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From Health Insurance Spin Doctor to Truth Teller

“I was getting people to make decisions based on misleading information that could have life or death consequences.”

That’s Wendell Potter, the former head of public relations for CIGNA. As the executive spin doctor for one of the biggest health insurance companies in the country, he was responsible for concocting tales that enabled CIGNA to deny coverage, discredit critics, and otherwise cast the corporate health insurance machine in a positive light. That was until the numbers in his spreadsheets became actual people with real lives.

What happens when a health insurance PR executive confronts the consequences of his spin? Dive into one man’s odyssey from health insurance spin doctor to activist truth teller.

Featuring:

  • Wendell Potter, Former head of public relations for CIGNA
  • Stephanie Lepp, Host and producer of Reckonings

Music:

Kathryn Styer: This is Making Contact. I’m your guest host this week. Kathryn Styer.

A long time ago, before words were written, human beings sat and told each other stories.

And if we paid attention, they helped us avoid their mistakes. As the written word made its way onto the scene, oral tradition lost the top spot as the method of communication, but storytelling stuck around. Somewhere along the way, we humans learned the negative power of story — spinning story in a new, almost unrecognizable form.

You know, a lie is a story, too.

Today we hear from Stephanie Lepp, producer of the podcast Reckonings. She talks to Wendell Potter, a master storyteller who used his power to serve as employer Cigna Health Insurance, until his personal reckoning with the effects of his profitable spin.

Stephanie Lepp: Today, we are reckoning with the dark side of our corporate health insurance machine and the deceptive tales we tell to maintain it. For-profit health insurance companies make money when patients don’t use their insurance, and spend money when patients do. So there’s kind of an unignorable conflict of interest in their business model because they make money by denying the service that they provide, which is why most insurance providers in other industrialized countries are nonprofit.

Wendell Potter grew up in rural eastern Tennessee.

Wendell Potter: I never did anything that was illegal. But we’re talking about things that are misleading.

You’re getting people to make decisions based on misleading information that can have life or death consequences. So it’s wrong.

Stephanie Lepp: And that misleading information he was giving people that could have life or death consequences.

Wendell was serving that as the head of PR for Cigna. In other words, as the executive spin doctor for one of the biggest health insurance companies in the country.

Cigna has a few tricks up its sleeve for denying its customers the insurance they pay for.

One of them is called rescission.

Wendell Potter: What happens is the insurance company, when they’re faced with having to pay high medical bills, they often go back and look at the application that the person filled out at the time of getting the policy — Looking for any reason to cancel it so that they could avoid paying for the needed care. And by doing that, the companies avoided paying for many millions of dollars, hundreds of millions of dollars in care that people really needed –and that in many cases would have meant the difference between life and death.

Another trick Cigna has up its sleeve for denying coverage, which Wendell was responsible for, is spin. It was with this trick in mind that Wendell went to the premiere of the Michael Moore documentary Sicko, which examines America’s health care crisis and takes critical aim at our health insurance companies. He was there to take notes on what the movie had to say about CIGNA so he could formulate a counterattack. But sitting in that theater in the dark, Wendell found himself really for the first time hearing the stories of patients he ostensibly served.

Wendell Potter: One in particular involved a young girl who needed cochlear transplants to help her hear. She couldn’t hear.

But Cigna had denied a procedure that would have given her hearing, and you could just sense the anguish that that was going on in that father as he was trying to get Cigna to agree to cover a procedure that was commonly done.

It was just a… I felt terrible and I realized that while this this really is what a lot of people face and I know I can handle high profile cases in the past and not had the ability to see the person or actually talk to the patient — but seeing this film was different because I actually saw the people and heard them.

They weren’t just names and numbers. They became real flesh and blood.

Stephanie Lepp: Still, Wendell went on to develop and execute a PR campaign to discredit the film. The idea was to scare Americans from a quote unquote, government takeover of our health care system. And it was this kind of fear mongering that resulted in the nonsensical slogan, “keep your government hands off my Medicare.” Given how moved he was by the film, Wendell was not particularly thrilled about embarking on a sicko discrediting crusade.

Wendell Potter: I was conflicted about it. I agreed to do it, but I was not happy with myself for just going along and doing it.

Stephanie Lepp: A couple of weeks after watching Sicko, when he was visiting family back home in Tennessee. He saw an ad in the local paper for a health care plan by an organization called Remote Area Medical, providing free medical services to people without access to basic health care. He was still feeling torn about the work he was doing to discredit the film. So he took the bold move for a health insurance executive and decided to go to the fair.

Wendell Potter: It was just an entirely different world.

It was as if I had walked out of my reality into a war torn country or what I could have imagined would been in a refugee camp. There were hundreds and hundreds of people who were standing in many different long, long lines to get care.

And some of those lines led to barns and animal stalls.

Stephanie Lepp: Remote Area Medical organizes pop up health fairs in remote areas around the country, in the world. An army of volunteer doctors and nurses and dentists set up camp for a couple days to treat people without access to basic health care for free.

Those people, thousands of them for each fair, travel sometimes for hundreds of miles and wait in line, sometimes for days to get the most basic medical procedures in the likes of barns and animal stalls.

Wendell Potter: I just assumed that everybody there was uninsured. And I remember one man telling me that he was in a plan with these high deductibles, or he just couldn’t afford to get the care that he needed because he would have to pay so much out of pocket.

That’s why he was there.

But when I heard that from this man standing in line, waiting to get care, frankly, in an animal stall, that just really stunned me.

Stephanie Lepp: A deductible is the amount of money you have to pay out of pocket before your insurance kicks in.

So a high deductible plan means you have to pay more before your insurance covers you.

But many of the patients in these plans, like the man Wendell was talking to, can’t actually afford their deductibles, so their insurance doesn’t kick in and they don’t get care.

[MUSIC]

Had everyone attending the Remote Area Medical health fair been uninsured like Wendell assumed the scene would have been bad, but not such a burden on his conscience. Those people without insurance are not Cigna patients.

But as it turns out, 40 percent of people who attend remote area medical fairs do have insurance, and it’s due to the shenanigans insurance companies pull, that their insurance doesn’t get them the care they need. In fact, Wendell had led PR campaigns to get Cigna patients into precisely those kinds of high deductible plans. And being near where he grew up, it all felt especially personal.

Wendell Potter: Looking in the eyes of those people, looking at their faces… People I grew up with could have been in those lines. I could have been one of those people in those lines. These were my people. And then realizing that,

Oh, my God. What is going on here?

What I was doing was making it necessary in one way or another for people to get care that way.

[MUSIC]

Kathryn Styer: You’re listening to Wendell Potter, the former head of public relations at Cigna Health Care, in conversation with Stephanie LEP of The Reckoning podcast at Reckonings-Dot-show. You’ll hear more in a minute on Making Contact. To listen to past shows or subscribe to our podcast. Visit us at radio project O R G. And of course, tell us what you think on social media.

So what happens when a public relations executive confronts the consequences of spin?

Wendell Potter was about to have his third and most potent reckoning with the effects his work was having on people.

In 2007, Cigna Healthcare Insurance got itself into the public spotlight and needed Wendell to smooth out their image, but it turned out to be too much for Wendell’s conscience.

Stephanie Lepp: The case of a girl named Nataline in Sarkisyan. Nataline was a teenager, Armenian American, living in L.A.. Loved fashion and had recurrent leukemia. She needed a liver transplant. But Cigna was refusing to cover it despite the advice of her doctors. This was a life or death situation, and Nataline’s story was starting to generate bad publicity, which is why it came across Wendell’s desk.

Wendell Potter: At first I was kind of ambivalent about the case. In my job I had handled a lot of high profile cases. It just was one of many cases that had come to my attention. And I thought, well, there would be some way that this will be resolved and it will be off my plate sooner rather than later. When that didn’t happen and I became more aware of the actual circumstances involved in this case, I became increasingly troubled about the way the case is being handled internally at Cigna.

Stephanie Lepp: Basically, Nadeline’s doctors had been urging Cigna to cover the transplant, but Cigna had stalled to the point where Nataline’s condition had worsened so much that the transplant could be deemed too experimental to cover under her plan. In other words, Cigna had dragged its feet to the point where it could justify not covering a life saving procedure, for a teenage girl who happened to be almost the same age as a Wendell’s own daughter.

Wendell Potter: I came to realize that we’re talking about a young 17 year old girl, and I could just imagine what it was the family must’ve been going through.

I let myself go there to imagine what this family was trying to do to save their daughter’s life.

But I was expected to be the spokesperson for the company, and I was becoming conflicted. I found myself being more engaged than I had been in any other case it ever came before me.

Stephanie Lepp: The case became a national media sensation.

And in response, Cigna finally agreed to cover Nataline Sarkisyan’s liver transplant, but it was too late. Just hours after Cigna announced its decision, which Wendell himself communicated to the media, Nataline died.

Wendell was at Cigna when he found out.

Wendell Potter: I was in my office and I do recall just closing the door and wanting to be alone. It was a very emotional thing for me. I really had thought, just hours before that she would live.

I was not responsible I don’t think for Nataline’s death, but I was a player in the drama of Nataline’s story.

Pretty soon I was starting to get phone calls, so it wasn’t something that I could I couldn’t just hide. I had I had to get back into the mode of being PR guy.

Many, if not most of us, maybe all of us, have this feeling that. Well, I’m here for a reason and I don’t think this is it. I don’t like what I’m doing. It’s it. So what is it? I don’t know. But something was tugging at me. Something was bothering me that I need to be doing something that is not just for my benefit. I need to be doing something that is better than this. I’m better than this. I’ve got it figured this out. What is it?

[MUSIC]

It was very unsettling. I was in my mid 50s. I didn’t have another job lined up. Why do I do with this feeling, with this crisis of conscience? How do I act on it? Can I or should I just live with it? Compartmentalize it and just keep going on? I’m 10 years away from retirement so I can just hang in there. And for you know it, I’ll be out of here. But then I realized, my gosh, that’s just waiting to die. I mean, that’s not even living.

When I got that news that Nataline had died, it just took something out of me. I just, I didn’t have it in me to handle a high profile case. I did that on many occasions during my career.

And I just didn’t want to do it again.

Pretty soon after that, I turned in my resignation.

Stephanie Lepp: Soon after resigning from Cigna, Wendell saw an interview with Tennessee Congressman Zach Wamp on TV. Obama had just kicked off a national health care reform and Wamp was being asked what he thought about it:

News Reporter: Congressman, thank you so much for joining us. From what you’ve heard so far about some of the ideas coming from this new administration regarding health care. Are you in support of it?

Congressman Zach Wamp: Well, it’s probably the next major step towards socialism. I hate to say so…

Wendell Potter: The congressman from my home state started using language that I recognized, that my colleagues and I had written that we wanted to make sure it got into the hands of people like him.

Congressman Zach Wamp: So the warning signs ought to go up everywhere. Here we go from a trillion dollar bailout to a trillion dollar stimulus, to a trillion dollar healthcare, a trillion dollar cap and trade proposal. This literally is a fast march towards socialism, where the government is bigger than the private sector in our country and health care is the next major step.

Wendell Potter: for example, he was asked about: don’t you think that with 50 million people uninsured, that’s a big problem?

New reporter in background: — 46 million Americans are without health care that one point five will lose…

Wendell Potter: And he said, “well, you know, the reality is that half of those people are that way by choice and they just decide to go naked.”

Congressman Zach Wamp: Listen, the 45 million people that don’t have health insurance, about half of them choose not to have health insurance.

Wendell Potter: He pronounced it Neked as I remember

Congressman Zach Wamp: Half of them choose to watch called go naked and just take a risk of getting sick. They end up in the emergency room costing you.

Wendell Potter: That was a word that we’ve used many times that we’d wanted to get people to say so. I knew when he said that, that a lobbyist had had slipped him the talking point that the strategy that I’ve had a part of in creating was being implemented.

And Zach Wamp was a pawn in that strategy. And the whole purpose of that strategy was to derail reform. And I was just watching it on the TV in the kitchen.

And I said, all right, I can’t I can’t stay on the sidelines any longer. That’s it. I’m going to make a phone call. And I did that very day, started calling people who I thought might help connect me to people involved in health care reform advocacy, to offer any help that I might be able to offer them.

Stephanie Lepp: Wendell was going public.

He had decided to testify before Congress on the intimate details of our health insurance industry’s deceptive practices.

Wendell Potter: It was, I think, probably the scariest day of my life. I remember they they asked me to come into kind of an ante room, an office off of the hearing room, and I sat there breathing and collecting my thoughts. I knew before ever saying a word that once I gave my testimony, my life was going to be changing because I knew from the work that I’d done to discredit Michael Moore that the industry had no reservations about coming after someone’s character and trying to destroy them if necessary.

While I was giving the testimony, I felt a kind of freedom that well, I am able to say things truthfully about the way things really are and speak truth without any kind of a need to filter them. It was it was freeing.

For so many years, I had been a spokesman for an industry, and I realized that this is what I am supposed to be doing and says I’m supposed to be a truth teller.

I know I’m no saint for doing what I’m doing. I played a role over the years in people not getting the care that they needed. For the rest of my life I’ll be doing something to make amends for the wrongs that I’ve caused.

Stephanie Lepp: And he decided he wanted to make amends with Nataline Sarkisyan’s parents. Two years after her death, NBC arranged for Wendell to visit them in their home.

Wendell Potter: I knew that it would be a difficult meeting. And I walked in the door and it was… It was…

I can’t say I was warmly embraced, I was it.

I think it was it was a distance between us.

And Mrs. Sarkisyan did most of the talking. She wanted me to know about Nataline and she wanted me to understand what the world lost. And she took me into Nataline’s bedroom to see where she … You know, ss her things. It was, as you know, just as it was when she left for the hospital.

You know, that was hard to see.

I did a lot of listening. And I. I wanted to just say I’m sorry I didn’t have anything else to say.

[MUSIC]

And just in the course of conversation, we became human beings trying to connect with each other. And things began to change.

Stephanie Lepp: Indeed, things changed. That meeting ended in the beginning of a friendship between Wendell and the Sarkisyans and the beginning of a collaboration on health care reform advocacy.

Insurance companies spend hundreds of thousands of dollars per year on PR and lobbying campaigns like the ones Wendell waged at Cigna. So perversely, a chunk of the money Americans spend on health insurance goes towards preventing us from being able to use that health insurance, which has very real consequences. It’s been estimated that the lack of affordable, quality health care coverage contributes to the deaths of almost fifty thousand Americans per year, or one hundred and fifty Americans every day.

So while Wendell was at Cigna, how did he justify his work? How did he justify misleading people in ways that could have life or death consequences? Part of it was pack mentality.

Wendell Potter: Everybody else was doing it, people that I liked, I felt were moral people. They were engaged in this kind of work.

So you tend to think, well, I guess it’s OK if others are doing it. What’s what’s the wrong? What’s wrong with this?

Stephanie Lepp: Part of it was wanting to win.

Wendell Potter: You want to be recognized for good work. You want to be recognized for being a team player. You want your team to win in the marketplace. So it becomes kind of us in a way kind of a sport.

Stephanie Lepp: Part of it was numbing himself.

Wendell Potter: I had misgivings about what I was doing. There’s no doubt about it. But as long as I was drinking and self medicating, I would just go along with it.

Stephanie Lepp: But the biggest part of how Wendell justified his work was the simple fact of being shielded from the people whose lives his spin doctoring affected.

Wendell Potter: I sometimes describe what the life is like as a top executive and how you’re able to keep such a distance from the consequences of your own decisions and how those decisions affect other people’s lives.

What I was doing, something wasn’t unique. It happens in corporate America day in and day out.

Stephanie Lepp: If what Wendell was doing and how he was feeling about it are not unique — how many other people in Wendell’s shoes are just going along with the pack mentality and the very human desire to win.

How many are numbing themselves to cope with work they’re not proud of. How many would care deeply about the way their decisions affect people’s lives, if only confronted with the consequences. What is the opportunity for transformation among the power players of our corporate health insurance machine?

Wendell Potter: There is individual responsibility there. It does lie with those executives who make sure that they never let themselves show up in a clinic like Remote Area Medical.

They make certain that they are not really exposed to the consequences of their actions. So I don’t consider them evil people, but I do think they they do have that responsibility. They just don’t take it.

Stephanie Lepp: What if we all did the equivalent of Wendell going to the remote area medical fair and took it upon ourselves to bear witness to the people whose lives we impact? What if fast food executives spent one day every year working as line cooks or prosecutors, spent a day each year in prison? The obvious question is how to ever get us to do that. But the exciting implication is that if Wendell’s odyssey is any indication of what’s possible, simply bearing witness to how we affect other people might be a win win for everybody.

Wendell Potter: Staying put and just going along is the easy way to go.

[00:27:10] Listen to your conscience and listen to your heart and allow yourself to see how the rest of the world is living.

Stephanie Lepp: Wendell Potter is a former health insurance executive turned industry whistleblower and health care reform advocate.

Today, his advocacy points at the root of our corporate health insurance machine. Tackling the influence of corporate interests on health care and on all other aspects of our democracy.

In his shift from spin doctor to truth teller, Wendell is returning to his roots as a reporter with the launch of Tarbell, an independent news organization exposing juicy stories of corporate influence, which means he’s actually going back to being a truth teller.

Gratitude goes to Patrick Cannon for connecting me to Wendell, to Vika Aronson, Phil Groman, Allie Wollner and Helena de Groot for their editorial guidance and to the Gemanicos Foundation for so thankfully supporting the Reckonings show.

Kathryn Styer: And thanks to you, Stephanie, for bringing the story to light.

You’ve been listening to Wendell Potter in conversation with Stephanie Lepp, producer of the Reckonings podcast. You can listen to more episodes of Reckonings at Reckoning.-Dot- Show.

Please share your thoughts on this Making Contact episode at https://www.radioproject.org/ or via social media. We want to hear from you. I’m your host this week. Kathryn Styer, thanks for listening to Making Contact.


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