Longtime health insurance company bigwig and former holder of “the ultimate PR job,” Wendell Potter recently told PBS‘ Bill Moyers (Bill Moyers Journal, 7/10/09) how he had been “involved in the campaign by the industry to discredit Michael Moore and his film Sicko,” and now sees that “the industry is resorting to the same tactics they’ve used… back in the early ’90s, when they were leading the effort to kill the Clinton plan” for national healthcare reform.
Potter told Moyers that he “knew that 47 million people were uninsured, but I didn’t put faces with that number” until he “picked up the local newspaper and I saw that a healthcare expedition was being held a few miles up the road.” Seeing “people lined up, standing in line or sitting in these long, long lines, waiting to get care,” sparked his defection from the PR machine, and ultimately moved him to appear on Moyers’ show to describe the insurance companies’ fear of “high-profile cases”:
When you have a case like that–a family or a patient goes to the news media and complains about having some coverage denied that a doctor had recommended. In this case, Nataline Sarkisyan’s doctors at UCLA had recommended that she have a liver transplant. But when the coverage request was reviewed at Cigna, the decision was made to deny it.
It was around that time, also, that the family had gone to the media, had sought out help from the California Nurses Association and some others to really bring pressure to bear on Cigna. And they were very successful in getting a lot of media attention, and nothing like I had ever seen before….
It got everyone’s attention. Everyone was focused on that in the corporate offices.
Unfortunately, the U.S. press’ general attention toward the larger story of insurance company evildoing has been neglectful to say the least, as exemplified by the fact that this was Potter’s “first extended television interview since leaving the health insurance industry…last year.” Encourage journalists to correct at least part of this by signing FAIR’s petition to Tell Media: Include Single-Payer in Healthcare Debate.
I have had a 5 year odyssey with the health care industry and insurance industry. I was experiencing severe breathing difficulties for 5 years, due to a ligament that attaches my thoracic rib to my spine being stretched. I went through the University of Pittsburgh Medical Center for 3 years, undergoing many… many tests. To no avail. I later found out that UPMC, one of the most profitable hospitals in the country, allows their doctors only 15 minutes per patient. I was never touched in the 3 years I was there.
I went to some massage experts for the Pittsburgh Steelers as a last resort, who immedaitely noticed that my back muscle that attaches my hip to my bottom thoracic rib was swollen significantly.
They helped me, and put me in touch with a wonderful sports doctor, Dr. James Scarpone of Wintersville, Ohio, who works on many major league pitchers. He moved parts of my body around.. he did various things, and related what he thought my problem was (I was a competitive swimmer), and that it was similar to what his pitchers went through when they couldn’t breathe. From such strong rotational force, I had stretched a rib out of its place, allowing it to float.
He did injections of my own white blood cells directly into the ligaments, and I was on my feet for the first time in 3 years. (I had spent 3 on my living room floor, wondering how to breathe all day.) The insurance company, Blue Cross of PA, first approved it, then, after it was done as a procedure… denied payment, leaving me with a considerable payment. A year later, after much difficulty, I got a second approval, as I had been improving. They again approved it, I had the procedure, then they called it experimental and denied it a month or more after the procedure was done, again saddling me with the bill.. a significant one.
This is the same procedure touted as getting Super Bowl receiver Hines Ward of the Pittsburgh Steelers up and on his feet for the SuperBowl after suffering a severe ankle injury.
I continue to rehab, but none of the things that help are paid for by my insurance company. I pay it out of pocket, with much of my income going to keeping me going. (The option is to not treat it and go on disability, which I have battled against for 5 years.)
Oh.. and did I mention that during the first year.. 5 years ago.. when taxes were being cut for the wealthy, I additionally had been audited because they declared my business a hobby as I was out of work for so long and unable to take on work. I own my own woodworking business. I spent 6 months, while being disabled (and trying not to claim it), having to get all of my medical and financial records together and hire a tax attorney. (I am meticulous and always pay my taxes religiously, unlike some who look for loopholes.) When the IRS could not find anything, after choosing to go back 3 years, they decided my mileage was off, and decided to bill me $200 over that 3-year period. My mileage was accurate. I was also saddled with a significant legal bill (which you can not claim on your taxes, if you are victorious in your IRS battle), in addition to my medical bills.
Unregulated business? I don’t see how it works for the average American.
I have recovered enough to buy a new house and clear my bills. The bank here, BankNewport, has instigated new overdraft fees by not fully clearing checks (only a portion of a check deposited is cleared), making it difficult to keep the proper records on my balance. I just am careful in order to combat those deceptive practices. And the mortgage on my new house? It’s been sold 3 times in a month from my broker to Bank of America to Chase to Fanny Mae. Didn’t they learn their lessons? I know I will pay my mortgage, but I do expect them to get in trouble. I am not sure how they make money trading that mortgage.
Has anyone learned a lesson from the last 8 years? It appears not.
I would be dead now. I would have been a dead baby. (Not like the ones that anti-choice Conservatives wax on about). I was born a preemie, two months early. I was a little over 3 pounds. Six weeks in the hospital saved my life numerous times. My mother was a poor single college student. Imagine, for a moment, the incredible debt that six weeks in ICU as a newborn racks up. And then, picture that crushing mountain of debt going away, and never bothering you ever again. For one simple reason: I was born in Canada. Yep. Canada-born. So don’t let any right-wing corporate propaganda about the Canadian health care system fool you, I was there. And I’m here today because of it.
Unlike when I was at home one day, uninsured, working as a cook. I was cutting up some semi-frozen meat and the knife slipped. Uninsured, I just had to clean it and keep pressure on it, and hope that it didn’t get infected. I have nerve damage that persists to this day.
I have a ton of stories. I fight with insurance companies every day for crimes committed against patients and providers. It is so frustrating and a terrible waste of our resources.
I worked in Medical billing for many years, and I can tell you definitively that these companies you pay premiums to want you to die ASAP so they don’t rack up anything more. I was threatened that unless I demanded payment from the patients when their insurance company (routinely and inevitably) denied their claims (for such luxuries as broken arms, sliced jugulars, internal hemorrhaging and diabetic attacks) that I would be fired.
The accountant giving me these orders had spent ten years at IBM and would routinely blast the ‘welfare state’ that allowed ‘these people’ to even exist ‘on the planet earth.’
Do I even need to tell you I was eventually fired for not pursuing collections aggressively enough.
To the woodworker in PA: Don’t give up the fight. You sound like a really decent American, who actually walks the walk that other cretinous, slack-jawed, mouth-breathing, Fox-News watching simpletons only talk. I really admire your tenacity, and it has inspired me to keep going with my own enterprise this week. I just can’t give up so easily, knowing how hard someone like you works.
Keep ripping that wood and making those joints, bro!
Martyn (in New York)
I’ve had a time with the U.S. healthcare system since being diagnosed with asthma and multiple chemical sensitivities. As a single woman, I bought a house near a trash incinerator. After a year living there, I had asthma attacks lasting 2-4 hours every night and started to become allergic to everything in my life, detergents, hair products, chemicals, soap, cat litter, dust, trees, flowers. I went to doctor after doctor. Some of them were pretty bad. Eventually I became so sick I left work (I was a daily newspaper reporter who worked long hours).
I happened upon the website for EOHSI at Robert Wood Johnson Medical Center. They are supposed to handle environment-related illness. In fact, a doctor at EOHSI (who is no longer taking patients) had received an award for his work on multiple chemical sensitivities. The person I spoke with on the phone told me they’d make recommendations of doctors and conduct tests for chemical allergies. They emailed me an extensive questionnaire. I made an appointment and saw Dr. Laumbach, who provided me with quite a memorably poor experience.
He literally saw me for two minutes. The answers he gave to my questions were entirely dismissive. He didn’t even read the EOHSI questionnaire (several pages) which I had answered in detail. I had written on the sheet about the trash incinerator, and the fact that I also lived within five or six miles of a coal reactor with emissions violations. I asked if he would do any tests. He said no “he didn’t do that”. I asked about being allergic to chemicals. He said: “Chemicals don’t cause illnesses, the levels of chemicals are not high enough, so don’t worry about that.” I asked about smoke (obviously I was allergic to it). He said, I’m not kidding, or lying, and it really is too stupid to be true:
“People generally think they are sensitive to smoke now because they encounter it less frequently. Now that there are smoking bans smoke bothers people. But before, everyone was exposed to smoke and it didn’t bother people.”
I had said several times (since he failed to read my survey) that I was reacting to smoke from a trash incinerator, but this was lost on him. The whole time he thought I was talking about people smoking. This was his bizarre medical point of view about. Then I asked if he would recommend an allergist who deals with people with chemical sensitivities. He answered: No.
Ironically, Dr. Laumbach was about to do a PR spot to encourage World Trade Center responders to come to EOHSI (as he was literally pushing me out the door). There were TV news cameras set up. I watched as he appealed to WTC responders with respiratory problems to seek treatment at EOHSI instead of in New York City.
I was sent a bill from EOHSI for $450. At the time I had no insurance.
“Unfortunately, the U.S. press’ general attention toward the larger story of insurance company evildoing has been neglectful to say the least…”
Unfortunately, the US press’ general attention toward the larger story of everything and anything that’s wrong in this country has been neglectful to say the least, period!
Still, they wonder why newspapers everywhere are going bankrupt and have to close their doors. And, NO! it’s not because of the availability of free news on the Internet but because they’re all sold out whores who aren’t even good to take their own Poodles for a walk. They suck! They’re sold out! And, that is the real reason why their newspapers aren’t selling – because their ‘news’ ain’t worth squat!
“Unfortunately, the U.S. press’ general attention toward the larger story of insurance company evildoing has been neglectful to say the least…”
Unfortunately, the U.S. press’ general attention toward the larger story in the general evildoing has been neglectful to say the least period. Still, they wonder why newspapers are going bankrupt everywhere and, rather than realize that they have become nothing more that parrots for the corporate press and the propaganda machine, still blame their sale-out to the Internet. Their papers aren’t selling more because there’s nothing to read! These whores don’t investigate and report the news, they just repeat ad nauseum what their corporate owners want them to. Their ‘news’ aren’t worth the paper they’re printed on.
I recommended to a friend of mine to watch the Bill Moyers interview of Mr Potter on the web. She said it was meaningless, and why would I want more goverment in our lives. I cannot understand what is not clear in such interviews such as Moyers with Potter that it is clear health insurance corp are out to squeeze most of our money but not recognize our health issues and pay the bills patients accrue. Why are many afraid to have a system that can work for all like other countries who have success with their systems. Not to copy it but to come up with something to work for all.
I have never lived in Mexico but my family originates from there, and many go to the doctor there also my mother recieved a major operation removal of a giant fibriod tumor and hysterectomy. Which by the way they also reconstructed some organs because she had delivered all 3 children via C section many years earlier. Which left her intestines swean up to her C section seam. She paid less than $3000.00 US dollars, if I am recalling correct, all the while the doctors from her insurance in the US never diagnosed this, ultra sound after ultra sound after ultra sound. This was approximately 23 years ago. So all in all the insurance corp pratices in the U.S. is nothing new today it has been 23 years of denials that patients are sick. It is we the people who put up with year after year of abuse, they need to be boycotted or we need to find a new path to health coverage. So in my view Mexican Dr’s attend you with dignity, accuracy, economically, no beating around the bush.
As for me here in the U.S. my gynocologist said my well woman check-up was fine, refering to the hormone panel in specific. And I said, “Dr you cannnot tell me that a woman who has to cry to your receptionist to ask for a simple appointment cries? I am not obviously well.” He said, “well in order to take care of this for you I recommend you go on antidepressants.” I had just succesfully and gradually gotten off them and would look for other alternatives before I took antidepressants again. I have gotten my hormones balanced and feel like a normal woman again. I have spent bundles of money looking for the answer homeopathically, and doing well. Yet mind you I’ve been insured all the while and insurance does not pay these treaments or visits. All in all our Dr’s majority of them place bandaids on illness but not cure or anywhere near that. How sad for a country that is so called the most powerful in the world! We are sinking this country, in a deep abyss through many forms and health insurance companies is one of the many doing this to our citizens to United States.
Much of the opposition to public or single payer insurance seems to center around promoting fear of having bureacrats involved. Can somebody explain to me why it is preferable having people whose primary function is to make the most money for the least expenditure for their employers making healthcare decisions for people than civil servants who have sworn to “…support, protect and defend the Constitution of the United States…” have taken an oath to “…establish Justice, insure domestic Tranquility…” and “…promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity…”? I would sure like to know?
I have one question. Why is the only topic of discussion related to health care just questioning insurance? I have not once heard any talk of reducing the cost of health care providers services and the cost of prescription drugs, and other related costs. If an overhaul in the system does not involve government subsidized health care, then I think this is an item that needs attention. Subsidization will naturally lower the costs just by the fact that the government will start to question and examine these costs more closely if it is paying for it. My one concern is that taking away profit margins and profit motives might end in a reduction of the quality of service. Hasn’t the quality of service been reduced anyway by the insurance companies striving for greater profit margins? But I think this risk is worth the gamble in light of the fact so many do not have health care insurance at this point. Amy Goodman of democracynow.org recently listed Senators and Congressmen that had health care industry investments. Sounds like a conflict of interest to me? I highly doubt whether these men would be willing to risk their investments for the good of the common man. What do you think? This will be difficult to impossible unless we start voting these bums out of office! Start publishing voting records on key topics of concern for the proletariat.