When an insurance firm boss saw a field hospital for the poor in Virginia, he knew he had to speak out. Here, he tells Paul Harris of his fears for Obama’s bid to bring about radical change
Wendell Potter can remember exactly when he took the first steps on his journey to becoming a whistleblower and turning against one of the most powerful industries in America.
It was July 2007 and Potter, a senior executive at giant US healthcare firm Cigna, was visiting relatives in the poverty-ridden mountain districts of northeast Tennessee. He saw an advert in a local paper for a touring free medical clinic at a fairground just across the state border in Wise County, Virginia.
Potter, who had worked at Cigna for 15 years, decided to check it out. What he saw appalled him. Hundreds of desperate people, most without any medical insurance, descended on the clinic from out of the hills. People queued in long lines to have the most basic medical procedures carried out free of charge. Some had driven more than 200 miles from Georgia. Many were treated in the open air. Potter took pictures of patients lying on trolleys on rain-soaked pavements.
For Potter it was a dreadful realisation that healthcare in America had failed millions of poor, sick people and that he, and the industry he worked for, did not care about the human cost of their relentless search for profits. “It was over-powering. It was just more than I could possibly have imagined could be happening in America,” he told the Observer
Potter resigned shortly afterwards. Last month he testified in Congress, becoming one of the few industry executives to admit that what its critics say is true: healthcare insurance firms push up costs, buy politicians and refuse to pay out when many patients actually get sick. In chilling words he told a Senate committee: “I worked as a senior executive at health insurance companies and I saw how they confuse their customers and dump the sick: all so they can satisfy their Wall Street investors.”
Potter’s claims are at the centre of the biggest political crisis of Barack Obama’s young presidency. Obama, faced with 47 million Americans without health insurance, has put reforming the system at the top of his agenda. If he succeeds, he will have pushed through one of the greatest changes to domestic policy of any president. If he fails, his presidency could be broken before it is even a year old. Last week, in a sign of how high the stakes are, he addressed the nation in a live TV news conference. It is the sort of event usually reserved for a moment of deep national crisis, such as a terrorist attack. But Obama wanted to talk about healthcare. “This is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades,” he told the nation.
Obama’s plans are now mired and the opponents of reform are winning. The Republican attack machine has cranked into gear, labelling reform as “socialist” and warning ordinary Americans that government bureaucrats, not doctors, will choose their medicines. The bill’s opponents say the huge cost can only be paid by massive tax increases on ordinary Americans and that others will have their current healthcare plans taken away. Many centrist Democratic congressmen, wary of their conservative voters, are wavering. The legislation has failed to meet Obama’s August deadline and is now delayed until after the summer recess. Many fear that this loss of momentum could kill it altogether.
To Potter that is no surprise. He has seen all this before. In his long years with Cigna he rose to be the company’s top PR executive. He had an eagle-eye view of the industry’s tactics of scuppering political efforts to get it to reform. “This is a very wealthy industry and they use PR very effectively. They manipulate public opinion and the news media and they have built up these relationships with all these politicians through campaign contributions,” Potter said.
Potter was witness to the campaign against Michael Moore’s healthcare documentary Sicko. The industry slammed the film as one-sided and politically motivated. Secret documents leaked from the American Health Insurance Plans, the industry’s lobby group, detailed the plan to paint Moore as a fringe radical. Potter now says the film “hit the nail on the head”. “The Michael Moore movie that I saw was full of truth,” he admits.
Potter was also working for Cigna when it became embroiled in the case of Nataline Sarkisyan, whose family went public after Cigna refused to pay for a liver transplant that it considered “experimental” and therefore not covered by their policy. Cigna reversed this decision only hours before the Californian teenager died. “I wish I could have done more in that case,” Potter said.
Such sentiments are rare in an industry that has given America a healthcare system that can be cripplingly expensive for patients, but that does not produce a healthier population. The industry is often accused of wriggling out of claims. Firms comb medical records for any technicality that will allow them to refuse to pay. In one recently publicised example, a retired nurse from Texas discovered she had breast cancer. Yet her policy was cancelled because her insurers found she had previously had treatment for acne, which the dermatologist had mistakenly noted as pre-cancerous. They decreed she had misinformed them about her medical history and her double mastectomy was cancelled just three days before the operation.
Last month three healthcare executives were grilled about such “rescinding” tactics by a congressional subcommittee. When asked if they would abandon them except in cases of deliberately proven fraud, each executive replied simply: “No.”
To Potter that attitude has a sad logic. The healthcare industry generates enormous profits and its top executives have a lavish corporate lifestyle that he once shared. Treating patients for their expensive conditions is bad for business as it reduces the bottom line. Kicking out patients who pursue claims makes perfect economic sense. “It is a system that is rigged against the policyholder,” Potter said. The congressional probe found that just three firms had rescinded more than 20,000 policyholders between 2003 and 2007, saving hundreds of millions. “That’s a lot of money that will now go towards their profits,” Potter said.
A lot of that money also goes into contributions to politicians of both parties – $372m in the past nine years – and in lobbying groups to run TV ads slamming Obama’s plans. Many of these ads deploy naked scare tactics. One report said that the industry was spending $1.4m a day on its campaign. In the face of that, it is perhaps no wonder that the Senate has delayed its vote, dealing a massive blow to Obama. “I have seen how the opponents of healthcare reform go to work… they are trying to delay action. They know that if they keep the process going for months, and turn it into a big mess, then the political impetus behind it will lessen,” Potter said.
Potter, who now works at the Centre for Media and Democracy in Wisconsin, says the industry is afraid of Obama’s reforms and that is why it is fighting so hard. It wants to deal him the same blow as it did Bill Clinton when it scuppered his attempt at reform in the 1990s. Potter admits that he is worried the industry might win again. “I have seen their tactics work. I have been a part of it,” he said. He knows he has no chance of ever working again for a major firm. “I am a whistleblower and corporate America does not tend to like that,” he said. But there is one thing Potter is not sorry about: leaving the healthcare industry and speaking out. “I have absolutely no regrets. I am doing the right thing,” he said.
Comprehensive healthcare reform in the US has been an ambition of many presidents since the early part of the 20th century. None has succeeded in creating a system that gives all Americans the right to coverage. Barack Obama, below, is desperate to avoid the same fate.
Finding a cure
What is the current system?
It is a complex mish-mash of systems. Millions of Americans have their own private healthcare plans, either individually or through their employer. About 47 million Americans have none. However, systems do exist to cover the very poor and the old. The system is fiendishly complex and full of loopholes, so even those with coverage can have it withdrawn.
How bad is it?
US hospitals are the best in the world if you can afford them. Many cannot, and an accident or sudden illness can often bankrupt someone.
How does it compare with other countries?
It depends how you measure things. The US spends about 16% of GNP on healthcare, far more than France and Germany, which spend 11 to 12%. Yet those countries provide universal care.
What is the biggest problem?
Critics say the biggest issue is the profit motive that drives US healthcare. This ensures that costs are always rising as the incentive is there to provide expensive treatment. It also gives health insurers the incentive to refuse treatment to claimants, by seeking to withdraw their cover.
What is Obama’s solution?
Obama has asked Congress to draw up a government option, allowing all Americans to get some sort of cover. The sheer size of the state plan should theoretically allow it to drive down costs by economies of scale.
What’s happening now?
Obama has put his reputation on the line to persuade wavering Democrats and moderate Republicans to vote on legislation by August. The Senate has said this will not happen. That’s a major blow, as it puts off the debate until September and could see the political momentum stall.
Franken laughs last
The long-running battle for Minnesota’s Senate seat is finally over. Democracy – and Al Franken – won fair and square
In the end, the conspiracy theories became so laughable that the Republican Senatorial Campaign Committee (RSCC) quietly removed its own “Minnesota Recount” website, once it became clear that no, the Democratic candidate Al Franken was not “stealing” the US Senate election in Minnesota, as the Republican party had been shamefully declaring, without actual evidence, for weeks following election day back on 4 November 2008.
Nearly eight months on from election day, Franken finally got to celebrate his election as Minnesota’s next US senator after the defeated Republican incumbent Norm Coleman dropped his quixotic legal challenge, and the state’s Republican governor announced he was going to formally approve Franken’s victory.
Although the victory was sealed today, the Republican claims of “voter fraud” became impossible to support long ago, because hand-marked paper ballots – nearly three million of them – as cast by the voters in the squeaker of an election, were actually being counted, in full view of the media and any interested citizen alike. To a ballot, they were all accounted for, and any disagreement about voter intent on those ballots was adjudicated in an open process by a bipartisan state canvassing board. All but a handful of those votes were determined unanimously by the board to have been cast either for Franken, for Coleman, for a third party candidate or for nobody at all.
The only question remaining after the weeks-long, painstaking, public hand-count was whether a number of uncounted absentee ballots, rejected as per the state’s strict standards for counting, should, in fact, be counted.
A tripartisan, three-judge panel took their time, in yet another fully public process, in reviewing evidence and hearing witness testimony presented by both sides. A few hundred more ballots were deemed to be legitimate and improperly rejected, and those too were then publicly counted – the counting again witnessed by all – and added to the final tally.
Hand-counted paper ballots proved, yet again, to be the gold standard in this election, which the state canvassing board, the three-judge election contest panel and now the state’s supreme court has affirmed as won by Franken, the former radio talkshow host and comedian, by a mere 312 votes.
Minnesota’s excellent election law, requiring both the secretary of state and the governor to sign the election certification only after all election contests are settled in the state, has assured that the next senator from Minnesota will not serve under a cloud of suspicion. Only the most insane and/or disingenuous could challenge the findings from one of the longest and most transparent election hand-counts in the history of the US.
Coleman, of course, may do exactly that. Though it’s exceedingly unlikely the US supreme court would rule in his favour – or even deem to review the case – Coleman still has the right to decide whether or not he’ll continue his fight, by taking it to the highest authority in the land.
If other states, and even the nation, had a law requiring that all ballots actually be counted, and all contests be fully settled before seating, we might have avoided the clouds of illegitimacy which always shrouded the Bush administration following the disputed election results in Florida 2000 and Ohio 2004, as well as countless other races – including Iran 2009.
When ballots are counted in secret (or, in many cases, not counted at all), democracy is dangerously imperilled. Lucky for Minnesotans, that wasn’t the case up there, even if it meant some eight months without proper representation in the US Congress. It was worth the wait.
Transparency was no match for the conspiracy theorists, including the RSCC, the head of the Republican party and even the Republican National Lawyers Association, who embarrassingly joined the black helicopter crowd in touting evidence-free claims of Franken’s “efforts to steal a seat in the United States Senate”.
Coleman, of course, was entitled to his contest, though it quickly became a desperate comedy of errors for the ousted Republican. His election contest began with a presentation of doctored evidence and concluded with the revelation of hidden legal notes and witnesses. The more he challenged the election and the counting of previously rejected absentee ballots, the wider Franken’s margin of victory grew.
The hard-fought post-election contest was understandable, of course. It’s a pity that Democrats don’t fight like hell for each and every vote they’re entitled to (yes, I’m speaking to you, John Kerry, and too many of your colleagues, or would-be colleagues.) Franken’s victory will now offer the Democrats a 60-vote, filibuster-proof majority in the Senate, following the recent party jump by former Pennsylvania Republican Arlen Specter.
Minnesota’s law is a good one, but as with any law, there is no guarantee it won’t be abused, as Coleman has done for so many months by filing specious challenges, flipping and flopping on ballots he first fought to keep from being counted, only to change his mind later in hopes of having them counted after all, once it appeared he was on the losing side of the democratic draw.
And what of those infamous claims of Democratic “voter fraud” by all of those Acorn voters? After the most detailed, ballot-by-ballot, voter-by-voter analysis of an election likely in the history of the country, surely the Republicans would be able to show at least one case of fraud committed by their favourite bogey-man community organising, voter-registration group, right? After all, Acorn managed to register more than 42,000 new voters in Minnesota in the last election cycle. With all the claims of voter fraud being committed by the group, surely this election, of all elections, would be where evidence of all that fraud would finally be revealed for all to see, no? Um, no. Apparently not.
Not a single allegation of Acorn-related voter fraud was presented by the Republicans throughout the entire eight-month contest, even in an election in which just a few hundred votes separated winner from loser. The closest anybody came to presenting evidence of such fraud was when Coleman’s own witness admitted that he hadn’t signed his ballot, and that it had been forged by his girlfriend. Coleman fought to have that ballot, and others that were also illegally submitted, accepted in the final tally. So much for the Democratic voter fraud canard. If nothing else, this election once again revealed the Republican claims of voter fraud to be amongst the biggest frauds in modern American elections. Transparency has a way of doing that.
Despite his concession speech this afternoon, Coleman could still try his luck at the US supreme court, and given the wild-card make-up of that body, anything could happen, I suppose. The law has little to do with it, it seems (see 2000′s Bush v Gore). But the story here is that democracy only works when every citizen is allowed to participate both in the casting and – as importantly – in the counting of the ballots.
When democracy is visible to all, it works. When it becomes buried behind secrecy, insider tabulations and computerised black boxes, the very basis of our system of government is put dangerously at stake.
Transparency wins again. Along with the voters of Minnesota. Nice to see the voters win one for a change. Now if Barack Obama puts his money where his mouth is and delivers some of the transparency to the American people that he once promised, we might stand a chance at rebuilding this country. That appears a difficult fight at this time. But the results, if we can get them, just as in Minnesota, will be worth every moment of that fight.