Monday, July 27, 2009

Whistleblower on America's Nightmare for Its Sick Poor, California's own Nightmare

Monday morning 7AM to 8 on CONNECT THE DOTS, (KPFK 90.7FM)

The Subject is California.

To pay off the 26 billion dollar deficit, caused largely by the
incompetence of Gov. Schwazenegger, the biggest hit will be taken by the
schools (Kindergarten right through the University system) the poor, the
middle class, the sick, the state workers , the elderly...just about
everybody but the oil and tobacco companies and the rich. The Governor and
the Republicans held firm on protecting them. How can California, the 8th
largest economy in the world, go bankrupt? With us to discuss this
avoidable
disaster will be Lt. Gov John Garamendi, State Controller John Chiang,
social worker Bronwyn Ingram, and SEIU union Rep Faith Santilla.
Monday morning at 7 on CONNECT THE DOTS.

Lila Garrett (Host of CONNECT THE DOTS)
KPFK 90.7 FM in LA; 98.7 Santa Barbara
Airs Mondays from 7AM to 8AM.
To pod cast or download the broadcast just use this link:
http://archive.kpfk.org/parchive/index.php?shokey=ctd
Each show is on line for three months.

***

http://www.commondreams.org/headline/2009/07/26-2

Whistleblower Tells of America's Hidden Nightmare for Its Sick Poor

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

by Paul Harris
The Guardian/UK : July 26, 2009:

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.


© 2009 Guardian News and Media Limited

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