posted
Thanks so much for this. I actually think I was over charged by my former insurance company and am in the process of gathering information to see if our state insurance board can do something about this.
Posts: 177 | From God's Grace | Registered: Apr 2007
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Thank you for this article! Health Insurance is the largest piece of the pie in our budget. Even without Lyme expenses, the premiums are astronomical.
My husband works for a not-for-profit and we pay for our own insurance -- the company gives access to a group policy, but doesn't chip in. Insurance costs are larger than our mortgage or food costs.
Each year the insurance contracts come up for renewal with raised premium and lessened benefits. Just like in the article, we often leave one company and go to another because of this.
It 's clear our options are getting smaller while the costs are getting bigger.
Obama should work closely with the author of this article as well as with the guy interviewed!
Best wishes and fervent hopes,
wiserforit2
Posts: 273 | From Banks of the Hudson | Registered: Nov 2008
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bettyg
Unregistered
posted
copying article here since i can't read that font at all and breaking it up as necessary for comprehension for us neuro lyme folks .... betty
June 24, 2009 05:30 AM
Excluded Voices
An interview with Wendell Potter By Trudy Lieberman
This past year's health discussion has been remarkable for the narrow range of ideas and opinions that have floated down to the man on the street.
Journalists have sought out the same organizations and sources for their stories, offering up what has become the conventional wisdom for reform.
To bring more voices into the conversation, our Excluded Voices series will intermittently feature health care experts who aren't on the media's A-list of sources.
This is the sixth entry in the series, which is archived here.
We want to offer journalists more options for their stories and encourage a deeper conversation. To that end, we've asked the experts featured in each post to respond to questions from Campaign Desk readers.
Historically, insurance companies haven't topped reporters' story idea lists. Boring, editors say.
Complicated, reporters think. Of course, that's all good for the insurers--especially health insurers that would just as soon not have snooping reporters scrutinizing their practices.
As someone who has spent nearly an entire career covering insurance, I can tell you the subject is neither boring nor complicated once you delve into it.
More reporters should do so if they want to explain what the various bills winding their way through Congress will mean for the public as well as for insurance companies.
One reporter who has made something of a specialty of covering insurance is Lisa Girion of the Los Angeles Times.
Last week, Girion covered the testimony insurance executives gave before the House Subcommittee on Oversight and Investigations, and offered readers some insight into industry-think.
The executives told Congress that they would continue to rescind coverage for people who unintentionally fail to disclose what insurers consider preexisting conditions when applying for health insurance.
UnitedHealth Group, WellPoint, and Assurant Inc. have cancelled some 20,000 policies, leaving policyholders stuck with medical bills.
Sometimes, companies cite even the flimsiest evidence of deceit in order to justify rescinding their coverage.
And sometimes they've paid bonuses to staffers who help purge their books of policyholders likely to file expensive claims.
Campaign Desk sat down with Wendell Potter, a former head of corporate communications for CIGNA, the country's fourth-largest insurer, and now a senior fellow on health care at the Center for Media and Democracy.
Potter, who also spent four years at Humana, left the industry in 2008 after nearly twenty years of promoting its messages.
Trudy Lieberman: Why did you leave CIGNA?
Wendell Potter: I didn't want to be part of another health insurance industry effort to shape reform that would benefit the industry at the expense of the public.
TL: Was there anything in particular that turned you against the industry?
WP: A couple of years ago I was in Tennessee and saw an ad for a health expedition in the nearby town of Wise, Virginia. Out of curiosity I went and was overwhelmed by what I saw.
Hundreds of people were standing in line to get free medical care in animal stalls. Some had camped out the night before in the rain. It was like being in a different country. It moved me to tears.
Shortly afterward I was flying in a corporate jet and realized someone's insurance premiums were paying for me to fly that way. I knew it wasn't long before I had to leave the industry. It was like my road to Damascus.
TL: What was so upsetting about the industry that pushed you over the edge?
WP: I was in a unique position to know how companies made money--what they had to do to satisfy shareholders--and how the industry has been able to kill reform in the past. I had been part of those efforts and didn't want to be part of them again.
TL: How did you spin the press to the industry's way of thinking?
WP: Over the years I developed relationships with key reporters. When you do that, you are in a much better position to influence the tone and content of stories reporters write, or at least be sure that your company's key messages are included.
It's similar to the way special interests woo members of Congress. It's not just money; it's relationships.
TL: Did you ever deliberately mislead the press?
WP: I would say yes, if you mean not disclosing some pertinent information at times. PR people are always making selective disclosures of information. That's what you do. I did not knowingly provide inaccurate information.
TL: How do reporters know what's missing?
WP: They don't. That's why it's really important to know what you're covering.
TL: Can you give an example?
WP: Most large insurers are marketing consumer-directed plans. They do research and use selective data to persuade the public that these plans are popular and work as the companies say they do. There's a lot at stake for these companies.
They are building their business models around these plans, so they need to make them succeed. They need to counter research by others that shows many people don't get the care they need because of the high deductibles that must be met.
TL: What else made it possible to get the stories you wanted?
WP: I quickly learned that reporters, because they're so busy, haven't learned as much as they should. I was able to take advantage of that.
When companies would announce quarterly earnings, few reporters had any understanding of the details of the report.
TL: Do companies let reporters come visit for an entire day to learn the ropes, as they once did?
WP: Many companies won't do it for fear that something might go wrong. An executive might say something he shouldn't. A PR person puts him or herself at considerable risk by bringing a reporter in. Your job is on the line if stories are not flattering.
page 2 ...
TL: Are insurers better able to control their messages now than, say, twenty years ago?
WP: Yes. For one thing, the media has lost interest in writing stories similar to the managed care horror stories they wrote in the 1990s, when insurers and employers were forcing people into HMOs.
There is less coverage of the consequences to people resulting from insurance company practices. A lot of critical reporting is just not being done.
Most reporters willingly accept a prepared statement that company executives and lawyers have written, and they feel their obligation is over.
The calls we got were few and far between after the media lost interest in managed care.
TL: What insurance stories did reporters write most often?
WP: They wrote brief stories for investors, but wouldn't go into the details of the important facts and numbers--such as a company's medical loss ratio, which tells the percentage of premium dollars that the insurers pay out in claims.
This is a closely watched measure by investors and Wall Street analysts, because it tells them how well a for-profit company is meeting investors' earnings expectations.
TL: Did reporters ever ask about this?
WP: I can't recall a reporter ever probing how insurers manage to meet Wall Street's expectations through medical management and claims practices, which are key ways to manipulate the medical loss ratio and dump unprofitable accounts.
Not once was I asked by a reporter what happens to people who work for small and mid-sized companies that get ``purged'' by insurers because their employees' claims were causing the insurer's medical loss ratio to move in the wrong direction from an investor's point of view.
No one ever asked me about the human consequences of satisfying Wall Street. Most reporters are happy to do a superficial job.
TL: How do companies manipulate the medical loss ratio?
WP: They look at expensive claims of workers in small businesses who are insured by the company, and the claims of people in the individual market.
If an employer-customer has an employee or two who has a chronic illness or needs expensive care, the claims for the employee will likely trigger a review.
Common industry practice is to increase premiums so high that when such accounts come up for renewal, the employer has no choice but to reduce benefits, shop for another carrier, or stop offering benefits entirely.
More and more have opted for the last alternative.
TL: What tactics do they use in the individual market?
WP: They rescind policies when a review indicates that an individual has filed a lot of expensive claims. They will look for conditions that were not disclosed on the application.
Often the policy likely will be canceled and the individual left without coverage. Sometimes people aren't aware that they have a pre-existing condition.
It might be listed in the doctor's notes but not discussed with the patient.
TL: One way to end this practice might be to regulate it out of existence. Can we count on the industry to submit to more stringent regulation?
WP: The industry says it will accept more regulation, but the evidence is that it flaunts regulation on the books now.
Insurers are often cited for violations of many state regulations, and they usually agree to settle with insurance commissioners or the attorney general and pay a fine.
Fines are the cost of doing business, and even if the fine is several million dollars, it is inconsequential compared to profits insurers make.
TL: What can we expect from insurers as this reform discussion continues?
WP: Until there is actual legislative language, we will see the industry continue to be in favor of reform and portray themselves as coming to the table with solutions.
They will try to persuade reporters that the industry has changed this time. They are saying the same things now that they said before.
A lot of young reporters weren't around then, and don't know what they said in '93-'94.
TL: What can we expect from insurers after the bill language appears?
WP: It's what we won't see--what goes on behind the scenes--that will be most important.
The industry conducts what I call duplicitous PR campaigns--one of which I refer to as the charm offensive.
They talk about how much they are committed to reform. But, behind the scenes, they are financing efforts to kill elements they are opposed to, or they kill reform entirely.
They will work through what they refer to as ``third-party advocates''--people and groups that are ideologically aligned with them--and use their PR firms and lobbyists to do that work.
These surrogates will reach out to radio and TV talk show hosts and conservative editorial writers.
Insurers will also activate their grassroots organizations--their employees, businesses, and political allies--and if their ability to make money in the Medicare program is threatened, they will reach out to senior citizens enrolled in their plans.
Activities range from sending industry-written letters and e-mails to lawmakers and the media to flying people to Washington to lobby on their behalf. These are called fly-ins.
TL: Who are the industry's grass tops, and how do they work?
WP: Grass tops are corporate executives and business leaders who develop relationships with elected officials. Insurance company executives routinely go to Washington to meet with members of the House and Senate.
Companies' lobbyists regularly meet with their staffs and bring plenty of ``leave-behinds,'' such as carefully crafted position papers and talking points.
TL: How much weight does that carry?
WP: Quite a bit. Even if an executive meets with a Democrat not perceived as an ally, just a meeting and an offer to be supportive is worthwhile. It improves or forms a relationship that might not otherwise take place.
Executives want to be perceived as reasonable and cooperative--as people who have their constituents in mind. The executives don't go to Congress to talk about medical loss ratios and profits.
page 3
TL: What else will we see?
WP: We will see front groups formed to attack any legislation or parts of legislation the industry doesn't like. They've done this in past campaigns.
They will use front groups to rip legislation to shreds. It's inevitable that will happen again. It already is.
You can be assured that the industry is behind the increasingly vocal opposition to the public plan that would compete with private insurers.
TL: Can you give an example?
WP: The Health Benefits Coalition was formed in the '90s to fight anti-managed care legislation, including the patients' bill of rights.
It was funded primarily by big insurance companies, but it was portrayed as a broad-based business organization.
The industry recruited the NFIB (National Federation of Independent Business) to be the primary spokesperson. Insurers and the NFIB have had a long history of being allies.
TL: Can you explain how the industry organized to fight Sicko a couple of years ago?
WP: Through one of its PR firms, it orchestrated a huge behind-the-scenes campaign that involved giving industry allies, including columnists and editorial page editors, very selective and often misleading information about the shortcomings of other countries' health systems that were depicted as socialistic or government controlled.
It created a front group to churn out press releases and statements criticizing the movie, and warning about long waits for care in Canada and the U.K. That's what went on behind the scenes.
What the PR firm advised insurance executives to say to the press was quite different.
You might recall hearing executives and industry spokespeople dismissing Michael Moore as an ``entertainer'' and quickly adding that the movie served a useful role in focusing attention on the need for meaningful health care reform.
TL: What practices will the industry fight to the death to keep?
WP: They will fight to keep flexibility to design benefits as they see fit; in other words, low-cost policies that don't cover very much.
They will insist on flexibility to continue designing more products that shift the financial burden to consumers.
That will enable them to market leaner benefit plans, and it will let them market ``voluntary'' plans to certain employers that have high employee turnover.
These plans don't require financial participation by employers.
Insurers want to have the flexibility to continue designing plans that cover less and move further and further away from the concept of insurance to personal responsibility.
Insurers want people to have ``more skin in the game,'' and they want to have less.
TL: What else will they fight strongly for?
WP: They will fight to keep the ability to base rates on age. That will be a way to keep charging the most to people who are likely to be the sickest.
That will enable them to offer cheaper policies to younger and healthier people, and that is the market where the competition will be.
TL: If there is an individual mandate, how will the industry benefit?
WP: They have the potential for millions of more health plan enrollees. The ability to have flexible benefit design and base rates on age will allow them to design plans to maximize their profitability.
TL: Why is the industry so powerful?
WP: Over the many years, their PACs and individual executives have contributed to many political campaigns.
They've hired former members of Congress as lobbyists, such as my former colleague Bill Hoagland, who was a top aide for Senate majority leader Bill Frist and now heads CIGNA's government relations operation.
All the companies have independent lobbying firms working for them. Some are close to Democrats and some are close to Republicans.
TL: How else has the industry strengthened its grip?
WP: Consolidation in the industry into seven dominant carriers makes it more powerful. It has strengthened its grip through mergers and acquisitions.
A consequence of this is that, as a few insurers have grown to dominate local markets, doctors and hospitals have organized themselves into powerful conglomerates.
As a result, insurers don't have the bargaining clout they once had with providers and have lost the ability they once claimed to have to control medical costs.
TL: Why is the industry scared of a public plan that would look and act like Medicare?
WP: A public plan could offer the same benefits as a private plan at less costs because it would not have the high administrative costs--which include sales, marketing, and underwriting expenses--associated with most private plans.
It would not be under constant pressure from Wall Street to reward shareholders by constantly keeping an eye on the medical loss ratio and earnings per share, another key measure of profitability.
TL: Are the members of Congress who are most vocally against a public plan aligned with the industry?
WP: Yes. One of the things they can exploit is to talk about how a government-run plan would wreck the free market system in health care.
Many members of Congress believe the free market can still work with health care.
TL: Can it?
WP: There's no evidence that it has worked since the Clinton plan failed.
TL: Will we see a reprise of Harry and Louise?
WP: No. The industry knows its image is at an all-time low. So the industry can't be as obvious in attacking a plan as it was in 1994. They will work through front groups and allies to attack it through ads and commercials.
TL: So what's happening now with all these ads we're seeing?
WP: What's happening now is what happens in primary campaigns.
We're seeing a lot of targeted advertising by advocates of reform, aimed at members of Congress who might be persuaded on the wisdom of a public plan.
That's why you're seeing a lot of advertising in Maine aimed at Olympia Snowe and Susan Collins.
Later in the summer we'll see more national advertising attacking or supporting aspects of the reform bills. It will be like a political campaign, and it will be very expensive.
page 4
TL: How should journalists be covering this middle and last phase of the campaign?
WP: They should be looking at what insurers, drug companies, and organized medicine said during earlier reform efforts, and then report on how well they've delivered on those promises.
Instead of just reporting costs estimates from the Congressional Budget Office about how much a certain plan will cost taxpayers, which is easy to do, they should write investigative and analytical pieces on the costs to society and the economy if reform is not enacted.
Is reform an expense we can't afford, or an investment we can't afford not to make?
What is the ROI--the return on investment?
� Copyright 2009 Columbia Journalism Review.
COMMENTS ****************
Trudy: I have posted extensive excerpts of this over on Kos. I included lots of links with "go read Trudy Lieberman in full" and "please give her the traffic".
But also because this interview was so important, my piece is lengthy and probably in violation of standard fair use, unless it is okay with you.
Posted by dr.steveb on Wed 24 Jun 2009 at 08:16 PM
Dear Trudy:
I posted extensive excerpts of this over at Kos. I cite you in opening sentence and include lots of links to your original along with exhortations to "read Trudy Lieberman's piece in full" and "give her the traffic.
But it is lengthy excerpt and probably in violation of fair use... unless it is okay with you...? I will delete if you want me to.
Posted by Dr.SteveB on Wed 24 Jun 2009 at 08:19 PM
I came over from dkos. Thank oyu for this article. I hope some journalists read it!!
Posted by quadmom on Wed 24 Jun 2009 at 09:05 PM
Truly eye-opening!
Posted by Bill T on Wed 24 Jun 2009 at 09:14 PM
Thanks for this. You asked all the questions I wanted to ask.
Posted by laura on Wed 24 Jun 2009 at 09:26 PM
My plea to the President:
"Please, President Obama, interview Mr. Potter yourself on nation TV. After such an interview you would see public support for a vigorous public option explode and all your troubles passing meaningful reform melt like dew in a bright morning sun."
I just don't see why the President is not using his bully pulpit more vigorously in this regard.
Posted by Michael Murphy on Wed 24 Jun 2009 at 09:26 PM
As someone priced out of a Cigna plan as I aged (and required more medical care), I can easily believe what he says.
My individual Cigna plan started at about $600 a month for the PPO, several years later and Cigna had rasied my rate to $1,000 a month for the HMO for just little ole me.
Why? Because they could, and yes, they finally priced me out of health insurance, and health care. I have six years to go to qualify for Medicare, and the possibility of a public option in health care.
That's it.
I have at least four more health insurance horror stories in my immediate family alone, including a stepbrother fired from his job after heart surgery.
Later he was told in confidence that the insurance company had pressured his work to "fire the heart patient" -- or lose coverage for that small business, entirely.
Posted by Judy Brown on Wed 24 Jun 2009 at 09:52 PM
Thank you for helping to expose the corruption of the health insurance industry, while our democratic senators are doing everything in their power to conceal it.
Posted by obsessed on Wed 24 Jun 2009 at 10:09 PM
I came over from DKos as well, following the link in Dr.SteveB's diary.
Thank you for this interview! It's really quite amazing how the lust for money can drive out every other value. Thanks to Wendell Potter for breaking away from the industry & having the courage to speak out.
Posted by Positronicus on Wed 24 Jun 2009 at 10:21 PM
Thanks for this. I'm sending the link to everyone I know
Posted by Lindy on Wed 24 Jun 2009 at 10:26 PM
Thanks Trudy for this excellent reporting. I will be following your blog... Link came from Kos.
This is vital info. Also, have you read the book by David Berardinelli about the casualty insurance industry?
"From Good Hands to Boxing Gloves: the Dark Side of the Insurance Industry"... focusing on Allstate, among others.
It is EXCELLENT reading.. really required.. about the orchestrated plan to move $$ from policy holders to shareholders... all laid out in a McKinsey Co. Power Point presentation.
i came over from dkos, as well. thank you so much for this terrific journalism. they should have you on the Newshour!
Posted by polar bear on Wed 24 Jun 2009 at 10:34 PM
Thank you Trudy L. for this article; I found the link on DKos and will be recommending to friends and family that they come here to read the full interview.
Posted by Sheila Newbery on Wed 24 Jun 2009 at 10:37 PM
Trudy,
Thank you for this informative interview ... I've sent the link on to my network. It is important that this type of information is part of the reform discussion
Posted by joyous on Wed 24 Jun 2009 at 10:47 PM
I'm another kos visitor. Excellent piece. Do journalists read the CJR much these days?
Posted by lakeside on Wed 24 Jun 2009 at 10:56 PM
I popped over here from kos. It really frustrates me how many elected officials vote based on who funds their campaigns. It's all about power for them instead of what is best for the people who elect them.
We really need to publicize which congressional people are getting money from the insurance, pharma industries. We also need more in the media who will investigate on their own and not repeat 'talking points' given to them.
Posted by Renie on Wed 24 Jun 2009 at 11:07 PM
Dear Trudy,
Came over at the behest of DrSteveB from DailyKos... and I would like to thank you for this article..
Glory Glory Hallelujah I hope Americans push reform down the throats of those corporate puppets, oft times referred to as "Congress". They better get on our side or they will have NO side at all.
Posted by DMcCoy on Wed 24 Jun 2009 at 11:18 PM
Thanks to you Trudy and to Mr. Potter for exposing the scam private health insurance is! Now if ABC and NBC and CBS will cover this!
Posted by Sue, RN on Wed 24 Jun 2009 at 11:27 PM
I am over from dKos, a nurse with adult kids.
U.S. heatlh care for-profit system stinks. Health, and health care are different from marketing and selling widgets, or investment advice, or just about anything else in the free market.
For each decision, for each account, every single one, people live and die by the decisions made in boardrooms, and on the advice of actuaries.
HEALTH CARE IS DIFFERENT, AND NEEDS A DIFFERENT SYSTEM THAN GARDEN VARIETY WIDGETS AND SERVICES, A DIFFERENT SYSTEM THAN THE FOR-PROFIT FREE MARKET SYSTEM.
Posted by PMA on Wed 24 Jun 2009 at 11:30 PM
thanks, trudy, great article. am forwarding to my sister who worked for insurance companies prior to having a baby. she will concur on all points i expect.
should mention that i found my way here through dkos and drsteveb's diary.
Posted by sharon aka conchita on Wed 24 Jun 2009 at 11:37 PM
Trudy, excellent article and it couldn't be more explicit in what journalists should be doing on this important issue. We'll see.
Came to you from DKos.
Posted by Bekah on Wed 24 Jun 2009 at 11:55 PM
I am a journalist, came here directly from DrSteveB's DKos diary, & also posted a link to this article with a group of fellow professional writers...
I am delighted to see this discussion since, as an individual policy holder for 30+ years, I directly experienced much of what Potter described.
I had to drop my individual coverage this past March due to its expense (over $800 for my policy&meds per month - w/a $2000 deductible) but I'm lucky enough to be age 65 in July. Medicare, here I come... with arms wide open.
My hope is that US citizens of every age will finally begin to have some secure health care options - starting with the 2009 Health Care legislation. But it won't be easy.
Posted by Lynwaz on Thu 25 Jun 2009 at 12:31 AM
Outstanding article. I followed the link from Dailykos, too, and will look for your byline in the future. Thank you.
Posted by catherder on Thu 25 Jun 2009 at 01:16 AM
Great interview, Trudy (came over from Kos). Sent link to Rachel Maddow with suggestion she get you and/or Wendell Potter on her show. This is major insight that needs to be broadcast wide for general public to understand what we're up against in this "healthcare reform" jazz. Major media won't touch it. Rachel's the gal to break the spell on the TV machine.
Reminds me of "The Insider" about Jeffrey Wigand, the whistle-blower on cigarettes.
Posted by Dissenta on Thu 25 Jun 2009 at 02:12 AM
Thanks for this interview with Potter. Truth is good medicine! It seems the MSM would rather report on the most superficial, pre-packaged aspects of the health-care reform battle -- which the insurance industrial complex is especially good at providing.
There should be a lot more emphasis given to the impact of the corporate profit motive on the health and lives of everyday Americans. Sending the link to your series to my local McClatchy rag.
Posted by CMYK on Thu 25 Jun 2009 at 03:58 AM
I am DKOS # 7630 - my wife was fired in January 2009 from her 20 person unit BECAUSE she had Health Insurance!
Two women were let go that day - the only two who had Health Insurance from her employer.
Posted by sen. bob on Thu 25 Jun 2009 at 07:42 AM ***********************************************************
I followed the link over from DKOS to read your article. Thank you for showing a new perspective on the health insurance industry.
Posted by dfwmom on Thu 25 Jun 2009 at 08:36 AM
Trudy, Thanks for this great interview. I came from DKos to give you props. Keep up the excellent investigative reporting!
Posted by majii on Thu 25 Jun 2009 at 08:37 AM
Never would have found this without Dr.SteveB's DK link. Thanks. I'm tweeting the link!
Posted by Aaron Roland, M.D. on Thu 25 Jun 2009 at 09:32 AM
another kos reader - great job, and thank you for the trutch. Here's hoping that Maddow (or at least Jon Stewart) pick you up....
Posted by anne on Thu 25 Jun 2009 at 10:18 AM
I also came over from dKos.
Great job on a critical issue. Thanks!
Posted by Fran on Thu 25 Jun 2009 at 10:26 AM
Another kos reader who followed the link to read the whole article.
Thank You!
Although, reading it has made me ill! :-(
Posted by Jim on Thu 25 Jun 2009 at 10:57 AM
Another dKos migrant. Excellent, enlightening and enraging interview...thank you and I, too, will continue to watch. Dissenta above had a good idea...get this series into Rachel's hands!
Posted by Heather in SFBay on Thu 25 Jun 2009 at 11:45 AM
Another who was steered here by the Kos link - chiming in just so you know the benefit of the linkage.
Posted by Jay on Thu 25 Jun 2009 at 12:36 PM
I followed one of DrSteveB's links from DailyKos to your article. Great article!!
Posted by cowalker on Thu 25 Jun 2009 at 12:59 PM
"TL: How should journalists be covering this middle and last phase of the campaign?
WP: They should be looking at what insurers, drug companies, and organized medicine said during earlier reform efforts, and then report on how well they've delivered on those promises.
Instead of just reporting costs estimates from the Congressional Budget Office about how much a certain plan will cost taxpayers, which is easy to do, they should write investigative and analytical pieces on the costs to society and the economy if reform is not enacted.
Is reform an expense we can't afford, or an investment we can't afford not to make? What is the ROI--the return on investment? "
Let's not kid ourselves: Journalists will write what their bosses PAY them to write, and the corporate media stands to lose tens of billions in ad revenue should true health care reform ever become reality.
The journalists of the corporate media have a vested interest in the Status Quo, and those of us on the side of reform should rightfully see them as enemies rather than allies in the fight.
Posted by drewfromct on Thu 25 Jun 2009 at 01:31 PM
Trudy: I have posted extensive excerpts of this over on Kos. I included lots of links with "go read Trudy Lieberman in full" and "please give her the traffic". But also because this interview was so important, my piece is lengthy and probably in violation of standard fair use, unless it is okay with you.
Posted by dr.steveb on Wed 24 Jun 2009 at 08:16 PM
Dear Trudy: I posted extensive excerpts of this over at Kos. I cite you in opening sentence and include lots of links to your original along with exhortations to "read Trudy Lieberman's piece in full" and "give her the traffic.
But it is lengthy excerpt and probably in violation of fair use... unless it is okay with you...? I will delete if you want me to.
Posted by Dr.SteveB on Wed 24 Jun 2009 at 08:19 PM
I came over from dkos. Thank oyu for this article. I hope some journalists read it!!
Posted by quadmom on Wed 24 Jun 2009 at 09:05 PM
Truly eye-opening!
Posted by Bill T on Wed 24 Jun 2009 at 09:14 PM
Thanks for this. You asked all the questions I wanted to ask.
Posted by laura on Wed 24 Jun 2009 at 09:26 PM
My plea to the President:
"Please, President Obama, interview Mr. Potter yourself on nation TV. After such an interview you would see public support for a vigorous public option explode and all your troubles passing meaningful reform melt like dew in a bright morning sun."
I just don't see why the President is not using his bully pulpit more vigorously in this regard.
Posted by Michael Murphy on Wed 24 Jun 2009 at 09:26 PM
As someone priced out of a Cigna plan as I aged (and required more medical care), I can easily believe what he says.
My individual Cigna plan started at about $600 a month for the PPO, several years later and Cigna had rasied my rate to $1,000 a month for the HMO for just little ole me.
Why? Because they could, and yes, they finally priced me out of health insurance, and health care. I have six years to go to qualify for Medicare, and the possibility of a public option in health care.
That's it.
I have at least four more health insurance horror stories in my immediate family alone, including a stepbrother fired from his job after heart surgery. Later he was told in confidence that the insurance company had pressured his work to "fire the heart patient" -- or lose coverage for that small business, entirely.
Posted by Judy Brown on Wed 24 Jun 2009 at 09:52 PM
Thank you for helping to expose the corruption of the health insurance industry, while our democratic senators are doing everything in their power to conceal it.
Posted by obsessed on Wed 24 Jun 2009 at 10:09 PM
I came over from DKos as well, following the link in Dr.SteveB's diary.
Thank you for this interview! It's really quite amazing how the lust for money can drive out every other value. Thanks to Wendell Potter for breaking away from the industry & having the courage to speak out. Posted by Positronicus on Wed 24 Jun 2009 at 10:21 PM
Thanks for this. I'm sending the link to everyone I know Posted by Lindy on Wed 24 Jun 2009 at 10:26 PM
Thanks Trudy for this excellent reporting. I will be following your blog... Link came from Kos. This is vital info. Also, have you read the book by David Berardinelli about the casualty insurance industry?
"From Good Hands to Boxing Gloves: the Dark Side of the Insurance Industry"... focusing on Allstate, among others.
It is EXCELLENT reading.. really required.. about the orchestrated plan to move $$ from policy holders to shareholders... all laid out in a McKinsey Co. Power Point presentation.
i came over from dkos, as well. thank you so much for this terrific journalism. they should have you on the Newshour!
Posted by polar bear on Wed 24 Jun 2009 at 10:34 PM
Thank you Trudy L. for this article; I found the link on DKos and will be recommending to friends and family that they come here to read the full interview. Posted by Sheila Newbery on Wed 24 Jun 2009 at 10:37 PM
Trudy, Thank you for this informative interview ... I've sent the link on to my network. It is important that this type of information is part of the reform discussion Posted by joyous on Wed 24 Jun 2009 at 10:47 PM
I'm another kos visitor. Excellent piece. Do journalists read the CJR much these days? Posted by lakeside on Wed 24 Jun 2009 at 10:56 PM
I popped over here from kos. It really frustrates me how many elected officials vote based on who funds their campaigns. It's all about power for them instead of what is best for the people who elect them.
We really need to publicize which congressional people are getting money from the insurance, pharma industries. We also need more in the media who will investigate on their own and not repeat 'talking points' given to them. Posted by Renie on Wed 24 Jun 2009 at 11:07 PM
Dear Trudy, Came over at the behest of DrSteveB from DailyKos... and I would like to thank you for this article.. Glory Glory Hallelujah
I hope Americans push reform down the throats of those corporate puppets, oft times referred to as "Congress". They better get on our side or they will have NO side at all. Posted by DMcCoy on Wed 24 Jun 2009 at 11:18 PM
Thanks to you Trudy and to Mr. Potter for exposing the scam private health insurance is! Now if ABC and NBC and CBS will cover this! Posted by Sue, RN on Wed 24 Jun 2009 at 11:27 PM
I am over from dKos, a nurse with adult kids.
U.S. heatlh care for-profit system stinks. Health, and health care are different from marketing and selling widgets, or investment advice, or just about anything else in the free market. For each decision, for each account, every single one, people live and die by the decisions made in boardrooms, and on the advice of actuaries.
HEALTH CARE IS DIFFERENT, AND NEEDS A DIFFERENT SYSTEM THAN GARDEN VARIETY WIDGETS AND SERVICES, A DIFFERENT SYSTEM THAN THE FOR-PROFIT FREE MARKET SYSTEM. Posted by PMA on Wed 24 Jun 2009 at 11:30 PM
thanks, trudy, great article. am forwarding to my sister who worked for insurance companies prior to having a baby. she will concur on all points i expect.
should mention that i found my way here through dkos and drsteveb's diary. Posted by sharon aka conchita on Wed 24 Jun 2009 at 11:37 PM
Trudy, excellent article and it couldn't be more explicit in what journalists should be doing on this important issue. We'll see. Came to you from DKos. Posted by Bekah on Wed 24 Jun 2009 at 11:55 PM
I am a journalist, came here directly from DrSteveB's DKos diary, & also posted a link to this article with a group of fellow professional writers...
I am delighted to see this discussion since, as an individual policy holder for 30+ years, I directly experienced much of what Potter described.
I had to drop my individual coverage this past March due to its expense (over $800 for my policy&meds per month - w/a $2000 deductible) but I'm lucky enough to be age 65 in July. Medicare, here I come... with arms wide open.
My hope is that US citizens of every age will finally begin to have some secure health care options - starting with the 2009 Health Care legislation. But it won't be easy. Posted by Lynwaz on Thu 25 Jun 2009 at 12:31 AM
Outstanding article. I followed the link from Dailykos, too, and will look for your byline in the future. Thank you. Posted by catherder on Thu 25 Jun 2009 at 01:16 AM
Great interview, Trudy (came over from Kos). Sent link to Rachel Maddow with suggestion she get you and/or Wendell Potter on her show.
This is major insight that needs to be broadcast wide for general public to understand what we're up against in this "healthcare reform" jazz. Major media won't touch it. Rachel's the gal to break the spell on the TV machine.
Reminds me of "The Insider" about Jeffrey Wigand, the whistle-blower on cigarettes. Posted by Dissenta on Thu 25 Jun 2009 at 02:12 AM
Thanks for this interview with Potter. Truth is good medicine! It seems the MSM would rather report on the most superficial, pre-packaged aspects of the health-care reform battle -- which the insurance industrial complex is especially good at providing.
There should be a lot more emphasis given to the impact of the corporate profit motive on the health and lives of everyday Americans. Sending the link to your series to my local McClatchy rag. Posted by CMYK on Thu 25 Jun 2009 at 03:58 AM
I am DKOS # 7630 - my wife was fired in January 2009 from her 20 person unit BECAUSE she had Health Insurance! Two women were let go that day - the only two who had Health Insurance from her employer. Posted by sen. bob on Thu 25 Jun 2009 at 07:42 AM
I followed the link over from DKOS to read your article. Thank you for showing a new perspective on the health insurance industry. Posted by dfwmom on Thu 25 Jun 2009 at 08:36 AM
Trudy, Thanks for this great interview. I came from DKos to give you props. Keep up the excellent investigative reporting! Posted by majii on Thu 25 Jun 2009 at 08:37 AM
Never would have found this without Dr.SteveB's DK link. Thanks. I'm tweeting the link! Posted by Aaron Roland, M.D. on Thu 25 Jun 2009 at 09:32 AM
another kos reader - great job, and thank you for the trutch. Here's hoping that Maddow (or at least Jon Stewart) pick you up.... Posted by anne on Thu 25 Jun 2009 at 10:18 AM
I also came over from dKos. Great job on a critical issue. Thanks! Posted by Fran on Thu 25 Jun 2009 at 10:26 AM
Another kos reader who followed the link to read the whole article. Thank You! Although, reading it has made me ill! :-( Posted by Jim on Thu 25 Jun 2009 at 10:57 AM
Another dKos migrant. Excellent, enlightening and enraging interview...thank you and I, too, will continue to watch. Dissenta above had a good idea...get this series into Rachel's hands! Posted by Heather in SFBay on Thu 25 Jun 2009 at 11:45 AM
Another who was steered here by the Kos link - chiming in just so you know the benefit of the linkage. Posted by Jay on Thu 25 Jun 2009 at 12:36 PM .
I followed one of DrSteveB's links from DailyKos to your article. Great article!! Posted by cowalker on Thu 25 Jun 2009 at 12:59 PM
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Leelee
Frequent Contributor (1K+ posts)
Member # 19112
posted
Thank you for posting. Quite a thought-provoking piece.
-------------------- The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. Martin Luther King,Jr Posts: 1573 | From Maryland | Registered: Feb 2009
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posted
"TL: How do companies manipulate the medical loss ratio?
WP: They look at expensive claims of workers in small businesses who are insured by the company, and the claims of people in the individual market. If an employer-customer has an employee or two who has a chronic illness or needs expensive care, the claims for the employee will likely trigger a review. Common industry practice is to increase premiums so high that when such accounts come up for renewal, the employer has no choice but to reduce benefits, shop for another carrier, or stop offering benefits entirely. More and more have opted for the last alternative."
Posts: 526 | From NJ | Registered: May 2007
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
Unfortunately, none of this is new to me. I do benefits administration (for people who actually want to provide good health care), and have to deal with the insurance companies in my job.
Many small and mid-size employers don't understand how insurance works. They depend on an insurance broker to inform them. Insurance brokers often receive their income from the insurance companies, getting paid for the clients they sign onto the insurance plan.
We used to have an insurance system where people had the same job for life, and that job was connected to one insurance company for life. Now employers change insurance companies regularly and people change jobs. People are on an insurance plan an average of about 18 months.
It is no longer beneficial for the insurance company to make you healthy, because they won't be paying for you in 20 months. They just want to push the cost off onto the next insurance company.
"Consumer driven" plans were a way to make the individual pay more of their health care. The ytook language that the President was using to back his policies, and it made it sound good to employers who bought into it.
A few years later, these "consumer driven" plans are having huge increases in costs because, guess what, when people have to pay for their physical or their diabetes and hypertension management, they don't pay! So in a few years, they end up with serious complications.
Sorry, could go on forever in my hate...
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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