Wendell Potter

Last updated
Wendell Potter
Wendell Potter - Montrose Street - cropped.jpg
Potter in 2010
Born (1951-07-16) July 16, 1951 (age 73)
Banner Elk, North Carolina, United States
Occupation(s)Health insurance communications director, health care reform advocate, best-selling author

Wendell Potter (born July 16, 1951) is an American advocate for health insurance payment reform, New York Times bestselling author, and former health insurance industry communications director. A critic of HMOs and the tactics used by health insurers, Potter is also a leading national advocate for major reforms of the health insurance industry, including Medicare for All [1] and universal health care.

Contents

Potter has been called the "Daniel Ellsberg of corporate America" by Michael Moore and "a straight shooter" by Bill Moyers. [2] [3] Potter is the first and only "health insurance insider" to have publicly criticized the industry's stance on the Obama health care reforms. [4] A supporter of the Affordable Care Act, Potter correctly predicted in 2010 the final version of the law would increase health insurance industry profits and argued they would find a way to "game the system." [5] He became a vocal advocate for Medicare for All in 2018, saying in September 2019 that "it's time to move to a program that makes a lot of sense economically as well as morally." [6]

Prior to his resignation in 2008, Potter was vice president of corporate communications for the health insurance company CIGNA. [7] In June 2009, he testified against the HMO industry in the US Senate to expose the health insurance industry's practices. [7] [8] [9] He has served as senior analyst at the Center for Public Integrity, a fellow at the Center for Media and Democracy, and a consumer liaison representative to the National Association of Insurance Commissioners. Potter is a regular guest on MSNBC and other national programming.

Early life

He was born on July 16, 1951, to Blaine and Pearl Potter. Raised in Mountain City, Tennessee, Potter was born in Banner Elk, North Carolina. [10] Potter was the first in his family to complete college, graduating from the University of Tennessee, where he edited the student newspaper Daily Beacon [11] in 1973 and was named a Torchbearer.

Career

Potter was employed by Humana in Kentucky before he moved to Connecticut to work for CIGNA in 1993. He began his journey towards resigning and becoming a consumer advocate in July 2007 when he saw a free clinic run by Remote Area Medical in rural Virginia:

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 or in the county fair livestock barns. Potter took pictures of patients lying on trolleys on rain-soaked pavements. [8]

Potter retired from CIGNA in 2008 shortly after the death of Nataline Sarkisyan [12] and became an active voice on healthcare reform in 2009. [13] [14]

On September 15, 2009, Potter appeared before the US House of Representatives Democratic Steering and Policy Committee. He said in his opening statement that if Congress "fails to create a public insurance option to compete with private insurers, the bill it sends to the president might as well be called the Insurance Industry Profit Protection and Enhancement Act." [15]

Potter's November 2010 book Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans details many of the industry's deceitful tactics, puts them in historical context by drawing parallels to the tobacco industry and the history of psychological manipulation in public relations, gives a history of healthcare reform, and shares his own personal journey.

In 2013, Potter published an e-book, Obamacare: What's In It For Me? What Everyone Needs to Know About the Affordable Care Act. It provides an overview of the consumer protections in the Affordable Care Act and illustrates how the law affects everyday Americans through stories of Potter's family members and friends.

In 2016, Potter published Nation on the Take: How Big Money Corrupts Our Democracy And What We Can Do About It, with co-author Nick Penniman. It argues that the corrupting influence of big money on US democracy has reached a state of emergency. It also details the history of moneyed influences on the US government and makes the case that the situation has become much worse in recent years, to pervade virtually every aspect of American life. The book also offers solutions that citizens can take to repair the damage and to make US democracy more responsive to the needs of its people. In 2017, Potter founded his eponymous nonprofit journalism company, to investigate how powerful people and companies use their influence to shape public opinion and public policy. [16]

In December 2018, Potter was named president of Business Initiative for Health Policy, a business group that supports universal healthcare. [17] In July 2019, Business Initiative for Health Policy was rebranded to Business for Medicare for All to advocate for the business case for Medicare for All. [18]

As part of his healthcare advocacy, since at least 2013, Potter has also been an outspoken critic of the federal government's efforts to partially privatize the nation's Medicare system for seniors via Medicare Advantage programs. Potter shifted his past informed insider's favorable opinion of MA plans after his more recent experience with his mother's healthcare. Critics like Potter say the third-party for-profit plans are neither Medicare, nor an advantage, and derisively call it Medicare Disadvantage. [19] [20] [21]

See also

Books

Related Research Articles

<span class="mw-page-title-main">Medicare Prescription Drug, Improvement, and Modernization Act</span>

The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.

<span class="mw-page-title-main">Cigna</span> American health services organization

The Cigna Group is an American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups. Cigna is incorporated in Delaware.

The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.

...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.

UnitedHealth Group Incorporated is an American multinational health insurance and services company based in Minnetonka, Minnesota. Selling insurance products under UnitedHealthcare, and health care services under the Optum brand, it is the world's eleventh-largest company by revenue and the largest health care company by revenue.

Families USA is a nonprofit, nonpartisan consumer health advocacy and policy organization.

AHIP is an American political advocacy and trade association of health insurance companies that offer coverage through the employer-provided, Medicare Advantage, Medicaid managed care, and individual markets.

eHealth, Inc., doing business as eHealthInsurance, is a publicly traded online marketplace for health insurance, organized in Delaware and based in Santa Clara, California. The company primarily provides plans related to Medicare such as prescription drug plans, Medigap, and Medicare Advantage plans. The company also sells individual plans, competing with health insurance marketplaces. The company sells plans in all 50 U.S. states and the District of Columbia from 170 health insurance carriers. Its large staff of licensed agents assist consumers with little or no computer experience with their online enrollments.

<span class="mw-page-title-main">Death of Nataline Sarkisyan</span> American student

Nataline Mary Sarkisyan was an American teenager with recurrent leukemia. Her case became part of the health care reform debate in the United States in 2007 when Cigna HealthCare denied coverage for a liver transplant operation. The company later reversed its decision after a great deal of media attention to her story, but Sarkisyan died hours later.

In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.

Healthcare reform in the United States has had a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.

In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange.

The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.

The proposed America's Affordable Health Choices Act of 2009 was an unsuccessful bill introduced in the U.S. House of Representatives on July 14, 2009. The bill was introduced during the first session of the 111th Congress as part of an effort of the Democratic Party leadership to enact health care reform. The bill was not approved by the House, but was superseded by a similar bill, the proposed Affordable Health Care for America Act, which was passed by the House in November 2009, by a margin of 220-215 votes but later abandoned.

The public health insurance option, also known as the public insurance option or the public option, is a proposal to create a government-run health insurance agency that would compete with other private health insurance companies within the United States. The public option is not the same as publicly funded health care, but was proposed as an alternative health insurance plan offered by the government. The public option was initially proposed for the Patient Protection and Affordable Care Act, but was removed after the independent US senator for Connecticut Joe Lieberman threatened a filibuster.

Healthcare rationing in the United States exists in various forms. Access to private health insurance is rationed on price and ability to pay. Those unable to afford a health insurance policy are unable to acquire a private plan except by employer-provided and other job-attached coverage, and insurance companies sometimes pre-screen applicants for pre-existing medical conditions. Applicants with such conditions may be declined cover or pay higher premiums and/or have extra conditions imposed such as a waiting period.

<span class="mw-page-title-main">Affordable Care Act</span> U.S. federal statute also known as Obamacare

The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act's provisions are still in effect.

<span class="mw-page-title-main">Elevance Health</span> American healthcare company

Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.

The Affordable Care Act (ACA) is divided into 10 titles and contains provisions that became effective immediately, 90 days after enactment, and six months after enactment, as well as provisions phased in through to 2020. Below are some of the key provisions of the ACA. For simplicity, the amendments in the Health Care and Education Reconciliation Act of 2010 are integrated into this timeline.

Oscar Health, Inc. is an American health insurance company, founded in 2012 by Joshua Kushner, Kevin Nazemi and Mario Schlosser, and is headquartered in New York City. The company focuses on the health insurance industry through telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems which would make it easier for patients to navigate.

The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.

References

  1. ↑ "Wendell Potter". Business for Medicare for All. October 18, 2019.
  2. ↑ Keith Olbermann - Wendell Potter Apologizes To Michael Moore, archived from the original on 2021-12-21, retrieved 2019-10-18
  3. ↑ Deadly Spin. Bloomsbury Press. 13 September 2011 – via Amazon.
  4. ↑ Pickert, Kate (2009-09-08). "The Making of a Health-Care Whistle-Blower". Time. ISSN   0040-781X . Retrieved 2019-10-22.
  5. ↑ Potter, Wendell; Tarbell.org, ContributorFounder of (2010-03-18). "Why I'm Not Joining the Call to "Kill the Bill"". HuffPost. Retrieved 2019-10-22.{{cite web}}: |first2= has generic name (help)
  6. ↑ "Healthcare Reformer Wendell Potter: The For-Profit 'System Is Unraveling'". Common Dreams. Retrieved 2019-10-22.
  7. 1 2 Hilzenrath, David S. (June 25, 2009). "Senate Hears of a Raw Deal Consumers Get From Health Insurers". The Washington Post . Retrieved 2015-07-24.
  8. 1 2 Paul Harris (25 July 2009). "Whistleblower tells of America's hidden nightmare for its sick poor | US news". The Guardian. Retrieved 2015-07-24.
  9. ↑ "Testimony of Wendell Potter" (PDF). Voices.washingtonpost.com. Archived from the original (PDF) on July 9, 2009. Retrieved 2015-07-24.
  10. ↑ Potter, Deadly Spin, p. 17.
  11. ↑ Potter, Deadly Spin, p. 19.
  12. ↑ Aronczyk, Amanda; Smith, Robert (2020-10-23). "Frame Canada". NPR. Retrieved 2021-10-15.
  13. ↑ "The Health Care Industry vs. Health Reform". PR Watch. 24 June 2009. Retrieved 2015-07-24.
  14. ↑ Wendell Potter. "Commentary: How insurance firms drive debate". CNN.com. Retrieved 2015-07-24.
  15. ↑ "Ex-Cigna Exec Wendell Potter: 'I Don't Think Co-ops Have A Chance To Succeed Or Compete' | The Public Record". Pubrecord.org. 2009-09-15. Retrieved 2015-07-24.
  16. ↑ Potter, Wendell; Tarbell.org, ContributorFounder of (2017-10-25). "Why We Need 'Pull-No-Punches Reporting' That Holds Big Corporations And Moneyed Interests Accountable". HuffPost. Retrieved 2019-07-29.{{cite web}}: |first2= has generic name (help)
  17. ↑ Diamond, Dan (2018-12-10). "The bruising battle looming over single-payer". POLITICO. Retrieved 2018-12-12.
  18. ↑ "BUSINESSES FOR MEDICARE FOR ALL". BUSINESSES FOR MEDICARE FOR ALL. Retrieved 2019-07-29.
  19. ↑ Potter, Wendell (2013-04-19). "Medicare Advantage? or DISAdvantage?". HuffPost. Retrieved 2023-01-23.
  20. ↑ "Health Insurance Whistleblower: Medicare Advantage Is "Heist" by Private Firms to Defraud the Public". Democracy Now!. Retrieved 2023-01-23.
  21. ↑ "Opinion | Here is the Truth: Medicare Advantage Is Neither Medicare Nor an Advantage | Common Dreams". www.commondreams.org. Retrieved 2023-01-23.
  22. ↑ "Bloomsbury". Bloomsbury Press. Retrieved 2015-07-24.
  23. ↑ Bloomsbury.com (6 December 2013). Obamacare: What's in It for Me?. Bloomsbury Publishing. ISBN   9781620407752 . Retrieved 2016-03-04.
  24. ↑ Bloomsbury.com (March 2016). Nation on the Take. Bloomsbury Publishing. ISBN   9781632861108 . Retrieved 2016-03-04.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.