Why We Cannot Trust the Health Insurance Industry--Deja Vu?

This post requires apologies because yes, this blog remains steadfastly about medicine and the pharmaceutical industry, and I am doing my best not to turn it into a political rant on sundry topics, or a health reform commentary. Nonetheless something I read today resonated so strongly with previous comments here and in HOOKED regarding some of the misdeeds of the drug industry that I could not resist mention.

The Columbia Journalism Review, as part of its health reform coverage, offers an interview by Trudy Lieberman with former and now recovered health insurance executive Wendell Potter:

http://www.cjr.org/campaign_desk/excluded_voices_6.php

I can give you the flavor of the interview if I repeat Potter's statement about how he came to decide it was time to abandon his industry post:

"A couple of years ago I was in Tennessee and saw an ad for a health expedition in the nearby town of Wise, Virginia. Out of curiosity I went and was overwhelmed by what I saw. Hundreds of people were standing in line to get free medical care in animal stalls. Some had camped out the night before in the rain. It was like being in a different country. It moved me to tears. Shortly afterward I was flying in a corporate jet and realized someone’s insurance premiums were paying for me to fly that way. I knew it wasn’t long before I had to leave the industry. It was like my road to Damascus."

If that is not a powerful statement about the state of American health vcare--a scene that Michael Moore would have given a lot to include in Sicko--I'd like to know what is.

Potter is not a great fan of the insurance industry. He recounts the strategies that the industry used in 1993-4 to kill Clinton health reform, and how they are positioning themselves in 2009 once again to kill any reform that does not send huge profits in their direction. Highlights:

• These companies are for-profit firms and are slaves of Wall Street. Anything that would actually enhance health care for the U.S public is of no interest to their shareholders. Anything that would increase profits is--even if it means denying care to the sick. That's the top, bottom, and middle line.
• Insurers will out out a PR blitz as to how socially conscious and pro-reform they are. They will then set up a shadow campaign, run by middlemen posing mostly as grassroots organizations that have no ties to the industry, designed to kill any real reform. What they say publicly and what they are trying to do behind the scenes will be two different things.
• We saw the insurers recently in their true colors when they went before Congress and refused to rule out cancelling a person's policy if the individual develops serious and costly illnesses. If they can go over that policy with a fine tooth comb and find a single thing that person failed to fill out correctly when she applied for insurance, then the policy will be cancelled and that person will be without coverage henceforth (since any new policy would be prohibitively costly). It makes no difference if the single thing that was accidentally left out is irrelevant to the later illness; any excuse to cut costs will be ruthlessly taken advantage of.
• When a bill is finally under consideration in Congressional committees, then we can expect the insurance lobby to go even deeper underground, and even the "grassroots" PR will not reveal the true negotiations that are going on behind closed doors. The industry has lobbying muscle on both sides of the aisle, enough, they hope, to insure that any bill unfriendly to insurance interests will die a quiet death out of public sight.

If any of that sounds familiar, it's because at various times, all those strategies have been used by Big Pharma to make sure that they get their way. We have here, in my humble opinion, yet another example of what happens when we allow the profit motive to dictate health care policy--or, as my colleague Leonard Weber wrote as the title to his excellent book, "Profits Before People."

I wish everyone in the US would read Lieberman's interview with Potter, in my role as a member of Physicians for a National Health Program. There is really only one conclusion a smart reader can come to after reading that interview--these people cannot be trusted. Any attempt at health reform that allows these folks at the table is a sham. The single payer advocates, who say that we must get rid of private insurance and basically start over, are right, however politically inconvenient their message may be. The politicians who have said that single-payer is off the table, period, from the start are in fact doing the bidding of the health insurance industry, and are would-be reformers in name only.