Wendell Potter: Public Option Essential, Baucus Plan An "Absolute Gift" To Health Insurance Industry (VIDEO)

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First Posted: 09-15-09 05:09 PM   |   Updated: 09-15-09 06:49 PM

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Speaking before the House Democratic Steering and Policy Committee Tuesday, former health insurance industry executive-turned-whistleblower Wendell Potter warned 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."

Potter also struck back against one of the key arguments made against the public option: that it would have an unfair competitive advantage over private insurers.

'Contrary to the misinformation being disseminated by the health insurance industry and its allies, the public insurance option would not have a competitive advantage over private plans," Potter told the committee. "It would have to meet the same benefit requirements and comply with the same insurance market reforms as private plans. "

Potter, who was previously a vice president of communication at Cigna, also sharply criticized Democratic Senator Max Baucus' health care reform bill in a conversation with reporters Monday, calling the plan an "absolute gift to the industry."

More on Potter's statements on the Baucus plan, via Politico.

Potter said the proposal would not provide affordable coverage. It gives the industry too much latitude to charge higher premiums based on age and geographic location, fails to mandate employer coverage, and pushes consumers into plans with limited benefits, Potter said.

For more of Potter's thoughts on Baucus you can read the transcript below. Here is video of his opening statements.

Thank you Madam Speaker for the opportunity to address the House Steering and Policy Committee. Madam Speaker and Members of the Committee, my name is Wendell Potter, and I am humbled to be here today to testify about the need for meaningful and comprehensive reform and about the efforts of an industry I worked in for many years to shape reform in ways that will benefit it at the expense of taxpayers and policyholders.

In the weeks since my June 24 testimony before the U.S. Senate Committee on Commerce, Science and Transportation, I have expressed hope at every opportunity that this indeed might be the year Congress will enact legislation to reform our health care system in ways that will truly benefit Americans for generations to come.

But I have also expressed concern that if Congress goes along with the so-called "solutions" the insurance industry says it is bringing to the table and acquiesces to the demands it is making of lawmakers, and if it 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.

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H.R. 3200, America's Affordable Health Choices Act of 2009, encompasses a comprehensive set of reforms that address the critical need for expanded coverage, lower health care costs, and greater choice and quality. Other legislative proposals, including the "Baucus Framework" being considered by the Senate Finance Committee's "Bipartisan Six," would benefit health insurance companies far more than average Americans.

The practices of the insurance industry over the past several years have contributed directly to the growing number of Americans who are uninsured and the even more rapidly growing number of people who are underinsured.

H.R. 3200 would go a long way toward making many of the standard practices of the industry illegal while providing much-needed assistance to low and moderate income Americans who cannot afford the overpriced premiums being charged by the cartel of large for-profit insurance companies that now dominate the industry.

H.R. 3200 would provide premium and cost-sharing assistance through the Health Insurance Exchange it would create. It would require the Secretary of Health and Human Services to establish a defined package of "essential health services" that all plans, public or private, would have to cover.

It also would prohibit insurance companies from denying coverage or basing premiums on pre-existing conditions, gender or occupation. It would eliminate deductibles or co-pays for preventive care as well as the lifetime limits currently common in health insurance policies. The bill also would set an annual cap on out-of-pocket expenses that is more reasonable than in other proposals.

As important if not more important than those market reforms, H.R. 3200 would also create a public insurance option to compete with private insurers. Contrary to the misinformation being disseminated by the health insurance industry and its allies, the public insurance option would not have a competitive advantage over private plans. It would have to meet the same benefit requirements and comply with the same insurance market reforms as private plans.

As I told Members of the Senate Committee on Commerce, Science and Transportation, insurance companies routinely dump policyholders who are less profitable or who get sick as part of their never-ending quest to meet Wall Street's relentless profit expectations.

While the reforms proposed in various bills before Congress would seemingly restrict insurance companies' ability to put investors' needs over those of consumers, Members must realize that provisions of some proposals, including the Baucus Framework, would actually drive millions more Americans, including many who currently have access to comprehensive coverage, into the ranks of the underinsured.

An estimated 25 million Americans are now underinsured for two principle reasons. First, the high-deductible plans many of them have been forced into by their employers require them to pay more out of their own pockets for medical care, whether they can afford it or note. Second, more and more Americans have fallen victim to deceptive marketing practices and bought what essentially is fake insurance.


The insurance industry is insistent on being able to retain what it calls "benefit design flexibility." Those three words seem innocuous and reasonable, but if legislation that reaches the president grants insurers the flexibility they claim they must have, and requires all of us to buy coverage from them, millions more of us will have little alternative but to buy policies that appear to be affordable but which will be prove to be anything but affordable if we become seriously ill or injured.


The big insurers have spent millions of dollars acquiring companies that specialize in what they call "limited-benefit" plans. Not only are the benefits extremely limited, the underwriting criteria established by the insurers essentially guarantee big profits.

H.R. 3200 would ban the worst of these policies. Other proposals, by providing financial incentives for employers to offer barebones plans with lousy benefits and high deductibles, would actually encourage them.

Unlike H.R. 3200, those proposals would not require employers to provide good benefits or even to meet minimum benefit standards. They also would permit employers to saddle their workers with the entire amount of the premiums in addition to the high out-of-pocket expenses, escalating the already rapid shift of the financial burden of health care from insurers and employers to working men and women.

The Baucus plan also would allow insurers to charge older people and families up to 7.5 times as much and younger people, impose big fines on families that don't buy their lousy insurance, and would weaken state regulation of insurers.

As a consequence, these proposals would do little to increase affordable coverage for those currently insured, or stop the rise in medical bankruptcy. They would, however, ensure that a huge new stream of revenue--much of it from taxpayers who would finance the needed subsidies for people too poor to buy coverage on their own--would flow--"gush" might be a more appropriate word--to insurance companies. And much of that new revenue would ultimately go right into the pockets of the Wall Street investors who own them.

Over the past several weeks, I have repeatedly told audiences around the country that the public option should not just be an "option" to be bargained away at the behest of insurance companies who are pouring money into Congress to defeat substantial and essential reforms. A public option must be created to provide true choice to consumers or reform will fail to truly fix the root of the severe problems that have been caused in large part by the greedy demands of Wall Street.

By creating a strong public option and restricting the insurance industry's ability to enrich executives and investors at the expense of taxpayers and consumers, H.R. 3200 will truly benefit average Americans.

The Baucus plan, on the other hand, would create a government-subsidized monopoly for the purchase of bare-bones, high-deductible policies that would truly benefit Big Insurance. In other words, insurers would win; your constituents would lose.

It's hard to imagine how insurance companies could write legislation that would benefit them more.

Over the coming weeks, I implore each Member of Congress to put the interests of ordinary, extraordinary Americans--the people who hired you with their votes--above those of private health insurers and others who view reform as a way to make more money.

Thank you for considering my views.

Speaking before the House Democratic Steering and Policy Committee Tuesday, former health insurance industry executive-turned-whistleblower Wendell Potter warned that if Congress "fails to create a pu...
Speaking before the House Democratic Steering and Policy Committee Tuesday, former health insurance industry executive-turned-whistleblower Wendell Potter warned that if Congress "fails to create a pu...
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Okay. My husband and I had a long talk about politics and health care reform and he thinks that the Baucus bill will be passed with some minor changes. That will be far from health care reform, but he thinks this is what we're going to get and that's why everyone is so upset about Baucus coming out with this. Do you guys think that is so? I just can't believe after so many years, so many hardships that they would actually sign that in. I just can't believe when the time has come to make some big changes that we are just going to throw away an opportunity like this. I would like to hear your thoughts. Please tell me it ain't so. I just don't want to think that we're finally going to make this work and someone doesn't have the balls to see it through...all the way through. Don't mean to offend. :)

    Favorite    Flag as abusive Posted 01:10 AM on 09/27/2009
- AJLester I'm a Fan of AJLester 4 fans permalink
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Any notion that a public option will create a competitive disadvantage for private insurers completely ignores this fact: The "Insurance Cartel" has done an effective and ruthless job crushing every competitive challenge that's come down the pike from the private sector itself over the past 15 years.

Remember how many managed care choices employers used to offer? Three or four HMOs, a couple of PPOs, and an indemnity option? With industry mergers, acquisitions, consolidations, and other means of monopolizing health insurance, alternative market choices have evaporated. How many employers now offer more than one major carrier to employees? Few, if any.

But let's imagine that a public option does pass and market reforms are implemented. Isn't Big Insurance going to use the same tactics in competing with the public option that they'd used to crush private competition? True, they may not be able to eliminate the public option entirely, but what'll happen once the dastardly PR and advertising machines at Mr. Potter's former employer, Cigna, and the other behemouths get fully energized? With virtually bottomless resources for turning public opinion and manipulating buyer behavior, they're sure to find a way to turn Americans, even the uninsured, against participation in the public option. Only the details of how they'd do it are unknown.

I hope it doesn't come to this, but I'm afraid the American public hasn't seen more than the tip of the iceberg of influence the insurance industry can have on public policy. Beware their wrath!

    Favorite    Flag as abusive Posted 02:16 PM on 09/23/2009

Keep going Mr. Potterl, all the way to the office of the president. Hopefully one day the mainstream media will give you some airtime as well, you deserve it. Thank you for bringing your intelligence and experience to the forefront and fighting on behalf of the haves, but especially the have nots.

    Favorite    Flag as abusive Posted 12:03 AM on 09/23/2009
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Thank You Mr. Potter, You are truly a patriotic American who has no self serving agenda. You speak for a vast majority of Americans who are oppressed by uncontrolled Corporatism. Public Option is nothing more than a competitive choice for accessable health care that is a right and not a commodity.

    Favorite    Flag as abusive Posted 04:45 PM on 09/22/2009

Public option is indeed essential! Until a health care bill is signed, we need to keep up the pressure!

If not now, when? If not us, who?

Kennedy was one of our greatest champions of health care reform. He carried the torch for a long time...and now it is up to us to continue to carry it!

Our elected officials in Congress receive health care mostly paid for by us tax payers, yet many are trying to make it impossible for us to purchase an affordable plan of our own :

While many of us are struggling to afford medical insurance/medical bills.
While Congress people try to stop healthcare reform.
While Congress people accept large contributions from lobbyists to prevent health care reform.

Please sign these petitions - and by all means, spread the word! Thank you!

http://www.petitiononline.com/PubOp676/petition.html
http://www.democrats.com/honor-ted-kennedy?cid=ZGVtczQ0MTA5OGRlbXM=
http://salsa.wiredforchange.com/o/5649/t/4922/content.jsp?content_KEY=2763&tag=hk1_typ-e1

Read more at: http://www.huffingtonpost.com/huff-tv/arianna-discusses-health_b_288023.html

    Favorite    Flag as abusive Posted 10:34 PM on 09/16/2009

I once watched over the course of three days as a friend after a car accident, bloated to twice her normal size after having both legs amputated was hooked up to a dozen devices to mimic 'life', with loved ones holding constant vigil with supreme confidence she'd bounce back... those few who actually SAW her could feel the futility in the exercise of superhuman effort being put out by emergency staff to the point of exhausted misery and were relieved when the extreme efforts all failed and nothing more could be done.... and saddened it had taken three days of that hellish realm she'd inhabited to admit that there'd been precious little hope for recovery to begin with. This economy feels to me like that ICU ward. When the patched up, electrified, bionic corpse finally flatlines once and for all, a huge sigh of relief can come along with wails of grief and nostalgic, even honest, eulogies can break the trance it conjured in life.

Perhaps, just perhaps. there's enough human intelligence, & creativity to glean important lessons from the grand, yet mightily flawed old patriarch's full catastrophe of life once out from under the old man's hyper-controlling boot.... Not with an eye toward feeding the same old commodific­ation//cor­porate personhood beast of power over others... But ready and willing to see 'health care' as just the way we humans can move forward cooperatively with a humility and acceptance of humankind's place in the actual web of LIFE.

    Favorite    Flag as abusive Posted 04:02 PM on 09/16/2009

Thank you for a very touching, profound and compassionate analogy. You are so correct.

I believe the health of our nation's citizens, our extended family, requires a non profit, single payer system, that cares for all in a cooperative, unbiased fashion. Our health is our country's greatest asset and moral responsibility, not an aspect of our lives that should be unfairly and selfishly profited from. The sooner our politicians can enact that, or a viable public option at the very least, the sooner we can collectively reap the benefits of that plan and move forward with a sigh of relief as well. For even those so obtuse as not to see this at the moment, will one day be accepting and possibly even thankful.

    Favorite    Flag as abusive Posted 11:54 PM on 09/22/2009
- xianred I'm a Fan of xianred 8 fans permalink

This past Saturday, Dr Norman Borlaug, "The Man Who Saved a Billion Lives," passed away. His passing, at the ripe old age of 95, got me to thinking about what we leave behind from our life's work.

Mr. Potter, your commitment to standing up and telling the truth about the practices of the health insurance industry are heroic. I believe that if we are successful and do manage to get some real reform in our health care system it will be in no small part due to your efforts. You have exposed the ugly truth that the insurance industry is motivated by pure greed and are driven by ever increasing profits rather than concern for the health or financial well-being of the American people. Since right now 18,000 Americans die each year due to lack of health insurance your efforts to change this brutal system will most certainly save lives.

What a lot of people refuse to see is that the DEATH PANELS ARE REAL - they already exist in the form of our for-profit health insurance industry.

Thank you!

    Favorite    Flag as abusive Posted 01:57 PM on 09/16/2009

"What a lot of people refuse to see is that the DEATH PANELS ARE REAL - they already exist in the form of our for-profit health insurance industry."

Truly the best description yet of a 'Death Panel', it deserves some serious air time. Incredibly well said.

    Favorite    Flag as abusive Posted 11:57 PM on 09/22/2009
- miriamfl I'm a Fan of miriamfl 15 fans permalink

WENDELL POTTER is my hero!

    Favorite    Flag as abusive Posted 01:54 PM on 09/16/2009
- Rule Of Law I'm a Fan of Rule Of Law 144 fans permalink

Once again, the Democrats--this time led by one bought and paid for by the Health Industry--craft a bill that gives away all that we had been promised by Candidate Obama, and the Republicans Still won't vote for it.

They'll play this the way they did the bailout. They would not pass that at first either. Once all the protections were gutted and the give aways (without oversight) to their financial masters secured, it was allowed to move forward.

Look for the same here.

Knowing this, why did the Dems not just show up with the bill most of us wanted? This is like going into a car dealer and offering to pay over sticker as your opening bargain postition. You got nowhere to go.

And, why is it that Potter is not a part of Obama's team so that we can benefit from his years of insider information? If, as he claims, all this bill will do is cement the Insurance and Health Co's profits at our expense while offering us no real competitive options, who is really working for us in DC?

    Favorite    Flag as abusive Posted 01:25 PM on 09/16/2009
- spinns17 I'm a Fan of spinns17 34 fans permalink

no public op no deal

    Favorite    Flag as abusive Posted 01:25 PM on 09/16/2009
- cybexg I'm a Fan of cybexg 23 fans permalink

A fundamental aspect of America (AND American Capitalism) is the concept of a level playing field. The last 40 years of business strategy has focused on Hyper competitive practices (see work by D’Aveni) – think Art of War translated into business. This has lead to the current situation in America (political parties now extensions of corporations, representatives voting against the public good, etc.) because corporations (following hyper competitive practices) have fundamentally altered the environment for their own benefit. In turn, America no longer has level playing fields.

What I don’t understand, why are so many Americans willing to go along with the destruction of America? For example, I can point to theoretical work in market theory by Arrow (done in the 60’s?) that pretty much proves you don’t want private pooling of risk (insurance companies) for health care – but no one seems to care. His later work (Arrow) gave conditions and warnings (using information theory, market theory, game theory) where corporations would always work against and undermine American Capitalism. Could someone please tell me why so many Americans are unwilling to accept results from modern Market theory, why so many Americans are willing to participate in the destruction of a system they claim to support?

    Favorite    Flag as abusive Posted 01:09 PM on 09/16/2009
- Rule Of Law I'm a Fan of Rule Of Law 144 fans permalink

It's the Stockholm syndrome. We are trained from birth and react in predictable ways to the stimuli that we receive.

    Favorite    Flag as abusive Posted 01:50 PM on 09/16/2009
- mazaza I'm a Fan of mazaza 35 fans permalink

My take on it (from talking to working-class folks who voted for Sarkozy though his agenda is anti-working class) is this : most uneducated and bitter people will side with the rich and the powerful because they are hoping to get a crumb, some day. They also tend to want everyone else to plunge with them, that makes them look less like failures. Last : indoctrination. They have been told for so long that "they can do anything they want" in "the land of freedom" that they cannot imagine a different world. Also : most, if not all, Europeans live less than a day's car drive from another country where people speak a different language, eat different food, govern themselves slightly differently, so they know deep down that you can live differently and not be less happy for it.
Journalists in France talk about health care reform in America being a "cultural revolution". Indeed, that is what is. Of course, the day a decent health care reform would be passed, people would wake up the next feeling immensely relieved that "pre-existing conditions" are gone and would wonder how they had gone by without it. But unless it happens...

    Favorite    Flag as abusive Posted 01:54 PM on 09/16/2009
- zeke67 I'm a Fan of zeke67 12 fans permalink

Back in the 60's people fought like wildcats against medicare (socialized medicine). The tea baggers of 9/12 are against a public option/single payer but will fight like wildcats to keep medicare (socialized medicine). It just boggles the mind.

    Favorite    Flag as abusive Posted 04:05 PM on 09/16/2009
- mazaza I'm a Fan of mazaza 35 fans permalink

..; wake up the next morning...

    Favorite    Flag as abusive Posted 01:55 PM on 09/16/2009
- miriamfl I'm a Fan of miriamfl 15 fans permalink

The ha te and prejudice trumps common sense.

    Favorite    Flag as abusive Posted 01:58 PM on 09/16/2009
- den1953 I'm a Fan of den1953 50 fans permalink
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I find this difficult because i don't think there may be one law maker that is for the American people and can put them in front of big business period i hope the h*ll i'm wrong but they all seem to be on the take! It would be nice if there was a group of 6 that really cared for Americans and not Blue Cross or AIG.

    Favorite    Flag as abusive Posted 12:47 PM on 09/16/2009
- sixx I'm a Fan of sixx 11 fans permalink
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The industry has been writing every word that Baucus says from day one.

    Favorite    Flag as abusive Posted 12:31 PM on 09/16/2009
- okjoel I'm a Fan of okjoel 5 fans permalink

How refreshing to hear the truth. This man knows what's he's talking about. See his interview with Bill Moyers.

    Favorite    Flag as abusive Posted 12:03 PM on 09/16/2009
    Favorite    Flag as abusive Posted 12:53 PM on 09/16/2009
- exmate I'm a Fan of exmate 12 fans permalink

When are we going to look at the French model for health care? The world Health Organization has ranked French health care # 1 (USA # 37) because the: French doctors, health Insurance companies and the French people themselves all like it. Life expectancy, infant mortality, unecessary deaths , and unnecessary hospitalizations are all better than elsewhere. All that at a per capita cost 1/2 of that of the USA. Who says we cannot afford health care reform? If the French can do it, so can we.

In our own country the goverment runs the VA health care system and Medicare both of which are liked by their participants. Who says the goverment cannot do as well as private enterprise?

    Favorite    Flag as abusive Posted 11:48 AM on 09/16/2009
- mazaza I'm a Fan of mazaza 35 fans permalink

Most universal health care systems in the world pretty much built on what they had. Obama, in an speech (I think it was in Minnesota), supported single payer but dismissed it as too huge an overhaul from what already exists. A strong public option would lay the foundations for single-payer, if American voters continued to elect Democrats and demand the best from them.
Another big issue really is ideology : the French have always thought that strong government is what keeps them protected from individual greed since... corporations are not elected and represent no one but themselves.
Another issue is the medical profession : to have affordable care, doctors might have to curb a bit their profits. Of course, if they come out of medical school with huge student loans, patients have to pay to reimburse those loans, where we have free medical schools. Then the government might consider waving some tuitions for bright and promising kids who can't afford school, offer 0% loans or whatever.
Most doctors in France are passionate about ethics :
This video is enlightening about the French health care system and doctors's take on it :
http://www.youtube.com/watch?v=uNR_6UuVl4s&NR=1&feature=fvwp
But can't find that link about how European systems came out of existing infrastructures.

    Favorite    Flag as abusive Posted 01:34 PM on 09/16/2009
- xianred I'm a Fan of xianred 8 fans permalink

Great link! Everyone interested in improving the health care system in the US should explore what is working (and what isn't) in other countries. They do it for FAR less, have outcomes that are at least as good and in many cases better - and they manage to cover all of their citizens - not just those that can afford it or don't have pre-existing conditions.

We are #1 - in cost!

    Favorite    Flag as abusive Posted 09:18 AM on 09/17/2009

Saying the per capita cost is half the US is somewhat misleading. Health care is labor intensive and salaries are far lower in France. Labor cost are likely to be higher here regardless of changes to the system. French physicians make a third as much as US physicians. The discrepancy for nurses is similar and nurse practitioners in the US make more than the average French physician. That is due in part to the fact that in France medical school is paid for by the state increasing the supply of doctors. In the US the number of slots in medical schools is very limited and medical school is extremely expensive. And a US physician pays malpractice premiums as high as a French doctor's entire salary. Nobody seems to be talking about reforming our system of medical schools to increase the supply of doctors. How could we match the cost of the French system if health care workers get paid three times as much here.

    Favorite    Flag as abusive Posted 04:26 PM on 09/16/2009
- mazaza I'm a Fan of mazaza 35 fans permalink

From what I understand, you have room to make huge savings on the price of medication and unnecessary exams. Medical exams should be portable, they are here. Obviously, there are also incredible overheads in administrative services, from what I get, insurance corps spend a lot of bureaucrats salaries to deny claims, inquire into pre-existing conditions and such. Last, if people went to their GP's and dentists on a more regularly basis, that would bring down costs. I had a student job in a university hospital in the US in the late seventies and even then, nurses told me people got to a doctor way too late. Finally, we used to have nurses in schools that would take care of preventive medicine, unfortunately, the government cut most of these jobs, but that was a fairly cheap way of reminding families to have vaccines done, take their kids to the dentist's or talk over eating disorders. And I do believe lots of doctors would take a bit of cut in their pay if they could treat patients without having to handle all this paperwork with the insurance companies and could be proud of their jobs for not turning down patients. Ethics goes a long way towards making true professionals happy with their lives.

    Favorite    Flag as abusive Posted 08:30 PM on 09/16/2009
- exmate I'm a Fan of exmate 12 fans permalink

It will have cost $530,000 to pay for my kid's college and med school by the time she has finished. In France, tuition for medical school is free. There are more doctors and fewer lawyers in France.

    Favorite    Flag as abusive Posted 01:22 PM on 09/17/2009
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