Time flies. Hard to believe that it was twelve years ago that healthcare reform activist Wendell Potter left his job as head of corporate communications at Cigna and shortly after, loudly blew the whistle on the gross malpractices of the health insurance industry that had employed him.
Ever since, Potter has devoted virtually every minute to telling the story of his time as a top executive in a business dedicated to raking in massive profits at the expense of those suffering in medical need or just trying to stay healthy. He preaches the gospel of Medicare for All, single payer medical insurance for everyone at little or no cost. To that end, he has lectured around the country, written countless op-eds, authored two books, started the investigative journalism website Tarbell and various healthcare advocacy organizations, including Business Leaders for Healthcare Transformation.
Now he’s the founder of a new non-profit group, the Center for Health and Democracy, because, he says, there’s “not nearly enough awareness of the problems associated with money in politics and why money in politics is a real barrier for this country to move forward on meaningful healthcare reform. We will be drawing attention to how big corporations and associations are spending enormous sums of money to influence campaigns and public policy, both legislation and regulations, and help explain why that is blocking progressive reforms.”
Potter has a strategy: “One of the things that is very important for us is to do a better job of winning the messaging battle. The advocacy community has made great strides over the past few years, but there’s more that can be done to push back against the corporate propaganda that I used to be a part of…
“There is a front group that is funded by industry money called the Partnership for America’s Healthcare Future. The money comes from the insurance industry, but also from the pharmaceutical industry and big hospital chains. At one point they were spending more money in Iowa than the candidates were spending to try to scare people away from reform. And they were attacking not only Medicare for All, but any kind of meaningful reforms, including the public option. So we have our work cut out for us. We will probably never have the same amount of money that they have… But I think we can make a difference.”
Even though the special interest cash has been pouring in, Potter continued, “There is legislation in Congress that would create a Medicare for All system in this country… And we saw during the primaries, despite all the spending that was done by the insurance industry and their front group, a majority of people who voted in the Democratic primary in every single state, including my home state of Tennessee and other southern states, said that they supported Medicare for All. And this was after they were told that Medicare for All would replace Medicare, would replace private insurance companies.”
Potter’s new Center for Health and Democracy comes at a time when the nation is ravaged by COVID-19, a crashed economy, vast unemployment and the prospect of a November election that already is the most contentious of modern times, one in which healthcare reform is a critical issue to all Americans.
“The COVID pandemic has really laid bare so many of the problems that we have in this country when it comes to our healthcare system,” he said. “It also has shown just how greedy the insurance industry is and how it’s able to profiteer. Over the first six months of this year, the six largest, for-profit health insurance companies have reported profits that exceeded Wall Street’s expectations.
“United Healthcare, for example, reported second quarter earnings that were the most they’ve ever made over three months in their history. So they’ve been making enormous profits. And one of the reasons is because they’ve spent far less on medical claims. That’s because so many elective procedures were canceled. So they’ve been taking in money. Their membership has been declining, but even with those declines in membership, they’ve still been able to take in record revenues and convert those revenues to record profits.
“We’ve also seen laid bare the absurdity of our employer-based healthcare system. A lot of the candidates during the primary talked a great deal about how much Americans valued the employer-based healthcare system… Well, what we’ve seen made abundantly clear in the pandemic is that Americans have been losing their jobs by the millions, more than 40 million people have applied for unemployment compensation. And a lot of those people have also lost their health insurance. So we’ve lost a great deal of ground that we gained when the Affordable Care Act was passed.
“People are dying unnecessarily in this country.”
Potter said that he’s “waiting with bated breath” for the healthcare reform Donald Trump keeps promising but never delivers. We spoke just before Trump announced that he would issue an executive order requiring insurance companies to cover pre-existing conditions – something that already exists under Obamacare. As for Joe Biden, “He has not embraced Medicare for All, which is regrettable. But I do think that there will be enormous pressure, if there is a Biden administration, on the president and Congress to move forward with reforms that go far beyond the Affordable Care Act…
“I think there is absolutely evidence that his thinking is evolving and has shifted some. His first indication of that was his willingness to at least begin by lowering the age of eligibility for Medicare to age 60, which is a step in the right direction. I think there are other things that will be proposed that will put us on a path toward Medicare for All… And I think we’ll continue to see Joe Biden shifting more, maybe not during the campaign, because I think he’s going to be very cautious about what he says out of fear of maybe alienating some perspective voters. But I do think that after the election, that there will be even greater pressure on him and his transition team and his administration to move forward much more rapidly than he probably would have imagined he would have.”
But, Wendell Potter added, if Trump gets reelected, “Lord… The one thing that we know about Trump is that he is the biggest friend of the plutocrats, and that would include the people who run the insurance companies and who invest in them. So I think that our chances of having anything meaningful in a second Trump administration are not very great. And I hope people will understand that as they’re voting, that if you continue to have Trump in the White House… nothing meaningful is going to happen. And they very possibly could make things worse. Much worse.”
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A transcript of our conversation follows, edited for length and clarity. There’s more about the Center for Health and Democracy, Trump, Biden, profiteering and the power of the health insurance lobby, how the insurance industry uses “choice” as a word “to bamboozle the public into thinking that what we value most is having a choice of health insurer,” COVID and Canadian healthcare, plus whether the healthcare business will seek even more ways to make money when a COVID vaccine becomes available. Full disclosure: I first met Wendell Potter when I was part of the team at Bill Moyers Journal that in 2009 presented his accusations and secret documents revealing healthcare industry attempts to denigrate and intimidate reform activists.
Wendell, you’ve launched a new organization, the Center for Health and Democracy. Congratulations. What is the purpose of this group?
This group brings together the work that I’ve done over the past 12 years after I left my job at Cigna and became a very vocal critic of the health insurance industry. I’ve also written a great deal, and spoken a great deal, about the problems of money in politics. We’ve talked about this, Michael, in the past, you know that I coauthored with Nick Penniman of Issue One, Nation on the Take: How Big Money Corrupts Our Democracy and What We Can Do About It. And this center, the Center for Health and Democracy, brings all that work together.
One of the things that I’ve observed in working with a lot of advocates for healthcare reform, is that there’s not nearly enough awareness of the problems associated with money in politics and why money in politics is a real barrier for this country to move forward on meaningful healthcare reform. We will be drawing attention to how big corporations and associations are spending enormous sums of money to influence campaigns and public policy, both legislation and regulations, and help explain why that is blocking progressive reforms.
What’s the plan in terms of getting your message across?
We’ll be using a lot of tools and messaging techniques, certainly social media. I have a pretty robust Twitter following, and we’ll be using that platform as well as Facebook and other social media platforms. We have a very robust mailing list as well. Grass roots email list with more than 100,000 names, and that’s growing. And working with traditional media, of course. As you probably know, I spent many years myself in the media. I’m a former newspaper reporter, but also in my corporate jobs worked with the media and know, certainly, the importance of working with traditional media, helping reporters to understand the issues in ways they really haven’t considered before, just informing them. So we’ll be using multiple media to do this work or to get our messaging across. One of the things that is very important for us is to do a better job of winning the messaging battle. The advocacy community has made great strides over the past few years, but there’s more that can be done to push back against the corporate propaganda that I used to be a part of.
It’s hard to believe that it’s been 12 years.
It is hard to believe. I left Cigna in May of 2008. I took time off to decide what I wanted to do. It was actually in June of 2009 that I testified before Congress, after working behind the scenes for several months with advocates to help advocates understand how the insurance industry really works and how their propaganda machine works. And, as you recall, the Bill Moyers Journal sent a crew to Washington to cover my first testimony on June 24th, 2009. And soon after that was the first major report based on that and the work that I had started doing. So I owe a great deal of debt to Bill Moyers and you all who were a part of that.
I gathered from reading your prospectus that one of the things you really want to talk about, as you have in the past, is the role of the health insurance special interests working behind the scenes of American politics, especially this year.
That’s right. The special interests have spent enormous sums of money to influence the primary elections earlier this year. There is a front group that is funded by industry money called the Partnership for America’s Healthcare Future. The money comes from the insurance industry, but also from the pharmaceutical industry and big hospital chains. At one point they were spending more money in Iowa than the candidates were spending to try to scare people away from reform. And they were attacking not only Medicare for All, but any kind of meaningful reforms, including the public option. So we have our work cut out for us. We will probably never have the same amount of money that they have. And in fact, I’m pretty certain of that. But I think we can make a difference.
The work we will do will be to pull the curtains back, to expose on an ongoing basis how insurers in particular are spending our money, the money that we pay in premium, a significant part of it is skimmed off to pay for their propaganda campaigns and to pay for lobbyists in Washington and in state capitals all across the country.
Are these interests the reason why some of the candidates have seemed to be so far behind [the curve of] the public desire for single payer, for Medicare for All?
I think it absolutely is the reason why we haven’t seen even Democrats in Congress and presidential candidates reflect the same point of view that the American public has on healthcare reform. The insurance industry that I know so well and the way they spend money to influence campaigns… In my old job, my team was responsible for doling out money from the Cigna Political Action Committee, and we would send money to Democrats as well as to Republicans. And some cases, the Democrats got more money than Republicans, depends on which way the political winds were blowing.
But we’ve seen, for example, in the House of Representatives and the Senate, but certainly the House, which is now been under Democratic control for some time, there is legislation that would create a Medicare for All system in this country. More than half of the Democratic Caucus has signed on as co-sponsors, there had been some hearings, but the legislation has not advanced out of committee for a floor vote. So that’s telling.
And we saw during the primaries, despite all the spending that was done by the insurance industry and their front group, a majority of people who voted in the Democratic primary in every single state, including my home state of Tennessee and other southern states, said that they supported Medicare for All. And this was after they were told that Medicare for All would replace Medicare, would replace private insurance companies. So in every single state, a majority of those who were participating in the entrance and exit polls said they supported Medicare for All. Yet we saw that a lot of the Democratic candidates for president, they just weren’t paying attention. And one of the reasons they weren’t paying attention, in my view, is because of all the money that these special interests give to candidates at all levels.
You know, when I read your prospectus, one of the goals that’s in that document is to expose how the current system harms Americans by overcharging them. And I think one of the insurance industry fallacies that has caused a lot of this harm is the notion of consumer choice.
That’s right.
That we don’t want to disturb the freedom of Americans to choose their own insurance plan or their doctors.
That’s exactly right. In fact, I wrote an op-ed for The New York Times earlier this year on that very thing, about how the insurance industry and its allies have used that word “choice” to bamboozle the public into thinking that what we value most is having a choice of health insurer. It’s bamboozling the public in many different ways. One, most of us, if you think about this, certainly those of us who get coverage through the workplace, we don’t have a choice of health insurance company. That choice is made by our employer. Even if you get coverage through the Obamacare exchanges, in many cases there’s a very limited choice depending on where you live. So we don’t have as much choice as they would like you to think we have. But the choice that really matters most to Americans is not choice of health insurance companies. It is choice of healthcare providers, doctors, and hospitals, and other providers.
And increasingly, insurance companies have been taking those choices away from us through their limited networks. And those networks are getting skinnier and skinnier every year. And also insurance companies in the middle of a year, a policy year for someone, can and often will remove doctors and hospitals from their provider networks. So we don’t have the choice that they would like us to believe. And they’re trying to obscure the choice that matters most to us, which is a choice of healthcare providers. And by the way, the Medicare program doesn’t have these limited networks. If you are enrolled in Medicare, you have unlimited choice of providers who participate in the Medicare program. And that is the vast majority of all doctors and hospitals in this country.
What further has the COVID pandemic shown you about the state of healthcare and health insurance in the country?
The COVID pandemic has really laid bare so many of the problems that we have in this country when it comes to our healthcare system. It also has shown just how greedy the insurance industry is and how it’s able to profiteer. Over the first six months of this year, the six largest, for-profit health insurance companies, and they are Anthem, Aetna, Cigna, Centene, United Healthcare, and Humana, have reported profits that exceeded Wall Street’s expectations.
United, for example, reported second quarter earnings that were the most they’ve ever made over three months in their history. So they’ve been making enormous profits. And one of the reasons is because they’ve spent far less on medical claims. That’s because so many elective procedures were canceled. So they’ve been taking in money. Their membership has been declining, but even with those declines in membership, they’ve still been able to take in record revenues and convert those revenues to record profits.
We’ve also seen laid bare the absurdity of our employer-based healthcare system. A lot of the candidates during the primary talked a great deal about how much Americans valued the employer-based healthcare system. And how many times did we hear that 150 or 160 million Americans get their coverage through their workplace? — they didn’t want to lose that. Well, what we’ve seen made abundantly clear in the pandemic is that Americans have been losing their jobs by the millions, more than 40 million people have applied for unemployment compensation. And a lot of those people who’ve lost their jobs, millions have also lost their health insurance. So we’ve lost ground, a great deal of ground that we gained when the Affordable Care Act was passed.
So why should we continue on with a healthcare system in which our healthcare access is tied to having a job and an employer that offers benefits? And increasingly over the years, employers have been throwing in the towel. They can’t continue to offer benefits. So that’s one thing.
We’re seeing some of the other problems caused by the insurance industry in particular. They also are able to make money through very aggressive prior authorization requirements, which make it necessary for doctors to ask for permission or approval before they can proceed with a treatment or prescribe certain medication. So increasingly, Americans are not getting the care that they need because someone in the insurance company is saying no. Even if it’s a covered benefit, it’s their legal right to say, “We’re not going to cover that” for whatever reason.
You may recall that during the debate on what became the Affordable Care Act, Sarah Palin and some others said that we should worry because the government would be setting up “death panels.” Well, there was never anything in the legislation that would have done that. But that obscured something else that I talked about then, but it’s also becomes very apparent, insurance companies operate death panels, and they do this in one way through these prior authorization requirements. In many cases, people are not getting the care that could save their lives. And that’s just because the insurance industry says no to a doctor who, in many cases, is pleading for approval for coverage, for something the patient urgently needs.
So you’re saying that despite the enormity of this current crisis, and despite the press releases that have gone out from the insurers about how beneficial they’re being and how much they’re trying to help people, that there’s still a lot of predatory behavior taking place?
Oh, there’s enormous predatory behavior. And it’s interesting, if you look at the press releases that these companies have put out for their quarterly earnings this year, they always spend paragraph after paragraph, bullet point after bullet point at the top of their press releases, talking about how good they are, how they are spending money or accelerating payments to doctors and hospitals. It’s just, again, an effort to hide their embarrassment of riches, or at least bury it under many paragraphs of patting themselves on the back.
And when you really look at what they’re doing, the money that they presumably are spending or contributing to nonprofit organizations throughout the country is minuscule, when you look at it as a percentage of the profits they’re making, and certainly as a percentage of the revenues they’re hauling in.
So you caused a little bit of a stir on Twitter earlier when you said that Canada’s response has been better than ours because of the differences in our healthcare systems. Are people dying unnecessarily?
People are dying unnecessarily in this country. And I also have an op-ed in the Washington Post now along those same lines, pointing out just how badly we’ve done in this pandemic, how poorly prepared we were and how, because of our multi-payer system in particular, we’ve done such a poor job and far worse than Canada has done in so many different ways, in anticipating and getting ready for the pandemic, making sure that… In Canada, for example, you don’t have to worry at all about the cost of the test or treatment. There are no out of pocket requirements for the care that you need in Canada.
One deterrent in this country is the fact that people know that they’re going to be on the hook for sometimes thousands of dollars if they get the care that they need. So we’ve done such a poor job, not only compared to Canada, but to every other developed country in the world when it comes to being ready to handle this pandemic. And our numbers continue to be worse than any other country in the world. Other countries have seen a flattening and actually a decline in the number of cases and deaths, when we’re seeing an acceleration of it, certainly in a few states in this country.
So are you eagerly awaiting Donald Trump’s healthcare plan at the end of the month?
Oh, I just can’t believe that we haven’t seen it yet. Weren’t we already supposed to have it? It was two weeks that he was going to be unveiling it and that was about a month ago when he said that, or at least more than two weeks.
Yeah. I’m waiting with bated breath and I’m sure it’s going to be beautiful as we’ve been promised. And we were promised that when he was a candidate in 2016. And the Republicans kept talking about how great their plan was going to be that would replace the Affordable Care Act, and we just haven’t seen it materialize. With the exception of a bill that almost got passed that would have repealed the Affordable Care Act and would have just been catastrophic for the country. So thank goodness that John McCain stepped up and kept that from being enacted. But the thing is, Republicans, including Donald Trump, cannot come up with a healthcare plan that does what they say, which is to protect people with preexisting conditions and bring down the cost of health insurance and healthcare. They just don’t have a plan. Yeah, I can’t wait to see the president’s plan.
What do you think happens after the election? I mean, we know the Republicans haven’t really made it much of a priority other than, as you say, to repeal Obamacare. But what do you think? Do you have any confidence that Biden will be able to get anything taken care of?
I think Biden will really make a push to move forward. He talks about improving the ACA and there’s merit to that. He has not embraced Medicare for All, which is regrettable. But I do think that if there is a Biden administration there will be enormous pressure on the president and Congress to move forward with reforms that go far beyond the Affordable Care Act. The Affordable Care Act for all the good that it’s done, it has done good, it’s brought a lot of people into coverage, but again, we’re seeing a lot of those people go back into the ranks of the uninsured, but it left the insurance industry largely in control of the system and they’ve been able to profiteer. Their profits have been enormous since the Affordable Care Act was passed. So we need to do a lot to reduce the power and influence or the ability of the insurance industry to profiteer if they hang around.
He has supported a public option. We, as an organization, will be watching that very closely and weighing in, it has to be a very good public option that doesn’t mimic just the private plans that are available. There will be great pressure on the next president, certainly if it’s Joe Biden, to do something about out of pocket costs and about some of these other things that we’ve been talking about that people are just fed up with. And there will be, I think, a renewed interest in Medicare for All, because people are aware of the profiteering of the insurance industry, and they’re seeing they, more than ever, are disadvantaged financially and in ways that harm their health, because of the current system we have. And that’s largely because we have private insurance companies running our healthcare system.
So you think that the pandemic has shifted Biden closer to single payer at this point?
I think there is absolutely evidence that his thinking is evolving and has shifted some. His first indication of that was his willingness to at least begin by lowering the age of eligibility for Medicare to age 60, which is a step in the right direction. I think there are other things that will be proposed that will put us on a path toward Medicare for All, if it’s not done with a single piece of legislation, like Bernie Sanders has sponsored and Pramila Jayapal and Debbie Dingell have sponsored in the House. There are ways to get there other than through that one piece of legislation that just needs to be done sooner rather than later.
But I do think there will be enormous pressure. And I think we’ll continue to see Joe Biden shifting more, maybe not during the campaign, because I think he’s going to be very cautious about what he says out of fear of maybe alienating some perspective voters. But I do think that after the election, that there will be even greater pressure on him and his transition team and his administration to move forward much more rapidly than he probably would have imagined he would have.
And if Trump gets reelected?
If Trump gets reelected… Lord. I still think there will be an effort to try to move forward. The one thing that we know about Trump is that he is the biggest friend of the plutocrats, and that would include the people who run the insurance companies and who invest in them. So I think that our chances of having anything meaningful in a second Trump administration are not very great. And I hope people will understand that as they’re voting, that if you continue to have Trump in the White House and Democrats in control of the Senate, nothing meaningful is going to happen. And they very possibly could make things way worse. Much worse.
What about in terms of a vaccine? There’s obviously pressure for the vaccine to be made available free to everyone, but I get the feeling that the insurance companies are trying to figure out ways to get a piece of that action, which will be massive.
Yes. And the insurance industry will be more controlled than they should be it seems in who gets those vaccines and who gets them first. I guess the government, they have the ability to play some role. But I’ll say it again, insurance companies have a lot of control over the access to healthcare that we have. And I don’t trust them a minute to do the right thing. And they certainly will want to make sure that they will, at the very least, not lose money. And they will be trying to figure out how they can make money. The one thing I’ve said that these companies know how to do best is to make money. And we’ve certainly seen that over the years.
So who are some of the people you’ve got involved in this new Center for Health and Democracy?
I’ve got a good team of people. One of the things that we’re going to be doing is our effort to win the messaging battle. We’ve got a small, but very capable, communications team of communications experts who are expert at both social media and traditional media. We are bringing in people who’ve had a good track record of establishing and operating nonprofits and bringing in the donations that are necessary for a nonprofit to succeed. We have substantial financial commitments already. And a lot of the money that we are getting is coming from small donations, mainly from the email program that we have, which has more than 100,000 names now, and that program is growing.
We also will be working in partnership with other organizations that are involved in one way or another with advancing healthcare reform and addressing the problems associated with money in politics, like Issue One, and represent some other organizations that are working and have been working to reform our current political system.
You have several different affiliations now that you’ve helped create. And is it sort of a synergistic thing where each of them is better because of the others?
Yeah, I think there is a synergistic relationship among the organizations that I’ve helped create and lead. Another organization that is ongoing and that I served as president of is called Business Leaders for Healthcare Transformation. And that is an organization that represents more than 3,000 businesses across the country of all sizes that support Medicare for All, or moving toward that, and that continues. Also, more than three years ago now, launched Tarbell, which is a nonprofit news organization that’s ongoing, that does important investigative work. And that will continue to look at the intersection of healthcare and money and politics and do important investigative reporting on that.
Anything you want to add?
I guess I would add that I hope that people would visit our website, CenterforHealthandDemocracy.org, reach out and join our e-mail list to stay updated on the work that we do.
Wendell Potter, thank you.
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Michael Winship is the Schumann Senior Writing Fellow for Common Dreams. Previously, he was the Emmy Award-winning senior writer for Moyers & Company and BillMoyers.com, a past senior writing fellow at the policy and advocacy group Demos, and former president of the Writers Guild of America East. Follow him on Twitter: @MichaelWinship.
