When Having Health Insurance Doesn’t Help

 

 

 

 

 

 

IN THIS EPISODE

 

Why is it that many Americans who have health insurance are still not able to get the care they need? How are health insurers increasing their profits at the expense of American families?

To find out, we spoke to Wendell Potter, ex-communications executive for the health insurance giant Cigna turned industry whistleblower and New York Times bestselling author. Wendell is the co-founder of Business Leaders for Health Care Transformation and the president of the Center for Health and Democracy. He’s also a strong advocate for Medicare for All. 

 

 

SHOW NOTES

 

WE DISCUSS

 

How do high out-of-pocket costs keep families from getting the care they need?

 

“More and more families have insurance, (they are) paying a lot of money every month and in many cases they just simply don’t have enough money to spend, out of their own pockets, what they have to spend before their coverage will kick in.”  – Wendell Potter

 

 

How do health insurers justify charging such high out-of-pocket costs?

 

“…the talking point…was that Americans needed to have more skin in the game. That during the era of managed care plans, of HMOs and PPOs, people didn’t have to pay very much money out of their own pockets, except in most cases, what was considered a relatively modest copayment maybe $10, $20 to see a doctor. That was not generating enough profits for the industry so they essentially said ‘Let’s move people into plans that make them pay more for care before we’ll pay anything.’”  – Wendell Potter

 

 

How do high out-of-pocket costs affect providers, such as hospitals?

 

“…it’s really quite a racket that’s worked beautifully for the insurance companies and their shareholders, but for hospitals, the biggest and fastest growing component of uncompensated care is from people who have insurance. But they can’t cover their out-of-pocket requirements that their insurers demand.” – Wendell Potter

 

 

Helpful Links

 

Business Leaders for Healthcare Transformation

 

A decade-long look at how Big Insurance profiteers American taxpayers and the sick, Wendell Potter

 

Americans’ Challenges with Health Care Costs, Kaiser Family Foundation

 

Out-of-pocket maximum/limit, Healthcare.gov

 

AMCP 2022: High Out-of-Pocket Costs Are Associated with Nonadherence Among Patients Taking Oral Cancer Drugs, Managed Healthcare Executive

 

Catastrophic Out-of-Pocket Health Care Costs: A Problem Mainly for Middle-Income Americans with Employer Coverage, Commonwealth Fund

 

 

Episode Transcript

 

Read the full episode transcript!

 

 

 

Wendell Potter Biography

 

Wendell has more than four decades of experience as a communications professional, going back to his teenage years in Tennessee, where he served as a high school correspondent to his hometown paper, The Kingsport Times-News. His journalism career would later take him to Memphis, Nashville, and finally Washington, D.C., where he covered Congress, the White House, and the Supreme Court for Scripps-Howard Newspapers.

Although best known for his career in corporate public relations, Wendell has also served as press secretary to a Tennessee gubernatorial candidate, head of advertising and PR for a large integrated health care system in East Tennessee, a partner in an Atlanta public relations firm, and a state and federal lobbyist.

His first corporate job was at Humana Inc., where he headed the company’s communications department in Louisville, Kentucky. From there he was recruited to Cigna Corporation, where he served in a variety of positions over nearly 15 years in the company’s Bloomfield, Connecticut, and Philadelphia offices. His responsibilities included leading the company’s corporate communications team and serving as chief corporate spokesperson. He also represented Cigna on several industry committees and task forces, including the strategic communications committee at the industry’s largest PR and lobbying group, America’s Health Insurance Plans.

After seeing firsthand how strategic PR and lobbying is used unfairly to tilt the scales toward corporate interests against the people’s interests, Wendell left his corporate career to advocate for meaningful health care reform. He made headlines in 2009 when he disclosed in Congressional testimony how insurance companies, as part of their efforts to boost profits, have contributed to spiraling healthcare costs and the growing number of Americans without health insurance. He also revealed how insurance companies use their customers’ premiums to wage multi-million dollar PR and lobbying campaigns to influence public opinion and public policy. Since then, he has spoken at more than 200 public forums and authored the award-winning book, Deadly Spin, An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans. His latest offering is an eBook entitled, Obamacare: What’s in for Me? What Everyone Needs to Know about the Affordable Care Act.

Previously, Wendell was a columnist for The Center for Public Integrity, a nonpartisan, nonprofit organization that produces original investigative journalism.  His articles and commentaries have appeared in many publications including The New York Times, Los Angeles Times, Chicago Tribune, Tampa Bay Times, The Guardian, Newsweek, The Nation, Huffington Post, CNN.com, NBC.com, Democracy Journal, and healthinsurance.org. Wendell has been the subject of numerous articles in the U.S. and foreign media, including The New York Times and The Washington Post, and has appeared frequently as a guest on ABC, CBS, NBC, FOX News Channel, MSNBC, PBS, and NPR.

In 2017, Wendell launched Tarbell.org, a non-partisan news publication with the mission is to provide objective, investigative reporting on hard hitting topics affecting Americans.

 

 

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