August 24, 2009
The health care debate-14: The 'death panels' of the insurance companies
(For previous posts on the issue of health care, see here.)
Wendell Potter used to be the head of corporate communications of CIGNA, the highest public relations position of one of the largest health insurance companies. That position gave him a special insight into how the health insurance industry actually works and the very different way they present themselves to the public. At some point the contradictions became unbearable for him. He could not take it anymore and left his position and since then he has been spilling the beans about how the insurance companies really operate, how they put profits before any other consideration, and make money from the misery of sick people by denying them care in their time of need.
Potter spoke to Amy Goodman of Democracy Now! about two cases. One was a California teenager, Nataline Sarkisyan, who in 2007 was denied coverage for a liver transplant, even though her doctors' recommended it and they had insurance and had done everything that was expected of them. The family was able to get media attention and force CIGNA to reverse itself, but the reversal decision came just two hours before she died. No doubt CIGNA views this outcome as a great success since they did not have to pay for the liver transplant after all, hence their costs went down and their profits went up. Their shareholders must have been pleased.
Then there was the case of Thomas Concannon, who in 2002 was suffering from multiple myeloma, a rare form of cancer. As Goodman reports "His doctors planned to perform a bone marrow transplant, but as Concannon lay on the operating table, his insurance company, CIGNA, announced it would not cover the operation." (my emphasis)
Potter remembered both those tragic cases because he had to try and mitigate the public relations damage. In a recent interview with Bill Moyers, Potter describes how he came to his epiphany about how rotten the current system is and his own sordid role in it. It occurred when he visited a 'health expedition' run by volunteer doctors at the Wise County fairground near his hometown when he was visiting his family. Such events are sprouting up all over the country and the huge crowds that turn up are a testimony to how many people lack access to basic primary medical care. Potter describes what he saw.
I took my camera. I took some pictures. It was a very cloudy, misty day, it was raining that day, and I walked through the fairground gates. And I didn't know what to expect. I just assumed that it would be, you know, like a health-- booths set up and people just getting their blood pressure checked and things like that.
But what I saw were doctors who were set up to provide care in animal stalls. Or they'd erected tents, to care for people. I mean, there was no privacy. In some cases-- and I've got some pictures of people being treated on gurneys, on rain-soaked pavement.
And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee-- all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth.
There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.
Potter says that the widely contrasting world that the insurance industry executives live in carefully insulates them from the harsh realities that most people face, so that the people they deny coverage to are never seen as real people but are merely statistics.
I had a great job. And I had a terrific office in a high-rise building in Philadelphia. I was insulated. I didn't really see what was going on. I saw the data. I knew that 47 million people were uninsured, but I didn't put faces with that number.
Just a few weeks later though, I was back in Philadelphia and I would often fly on a corporate aircraft to go to meetings.
And I just thought that was a great way to travel. It is a great way to travel. You're sitting in a luxurious corporate jet, leather seats, very spacious. And I was served my lunch by a flight attendant who brought my lunch on a gold-rimmed plate. And she handed me gold-plated silverware to eat it with. And then I remembered the people that I had seen in Wise County. Undoubtedly, they had no idea that this went on, at the corporate levels of health insurance companies.
In the same interview, Moyers reveals the strategy of the opponents of health care reform, who are trying to scuttle it while saying they want it.
BILL MOYERS: I have a memo, from Frank Luntz. I have a memo written by Frank Luntz. He's the Republican strategist who we discovered, in the spring, has written the script for opponents of health care reform. "First," he says, "you have to pretend to support it. Then use phrases like, "government takeover," "delayed care is denied care," "consequences of rationing," "bureaucrats, not doctors prescribing medicine."
This came as no surprise to Potter: "They don't want a public plan. They want all the uninsured to have to be enrolled in a private insurance plan. They want-- they see those 50 million people as potentially 50 million new customers. So they're in favor of that."
It is a fascinating interview, giving a disturbing insider's look at the really evil practices of the health insurance industry. Moyers describes another case.
The day before she was scheduled to undergo a double mastectomy for invasive breast cancer, Robin Beaton's health insurance company informed her that she was "red flagged" and they wouldn't pay for her surgery. The hospital wanted a $30,000 deposit before they would move forward. Beaton had no choice but to forgo the life-saving surgery.
Southern Beale writes about her own experience:
You have no idea what it's like to be called into a sterile conference room with a hospital administrator you've never met before and be told that your mother's insurance policy will only pay for 30 days in ICU. You can't imagine what it's like to be advised that you need to "make some decisions," like whether your mother should be released "HTD" which is hospital parlance for "home to die," or if you want to pay out of pocket to keep her in the ICU another week. And when you ask how much that would cost you are given a number so impossibly large that you realize there really are no decisions to make. The decision has been made for you. "Living will" or no, it doesn't matter. The bank account and the insurance policy have trumped any legal document.
Such stories expose that the falsity of the fear mongering that in a single payer or socialized system, bureaucrats will come between doctor and patient and make life or death decisions. Such things only happen with the private, profit-seeking health insurance companies. So the closest things to the bureaucratic 'death panels' that emerged from the fevered imaginations of the deathers are actually run by the private, profit-seeking health insurance industries who, in conjunction with hospital administrators, callously consign people to death purely because of their desire for profits.
POST SCRIPT: Capitalism – A Love Story
Here is the trailer for Michael Moore's upcoming film which, like his others, should be well worth watching. His Sicko that dealt directly with the health system was great, and if you did not see it, you should rent it. But the problem with the health system is that is embedded in the capitalist mindset that values profit above all other things, and so this new film should give the bigger picture.
People will try and dismiss Moore as a 'mere' comedian in order to discredit his message. This is what the health industry and its shills in the media (I am looking at you Sanjay Gupta) tried to do with Sicko. In his interview with Moyers, Wendell Potter describes the industry's strategy of which he was a part.
Don't be fooled. His films are funny but Moore is smart and researches his material well. Try as they might, his detractors could not fault him on the facts.