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Wendell Potter

Wendell Potter

Posted: February 14, 2011 05:33 PM

As I noted Friday, health insurers in Connecticut will call on some of their longtime allies to help turn the public and state lawmakers against the idea of creating a state-run public option.

Legislators in Hartford are taking up the idea of doing just that today, as three legislative committees hold a joint public hearing on SustiNet, which they actually created in theory but didn't fund in 2009. If implemented, SustiNet would provide a health care benefits package starting in 2014 for a prospective pool of recipients including state workers, Medicaid recipients, individuals and small businesses.

A similar public option was proposed in last year's federal health care reform debate, but it didn't survive -- and that was no accident. In Washington, lobbyists for insurance companies wanted to kill the public option, because they knew it would be a formidable competitor -- offering greater value to customers because it would not have to divert a big chunk of premium revenue to meet Wall Street's profit expectations or to pay executives millions.

Polls showed that the public option enjoyed substantial public support -- so much so that it was included in the House version passed in the fall of 2009. Alarmed, insurance lobbyists went to work in the Senate and hit paydirt when they convinced Sen. Joe Lieberman of Connecticut to come out against it.

Lieberman had previously expressed support for the public option, but also had to manage relationships with several rich insurance company executives who are among his most powerful constituents. Lieberman became such a steadfast shill for the industry that Harry Reid had to strip the public option out of the bill. The House ultimately had no choice but to follow the Senate's lead, which is why the bill that became law last March did not include what President Obama had said was necessary "to keep insurance companies honest" and to ensure that Americans had at least one option for affordable coverage.

Meanwhile, though, state legislators in Connecticut passed a bill to create the framework for SustiNet. In an effort to quash funding that SustiNet will need to get off the ground this year, the insurance industry will be calling in favors from its friends in the business world. That's because industry executives know that the public would be highly skeptical of a big PR campaign overtly led by insurers.

As I describe in Deadly Spin, in times like these, special interests turn to allies, preferably allies with better reputations, to lead efforts to manipulate public opinion. Two such allies fit the bill for insurance firms: the U.S. Chamber of Commerce and the National Federation of Independent Business (NFIB).

As Bloomberg reported last November, insurers secretly funneled $86.2 million of their policyholders' money to the Chamber in 2009 to help finance a deception-based campaign to influence the reform debate. That campaign played an important role in convincing many Americans that a public option would lead to a "government takeover of health care."

At the state level, the insurers will find that the NFIB, which bills itself as the voice of small business, is potentially more helpful. In fact, the NFIB is already on the job in Connecticut.
The Hartford Courant last week quoted an NFIB official as saying that "SustiNet's faults go beyond the problem of duplicating many of the features of federal health care reform."

Andrew Markowski, the NFIB's Connecticut director, told the Courant that, "What everyone is talking about is the state's fiscal situation and the need to downsize government. SustiNet is going to create a whole new quasi-government authority at exactly the time we're trying to move away from that. I have not talked to a single business owner who thinks SustiNet is a good idea."

My belief is that there's a good chance Markowski can make that claim by carefully avoiding small business owners who are not dues-paying members of the NFIB. The federation has a long history of being tight with Republican candidates and lawmakers and the health insurance industry. I know this first-hand from working closely with the NFIB in previous attempts to defeat reform initiatives insurers didn't like.

One of the NFIB's tactics is to conduct polls of its membership -- a membership that declined from 600,000 members in the late 1990s to fewer than 350,000 in 2009 -- and suggest that the opinions expressed by its members are representative of all small business owners.

The reality is quite different: the NFIB is one of the nation's most conservative, anti-government lobbying organizations, and attracts like-minded business people as members. According to CQ MoneyLine, the NFIB's political action committee directed 93.7 percent of its Congressional campaign contributions to Republicans in the 2010 election cycle.

As I noted Friday, the insurers and their allies will conduct an extensive fear-mongering campaign to persuade Connecticut residents and lawmakers that the public option would lead to a massive layoff of insurance company workers in the state. It is a common tactic to put either higher taxes or job losses -- or both -- at the center of such campaigns. The NFIB is especially adept at waging such efforts.

As U.S. News & World Report noted in a 1994 piece about Bill and Hillary Clinton's ill-fated attempt to reform the health care system, the NFIB played a lead role in killing the Clinton plan by scaring people into believing they could lose their jobs if it became law. The magazine reported that the NFIB used a study it conducted to argue that "Hillarycare" would kill up to 1.5 million jobs.

About those NFIB studies. They are not necessarily representative of all small business owners in the country, although the media dutifully report them as if they were. In reality, as the organization acknowledges, the surveys typically are of its own dues-paying members.

For example, in a May 22, 2007, news release about one of its surveys, the NFIB noted that it only surveyed its members to reach the conclusion that small business owners were more concerned about the cost of health care than about expanding coverage. The federation said that "making consumers more aware of health care and health insurance costs will encourage them to become better-health care consumers."

That language is almost verbatim from one of the talking points I used when I was an insurance industry PR executive.

The reality is that the public option enjoyed significant support from the small business community during the recent national debate on reform. At least two small business groups, the Small Business Majority and the Main Street Alliance, were vocal supporters of reform in general and the public option in particular.

During my time in the industry, I had first-hand knowledge of how insurers use the NFIB as a front for its messaging. During the late 1990s and early 2000's, I was a participant at numerous strategy sessions in a conference room at the Porter Novelli public relations firm in Washington, where plans were being developed to turn public attitudes against the Patient's Bill of Rights. That bill of rights at the time enjoyed wide bipartisan support in Congress, but the industry opposed it, and especially hated a provision that expanded patients' right to sue insurers if they had been wrongfully denied coverage for doctor-ordered care.

The industry hired Porter Novelli to create a front group it named the Health Benefits Coalition, and to lead a fear-mongering campaign in an attempt to make Americans fear trial lawyers and "frivolous lawsuits" more than denials of coverage for potentially life-saving procedures. The campaign was so successful that the Patient's Bill of Rights, co-sponsored in the Senate by John McCain and Ted Kennedy, never made it to the president's desk. Dan Danner, the current NFIB CEO, was the group's vice president of public affairs at the time, and he served as the coalition's lead spokesman.

Connecticut residents and lawmakers can expect the insurers and its allies -- the NFIB in particular -- to conduct a similar well-financed and extensive campaign to scare the bejesus out of everybody in the Nutmeg state. And if it succeeds like previous efforts, people won't even know the insurance industry is pulling the strings--or that they themselves will be financing the campaign with the health insurance premiums they pay every month.

This analysis was also published on the website of the Center for Public Integrity (publicintegrity.org).

 
 
 

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Actraiser
Medicare for all!
12:50 PM on 02/16/2011
For those very hopeful that this news means America is on its way to get single payer the same way Canada did, I have two questions:

1) Do you realize that without the Kucinich amendment, the health insurance industry can use ERISA laws to sue states aspiring to have their own public health plan or single payer health care system? They can only get out of this via a waiver?

2) Why are you so sure that the White House will grant a waiver to any state aspiring to have their own public health plan or single payer health care system?

For the record, I am very much in favor of single payer or a strong public health plan (i.e. public option, medicare for all, etc.)
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HUFFPOST SUPER USER
dragonmaster
06:26 AM on 02/16/2011
Connecticut, where I live will pass Sustinet this year- over the objections of the Insurance Companies and their lap dogs (Joe Lieberman) We have nearly 400,000 people in Connecticut w/o health care coverage, many with pre-existing conditions. If they where to buy Health Insurance from Aetna, Cigna, United- in this state they would end up with; Large deductibles, and scant coverage, and costly premiums.

How any state or nation that puts its sick and needy out in the street for a basic need like health care, is a nation with days that are numbered.
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HUFFPOST SUPER USER
blueken
Finger Picking blues man
04:12 PM on 02/15/2011
I always thought that Medicare was dreamed up by the private insurance industry. It culls the people who are in most need of care from the risk pool. They probably sold it to Washington as a way to keep health care costs down. So what happens, health care costs rise at three times the national inflation rate. Perfect double cross.
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Actraiser
Medicare for all!
12:47 PM on 02/16/2011
The government only provides care to those Americans who are in the highest risk groups: the elderly, the very poor, the incarcerated, current members of the US armed forces, and some (poorer) veterans. The only part of health care that America will ever be permitted to socialize, is the loss.
08:31 PM on 02/16/2011
I totally agree - Medicaire and Medicaid are sweetheart deals for big-profit insurance. They want to "do" insurance when they get healthy, wealthy and young folks, but they want the government to "do" insurance when it comes to sick people. Why are we subsidizing the existence of a boutique insurance industry that serves to enrich the few at the expense of the middle class?
researcher
researcher
12:29 PM on 02/15/2011
a nation that makes mega profits off the sick and needy and denies health coverage to many of its citizens for pre existing medical conditions is a nation destined for self destruction. that simple that complex.

thank you for your caring, you are a national hero but your work will be in vain. the selfishness and american greed will overwhelm yours and other efforts. too many years of capitalism of survival of the fittest.

a religious nation wilth a survival of the fittest mentality is interesting is it not. :-)
10:55 AM on 02/15/2011
With all the town, city governments and state governments struggling with their budgets- taking the age restriction off MediCare would really help them cut costs. Another reason Corporate America does not want the Public Option is that the private insurance expense keeps the competition down from small business. (Free Market- as long as they have the deck stacked in my favor)

It is the small businesses that create jobs. Jobs that we desperately need. Big Corporations are just sitting on their cash and have every person doing the work of 2. There is this perception that when Wall Street is doing well- the nation is too. I'd say the top 1% are doing very well- but the rest of the country is just suffering.

Where is the common decency, the sense of fair play and concern for the country as a whole?
10:43 AM on 02/15/2011
Unfortunately- we live in a country where unbridled corporate greed is allowed to rule the roost. The corporations do not want a level playing field- they want the deck stacked as far as possible in their favor. (Free Market- what a joke!) As far as health care is concerned I think the simplest fix would be to take the age restriction off MediCare and let younger, healthier people into the system. Medicare does not have the high administration costs of private insurance- since it does not have advertising, staff of people dedicated to finding ways to deny your claims and don't forget the mega-million dollar CEO's. Our health care system is a national embarrassment- I think we our #37 in the world.
In a country as wealthy as ours- I can only think of a few areas that we are number 1:

MILITARY SPENDING!! CEO COMPENSATION!! DIRECT MARKETING OF PHARMACEUTICALS!!!

aren't we special?!
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HUFFPOST PUNDIT
den1953
The best politicians are for free!
09:56 AM on 02/15/2011
Somehow Washington's denial of the public option to the American taxpayer and their ability to maintain a very good government health care program is a little upsetting to say the least, the law makers and government workers are paid by the American people, it just seems unjust they should have to pay part of their own insurance just like they want the American people to pay!
09:47 AM on 02/15/2011
It won't matter, you saw how their Senator, Chris Dodd, was bought off. At first he vowed to block any banking regulation, it was only after an outcry that he let it go through....after completely gutting it. The only way to stop this is if the news accurately starts reporting exactly WHAT lobbying is and WHY, elected officials succomb to it. It is bribery pure and simple.
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jmpurser
See My micro-bio
09:25 AM on 02/15/2011
Why would you want one more insurance company?  If insurance companies were the SOLUTION to the health care fiasco then the problem would have been solved in the 1970s.  They are NOT the solution.  All evidence points to them being the PROBLEM.

Look at Vermont.  If you're going to fight for something why not fight for something worthwhile?  Go single payer and quit shooting yourself in the foot.
09:48 AM on 02/15/2011
Easy, because the public option is a threat to the other companies to keep their prices in line. Many countries that have had it, actually don't need to use it that much because the other insurers toe the line. You can live in France, with is mostly privately insured and pay $1,500 a YEAR for medical insurance rather than almost that per month here.
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jmpurser
See My micro-bio
10:41 AM on 02/15/2011
Either you responded to the wrong post or you didn't read mine.  And no, no one else uses a "public option" as Obama proposed the idea.  It's one of those "uniquely American" solutions because no one else is that "bidness friendly".
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09:03 AM on 02/15/2011
I just received notice that a claim for hospital stay had been denied because it was improperly filled out. It should have been billed to Medicare and two different entities of my supplementary insurance carrier. My insurance company informed me that the claim would have to be resubmitted. How efficient! Three bureaucracies, two submissions for one claim.
If government is so inefficient and bureaucracy laden, why is the private sector so afraid of the public option? It seems to me that insurance companies would welcome an example so they could prove to us how much more efficient they are.
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Prib2009
Expect the worst. You'll never be disappointed.
10:52 AM on 02/15/2011
Having worked in this field most of my life, it would appear that the hospital did not bill for their services correctly. I'm not sure what type of hospital you use, whether it was government run or not. I think the private insurers are afraid of the public option because it will eventually put them out of business and they know it. No more huge CEO pay for the head of the insurance companies, no more sway with our congressmen/women, no more control over our media. The government is not inefficient. Medias controlled by insurance companies, and insurance companies themselves just want us to think they are, as well as the republican party in general.
01:39 PM on 02/15/2011
I work in this industry. I have one question for you. Did you provide the hospital with your insurance cards? Did you tell them which one was primary, secondary, and terciary? I see where you say your insurance company needs the claim resubmitted. That means that the claim was processed correctly by Medicare, and that you probably did not provide the hospital with the correct filing order for claims. Otherwise you post makes no sense.
08:41 AM on 02/15/2011
I love this guy. He used to work in the health care insurance industry, and so he knows their sleaziness very well. The White House should hire him as a spokesperson for some kind of public option for the current health care bill if the decision is made to make amendments to improve it.
08:26 AM on 02/15/2011
Hi Wendel.....

Thank you for joining "The Jedi" in this fight over healthcare. I never dreamed I would work many years in this country, only to be fired, because of no longer wanting to offer it. May mid-size companies are throwing really good people out of work because of it. It is a disgrace that so many people are uninsured right now in America. Thank you for fighting "the good fight".
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Beatitudes
Cajun author
08:26 AM on 02/15/2011
Funding is always the problem. So many excuses can be made for not doing something.
Elijah Rising
02:44 AM on 02/15/2011
The health care hoax that Obama has put forward ranks up there with the global warming hoax put forth by Al Gore. How can anyone believe that adding multiple layers of bureaucrats and 20 million people to a government mandated health plan can reduce the budget deficit. Ha!
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HUFFPOST SUPER USER
Richard Bartholomew
My micro-bio isn't empty.
04:36 AM on 02/15/2011
My theory is that folks studiously ignore the obvious because they desperately want to believe that they can get something for nothing. And if they can't get something for nothing, then they are willing to do anything to maintain the illusion that they can. That includes the thrillsome threesome: lying, cheating, and stealing.

I'm not sure what we can do about this. It looks like we're going to have to be dragged through the only cure ever known to work (temporarily): the hangover that results from having tried it once again. It would be bad enough if only the free-lunch crowd had to suffer the consequences, but everyone else is going to have to take the medicine along with them.

It's rather like trying to reason with war fever. Once people get into a killing mood, woe to anyone who soberly points out to them that they're wrong. It doesn't matter how wrong-headed the suffers are.
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Uniongrl
Working for a livin'!
05:58 AM on 02/15/2011
"Lying, cheating, and stealing". You need to stop pointing out the core values of republicans who take advantage of the middle class.
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HUFFPOST SUPER USER
dragonmaster
06:30 AM on 02/16/2011
The republican party, and their staunch allies the health Insurance companies have been allowing thousands of Americans to die each year for decades.

The same republican party also that is destroying the environment with their greed and disregard for other humans and animals to perpetuate a plutocracy that only a right wing fanatic Ayn Rand would love.
08:21 AM on 02/15/2011
Looks like someone is watching too much Fox News and ignoring some important facts - Medicare admin costs are dramatically lower than private insurance overhead costs. Somehow the Fed Gov manages to be more efficient that the insurance companies. Having just navigated someone in my family through a major illness I can tell you that the private insurance companies are not very efficient or effective. I see a much more efficient and effective delivery of insurance coverage by Medicare to my elder In-Laws.
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hempster
Let it be said, let it be written, let it be done.
09:47 AM on 02/15/2011
Single Payer is the only way to travel.
10:38 PM on 02/14/2011
http://www.ohiopirg.org/news-releases/health-care--prescription-drugs/health-care/health-care-repeal-would-have-costly-consequences-for-ohio-consumers-and-small-businesses

"Consumers and small businesses in Ohio will face significan­­­­tly higher insurance premiums and could see coverage denials and price discrimina­­­­tion if the federal health care law is repealed, a research group says.

Ohio Public Interest Research Groups, a nonpartisa­­­­n public interest advocacy organizati­­­­on, details the potential impact in a report, "The Cost of Repeal," released Jan. 10.

According to the report, repeal would strip tax credits from 149,100 Ohio small businesses in the short-term­­­­...

Several health insurers have already made changes in advance of health care reform. The parent companies of both UnitedHeal­­­­thcare and Anthem said they would end the criticized practice of seeking ways to drop sick patients from health plans, doing so much earlier than the new health care reform law requires.

http://krugman.blogs.nytimes.com/2010/03/17/demons-and-demonization/

http://www.cjr.org/the_audit/reuters_is_excellent_in_diggin.php

The report says:

• 25 percent of Ohio residents who have pre-existi­­­­ng conditions will continue to face coverage denials...

• employer health costs will rise, leading to 7,400 fewer jobs created per year in Ohio by the end of the decade; and

• $17.1 billion in federal Medicaid dollars would be pulled out of the state’s economy””””