if insurance lobbyists "pass bills" to our Congressional Representatives and literally veto the Executive Branch. While I commend whistleblowers for their courage in the face of what is undoubtedly a risk not only to their careers and reputations, but possibly their safety, I have to stand aghast at their knowledge of such unlawful and immoral activities being disclosed to the very people their testimonies indict...what do the American people expect our representatives to do about it? Is not Mr. Potter, in fact, testifying to their complicity?
This committee hearing will be documented for future attempts at reform, thwarted under the guise of "a complicated issue." An issue, it seems to me, only becomes complicated when those who are simply asked to do the right thing try to find any and all ways around it.
The great misfortune in this country is that socialism of any form, even the most humane and progressive, are beaten back by prejudice and propaganda. It is absurd to believe that any economic system in pure theory and/or practice is perfectly suitable in all respects; why is it inconceivable to implement the most beneficial economic system accordingly? Make private/financial institutions capitalist and public/social institutions socialist? Why must there be an absolute, an all or nothing approach?
This explains why the smallest, almost inconsequential change in healthcare is met with derision: healthcare reform is not a national issue: it is a national spectacle, like an Ultimate Fighting Championship. Only the losers are in the millions, and dying...
You've got to love our politicians.
First, we have Baucus (et al.) remove Single Payer from the equation (even though everyone knows it is clearly the best system). WATERDOWN.
Then the administration cuts crappy deals with Big Pharma and hospitals, seriously limiting the real savings that could be made by negotiations. WATERDOWN
Then when the lobbyists/media complain that a "public option" will be too competitive and put the insurance companies out of business, they say, "no that won't happen. In fact, we'll make sure that won't happen by limiting who might be eligible for taking away the advantages that would have forced down costs (and undercutting the whole reason for having it). [the correct response to private insurance would be, "unless you take steps to follow the rules and to cut costs, you might go out of business"]. WATERDOWN
Then when that is not enough they say, "well maybe we shouldn't have a public option. We'll have state/regional co-ops instead. Not only will there be Swiss cheese like holes in such a system, but co-ops will be so week that insurance companies won't have to worry about the competition." WATERDOWN
Sure, Congress pass something called healthcare refortm. The politicians will hail it and Obama will sign it, claiming it as a major achievement.
And it will turn out to be as watered down as soup broth. Everyone will be forced to get coverage, but costs won't go down. It will be a major boon for private insurers and a boondoggle for consumers.
This is a very uninformed article. Obama's public plan cannot and will not work:
Top Ten Reasons the Public Plan is a Bait and Switch
1. It leaves in place the deficient employer based model. As the National Organization for Women noted in their single payer endorsement (July 7, 2009) of the only viable reform model, single payer, many Americans are tied to jobs they don’t like because of the antiquated employer based insurance model. For those switching from one job to another, those wanting to go on strike, those wanting to quit a job, etc. it prevents the ability to move freely as a laborer.
2. It leaves private insurance, a major contributor to administrative inefficiency and bloated bureaucracy, in charge of health care decisions.
3. It only results in about 10% of the savings that would accrue were single payer to be enacted. That’s assuming 50% of Americans can enroll---an optimistic figure (Jacob Hacker’s assumption that Congress has drastically scaled back to a tiny plan). Since hospitals and doctors will still have to deal with 1300 insurance companies little savings will result by adding a public option, reports Dr. Don McCanne of the Physicians for a National Health Plan, March 26, 2009, www.pnhp.org. 24% of hospital budgets go to billings (only 12% in Canada) and this wouldn’t change under any version of the public option. As Drs. Steffie Woolhander and David Himmelstein note, the bureaucratic savings of the public plan option “would be miniscule”. (The New York Times, Room For Debate, June 18, 2009).,,
4. It does not pay for itself, unlike single payer, requiring a huge tax increase. As the State Legislators for Single Payer Healthcare (including initiating sponsor WI State Sen. Mark Miller) note there is “no increase in total health care spending” with single payer. Instead of everybody in, nobody out, an inclusive approach based on solidarity, public option pits the wealthy against poor, taxing the rich to provide subsidies to help poor people buy overpriced, insufficient private health insurance. In the mainstream media this is being framed as the liberals taxing the rich for their liberal plan to force everyone into big government care, when In reality, the tax proposal would be used to shore up the private insurance system, giving them more customers and higher profits. In her June 24 Congressional testimony, Dr. Woolhander estimated that it will cost 200 billion annually to pay for health insurance costs for those who cannot afford it. That’s a much larger tax increase on the wealthy.
5. It becomes part of the same failed private model: co pays, deductibles, denials of some necessary procedures, services and medications. Coverage and benefits will be similar to the private plans due to inability to control costs. (see no. 3) “The ‘Public Plan Option’: Myths and Facts available at www.pnhp.org and see the excellent analysis , “Health Care Reform 2009: A Train Wreck in Slow Motion by Dr. John Geyman, July 21, 2009 available at www.pnhp.org/blog.
6. It leaves millions uninsured. Mandates have already failed in states where it has been tried, mostly recently in Massachusetts. And, the model for a health insurance exchange, the Federal Employee Health Benefit Program leaves hundreds of thousands of federal workers uninsured, and does not control costs (Nicholas Skala, Congressional Progressive Caucus testimony, June 4, 2009).
7. It Segregates patients into two groups: health patients who will be aggressively pursued by insurance companies and sicker/older patients who will end up in the public plan. The public plan will not make private insurers honest. Private insurers compete by denying (necessary coverage). The public plan will either emulate this model, or quickly go under as it becomes overburdened by the sicker, older patients, reports Dr. Woolhander (June 24 House Subcommittee on House Energy and Commerce).
8. Projected savings claimed by Wisconsin Citizen Action (based on a Lewin group study of Hacker’s original PO proposal) are not based on historical trends with public option plans that have already failed in every state where they have been tried. (see Wisconsin Cost Savings under National Health Care Reform by Dr. Robert Kraig available at citizenactionwi.org) The HMO-Medicare history shows that public plans do not keep private insurers “honest”. “A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field.” The Public Option Con, www.pnhp.org
9. Private insurers will still continue to deny claims and as a result, a major issue, bankruptcy due to health costs will remain unaddressed. In their June 2008 endorsement of single payer, the U.S. Conference of Mayors noted that “millions with insurance have coverage so inadequate that a major illness would lead to financial ruin.” www.usmayors.org/resolutions/76th_conference/chhs_03.asp
10. The public option will not provide choice of provider unlike single payer since the public option will need to appeal to providers to obtain services. “Patients will still have a limited choice of provider restricted by networks” as a Physicians for a National Health Program fact sheet states.
“The ‘Public Plan Option’: Myths and Facts available at www.pnhp.org
Thank you! I only used PNHP as a source for announcments before.
PNHP is an excellent resource, Sullivan's "Bait and Switch" article is terrific.
Just to respond briefly to your points, weacguy July 26th, 2009 11:00 pm.
1. Of course, single-payer universal health care based on the Norwegian or Canadian model would be ideal, but that's not going to happen with this Congress -- we are not getting that pony for our birthday. Contrary to what NOW stated, Obama's plan, if enacted, would allow workers to move their insurance with them if they changed jobs, as he said in his speech last week.
2. That's the Republican 'plan,' but not the one Obama has put forth. In fact, he wants a public option that will compete with private insurers.
3. PNHP is wrong -- savings will result from such things as streamlining billing systems, integrating patient data, curtailing information redundancy and ending multiple tests and overtesting, all of which has been proposed as part of Obama's public option.
4. Taxing the rich a little more to improve the health care system seems like a good idea to me, and I don't know where you got the idea that a public option would mean you'd be chained to the health care industry. In fact, it's a public option -- like VA and Medicare, it would be paid for by the government, not private for-profit insurers.
5. This is not true.
6. A public option would be basically an extension of Medicare, meaning everyone would be covered. I have not heard Obama support mandates nor any of the other nonsense you're talking about -- obviously he doesn't want to repeat the 'Massachussetts mistake' that was signed into law by Republican Mitt Romney when he was governor of that state. The articles you cite are based on erroneous information or intentionally designed to mislead.
7. Indigent sick and older patients are already covered by Medicare/Medicaid, so I fail to see how this will segregate anyone. Their coverage will not change. Americans will simply have the option of enrolling in the public plan or staying with or acquiring private insurance. Most will probably go with the cheaper public option, which will open the door to ending for-profit health insurance in this country and move us closer to a single-payer universal system. Why do you persist in complicating what is essentially a simple idea? I don't know who 'Dr. Woolhander' is, but he sounds like a shill for the for-profit health care industry.
8. Medicare/Medicaid and the VA have provided good treatment for patients when they are properly funded and maintained by those who think government of, by and for the people has a role to play in the commonwealth of the nation. Not surprisingly, it only breaks down when in the hands of those who believe government should be drowned in a bathtub. As to your point, we have every industrialized nation on earth to look to as proof that public health insurance works just fine and at a much lower cost than we are paying for the mess we presently have.
9. No, this is not true. In Obama's speech, he specifically said he wanted a bill that ended the practice of private insurers denying claims for 'pre-existing conditions.'
10. Doctors and some hospitals could opt out of providing health care under the public option, but if public care is administered and funded properly, they would experience a steep loss of income, so it would not be in their best interest.
Finally, I don't know who 'Physicians for a National Health Program' are, but they sound like a clever health care industry Astroturf organization to me, every bit as underhanded in their calls for 'reform' as are the Harry and Louise ads. Anyone with half a brain knows single-payer is not going to happen this time around; to call for that exclusively while disparaging any other approach with GOP talking points is a very disingenuous way to instill enough public doubt to kill any alternative health care plan, leaving us with the disaster have now -- very profitable for the health insurance industry but no one else.
As always in America, the first priority is moneycare, and protecting those who have the money & are making more money.
First, bravo Wendell Potter!
Second, everyone -- even The Guardian -- gets the terms of the debate wrong. Its not healthcare reform, its healthcare INSURANCE reform. (Healthcare would still be the same drugs and surgery its always been.)
Third, why does The Guardian print the very PR bullshit that Mr. Potter warns about --- "The bill's opponents say the huge cost can only be paid by massive tax increases on ordinary Americans and that others will have their current healthcare plans taken away" --- without clarifying that both claims are total garbage?
And fourth, as Ralph Nader wrote for CD yesterday, the NYT reports that Rahm Emanuel and Max Baucus promised Big Pharma on July 7 that the reform bill "would not allow the reimportation of cheaper medicines from Canada or other countries even if they meet our drug safety standards."
It's hard to know who to root for in this fight.
I'll say this, the Republicans and right-wing Democrats who oppose this insurance reform should be lined up and shot. After that, we can send Obama, Emanuel and Baucus to a re-education camp.
It should be obvious to a fifth grader that if we can remove the obscene profits of "health care" companies, that the cost of true health care would go down and make it possible to cover all. Wealthy individuals who still wanted "Cadillac Coverage" and were willing to pay for it, could be accommodated for their cosmetic surgeries,etc., while the rest of us could still obtain needed care. Single payer would accomplish this. The big problem is not how to pay for it but rather, how to get our alleged lawmakers weaned from the lobbyists' money teats?
PS: Why are we only seeing this article in a paper from the other side of the pond? Just asking.
Bingo!! Same thoughts here.
You would know about Mr. Potter if you listened to Bill Moyers, but other than that, our own media is terrified or complicit. Moyers interviewed Trudy Lieberman & Marcia Angell this weekend (not as powerful as Potter) and I doubt if you'll hear much about them either.
I'm surprised that Obama doesn't take people like Potter or other well-studied doctors or nurses from PNHP or CA Nurses Assoc. on the road with him. Pottle would scare the Hell out of the insurers.
As Dr. Angell said, "...I would rather see Obama go down fighting for something coherent and practical that the public could mobilize behind, than go down fighting for this amorphous plan that tries to keep these private insurance industry in place."
I'll drink a toast that Obabma sees the necessity of winning this battle and grows a pair this week. My drinking will help me forget his FISA bill stance.
No, because the battle he is fighting is for "the amorphous plan to keep the private insurance in place." So, my opinion is that if he goes down, it will be a good thing. The fight can resume in congress or in the individual states.
blah blah blah blah blah, Politicians will always take us for a ride to promises land, and Barak taken us there once again. I say with out grassroots revolutions and people pissed off in the streets demanding what this country needs now, Not a thing will get achieved for the working class, Boot the crooked chicken politicians out of Washington and bring to criminal courts those greedy executives from the Insurance companies conglomerate.
After reading this article a chill ran through me.The most powerful, wealthest nation, does have enough conscious to take of it's sick.How telling it is!
However these fools at the top in their arrogance, don't have enough since to see that in the long run, their greed will be their end. When the people have finally had enough, they will rebel. History proves that.
Notes from Tennessee:
Availability of health care here continues to decline. Even those who still have a job with benefits are being charged more for less health "insurance" coverage. Those without coverage are treated briefly at the ER and thereafter ignored.
Quality of health care here continues to decline even as prices continue to climb. Mistakes, often attributable to shorthanded, overworked nursing staffs and policies dictated by accountants rather than real doctors, are rampant at local hospitals that mostly operate under the name of some religion.
But lest anyone think that government isn't doing anything to help the people, Tennessee has instituted a tax on stupidity: it's called the Education Lottery. Here's how it works (from the Wikipedia article):
"Nationwide, and presumably in Tennessee, the heaviest lottery players (top 20 percent) are nearly twice as likely to lack a high school diploma and have a household income below $10,000 as the population as whole.[2] Recipients from families with an annual income over $72,000 make up 47% of the Tennessee Education Lottery Scholarships awarded.[3]"
Of course, we can't take all the credit. The other 49 states are certainly doing their part to make this the "Greatest Nation on Earth".