Wendell Potter
Appearances
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
There's a story on the front page that said that there was a big outdoor health care clinic that was being held a few miles from where I grew up at a county fairgrounds. And I was curious. I've been to county fairgrounds all my life growing up. And they said thousands of people were expected to converge on this county fairground in Wise County, Virginia.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I grew up in that part of Tennessee that's right up against the Virginia state line. I went there out of curiosity. I borrowed my dad's car and drove there because I'd never heard of anything like this. And I can't tell you, it was almost like there was some divine intervention that drew me to that story and compelled me to go to this place as if I needed to see it.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I've often said that the road between Kingsport, Tennessee and Wise County, Virginia was my road to Damascus. Because when I got to that fairground site and walked through the gates, I saw something I just... couldn't imagine ever seeing, witnessing in this country.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
There were people who were lined up by the hundreds in many lines, and they were soaking wet because it had been raining before I got there, but they weren't about to leave their place in line. Many of these folks had spent the night, sometimes two nights or more, in their cars waiting for this event to start. And many of them, I found out later, by the way, had health insurance. But what I saw
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
when I paid attention to these lines was that in many cases, they were leading to animal stalls. Volunteers had cleaned up the animal stalls. This was the county fairground. And just weeks before, they had prized horses and pigs in these animal stalls. They had doctors who were volunteering their time and nurses. treating people in animal stalls. And it just did something to me.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I couldn't believe that I was seeing it, that this is what so many Americans had to resort to to get the care that they needed. I came to realize almost instantly that I had to accept some responsibility because what I did for a was to mislead people about our healthcare system, about how it operates, and to make people think that it has to be this way. Doing this for the benefit of our investors.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
For quite a long time, my top job objective was to enhance shareholder value. So even in my job, that was job number one for me, what I was measured on. At first, I thought, well, what's wrong with that? Till I saw people face to face. And then I realized what's wrong with that. Because what I was doing for a living was making it necessary for people to get care that way.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I think that's exactly right. And even the insurance industry plays some role in what you were describing there. Early on in my career at Cigna, we got a lot of bad publicity because the company began to implement a policy of refusing to pay for more than 24 hours in the hospital for a delivery or a mastectomy. The media at the time, and this was in Connecticut at
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I started calling this drive-through deliveries and drive-through mastectomies. The insurance industry had decided, or my company had decided, that new mothers didn't need to stay in the hospital more than 24 hours. It was perfectly fine for them to be discharged and go home.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
There were a lot of OBGYNs who were balking at that, and that's what made it initially a local story, but ultimately a national story. That was because of pressure from the insurance industry because the insurance industry didn't want to pay for more than 24 hours for a new mother in the hospital regardless. Now, the company said, well, those are just guidelines. That's not set in stone.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
But that was the expectation. And that's what would happen to you unless you or your doctor went to the trouble of objecting and saying you needed to have more time in the hospital.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
But hospitals, where we spend most of our health care dollars, it's extraordinarily expensive. And we've seen in recent years hospitals combining, becoming these massive businesses of their own. It's not just a single hospital anymore. Any hospital in the country almost is always now a part of a big system.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And they started doing this, in my view, largely in self-defense because insurance companies like the ones I work for began to consolidate. and become massively bigger. And they did that on my watch. I managed a lot of communications around the acquisitions that my companies made. And hospitals decided if they're going to play this game, we have to play that game too.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We've got to get bigger to be able to negotiate in a reasonable way with these guys. And so you've had this arms race that has been going on now for several years. As insurance companies got bigger, hospitals combined to bulk up. And it's all about the money. It's all about who can get the most money.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Purging occurs when a company like Cigna looks at its book of business and decides that these people are no longer profitable. They're using too many health care goods and services. So they're sick. They're going to the doctor more often. Right. But also businesses, particularly small businesses, that are trying to provide coverage to their workers.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
If one employee of a small business gets sick, then that will mean that when the policy comes up for renewal at the end of the year, the insurance company is likely going to say, you had one sick employee that cost us a lot of money, so we're going to raise your rates significantly for next year. And if that happens fairly often or significantly,
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
and the insurance company is having to pay out more than the underwriters had initially thought, they'll jack those premiums up more than that employer can afford. And that's why you have fewer and fewer small employers in this country able to offer coverage. It's dropped over the years significantly. A lot of people are employed
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And they work for small companies and those companies are just no longer able to stay in the insurance game. They can't offer benefits like they did 10 years or so ago. And that's been very prevalent. Once again, it's all about the money. These companies were always looking to see how much they're having to pay out in claims.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And they know that investors do not like that because the more they pay out in claims, the less is available to reward their shareholders.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Germany, to this day, has one of the best health care systems in the world. And it's not a pure single payer government run system either. But they do have a mechanism for making sure that everybody has coverage. That's critical. What you were describing, and I know it's right, you can go to any ER anywhere in the country and you'll find a similar situation.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
You'll find people who are there, you know that they're not going to have money to pay out of pocket. In fact, 40% of Americans have fewer than 400 bucks in the bank. That's right. I forgot about that. And how can you expect them to pay up to $10,000 out of their own pocket? In many cases, people have that kind of exposure before their coverage kicks in. Most of us in this country have coverage.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We're not at universal by any means. About 92% of us have coverage. That's fairly close. But with a country this big, that means we have about 30 million people who still don't have insurance, for one thing. But they get sick. They go to the hospital and we are having to pay more in premiums and taxes because of that.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
But then you have this other situation of people who have insurance, but they have these high out of pocket deductibles they have to meet before their coverage kicks in. They don't have that money either, even though they and or their employers are paying premiums when they get sick. If it's a big bill that they have to pay out of pocket, they can't do it.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So the rest of us are having to pay for it. It makes no sense whatsoever. Our employer-based system began accidentally. It was during the World War II era when employers were trying to figure out how they could attract scarce talent. They began offering health care benefits and it just took hold. And that is where the majority of us still, if we have private insurance, get it.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
But that's eroding as well, too. That's not growing either because small employers can't participate in this anymore. And even large employers are saying this is not sustainable. It's bound to collapse at some point. It's just a matter of when, in my view.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
That person will always be anonymous. You will never know who that person is by design. That person remains anonymous. You'll never know the person's name. That particular little girl who needed the cochlear implants She was insured by Cigna. One of the jobs that I had was to discredit Michael Moore when his movie Sicko came out. I had to know what the movie was about.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So I flew from Philadelphia to Sacramento to the first screening of that movie to know how Cigna was being portrayed. And that was one of the cases that was in the movie. And I knew it was a real one. And you're exactly right. Somebody at the company decided, well, this little girl can get by with just one, even though she needed to. She can manage with just one.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
This happens all the time because these people can remain anonymous and they're so far removed. They never examine the patient. They might see some paperwork or at least something scanned to them, faxed to them, whatever. In many cases, still faxed. But they're at such a distance, they have no real understanding of what that patient is going through.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, this is typical. And that was another thing that I had to handle when I was at Cigna, executive compensation. And big companies have disclosed what the top paid executives are paid. And the compensation is extraordinary. Here's the other thing about that. 90%, and this was a talking point that I used, and reporters bought it and thought that justifies the big paycheck.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, there aren't too many of us, but I worked as a health insurance company executive for 20 years and I was in positions of responsibility that gave me great visibility into how these companies work. And I left after a crisis of conscience and ultimately became a whistleblower.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
90% of his compensation, I would say, was at risk. In other words, he was paid in stock grants and stock options. When you step and think about that, that means that he's more beholden to Wall Street, to these investors, than anybody else in the company. So his motivation is always to make sure that those shareholders are happy.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
If the company reports earnings that disappoint Wall Street, then your net worth is going to decrease. And this guy, Brian Thompson, who was murdered, was one of the top executives. And similar deal. You're paid primarily in stock. And he was in New York that day on December the 4th at UnitedHealth's Investor Day. It's something I used to plan for Cignet.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's the day that the top executives go to New York City. It's really a kind of a dog and pony show with the biggest investors who persuade them that the company is in great financial shape and the future is bright. And that's what he was in New York to do, was to spend a day with the top shareholders of the company.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's a shame. It's a tragedy. You're right. He was under investigation for something along the lines that you described. The CEO of United retired. Oh, it's been more than 15 years. But he was in the news because he was found to have backdated some shares to inflate the value so that he would get more money when he cashed out.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And he was forced to give back about half a billion dollars that he had hoped he could walk away with. But he was manipulating the dates so that he could maximize interest. his payout.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And keep in mind, you're dealing with people day in and day out who have medical issues and many cases, mental health issues. Sometimes they're associated with the pain and agony you've been going through. And this seems to have been the case for this particular young man. But it's becoming increasingly impossible to deal with these companies if you've been denied something.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And we saw that just triggered this outpouring of storytelling on social media, people going to social media, sharing their stories, their horror stories with the world. And it was stunning how fast that began to develop. I wasn't shocked when I stepped back and looked at it, because even when I was in the industry, I knew that People despised our industry.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We spent an enormous amount of money, and these companies still do, on image advertising and product advertising. But we did surveys, and we would ask people, what can we do to get you to like us better, essentially? And it was always, the answer was, pay our claims and get out of our lives. But they can't do that and satisfy Wall Street. So they've got to do what they do. That's right.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I worked for two of them, Humana for about four and a half years, and then Cigna for a little over 15 years. So all together, about 20 years at these big, giant corporations. And I was in the communications department. When I left Humana, I was running that company's communications department. And then I was recruited to Cigna and was running that communications department.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's not bad. Not a bad deal for us.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Do that, because some version of that is what you need to do. I've told people whenever I have a chance, be a squeaky wheel. The problem is when you're really sick, it's hard to be your own advocate. It's hard to be that squeaky wheel. You've got to find the energy somewhere to do it. It's good to have an advocate, someone you know, someone...
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
and your family or a friend to help you with this when you're not at your best. But yes, be a squeaky wheel.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
There was one story in particular, one horror story that was it for me that I ultimately turned in my notice involved a girl in Southern California who needed to have a liver transplant and Cigna medical director 2,500 miles away in Pittsburgh said he didn't think it was medically necessary for her, even though the surgery was scheduled A liver had been found.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
The family had arrived at the hospital to wait for the procedure. But instead, the parents were taken aside and said, sorry, we can't go forward because Cigna has not given us clearance to do this. Long story short, the family decided to make a big deal out of this. And they were able to get reporters in L.A. to start calling me. So what's the deal here?
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Why is Cigna not paying for this girl's transplant? And it just mushroomed. It became a huge PR problem for the company. These companies don't like it. And they have people like me on staff who dealt with these day in and day out. And they do want these stories to go away.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So more often than not, when a reporter calls somebody in the media, probably someone with a big social media following these days, that can make a difference because these companies want to try to make these stories go away.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I was vice president of corporate communications. My job was to handle financial communications. I was the company's chief spokesperson. I was a gatekeeper for any media that wanted to talk to anybody at Cigna. Also, my staff and I wrote talking points for our lobbyists. So I was involved in lobbying, government affairs work, financial communications. I worked with the investor relations team.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's exactly right, because the vast majority of us don't get our names in the paper. We don't know you. We don't know how to get on your show. We don't know how to do these kinds of things. It's only the occasional ones that really break through that can get a reporter interested in taking your case and making a call on your behalf.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And they get away with this day in and day out because people don't know how to be a squeaky wheel. I say, give it a go. Do the best you can. But that's hard. It's hard to do that. And you're facing such odds. And I always encourage people to never take no as your first answer. always begin an appeal process. But the industry makes it so damn difficult.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
A lot of people don't know that they have rights to appeal. They just assume it's going to be such an ordeal or they feel so lousy that they don't do it. As a consequence, a small percentage of people actually fight back. They never file an appeal. They don't become the squeaky wheel. And they suffer and in many cases die early.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
You're essentially inventing groups that purport to be consumer organizations or patient organizations that are nothing of the kind, but you name them in certain ways to make people think they're legitimate. One in particular that comes to mind that I was a part of, we called it Healthcare America. We created it for two reasons. One was...
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Back to Michael Moore, we set it up to discredit him by having this outfit, which was run by a big PR firm in Washington. The people thought there might be some real consumer folks involved with it. There was nothing of kind, but it turned out press releases. It would get quoted in the newspaper. saying that Michael Moore was out of step with American society.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
He was advocating for a government takeover of health care, things like that, just to discredit a movie. But when Congress got down to business to try to pass health care reform legislation in the early days of the Obama administration, We repurposed that front group, Healthcare America, to try to get Americans to believe that what was being proposed would not be in their best interest.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It was paid for exclusively by big insurance companies. But Americans don't know that. You see these advertising, you see things on TV, particularly during election years, and think that whatever that advertisement is from some legitimate organization, more often than not, it's some industry that is
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
found some name and some outfit that they create and pay for and hire a PR firm to run that's behind it.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
All of that gave me this great visibility into this industry. I also worked with our chief medical officer and all the clinical staff at the company as well, too. So it was a unique position. Very few people in any company get that kind of visibility into how the company really operates and what motivates the C-suite.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's ridiculous. And it goes back to what we were talking about earlier about employers providing access to coverage. There's this law that was passed in the mid-70s to protect people's pension benefits, make it unlawful for employers to abscond with your retirement money. It's been interpreted over the years to apply to health benefits, and it gives employers enormous protection from state laws.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It makes them exempt from state laws, but it also makes it impossible for people to sue an insurance company or an employer and have much chance of recourse because the law says that all you can get is maybe a decision that the benefits were not administered correctly. So consequently, very few lawyers will take this case on.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I think Mark Geragos didn't fully appreciate the protections that employers and insurance companies have because of this law, and he was not able to get any money for this family.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Now you see why these companies make so much money, how they're able to pay their CEOs 20 plus million dollars every year and report profits of... one company like $30 billion a year. It's just stunning how much money they're making.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Exactly. You are able to throw money at influential folks to get them to carry your water for you. You mentioned the tobacco industry. That was a playbook that we followed, chapter and verse. And part of it is to form these front groups. Because if your industry has no credibility, you've got to have some outfit. And some allies, too. They will go to organizations like the U.S.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Chamber of Commerce and others that people hold with greater respect and believe are credible organizations that represent small businesses. And I can assure you the U.S. Chamber... It's not quite that. We worked with the U.S. Chamber and a lot of big organizations. We wanted to ally with them and let them carry our water for us because we couldn't do it ourselves.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, we were always constantly surveying people to find out what they were thinking about public policy as it pertains to health care. We would want to make sure that we understood how susceptible they were to agree with the Michael Moores of the world. How likely are they to say that we need to go to a single-payer health care system.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And our surveys showed, even when I was in the industry, that a majority of Americans were OK with that. So our job would be to dissuade Americans, to get people to fear that. And so our pollsters were also messaging experts. And they would also know how to ask some questions to get people to change their opinion or to see it from a different perspective.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And then that would enable us to do our talking points and to scare people in a certain way. For example, If you were to go to a Medicare for all or a single payer system in this country, by definition, it is going to be paid for with tax dollars. And every study you've ever seen will show that we can attain universal coverage in this country and pay less for it than the system we have now.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
but you have to pay more taxes. So you would shift from paying premiums to private insurance companies to pay more that would be dedicated to health insurance. The insurance industry knew how to manipulate people to fear a tax increase. you would obscure the fact that they wouldn't be paying premiums, but get them to be opposed to paying additional taxes.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So that's just an example of how you do that. You poll people to find out what they currently think, and then you figure out how can you scare the shit out of them? How can you develop a messaging campaign to get them to fear what your opponents are advocating for?
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I do. It's hard, certainly, to sustain any kind of movement, if you will. When Brian Thompson was murdered, there was a lot of publicity around that. I think there will be as that goes to trial. I think it's not a dead subject by any means yet. But I am seeing for the first time, I think in my lifetime, more bipartisan interest, at least here in Washington, to address some of these big problems.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
You're not going to see Republicans embrace Medicare for all. That's just not going to happen. But they are beginning to pay attention to some of the practices of this industry and seeing how they're ripping off their constituents. So I'm seeing that. And in fact, I'll be meeting with every time I come to Washington with Republican offices because they run the town now.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And I am seeing and hearing receptivity to doing something and working across the political aisle with Democrats to try to reform this industry. Will we reform it enough? It's going to take a while. It's going to be a while. But I do think that we Americans are seeing this for what it is, seeing how it's rigged against us and how they are profiteering.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And I think that will lead to meaningful reforms.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
They don't necessarily set the prices. In other countries, there is a national mechanism that does have some price setting responsibilities. In this country, we've taken an approach of essentially saying that's for insurance companies and hospitals and doctors to fight it out. And it obviously hasn't worked very well for us because prices keep going up and up and up.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
What people need to realize is that Insurance companies don't have all that much of an incentive to bring the unit cost of goods and services down because as it goes up, as a stay in the hospital goes up, as a prescription goes up, despite what an insurance company complains about, they benefit because they're the only game in town. We don't have a public option.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We don't have anything that really competes with private insurance companies. They're the only game in town. They all work as the cabal. And they're able to raise premiums every single year. The average cost of a family premium that you get through an employer is now $25,000. And that's not accounting for the out-of-pocket cost. So that's how much a policy for a family costs.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And that family can also be on the hook for $18,400 as a maximum out-of-pocket. So you can be paying... All this much in premiums and all this much in out-of-pockets also. So the way it is structured now almost guarantees that the cost of health care will go up. Drug companies, hospitals, physician practices, they're going to raise their prices because they know they can.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
These companies, the insurance companies, don't have as much of an incentive as they would like us to believe to control those costs. What they do control... or trying to, the lever that they often say that there are two ways to control prices. One is to do something about the unit cost of goods and services, how much a drug costs, or to limit access to that drug or treatment.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Geez, I'm not surprised.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And that's where they're really good at. And they have said it's our fault that we we want to use too much health care. So we need to have more skin in the game. That was a phrase that, sadly, I helped get out there to get people to believe that people need to pay more in deductibles because we were using, I said back then, too much health care. It's nonsense. People don't.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
necessarily love to go to the doctor. There may be some hypochondriacs, but they're few and far between. People who love to go to the doctor, love to go to the hospital.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
That's very important. It's where you start. Again, don't take no for an answer. If you get a bill from a hospital, call the hospital and call your insurance company and say, this can't be right. How can this be the bill that I'm being charged? Because often sometimes there is just an error or a clerical mistake or the insurance company hasn't filed a claim yet.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And so you're getting a bill from a hospital. Just don't pay that first bill. Start inquiring and appeal a denial. If you are told that the insurance company that you have is going to be refusing to pay for something your doctor says you need, fight that. Know what your appeal rights are. Ask your doctor to help you because the doctor has an incentive to join you in this.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Doctors, unfortunately, are having to spend more and more time every day fighting insurance companies to get approvals and to get paid appropriately. But you need to enlist them as well, too.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, they don't tell you that in medical school, but that's the reality of their lives. And a lot of them are getting burned out. They're retiring early. They're using this term moral injury to describe what it's like in many cases to be a doctor in America. It's crazy.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, I know. That is a growing thing that you described. They used to be called concierge medicine. I guess a more appropriate term from their perspective is direct access or something like that. And you can have quicker access to a physician. In mental health, this has been happening for quite a long time.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
A lot of psychiatrists and therapists don't accept insurance because they don't get paid enough. They haven't historically, and it's just too much hassle to deal with them. So in the mental health space, probably a majority of clinicians are out of network. But you're seeing that increasingly in medical care as well, too.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And even in primary care, there's a growing movement of direct primary care, direct access to primary care. If every American had access to primary care, we'd be a lot healthier country. But people, they don't have it. And in many cases, they're stuck in these high deductible plans and don't go even when they get sick. And that can lead to complications down the road.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We can go on forever about how the incentives are just so perverse in this country. But what you described is a growing thing and more appealing to physician practices.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I would dismantle these big corporations that I work for. They're far bigger now than they were when I was in the industry. They've embarked on something called vertical integration. Insurance companies are not just insurance companies. Now they increasingly own physician practices and clinics. You might not even know that the doctor that you're going to is employed by United Health Group.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
These companies need to be broken up. And that is one thing that there's growing bipartisan support for in Congress is to look at the makeup of these companies. United Health Group is the largest. It's a $400 billion company. It's the fourth largest company in America now. It's grown so much in recent years through acquisitions.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Increasingly in recent years, buying up physician practices all over the country, getting deeper and deeper into healthcare. home health care into hospice care and pharmacy benefits. People get annoyed at drug companies for the cost of medications, but increasingly insurance companies are taking a bigger chunk out of the pharmacy supply chain than the drug makers are getting.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
In other words, insurance companies now are taking a bigger chunk than what the drug makers are making because they have this thing called a pharmacy benefit manager that's a huge middleman that they own. And three big insurance companies, including Cigna, where I work, control 80% of the prescription market. It's an incredible scam.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And that's another reason why I spend so much time in Washington is to educate the lawmakers. This is what's going on, guys. You need to do something. You need to pay attention. Break these guys up. So that would be one thing that I would say right off the bat that we need to do is break up these big, giant conglomerates.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Go to the bathroom and walk out the back door. Every now and then I do. And they all know me, I'll tell you. They know who I am. If I don't know them, they sure know who I am.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
No, it makes no sense. We have a system in place that a lot of Americans just think that it is the way things must be and the way the rest of the world must operate. But it's entirely different. And we're unique in the world in that we did not have any plan to... create a healthcare system that's logical and fair and has some mechanisms to control cost.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I hope they'll listen to this and I hope it'll be something that triggers something with them like happened to me that you want to leave this life. feeling that you made a right decision somewhere along the line, that you weren't just in it to make money to get the latest new car or the next vacation house. Something is more important than that. And having a career that is honorable and
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
focused in ways that is not just enriching yourself and in particular in this business in which you are playing an active role in making it difficult for people to get the care that they need there's something wrong with that and i hope people who are involved certainly in high levels will have their come to jesus moment like i did too
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Folks at the lower levels of these companies are so far removed from an understanding of how the companies operate that they just don't have that kind of visibility or awareness. But I can assure you, the executives damn well do know what's going on.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
If I didn't think that, I wouldn't keep doing what I'm doing. I just think it's worth the fight. I can't tell you what the odds are. I just don't think that what we're currently doing... can last forever. And I think that we're seeing from this murder, just this understanding of this wrath, this rage is just right below the surface. People hate this.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And if they can figure out how to, and I think it's partly on me and some other advocates to help organize that, make sure that those voices continue to be heard. but also do what I do as well, speaking out, meeting with lawmakers, educating them, because I can assure you the companies will spend a lot of your premium dollars on campaign contributions and lobbying.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
But I do think there is hope, and I think it's worthwhile to stay in the game here.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
That's the thing. What I really want policymakers to understand, because you've got these perverse incentives, when you have a system that increasingly is controlled by shareholders, it is not going to work. I'm a capitalist, but they just need to understand it does not work in health care like it does in other sectors of the economy. And that has to change.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Even as recently as the 90s, most insurance companies were still on a nonprofit basis. I'd be happy if we could turn the clock back or have these companies spin off their insurance operations into nonprofits. Like it was prevalent for decades. That's how they started. The Blue Cross plans every single one of them a nonprofit. Many of them still are.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
A lot of them have converted to for-profit status. Anthem Blue Cross is part of a big, gigantic corporation. But we were doing a lot better when health insurance was operated on a nonprofit basis. We really went down the wrong road when we allowed these companies to go to for-profit status. And now we're seeing the consequences of that. So I would like to see that being addressed.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And again, it hasn't been all that many years ago in which we had a very different environment.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Instead, we just let this system kind of develop without any oversight from the federal government or even from state governments for that matter. It's very much of a patchwork and inefficient. I don't think anyone could possibly design a system that would be any more inefficient than ours.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
My pleasure, Jordan. Thank you so much. Hell of a good interview. I really appreciate it. And thanks for having me on.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I even said that I was undercover for 20 years. I was a reporter my first career. I was a newspaper reporter. And in Washington, I mean, I'm talking to you from Washington today. I still spend a lot of time here. And I was an investigative reporter and was lured into this kind of work because it pays more.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, it was a very good job, a senior-level corporate job. I thought for a long time that I'd pretty much arrived. It was at the top of the game of my profession, one of the country's biggest corporations. When I first started working in the industry, I was a real believer that these companies could really help manage people's care efficiently and fairly.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And then what I saw toward the end of my career in particular, because of this visibility we talked about, that's not what motivates these companies at all. It is not making sure that you have the care that you need and can afford. It is what Wall Street expects. Because our healthcare system increasingly is controlled by Wall Street, by big shareholders.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
The big shareholders, they're almost always institutional investors that invest millions, if not billions of dollars. And a handful of Wall Street financial analysts who work for big banks, they're the ones who really run the show. And almost no one knows that. I wouldn't have known it either had I not been given the responsibility of handling financial communications.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
I was the guy who was on the phone. The Wall Street Journal or Bloomberg or the New York Times had a question about the company's financial performance. So I had to know how the company made money, where the money came from and what it did with it. And most of the calls were how shareholders fared. I answered calls in particular from reporters when the company would announce quarterly earnings.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So I pretty much knew going into a call whether investors are going to be happy or not happy with their performance over the past three months. That's what the C-suite pays attention to. Far more important to them. What is more important is what Wall Street, what investors are going to think about your financial performance, about how much money you made over the past three months.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, that's exactly right. This is not a typical industry. And I'm with you. And almost anything else, I don't have that kind of a problem with capitalism, what Wall Street's interest is in this. But it's very different when you're talking about someone's health. Yeah.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And your point is also correct in that if your first goal is to make sure that you're paying attention to shareholder return and that is your top stakeholder, that means you're going to be doing things that in many cases makes it more difficult for people to get the care that they need. And we're seeing that especially now.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
These days, Wall Street, frankly, over the past year or so, has not been as enamored with these companies as they had been. And so these companies were having to ratchet up some of the things that they do that make it more difficult for us to get the care that we need. There are things that they do that falls into the category of what they refer to as prior authorization.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
They make your doctors get permission in advance before treating you. They will often kick some doctors and hospitals out of their networks. And if you go out of network, you'll have to pay a lot out of pocket. Out of pocket cost is another thing. We're paying more and more for premiums every year.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
but also having to pay even more and more out of our own pockets, in many cases, thousands of dollars before our coverage will kick in. All of this is just to make sure there is plenty of money left over to make investors happy.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
They do. And sometimes I wonder why I did it as long as I did and why other people who are in those roles and who have people who have my job now at these companies, why they stay there. What you do is compartmentalize it as long as you can.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
You can say that I'm making a lot of money. I have a family. I got a mortgage, got car payments, got kids in school. So I'm earning money, helping my family have a good lifestyle. That's one way of looking at it. And you can certainly become aware of things that you question and think this is not ethically the way I think things should be done.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Or one of the things that my staff and I did, we handle what we referred to as high profile stories or horror stories. We call them internally stories. And we were the front line for the company when a reporter would call the company because somebody was complaining about not getting approval for something or not getting a claim paid. We were the entry for the reporters into the company.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
One of the main things that we did was day in and day out handle these kinds of calls. And eventually you get numb to that. It becomes routine. But every now and then one will hit you that wakes you up. And that happened to me. And I think had it not, I probably might've stayed on until retirement, but I had a wake-up call or two. I really did.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
We repurposed that front group, Healthcare America, to try to get Americans to believe that what was being proposed would not be in their best interest. It was paid for exclusively by big insurance companies.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
They have set themselves up, and we as Americans have gone along with this as being the way it has to be. Insurance companies have established themselves as the ultimate decider as to whether or not you'll get a procedure, a treatment, even a medication, because they are the ones who presumably can make a determination as to whether or not something is medically necessary for you.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
So they have inserted themselves squarely between you and your doctor. This was not always the case. It certainly was not the case at all when I was younger. But it has become the norm, the routine. And most people have grown up with this system thinking this is the way it needs to be. But you have...
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
In many cases, an insurance company employee could be thousands and usually is thousands of miles away from where you are and where your doctor is making a call as to whether or not you're going to be eligible for coverage for something that could save your life. whether we're talking about a cancer treatment or a transplant or something like that.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
It's usually the big ticket items, but not necessarily. Sometimes they'll nickel and dime you to death because these companies have millions of people enrolled in their health plan. So every nickel, all that adds up. But it's mainly when someone gets sick. Most of us in a given year, thank goodness, are relatively healthy. We don't test the limits. of our healthcare plan.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
And don't go on vacation, go to Hawaii and have something happen to you. Things do happen to you ultimately, but they get away with what they get away with because in a given year, most of us think we're going to be just fine. If I get sick, if I get injured, I've got good health insurance, no problem. until they do get sick or injured and find out they do, in many cases, have a very big problem.
The Jordan Harbinger Show
1151: Wendell Potter | Killing Health Care and Deceiving Americans
Yeah, there were actually a couple of things that happened within a few months of each other. I grew up in Tennessee and I went back to visit family in the summer. It was in July. And I picked up my hometown newspaper where I had actually worked as a young reporter, as an intern.