[Image via The Coen Bros.]
BY JONATHAN VALANIA This is the third and final installment of a massive, 30,000 word, three-part Q&A with Philadelphian Wendell Potter*, former mild-mannered Cigna health insurance executive turned whistle-blowing superman standing up for truth, justice and the American way. (You can read Part I HERE and Part II HERE) You may have seen Mr. Potter testifying before Congress or talking about the ills of the health insurance industrial complex on CNN or MSNBC or PBS, or in the pages of The New York Times, Wall Street Journal or Time magazine, to name but a few. Last year he published Deadly Spin, an authoritative takedown of a sick and dangerous healthcare system and the incredibly powerful and phenomenally profitable industry that games it for billions. He debunks the dark arts of modern corporate P.R. that uses subterfuge, misdirection and good old fashioned distortion of the truth to manipulate public opinion and absolve its paymasters of all culpability for the dirty deeds that make those obscene profits possible. In the end, Deadly Spin is an impassioned call for substantive reform, basic mercy and common decency.
In the first installment we discussed the crisis of conscience that turned him from loyal, not to mention highly paid, company man to crusading reformer, watchdog and all-around thorn in the industry’s side. Having long thought he was on the side of the angels he increasingly came to realize that he was in fact playing for the other team, that the point of for-profit healthcare insurance is not paying for customers’ medical costs but avoiding doing so whenever possible. That for-profit health insurance corporations have a legal obligation to prioritize the enhancement of shareholder value over saving the lives of its customers. That he had blood on his hands. That he was an apologist for a system that denies medical care to more than 50 million Americans, and as a result more than 48,000 people die prematurely every year.
Potter was tasked with writing an official-sounding report that minimized the problem and shifted all the blame on the uninsured. He helped craft reform-killing talking points for the healthcare lobby’s Congressional stooges to repeat into the cameras of Fox News and CNN. He was part of the effort to smear Michael Moore and discredit Sicko, his 2007 critique of the iniquities of the healthcare industrial complex, even though deep down he knew Moore was dead-on. The final straw was having to serve as company spokesperson through the resulting media firestorm when Cigna denied 17-year-old Nataline Sarkisyan a liver transplant and she died less than a week later.
In the second installment we discussed the smear campaign against Michael Moore and Sicko. It begins with a cabal of health insurance operatives hiring a mole to sneak into the premier of Sicko at Cannes and take notes so that neutralizing talking points can be crafted. These talking points — which mostly rely on the usual lizard brain illuminators, namely fear (”Universal coverage is creeping Socialism!”) and loathing (”Taxpayers will have to pay out of pocket for illegal immigrants to get Cadillac health care!”) — are then passed along to various industry-owned Congressmen who dutifully parrot them in the echo chamber of 24-7 cable news and talk radio. It ends with Wendell Potter apologizing to Michael Moore live on national television.
In the final installment, we discuss how and why Obama’s effort to reform health care largely failed, who killed the public option and what was their motive, why moving forward with Obamacare is absolutely essential to substantive reform in the future. But the bottom line is that nothing will change until elections are publicly-financed and politicians are no longer beholden to powerful, deep-pocketed corporate interests for campaign cash. Money is the root of all that is evil, and wrong and dysfunctional in Washington, DC.
PHAWKER: When was your last day at Cigna?
WENDELL POTTER: May the 2nd, 2008.
PHAWKER: When did you go from guy who just went away quietly to guy who testifies before Congress about the ways the health insurance industrial complex games the system and torpedoes reform at every turn?
WENDELL POTTER: It was almost a year later, actually March of 2009. I think the date was March the 5th, the very day the president had his healthcare summit at the White House. It was kind of the kickoff of the healthcare reform debate at Washington. The president invited representatives of a lot of different organizations, insurers from pharmaceutical companies, hospitals, doctor groups, some consumer groups, employer groups and labor unions, a gathering of all the constituency groups that are important or would be involved in reform, with the hope of trying to get everyone on the same page working towards meaningful reform and to try to get it off on a positive start.
PHAWKER: Do you think most of those people showed up in good faith planning to cooperate and make reform happen? Or was it window dressing?
WENDELL POTTER: It was window dressing. What happens when you are setting out to reform any sector of the economy, in particular the healthcare system, there will be winners and losers, and everyone wants to make sure their interests are protected, that no one gets a haircut, that no one loses. So they all go in and say they support the president in favor of reform, but the reality was and is that they support reform as long as their interests are protected. As long as reform doesn’t have any adverse effect on them, their pockets or their incomes.
PHAWKER: You retired but had no plans to advocate reform or be an industry critic. In fact you were a little concerned that if you did speak up there would be blowback or recrimination, correct?
WENDELL POTTER: I felt it wouldn’t be in my best interest to be visible and vocal, so I thought if I ever did do anything it would be behind the scenes. It didn’t occur to me at that time that I would have the nerve to be anywhere near as public as I decided to be.
PHAWKER: What was the fallout you were afraid of?
WENDELL POTTER: I was afraid I could get sued if I wasn’t careful about what I said and how I said it. I’ve been very careful, I’ve worked with the legal and public affairs division of the company, I worked with lawyers all the time. My boss was general council. Of course I also was part of the effort to discredit Michael Moore, so I know what the industry does to try and discredit their enemies or critics, and they have a lot of money.
PHAWKER: Deep pockets, right?
WENDELL POTTER: Very deep pockets. When I decided to do this I took this all into consideration and I went back and forth a lot before I decided to finally do this. Many times I thought, ‘Are you crazy? Do you know what you’re getting yourself into?’ But eventually I got pissed off to the point I said, ‘I can’t not do this, I have to take a stand. I’ve got to do something.’
PHAWKER: So, March 5th, 2009, you were watching television…
WENDELL POTTER: And flipping through the channels I landed on this interview with this Congressmen I had met, I didn’t know him well but I had met him.
PHAWKER: What was his name again?
WENDELL POTTER: Zack Wamp. Very odd last name. Republican from Chattanooga. I went back later to make sure I heard what I thought I heard, but he was essentially calling Obama all but a Marxist and a socialist, and was very dismissive in particular to people who were uninsured. That’s what got me so mad.
PHAWKER: Didn’t he bring up the illegal immigrants and the money will go to pay for them?
WENDELL POTTER: It was clear that his comments to me were xenophobic in trying to make people believe that –
PHAWKER: Quasi-racist, really.
WENDELL POTTER: It was a racist comment. I just got really upset about it. I started making some phone calls.
PHAWKER: Zach Wamp, R-Tennessee, represents the next Congressional district over from where you grew up. You know the people whom he represents, you know how they live.
WENDELL POTTER: I know the section of the state, yes.
PHAWKER: There are probably a lot of working poor, people that would have to rely on free clinics to get medical care.
WENDELL POTTER: His Congressional district that borders the one where I grew up and includes some of the poorest counties in the country. I’ve been to every county in Tennessee, I know that state very well and I knew his district and I knew there were a lot of people in his district that were uninsured and were that way not by choice but because they couldn’t afford it and needed it but couldn’t get it, people that would have been helped by the kind of reform he fought against.
PHAWKER: So, you started making some calls to journalists you worked with when you were at Cigna, who connected you to some academics who connected you to some advocacy groups who eventually referred you to some Congressional aides to Senator Rockefeller, who chairs the Senate Commerce Committee, which was holding hearings on the health insurance industry, that could use a guy like you.
WENDELL POTTER: I was invited to meet with people who were on the committee’s investigative staff who did a lot of the leg work before the hearings. I agreed to do it and they grilled me for two solid hours. It was very interesting, very memorable, very scary because they were clearly trying to determine if I was legitimate, if I knew what I was talking about.
PHAWKER: And that you weren’t just a crank or a mole?
WENDELL POTTER: All that, they wanted to make sure I was not a mole and that I didn’t have an ax to grind, I wasn’t doing this because of a grudge with the company. After two hours they were satisfied that I was not a mole and that I didn’t have an axe to grind with Cigna. I even made the point of stating that during when I did testify to the senator that what I was talking about was not specific to Cigna, and I always do that, the practices I talk about are prevalent throughout the industry, just about every company engages in them because they have to. It’s developed as a standard operating procedure throughout the industry.
PHAWKER: You were called to testify before a hearing on what?
WENDELL POTTER: It was a hearing on healthcare information and how the healthcare reform law should be structured to make sure consumers get the information they need so they can make informed decisions, but also into the practices of the insurance industry and because of the broadness of that I told the industry about how much investors influence the ‘medical loss ratio,’ something that most members of Congress never heard about. Medical loss ratio is an indication first of all that insurers consider it a loss when they pay a claim and whenever they spend money on anything pertaining to medical care or claims, it’s a loss hence the name medical loss ratio. The ratio is how much money they spend on care compared to how much they take in in revenues from their policy holders. Investors are constantly pressuring for-profit companies to spend less and less of revenues on patient care because the less they spend on patient care, the more there is available to reward shareholders.
PHAWKER: How do you do that? You raise the bar on what you are willing to pay for, your guidelines become more rigorous?
WENDELL POTTER: The guidelines become more rigorous as to who you will insure in the first place, there’s a greater incentive to cherry pick the healthiest and exclude people who really need insurance, they have long engaged in a practice of refusing to sell coverage to people with pre-existing conditions, but also they do it by refusing to provide coverage for needed care.
PHAWKER: Policy holders who are sick and their doctors say they need this or that procedure or treatment.
WENDELL POTTER: And the insurance company will overrule that.
PHAWKER: Just to clarify how the insurance industry works, you guys are taking premiums from customers, it’s a huge pile of money and you’re taking that money and investing that elsewhere. In what?
WENDELL POTTER: They have a lot of pretty broad investment portfolio. It can be investments in index funds and other stocks, but also in real estate. These companies often have large real estate holdings. In fact, Cigna owned hotel properties and a lot of different kinds of real estate properties. So they have a broad investment portfolio, it’s diversified. Not just stocks and bonds, but in real property and things of that nature as well. Whenever they announce earnings, they segregate out how much money they earn from investments. When you pay premiums, you’re money is invested and they of course have to have a certain amount of money available to pay claims but a lot of the income is from investments.
PHAWKER: On average a person pays about $5,000 a year in premiums?
WENDELL POTTER: It depends on how much coverage you’re buying. The average for a family of four is about $15,000. Most families pay that but don’t realize they’re paying it because most of use get coverage through employers, so it’s subsidized. In other words, the employer pays a substantial portion, usually significantly more than half. So we workers assume that we’re getting, that it’s the employers money. It’s our money, but we’re not getting it in the form of compensation. It comes in the form of a benefit like that. For an individual now, it’s less that half of that – five to six thousand dollars a year. But if you have a family and have to have coverage for the whole family, the minimum cost now is $15,000.
PHAWKER: So in order for Cigna to make money, they have to pay out less over your lifetime than you pay into the fund?
WENDELL POTTER: All of the insurance companies have many underwriters on staff who do nothing more than estimate how much each person or a group of people will cost the company based on what underwriters come up with, they are able to price their premiums at a certain level to exceed what they pay out in medical claims. If the underwriters are good, they are always able to price their products at a certain percentage above inflated medical costs.
PHAWKER: So you testify, what exactly were you telling them that day?
WENDELL POTTER: I was telling them that for 20 years I saw how insurance companies confuse their customers and make it difficult for customers to understand and get the information they really need. I went on to explain some of the practices the companies engage in to make sure they meet shareholders’ expectations. I said they do what they do to meet Wall Street’s relentless profit expectations.
PHAWKER: What are some of the things they do? Where’s the absence of transparency in all this?
WENDELL POTTER: They often will purge their small business accounts when an employee’s dependent gets sick because that means the company will have to pay more claims than they anticipated and when the premium comes up for renewal, the company will jack the rates up so high the employer has no choice but to cancel coverage for everybody.
PHAWKER: And find coverage elsewhere?
WENDELL POTTER: If you can, because once you’re priced out of the market you have to disclose to your next prospective insurer that you have this employee that’s gotten sick. You have to provide a lot of information to your prospective insurance company, whether you’re an individual or a small group.
PHAWKER: Doesn’t this happen all the time though, isn’t somebody going to get sick in every company at some point?
WENDELL POTTER: Exactly, that’s why we have fewer and fewer small businesses able to offer coverage, they’ve been priced out of the market. Several years ago it wasn’t so bad, but but now far fewer than half of small businesses are able to offer coverage.
PHAWKER: This ratio you’re talking about, where they’re just demanding you pay out less so the profit margin is wider.
WENDELL POTTER: They’re quite willing to get rid of small businesses if they aren’t profitable and the company term for this is ‘purging,’ they use this internally not externally but I disclosed that in my testimony, that this is a common practice called purging. Another, which some members of Congress had heard about a few weeks before I testified, is called ‘policy rescission,’ that happens when someone who has bought a policy on their own through the individual market, usually because they don’t get it through an employer, and if the policy holder gets sick and that raises your claims, the insurance company will go back and take a close look at your application for coverage to see if they might find a reason to cancel your policy, which they usually do. They do that routinely.
PHAWKER: There’s a guy in Sicko whose job was to do just that.
WENDELL POTTER: The LA Times did a an investigation and found out some companies paid employees a bonus for finding policies they could rescind. They call it rescission or rescinding coverage which is essentially canceling someone’s policy often in the midst of treatment for cancer. There was one woman who testified she got a notice the day before she was scheduled to have a mastectomy because she had failed to disclose she had been treated recently for acne. These are examples of the lengths these companies will go to to avoid paying claims.
PHAWKER: Does this not result in lawsuits?
WENDELL POTTER: No, most people can’t afford to. And even if they do, the way the laws are written, policy holders have very little ability to sue insurance companies and employers for denying coverage.
PHAWKER: Let’s talk about the infamous ‘individual mandate,’ which requires that everyone purchases health insurance. Everyone. That was the industry’s idea.
WENDELL POTTER: As the healthcare reform legislation was working it’s way through Congress, the healthcare lobbyists were very insistent that the reform legislation had to have an individual mandate in it, a requirement that we all had to buy coverage or they would do all they could to derail the reform as they had in the past.
PHAWKER: Why were they so adamant about that?
WENDELL POTTER: It would favor them because not only would we be required to buy coverage but if I’m for example someone who has low income and can’t afford the costs, the government will subsidize the cost. They’ll be getting revenue from two sources, individuals who pay from their own pockets, but a lot of people can’t afford it so the government subsidizes it and the money goes straight to the insurance companies. So they get an entire new revenue stream they hadn’t had before. And since everybody will be required to buy coverage, no one company theoretically will be disadvantaged. No company will get more sick people than any other company, but there will be some risk adjustment in the way this all takes shape so companies are protected from adverse selection, from getting more sick people than their competitors. So they’ll get a lot of money.
PHAWKER: It’s corporate welfare.
WENDELL POTTER: It gives them what I call a new lease on life because they know their current business models aren’t sustainable in the long haul and we’re seeing the evidence of that with growing numbers of Americans without insurance, it’s not because they don’t want coverage but they’ve been priced out of the market or haven’t been able to buy at all because of the practices of the industry.
PHAWKER: When you say not sustainable — sustainable for them or the public?
WENDELL POTTER: Both. it’s not sustainable for them as health policy, but it’s not sustainable for them from a business standpoint because in this country we’ve got a mature market for health insurance – it’s not growing. What is growing is the number of people who cannot afford coverage. What the companies do is steal market share from each other, it’s not an expanding market so they way they grow is to buy each other through mergers and acquisitions or to take market shares from each other.
The other reason why it’s not sustainable, the current business model is based on what they refer to as consumer-driven care, a euphemism for high deductible healthcare policies in which they’re able to shift more of the cost of care from them to us. But there’ s a limit to the point where that doesn’t work. People will eventually get to the point of saying it doesn’t make sense to pay good money for a high deductible plan because I’ll pay so much out of pocket that they’ll become under-insured the minute they buy these high deductible plans. They’re forced to pay so much out of their own pockets that in many cases people are forgoing care. You have to spend in many cases thousands from your own pocket before your insurance company will give you a dime to cover your own care.
PHAWKER: If the individual mandate provision was inserted into the healthcare reform at the insistence of the health insurers, why are the Republicans, who clearly have the industry’s back, fighting the individual mandate so aggressively, using it as a cudgel to try to kill Obamacare, with Republican-run states suing the federal government in the courts.
WENDELL POTTER: It’s because of politics and ideology. They see this as a winning issue for them and it’s to their advantage to try to turn against this reform for the purpose of getting their allies or colleagues re-elected. It’s ideology. They’re saying it’s an infringement upon freedom and the free market, but it’s really a political strategy to win control of Congress and the White House. So they grandstand against the individual mandate but it’s not genuine. In my view, it’s disingenuous because they get a lot of money from insurance companies, the companies spend a lot of money on elections and lobbying efforts to influence how policy should take shape in Capitol Hill. These Republicans must realize, I think many of them do, that the insurance industry really needs this individual mandate. It’s disingenuous and the real motivation is not really to kill Obamacare, not to repeal it or have it declared unconstitutional despite what you might hear, it’s to get more Republicans elected.
PHAWKER: By saying look, this is socialism, it’s the government telling you what to do.
WENDELL POTTER: And the insurance industry is willing to go along with that because they know if Republicans control the Senate and the White House, they would be able to strip out consumer protections in the law, but they would be able to preserve that individual mandate.
PHAWKER: Let’s drill down on Obamacare – what are the consumer protections that are in there now?
WENDELL POTTER: Most importantly it prohibits them from refusing to sell coverage to us, it makes them at least offer us coverage. If we’re going to have a requirement that everyone has to buy coverage, the insurance industry can no longer use pre-existing conditions to refuse selling us coverage. That will be a thing of the past. It requires them to spend at least 80% in what we pay in premiums on medical care and they cannot go below that as many of them had been doing. It requires them to allow parents to keep adult children on their policies until age 26 if their children haven’t been able to get policies from their employers. It also makes it illegal for them to cancel policies when you get sick, unless you’ve committed fraud and lied on your application. If you’ve lied on your application, they can cancel your coverage, but they can’t do it just because the want to. And for senior citizens it closes a large gaps in Medicare coverage for medications that’s called a ‘donut hole.’ Plus Medicare will start paying for preventive care like screenings. So it is benefiting a lot of people already.
PHAWKER: Why aren’t the supporters of Obamacare explaining this to the people?
WENDELL POTTER: When people are told the benefits they say they like that and are for that, but they’ve been subjected to a relentless opposition to Obamacare and believe the whole act is bad, made to think the individual mandate is not in their best interest. They think wrongly that most of us who have insurance already will be affected. It will not affect most people except those who don’t want coverage. It’s been vilified by the opponents of the president and they have been successful in turning people away from reform. My belief is that it’s been so successful that we’ve forgotten why we need reform in the first place.
PHAWKER: You were saying half of all small business owners cannot provide health insurance for their employees anymore – when did it get to that percentage?
WENDELL POTTER: Even in the early- to mid-90s well over 60% were able to offer coverage but it’s been decreasing ever since. These days most of the smallest businesses can’t offer insurance.
PHAWKER: That’s one of the main Republican talking points: Obamacare will hurt small business owners.
WENDELL POTTER: What they don’t realize is the law doesn’t apply to small businesses that employ fewer than 50 people, which is the majority of small businesses. It’s a small percentage of small businesses that will be affected by this but we’ve been led to believe that this is something that will be onerous to all business owners but it’s not. It’s only a small number of small businesses that don’t offer coverage now will be required to. It also supplies a subsidy to small businesses if they want to provide coverage, so it will actually be a benefit to small businesses and help them offer coverage when they haven’t been able to in the past.
PHAWKER: Explain the public option and why the industry was so vehemently opposed to it and succeeded in killing it.
WENDELL POTTER: The public option as originally envisioned would’ve been a government insurance plan and would have been operated just like a private insurance. It would have had to abide by the same rules as the private plans. It would be a plan that would operate on a nonprofit basis and consequently more than likely offer the same benefits as a private insurance plan but possibly and probably at a less expensive premium because it’s a nonprofit. It would have been another choice, it would not have replaced private insurance, it would have been a public option. We would have the option of buying health insurance from the government or a private insurance company.
PHAWKER: You would pay the government premiums.
WENDELL POTTER: Exactly the way you would pay a private insurance company.
PHAWKER: But if people couldn’t afford private insurance, how would they afford public insurance?
WENDELL POTTER: If you wanted coverage from the government but couldn’t afford premiums you would’ve gotten a subsidy to pay for your premiums.
PHAWKER: Why were private insurers so vehemently opposed to it?
WENDELL POTTER: They didn’t want another competitor and realized the government operates more efficiently than they can. They operate on a nonprofit basis and are able to have a much lower overhead cost than private companies. They don’t have to pay CEOs a hundred million dollars a year, they don’t need to reward shareholders every three months. They operate much more efficiently. Private insurers knew that and knew it would take business from them and they didn’t want that.
PHAWKER: Wasn’t the public option for people who couldn’t afford private insurance?
WENDELL POTTER: As initially proposed, it would have been for anyone. If you had coverage available from your workplace, you wouldn’t have been able to apply for the public plan. Most get coverage from employers so it would have been a small percentage of people that qualified for the public option.
PHAWKER: I distinctly remember candidate Obama was talking about a public option, but I don’t recall President Obama ever saying much about it.
WENDELL POTTER: It became clear to me that the insurance industry was getting to him and those around him to embrace the individual mandate. When he was running for president he said he was opposed to it but the industry changed his mind. They sent people to the White House to do that and they were very successful. They did the same thing on Capitol Hill to members of Congress. The bill that that ultimately was passed, contained something that the president said when he was running that he did not support, the individual mandate, and it did not contain the public option which he had supported. It was becoming clear over the course of 2009 that he was backing away from the public option. He said that while the public option was important and would help keep insurance companies honest, it’s not the only way we can go about doing this. He was essentially back-pedaling. When he said that it was clear to me that he was throwing the public option overboard.
PHAWKER: That was the beginning of my great disillusionment. It was a litmus test for how corrupt the system has become — with the White House and control of both houses of Congress he couldn’t do any of the things he said he would do on the campaign trail — the things that made people vote for him.
WENDELL POTTER: It really is the system. I honestly think the president really believed it when he was campaigning and thought he had a chance to pull this off. The system wasn’t going to let that happen and it is the system that we have allowed to develop that controls Washington. No one person will ever be able to do things in a different way.
PHAWKER: He seemed to start running for reelection immediately after inauguration when he should have said ‘I’m happy to be a one-termer but I’m going to go balls to the wall and get this done because this is what the American want.’ Do you think that would have been suicidal?
WENDELL POTTER: I think it would have been and here’s why, yes he’s got the bully pulpit but he doesn’t have millions of dollars to devote to PR and advertising constantly, one of the reasons why we’ve seen erosion in the support for healthcare reform because even though he and Democrats can talk about benefits, they really can’t overcome all the opposition coming from millions of dollars spent on PR and advertising efforts to discredit the reform.
PHAWKER: I find this hard to believe, we’re talking about the federal government. They spend almost four trillion dollars a year and the public is wildly misinformed about healthcare reform because they can’t match a few million dollars worth of negative ad buys? There’s no money budgeted for this?
WENDELL POTTER: There is not, I’ve been to the White House and know there is no adequate amount of money to explain the Affordable Care Act. There just is not.
PHAWKER: Why isn’t he pushing for a change in Congress that would allocate some funds?
WENDELL POTTER: He got what he could get. Congress put this together. There’s a website but in terms of having money to hire big PR firms and advertising companies to compete, they don’t have close to the amount of money that opponents have.
Also consider that people would be skeptical if it was coming from the White House in the first place or the administration. There are a lot of constraints, a lot of credibility issues, but the other thing is to get the kind of change we really need, you have to change the system. He could go in there and go balls to the wall, I don’t care if I’m a one-term president or not, this will be a meaningful reform. A lot of people were saying why didn’t we go with single-payer or something bold that would put these companies out of business, which a lot of people support? It’s because the insurance industry has the money to devote to PR and advertising campaigns, corporate allies that have and will join them in an effort, and in fact the administration was already threatened by the pharmaceutical companies who said if you don’t play with us and give us what we want, we will bring in the heavy artillery, we will make sure nothing passes, the insurers will do the same thing, hospitals will do the same thing, they’re so influential and that’s why it’s hard to get anything done. We’ve been at this 100 years and haven’t because of the incredible power that special interests have. When you’re trying to influence or change something you’re affecting someone’s profits and income, these people have powerful trade associations and allies and millions of dollars to make sure it doesn’t happen.
PHAWKER: They have the money but we have the numbers, though.
WENDELL POTTER: That’s why I’m optimistic. That’s why I wrote Deadly Spin, to make sure people know their enemy and how they’ve been able to [kill reform] time and time again. Understand your enemy and play by their rules, you don’t need the money they’ve got but you need a strategy and what I have observed is that advocates for reform don’t have a clue about strategy. They don’t have coherent political and communications strategies. It’s not that the tools of PR are evil, they’ve just been used so successfully by people without our best interest at heart. You also need to have some kind of structure that is effective at pushing real change. We don’t have, as consumers, anything quite like America’s Health Insurance Plans, the big trade association for insurers, we don’t have anything like the Pharmaceutical Research and Manufacturers of America, which is able to amass a lot of resources and demand discipline and a cohesive strategy. Consumers are all over the map and have competing interests, it’s hard to bring them together with one way of doing it and that’s where things fall apart, because we have dissension within the ranks.
PHAWKER: If we had gone to a single payer system, do you think there would be degradation in innovation and the quality of care, would it be like the post office?
WENDELL POTTER: No, because you can look at all of the other developed countries of the world and see they’ve achieved universal coverage and can guarantee citizens of those countries has access to decent care and it is not lower quality care, the outcomes of success are often far superior to ours. No, there doesn’t have to be degradation of loss in technology, they can continue to do that. Single payer is not dead, it just won’t pass at the federal level in the near or distant future. It can start at the state level like it did in Canada. It started in Saskatchewan, one of the smaller provinces. One of our smaller states, Vermont, this year passed a bill to move towards single payer. It could happen. If Vermont does it, other states will notice that and if it can show that it can guarantee access while controlling costs, you’ll start seeing other states follow Vermont’s lead. That’s how we’ll get to the system we need, not out of Washington because of the way the system is structured.
PHAWKER: Why is Romneycare so hated by the right?
WENDELL POTTER: It wasn’t hated by the right until it became possible to use it as a tool against Obama. Romney doesn’t want to acknowledge that Romneycare was the model for the federal law that’s passed. It’s been able to get them very much closer to universal coverage but they did it trying to keep private health insurers in place with an individual mandate as the federal law has with new regulations as the federal law has and it was something that Governor Romney oversaw and worked very closely to get passed. They just don’t like it because they call it Obamacare. It’s all political and contrived to try and win an election, they could care less as to whether it might work or not.
PHAWKER: Why the long gap between Obamacare being signed into law and when it actually kicks in? is it really necessary for a 2 ½ years waiting period?
WENDELL POTTER: The long phase-in was in deference to the insurance industry largely because they were able to persuade the administration and Congress that it would take a long time for us to change, to abide by all these new regulations and get everything in place to be able to do what you say we’ve got to do, we need that kind of lead time. They were able to persuade them to do that.
PHAWKER: You don’t think it was really necessary, just time to dismantle reform before it kicks in?
WENDELL POTTER: Absolutely. Some of it is legitimate, these are huge companies that have to put this in place so it is complex, but I don’t think it was necessary to wait quite that long. They could have done it easily a year earlier or a more than that but clearly one reason for dragging it out is it gives special interests more time to weaken it or derail it and that’s exactly what we’re seeing behind closed doors now out of public view, even though the law has passed and as big as the legislation was, the way it’s implemented is what’s important. After the law is passed then people will then begin writing regulations to implement it and they are just as susceptible to lobbying as Congress is.
PHAWKER: In the main you are for Obamacare, it’s progress?
WENDELL POTTER: I said at the time that it was important for Congress to enact what was before them considering the political dynamics. I said it’s more important to pass it than to kill the bill. It took us 100 years to get to that point and it was unlikely that Congress would get anything better, it falls short in many ways and it’s far too friendly to insurers and special interests. But if it’s implemented as intended, it will bring coverage to 30 million people without coverage right now and those subsidies can be viewed in a positive way, enabling them to get coverage and ending some of the most egregious practices of the insurance industry and make them behave differently. It was not possible to get rid of the insurance industry, we might wish it so but it’s not the real world. We live in a political world and most people don’t understand that. They have a low opinion of Congress and often for very good reason because of the way it’s influenced and held captive by special interests, but we’ve allowed it to happen.
PHAWKER: How do you change that when the people responsible for changing the way elections are financed are on the take?
WENDELL POTTER: People are beginning to wake up to the reality of what’s going on and paying more attention. That’s what Occupy Wall Street is really all about, protesting the influence they have on our lives and government as rightly they should. That can be the beginning of a broader movement than it currently is to the point where it can be a growing awareness of how dysfunctional our government is and how captive it is by Wall Street and special interests. Until that gets more traction, and I think it will, it can reach that tipping point if more people understand what is really going on. There is more of us than them, as you noted earlier. Occupy may be the beginning of it.
PHAWKER: Linguistically, we need something sexier than ‘campaign finance reform,’ people’s eyes glaze over the minute you talk about this, they don’t realize how crucial it is, how it’s the key to everything. We need a Frank Luntz on the left.
WENDELL POTTER: We do and there isn’t that. Part of it is no one has figured out how to hire a Frank Luntz on the side of the angels. Linguistics and language are extraordinarily important, I wrote about that in my book, language is how these special interests achieve their goals. They’re masters of manipulating public opinion to achieve their policy goals.
PHAWKER: Where do we go from here?
WENDELL POTTER: Where I go from here is to continue building awareness of what’s going on to do exactly what we’re talking about, help a movement gain traction, enlighten people about just why Congress really is dysfunctional, why things can’t happen there, and why we need to take our government back from Wall Street and corporate interests.
[Photos by ROBIN ODLAND]
PREVIOUSLY: THE MAN WHO WASN’T THERE Part I
PREVIOUSLY: THE MAN WHO WASN’T THERE Part II