Medical Insurance Companies Can Decide Who Lives and Dies – RAI with Wendell Potter (4/7)



welcome back to reality asserts itself I'm Paul Jay on the real news network we're continuing our discussion with wendell potter who's the author of deadly spin an insurance company insider speaks out on how corporate PR is killing healthcare and deceiving americans and the book nation on the take how big money corrupts our democracy and what we can do about it which he did with Nick Panem and he now joins me in the studio thanks thank you Paul so we're gonna pick up from our story if you haven't watched part 1 and part 2 you really should cuz we part two we started the biographical story and we're gonna pick it up but in part one we got to wendell had joined the private insurance industry where he worked for about 20 years rising to a big position so we didn't quite get the rise but i assume you did really well i did well and a lot of promoted your job was essentially helping the private insurance companies create a layer of bullshit to cover up for how they were making money out of people's illness and disease and death and i did a pretty good job lasted twenty years and yeah i absolutely was a master of spin and helping to obscure a reality it's the title of the deadly spill that exactly and it and it absolutely is deadly spin continues to this day let's talk about being inside that culture you and i once talked off-camera and and i said to you this feels to me like it would have been something similar to kind of naively joining a tobacco company and once you're there long enough not only do you learn about the tobacco company knowing that smoking causes cancer but you so internalize the culture of the success of the tobacco company you even let your children smoke yeah is it like that in the front it is like that and it probably is in most corporate culture as you you are made to want to be a part of the team in fact if you are showing signs that you're not a team player you'll be winnowed out so it's important to to be a team player and to buy into what the company is doing and not to rock the boat there was people have asked me a number of times why didn't I try to effect change from the inside you really can't because if you start to do that if you start to question the company's strategy and suggest that they're there there's there's something unethical going on here you'll be you'll be out the door it just doesn't work that way and part of the job of the insurance companies to make money and part of the spin you need to do is to decide when some people actually get expensive treatment or not their insurance companies in fact are making life-and-death decisions though they are but and and while I was still in the industry and in my jobs the it was they control the healthcare system in many ways even more than they do now although they're still pretty much in complete control of the healthcare system but back then before the Affordable Care Act was passed they could declare you uninsurable they could refuse to sell you a policy because of a pre-existing condition or if you had one and they were willing to sell you a policy they would charge you a lot more for it than they would someone who was exactly your same age who had not been sick in the past or have that pre-existing condition and you're right they they they truly are set up to have death panels within these within these companies and that was certainly a term also that was used during the debate that led to the Affordable Care Act by Sarah Palin and others who were saying that Obama and Democrats wanted to establish death panels within the government there was no truth to that but the the reality was that they do indeed exist and still do because in this country if you have private insurance there is someone at the company your insurance company who will be making decisions as to whether or not you'll get coverage for a procedure or medication or whatever it is your doctor says you need and some people are deciding so and so who's most likely to be poor isn't worth treating because they won't live long enough anyway it happens that way in fact the case that contributed to or made I just couldn't do it anymore involved a 17 year old girl who was in a health plan that my company had and it covered transplants but a medical director at Cigna said in his opinion he didn't think the transplant was medically appropriate for this girl but the doctors did the doctors did the doctors her treating physicians certainly did and they appealed that decision and to no avail this is exactly as you were saying with Palin and others this is what the right claims happens in Canada and other places right but with the government health insurance which in fact it doesn't like in Canada does the doctors decide exactly the plan doesn't get to decide but the insurance companies can they do and they still do the Affordable Care Act did nothing to change that in fact I think it's gotten even worse because it did the Affordable Care Act did do some good things but I knew as soon as it was passed that the insurance companies would would do other things to make sure that they met Wall Street's profit expectations that is the most important thing to these companies and I can assure you that it's the case I've for 10 years was responsible for handling financial communications to the to the media and I know that what is most important is meeting Wall Street's financial expectations every three months when you announce your earnings and if you miss it by a penny earnings per share then you'll see the value of your stock more than likely take a hit and a lot of these exact executives owned a lot of stuff exactly and I did too and I saw exactly what happened there were time or two when we did miss the consensus estimates which I guess is one of the reasons they want executives still in stock because they have such a self interest in maintaining the stock oh it's true in fact one of the days I dreaded most was when we released our proxy statement that lists the salaries that the total compensation of the five most highly compensated executives I dreaded that because I I knew I'd probably get some calls from reporters asking how I would how I could justify the CEOs salary but one of the things I used to justify it was that look he's 90 percent of his compensation is what we referred to at risk which meant that his salary was it was it was significant but he got most of his salary and stock grants and stock options and so he had great incentive to make sure that he was meeting Wall Street's profit expectations because which means you want to say no to expense expensive procedures yeah more than then otherwise because of the self-interest you have in the stock price exactly so you're seeing this you realize this in the earlier segment of our interview you talked about pushing this Wendell who's kind of more conscious about all this stuff down right but I'm guessing that Wendell is yelling at ya yeah and striving to break oh yes over the course of years you're wrestling with this I was I was a trial was indeed wrestling with that and then over the the last year that I was there it was it was intense and there were some things that I was asked to do that made it increasingly more difficult we'll talk more about the case of the 17 year old girl because that was a one of the breaking points for you it was and I was I'd handle a lot of these cases that we referred to as high-profile cases sometimes we would call them horror stories because they they were horrible and they almost always involved a case in which someone who was enrolled in a Cigna health plan was going to the media to complain about a decision that they were not getting coverage for something that they felt they were entitled to and in many cases their lives depended on this this girl needed a transplant she did doctors say they needed it insurance yeah overseers says that ain't worth it because she's gonna die anyway right she was she was in Los Angeles UCLA Medical Center the guy who made that call who said no we're not we're not going to cover it was 2500 away in Pittsburgh he had never treated her never laid eyes on her and he was just as much of a corporate executive as the Iowas or corporate employee and the person making life-and-death decisions on stock yes absolutely there is incentive for for those employees if when you reach a certain level within these big companies you become eligible for stocks stock options and stock grants and so you have an instant if the other thing too you don't have to have a memo that says you will deny X number of transplants this quarter you know though that if you are out of line if you become an outlier then your your job is going to be in jeopardy so you don't have to send a memo well and you get pressure from all the other stock owning executives hey you're screwing all of us right exactly so this girl died she died it became a very highly publicized case and I thought that I was playing a role and her getting the transplant that she needed I started getting calls from reporters all across all across Los Angeles and then it became a national even an international story and I what year is this this was in 2007 and and yeah it's 2007 it was December 2007 and these calls started coming in I had to tell our executives in our CEO and a few others this is going on and that this was becoming a real PR problem for the company as a real PR so how did you spend this disaster initially it was pretty easy we would spend these initially they look this is I can't even acknowledge that she is a is someone who's enrolled in a Cigna health plan because of HIPAA violate the kind of federal laws pertaining to privacy so I thought that would chill this and it had worried had done the trick many times before but the reporters were unrelenting they wanted to know more than my little statement would would would would we know what we were trying to hand-feed them and the family began to get a lot of support from activists the California Nurses Association took up the fight and they were beginning to stage a protest in front of signals regional offices in Glendale California CNN was there and when I learned that that's when the decision was made very quickly after that after I told the CEO and others that this was happening on live TV they a very quickly reversed that denial and one of the jobs I had was to try then to make sure that the family as they were on TV got the word that Cigna had changed that and it was reversing that denial and was going to allow the transplant to go forward and I saw that happening I was I got someone to go until mrs. sarkeesian it was a family name with sarkeesian and I could see someone whisper and mrs. sarkeesian's ear something that clearly made her happy so I knew I gotten the word to the family and I feel pretty good about that I thought well maybe this girl is gonna get that transplant she'll probably live she died five hours after that cuz it was too late it was too late in the enough time had passed since the original request was made you know she got sicker and initially there was a liver waiting for her a perfect match had been found that was not the case when the that decision had been reversed that a Nile so she died and in fact the outcome of similar cases that did get transplants on the whole was actually pretty good yeah in fact her doctors believe that there was at least an 80% chance that she would live you know I think five years was was what they said they felt pretty certain that she would live at least that long and probably longer so they were confident that this would this would save her life and so where are you when you hear she died what were you sitting I had gone home I had gone home thinking that well I've you know I'm I was I am father and I could just imagine what this family was going through and I felt pretty good I felt that you know this family was rejoicing they thought that their daughter was going to get this transplant I got a call that evening from someone who told me and within the company that you better get ready with another statement because nataline sarkeesian just passed away just died I was so devastating to me I could not I was I had gotten emotionally involved in this case more than most and I just couldn't do another one I just didn't have it in me to handle another high-profile case so soon after that I went into my my boss's office and turned in my resignation there was another experience you had I've read about where you went south and saw people lining up for how free health care because they couldn't afford insurance that was exactly that that was just a few months that was in the same year as 2007 and I went there that was back home visiting visiting family in Tennessee and I picked up a newspaper and saw something called the healthcare expedition as being held a few just a very few miles where I grew up and I went there out of curiosity I think there was something that was you know this this Windell that had been submerged there was something that was was happening to me and I I went there out of curiosity I had been I was kind of frustrated because I at this time I was having to write a white paper for my company and for the industry on the problem of the uninsured which this white paper was seeking to diminish that as a problem and to try to make people think that the people are uninsured were that way by choice and I would write it and the drafts would come back I wasn't making the case strong enough so I I guess might have been compelled to go to this this outdoor clinic yet at a County Fairgrounds and Paul that that road between Kingsport Tennessee and in Wise County Virginia which is just on the other side of the state line that was a road to Damascus for me it truly was and when I got to those those fairground gates and I walked through them it was like I had somehow left this country and walked into a third world country and ascribed what you saw well there were people who were people were lined up by the hundreds and lines that stretched completely out of you so these are this is like a free clinic that some doctors are giving yeah people that can't afford health Ryan's and at a County Fairgrounds and there were tents that had been set up it looks sort of like a MASH unit that you and I had never seen one except on TV and it was raining and those folks were wet they were soaking wet but they were not about to lose their place in life and I noticed that a lot of those lines were leading to barns and animal stalls this was the County Fairgrounds and people were being treated in in in animal stalls volunteers I found out later would go in days ahead of this and and scrub them as much as they could and and put up sheets on the stalls to give some privacy and where did the people come from oh they would drive for hundreds from hundreds of miles around this little little bitty town in the middle of South West Virginia in the coal mining section the mountains of Virginia and people to this day they still do this every July people drive from 100 from Ohio and Michigan and some in order pregnant pregnant oh yeah yeah exactly and people of all ages and I found out later that some of those people had insurance but they are in high deductible plans there weren't high deductible plans they didn't have enough money to meet the deductibles so there they could use her insurance and I was actually told by some of the volunteers that that people had called them up and or we're telling them that when they had called their insurance companies to see if there might be some way they could get the care that they needed before they meant that adduct able they were told no but you might see if Remote Area Medical is going to have one of these free clinics in your area insurance companies were telling people to go to these charity events to get care it was it was stunning and these are kinds of people you grew up there there were people I realized that moment when I said it was kind of a road to Damascus i but I knew immediately it was an epiphany for me I knew immediately that that had I not been lucky if mom and dad not saved money so I go to go to college and get a good job I could have been one of those people in those long lines and I also knew that at that very moment that I had to take some responsibility for that because my job was to get people to believe things that just simply were not true about the US healthcare system and that was a that truly was the beginning of my my change I it's not long after that this young woman dies on your watch yeah yeah and I I've sometimes said this has been kind of a spiritual journey for me I don't know why those these things happen so close together but they were impactful to me and I I knew that I couldn't keep doing what I was doing I didn't know what I was going to be what I would do next I didn't have another job lined up I just knew I couldn't keep doing that okay well it's well next segment with wendell potter we'll talk about his year after he quits and what's next is the testimony at the Senate hearing so please join us for a continuation of our series with wendell potter on reality asserts itself on the real news network

27 comments

  1. Remember when the Right said Obamacare had death panels while ignoring the ones that they lobby for.

  2. So let me get this straight. The guest admits, after he's retired and made all his money off the demise of many people, that it's all a scam? Typical psychopath – without conscience. Many already know it's been a scam. They lived it. Duh. He knew it was wrong back then but did nothing except get into a better paid position. This man has zero ethics and is greedy. This is the kind of people you promote on this channel? This guest must be totally and irreparably disconnected from his conscience. That's the American secret to wealth.

  3. “High deductibles” were invented by the same soul-less, defective demons that invented “usury”. And we’re giving ourselves a lot of credit when we compare ourselves to third world countries. More like fourth world. So much for winning WWII and being the most productive people on earth in the entire history of time.

  4. I see death panels in our future, but it will have nothing to do with insurance or healthcare. It will be a new kind of “winnowing”.

  5. I'm very grateful that no matter how broke I ever get, I'll never have to see his face in the mirror. I do however feel sympathy, because given that he demonstrably has a conscience, he has to suffer the guilt of his moral sins.

  6. Even if we move to Medicare for All it is still drastically too expensive. According to a recent video on this channel it would "only" save 3.3% of GDP. We are already close to 20% when other countries like the UK spend 7% and have everyone insured. This calculation basically assumes that prices with hospitals and doctors will not be renogotiated. But that is exactly what has to be done. 2/3 of Americans can't pay for medical expenses and it's a huge burden. Why are they allowed to charge prices most people cannot even remotely pay for and that are far above those in other industrialized countries? The medical lobby and all the workers they employ are a huge lobby to deal with and they will never want to give up these earnings. So as a result it's not even debated. Only Dean Baker dares to even talk about this.

  7. A friend of mine worked at a call center that was a large employer in our area. They have since closed this location but the main customer was health insurance companies and their job was to deny every claim possible. They are average high school dropouts working for minimum wage, or just over, making taking calls from patients!

  8. But yet all American Politicians not only the ones on Washington but on state and local levels have the very best and I can bet that they never get turned down from any test or procedures!! We all should have the very medical insurance they have !! Damn bastards!

  9. then wendell sold all his extortion assets and donated them to non-profit health organizations, and he now lives in poverty. lol.

  10. Now they have the ambulance personnel checking for insurance for heart problems and upon finding out there is none they leave and say you'll be alright. Big Insurance and big pharma in collusion with the medical industries do not care about the American people.

  11. Can whomever runs this Youtube channel PLEASE organize how these interviews are released? You are doing a tremendous disservice to your organization by putting these videos in such a disorganized manner. Your channel homepage is a complete mess, it's a mishmash of disconnected pieces.

    Where are sections 1-3? Why does anyone interested in this topic have to waste his/her time hunting them down?

  12. Wendell has been calling out the industry for a lot of years now. Listen to him. He has the whole thing right.

  13. Wendell Potter was the main whistle-blower in Michael Moore's movie "Sicko". If you've never seen it, I highly recommend you do.

  14. I was alive before we had insurance in the 50s and 60s and people were never denied medical help. I also remember it not being difficult to access a specialist when my grandmother had a brain tumor and we had to pay cash for the surgery it was $10,000 back in 1964. Today my son had brain surgery last week and it was 850,000 and without insurance he now owes the medical industry 850,000 which he will never make because he is disabled. It took us a year and a half to get him into surgery at Davis.