Wendell Potter knows all the arguments against a government-financed healthcare system in the U.S., because he used to make them himself when he led communications for the health insurance giant Cigna.
A decade later, he is fighting against those same arguments, seeking to expose what he now views as a deeply flawed and inefficient healthcare system.
Potter, president of the newly formed Business Initiative for Health Policy, is working to convince employers to support the Medicare for All Act backed by liberals in Congress, a move that he says would extend coverage to 30 million uninsured and improve coverage for those already insured. He wrote in his 2010 book Deadly Spin that he had “sold his soul” in his previous career with Cigna. Since then, he has been blowing the whistle on insurers offloading the sickest and most expensive patients in order to boost profits.
“I obviously am very familiar with all the arguments against it because I was in the business of scaring people away from this,” said Potter, speaking to the Washington Examiner during an interview in downtown Washington, D.C. Potter, 67, is on Medicare himself. He speaks with a slight Tennessee accent and wears dark-rimmed glasses and a buzzed haircut.
The Business Initiative for Health Policy is mostly alone in trying to convince businesses that the Medicare for All Act would be good for them. Potter is up against business lobbies such as the Chamber of Commerce and the National Federation of Independent Business, which oppose government-financed healthcare. His own group was founded by Richard Master, the CEO of MCS Industries in Eastern, Pa., which supplies wall posters and frames. Master has also produced documentaries critical of the U.S. healthcare system.
The Medicare for All Act would subject business to considerable disruption. About 152 million people in the U.S. get coverage through their jobs, and roughly three quarters of them say they’re happy with it.
Still, Potter may have a case to make. Paying for medical coverage isn’t easy for businesses, who not only pay more for coverage each year but also are increasingly offloading the cost of coverage to their workers.
Annual premiums for employer-sponsored family health coverage reached $19,616 in 2018, up from $12,680 in 2008, according to a recent study from the Kaiser Family Foundation. Workers on average are paying $5,547 toward the cost of their coverage, up from $3,354 in 2008. Roughly 29 percent of people on employer coverage are considered “underinsured” by the Commonwealth Fund, meaning they pay for a good portion of medical expenses themselves despite having coverage.
“Most people year to year remain fairly healthy and they don’t test the limits of their coverage,” Potter said. “So most people are frankly unaware that they are underinsured. It’s when you get seriously ill or injured that you become all too aware that your coverage is less valuable.”
The Medicare for All Act would do away with private health insurance in favor of the government becoming the only payer of healthcare services. It would be more extensive than the current Medicare system — which covers adults 65 and older as well as people with disabilities — because it would have no out-of-pocket costs for patients and would still include coverage for prescription drugs, eye care, doctor visits, and hospital stays.
Most rank-and-file House Democrats are co-sponsors of the Medicare for All Act, as are most of the senators who are running for the Democratic nomination for president. House leaders, however, are on a different page. They instead favor fixes to the Affordable Care Act, commonly known as Obamacare, and letting people have the option of buying into Medicare at age 50 or 55.
Potter disapproves of such incremental approaches. In his view, insurers want to fend off government-financed healthcare and instead steer Congress toward tweaks to Obamacare for their own self-interest. He argues that merely funneling more money into Obamacare wouldn’t help people deal with high out-of-pocket costs.
“I think it’s time for an overhaul,” Potter said. “I think that a gradual shift is not in the best interest of the public or businesses, unless you are in the business of offering insurance. There’s going to be fierce resistance certainly from the entrenched moneyed interest in healthcare, not just the insurance companies.”
Potter acknowledges that the Medicare for All Act would inevitably generate massive disruption, but said that layoffs, shuttered hospitals, and the loss of jobs overseas are already disrupting the industry. He grants that certain people would lose their current jobs, but notes the Medicare for All Act sets aside funding for retraining.
A combination of factors led Potter to where he is now. As an insurance executive, he says, he was struck by the accuracy of filmmaker Michael Moore’s representations of industry practices in his movie “Sicko.” Shortly after, Potter attended a state health fair in Tennessee, in a county not far from where he grew up, and was floored by the number of uninsured people who waited for hours to receive medical care.
He reached a turning point following the death of Nataline Sarkisyan, a 17-year-old for whom Cigna had initially denied coverage for a liver transplant. Around the same time, he stopped drinking, which he said had numbed him in the past.
He resigned from Cigna in 2008, but it wasn’t until he saw a lawmaker on television giving out the same talking points he used to write that he decided he had a responsibility to act.
“I just got so upset with myself that I had played some role in propagating this nonsense that I said, ‘I’ve got to start making amends somehow,'” he said.
In 2009, he testified before a Senate committee about the ways insurers limit coverage for patients and became a columnist for the investigative newsroom the Center for Public Integrity. He recently launched a new media venture known as Tarbell, which is a nonprofit website detailing corporate influence on healthcare and other industries.
“I don’t want insurance companies to continue to be between my doctor and me calling the shots, adding to the expense of our healthcare system,” Potter said. “That’s the role that I want to disappear, that needs to disappear, and that will disappear because it is not needed anymore.”
