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Wendell Potter

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"Occupy Wall Street" Should Protest the Wall Street Takeover of Health Care At Insurers' Big Lobbying Group

Posted: 10/10/11 12:22 PM ET

The lobbyists for U.S. health insurers surely have to be feeling a little uneasy knowing that thousands of Occupy Wall Street demonstrators who have been marching and protesting in Washington as well as New York and other cities might target them in the days ahead. After all, the headquarters of the insurers' biggest lobbying and PR group, America's Health Insurance Plans (AHIP), at 601 Pennsylvania Avenue, N.W., is just blocks away from Freedom Plaza, where the demonstrators have set up camp, and problems with health insurers appear to be near the top of the list of protesters' concerns.

Health Care for America Now, an umbrella advocacy group that played a key role in the health care reform debate, last week analyzed the 546 comments that had been posted by then on "We are the 99 percent" Tumblr site. It found that 262 of the comments mention such problems as getting denials for doctor-ordered care from their insurance companies and having to forego treatment because of hefty out-of-pocket costs.

In my book, Deadly Spin, I wrote about how the "Wall Street takeover" of the American health care system has created many of the problems mentioned in the Tumblr site. I also described how AHIP offices have often been command central for developing and implementing coordinated efforts to derail health care reform efforts in the past and how the organization helped shape major provisions of the Affordable Care Act, which Congress passed last year.

Over the past few years, many of the largest health insurance firms have converted from nonprofit to for-profit status and have been acquired by huge corporations whose stock is traded on the New York Stock Exchange. Today, more than one-third of all Americans are enrolled in a health benefit plan owned and operated by just five large insurers -- a group that last year hauled in nearly $12 billion in profits. These companies have grown so big and powerful that they now often determine who has access to affordable care and who doesn't. Their business practices, condoned by investors and Wall Street analysts alike, have contributed to the growing number of Americans without health insurance -- more than 50 million of us at last count.

I worked for two of those large companies, Humana and CIGNA, during my nearly 20 years in the insurance industry, and I participated in many strategy meetings at AHIP's offices in Washington where plans were hatched to influence public policy.

I am now watching how AHIP is getting Obama administration officials to write the regulations required by the Affordable Care Act in ways that benefit insurance companies more than consumers. And I have talked to administration officials who have quit their jobs in disgust as the White House has repeatedly sided with insurers rather than consumer advocates, as important regulations were nearing completion.

Here's an example. Earlier this summer, the administration announced rules pertaining to new rights we supposedly now have, thanks to the Affordable Care Act, to appeal decisions made by insurers that don't go our way. When the Department of Health and Human Services quietly released the regulations in late June, consumer advocates realized that insurers had, for all practical purposes, written them.

As Sabrina Corlette of Georgetown University's Health Policy Institute wrote, the administration narrowed the range of issues consumers can appeal, gave insurers up to 72 hours, rather than 24 hours, to made decisions on emergency care claims and weakened a provision requiring health plans to provide enrollees with information about their appeal rights in understandable language. Administration officials also cut in half the number of days patients have for appeals and allowed insurers to frequently choose their own "judge and jury" when their enrollees request an external review.

Just last week, AHIP's muscle was on display when the Institutes of Medicine released guidelines for the Obama administration to follow in establishing the "essential benefits package" that all health plans will have to offer on the health care exchanges, or insurance marketplaces, beginning in 2014.

In January, an AHIP executive warned the IOM about making the benefits package too "rich." Insurers want the package to be as skinny as possible, which will enable them to continue selling plans that, in many cases, are inadequate for many peoples' needs.

The IOM's recommendation is almost exactly what AHIP suggested.

So if the Occupy Wall Street demonstrators want to show up in front of the offices of some of the most important and influential people in Washington, whose strings are pulled by a handful of people on Wall Street, they will not want to miss 601 Pennsylvania Avenue, N.W. Trust me on this.

 
 
 

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The lobbyists for U.S. health insurers surely have to be feeling a little uneasy knowing that thousands of Occupy Wall Street demonstrators who have been marching and protesting in Washington as well ...
The lobbyists for U.S. health insurers surely have to be feeling a little uneasy knowing that thousands of Occupy Wall Street demonstrators who have been marching and protesting in Washington as well ...
 
 
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Miles J. Zaremski
Attorney, essayist and commentator
08:08 AM on 10/16/2011
The words of Wendell are sage and should be listened to if we do not wish to see our health care system fall deeper into an abyss than it already is. Americans, listen up---without your health (viz, accessing it and paying for it), you have nothing at all. Wake up and smell the roses.
11:03 PM on 10/10/2011
It's not a good tone, telling protesters what they 'should demand'. Just state your point, not what you think someone else's point should be.
Brown Trout
Unaffiliated Voter
10:30 PM on 10/10/2011
why they are not protesting at the white house?

http://www.ajc.com/news/nation-world/spin-meter-obamas-disconnect-1197664.html
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09:50 PM on 10/10/2011
Party politics is nothing less than a divisive tool. They attempt to categorize us to keep us fighting amongst each other.
04:09 PM on 10/10/2011
My husband's company sent out an e-mail today telling employees that they were having a small open enrollment period with info to be sent soon on changes to the health insurance benefit. The last sentence in the e-mail: "take the opportunity to get your doctor appointments out of the way before the end of the year." Trying to tell us something? Obviously.

It seems these days that the only difference between those of us with insurance and those of us without is the lightening of our bank balances and the illusion of access.
12:39 PM on 10/13/2011
In other words, all Americans are now "going naked" in regard to health insurance. The suckers are the ones paying the exorbitant premiums with high deductibles. Good luck with getting your claims paid. Any appeals process is seriously stacked in favor of the companies.
02:26 PM on 10/10/2011
There is now a social networking site for the Occupy movement http://www.ioccupy.org
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josephebacon
01:32 PM on 10/10/2011
It's going to be very interesting to see how this plays out.
12:45 PM on 10/10/2011
do special interest groups and celebrity participat­ion in occupy protests lessen the substance and credibility of the movement? 
http://littlebiggy.org/4660547
12:03 PM on 10/10/2011
You had better do a little more research on Occupywallstreet. If you had read the declaration (http://nycga.cc/2011/09/30/declaration-of-the-occupation-of-new-york-city/), you would have found out that Occupywallstreet is for the elimination of all lobbying and corporate financed politics. Although its not stated directly, it would seem to me anyone except those who benefit from the current status quo, would not disagree with anything on that declaration.

I for one agree 100% and will support the movement as much as I can no matter how long it takes to get this elitist system changed.
12:02 PM on 10/10/2011
So how about everyone quit trying to pigeon hole this movement into your particular politics? All it will end up doing is alienating you from it.

The Dems trying to steal our thunder. Reps trying to say we're children. Companies trying to say they support us. Every media organization saying the movement is behind their ideals is a joke, no, it's not.

We are moving on from standard party politics and this stupid corporate idealism. Get used to it, your power is gone. It never existed and was only an illusion in the first place.
06:30 AM on 10/11/2011
kudos
07:47 AM on 10/12/2011
AND I am an Iraq veteran who has done software development among other things in the past. Currently using my GI Bill to get another degree because I can't find a job in this economy... you know, the one we have provided tax breaks for the past who knows how long, so the 'rich' can 'keep creating jobs'. Still waiting for the jobs to be created.

I would also like to point out a flaw in that argument I hear all the time: The 'rich' are no more job creators than the lower classes who purchase their shit. Period. Time to fix this worldview of ours.