'Crisis of conscience' led to exposť of health insurers

Wendell Potter
Wendell Potter

Hartford - After he switched sides in the debate over health care reform to become a searing critic of the industry in which he had worked for decades, Wendell Potter received an e-mail from another employee of CIGNA.

"He didn't think the PR operation was as I described it," said Potter, who spent years as the executive in charge of public affairs at CIGNA before resigning in 2008. "In fact, he said that, from his experience, the company never spent enough on PR to get our message out. I didn't even respond to it, because he didn't know what was going on."

That message might apply to all potential readers of Potter's new book, "Deadly Spin," in which he denounces for-profit health insurers for spreading misinformation about the state of the American health system and its costs, and for placing corporate and personal gain ahead of the interests of the needy and the sick.

Seated on a small couch on the top floor of the Legislative Office Building in Hartford hours before a scheduled book-signing in West Hartford, Potter projected the same calm presence that comes across in his new exposé, and that he projected in testimony before Congress when he broke his silence to support health care reform.

Potter had reached the far shore of a "crisis of conscience," he says, and sacrificed a high-paying position in the upper ranks of one of the nation's largest insurers in order to unburden himself, and to finally, he says, tell the truth.

In the book, Potter documents two of the events that drove him to abandon his profession.

The first is the excruciating story of the death of Nataline Sarkisyan, a teenager in Los Angeles who was covered by one of CIGNA's insurance policies, but to whom the company had decided to deny a liver transplant.

The company eventually reversed its decision, in part because of the wave of negative press attention that Potter and his staff were frantically trying to fend off, but the transplant never occurred. Nataline Sarkisyan succumbed to her illness before the surgery could be performed.

Potter also describes his shock upon attending a health fair in the summer of 2007 in Wise County, Va., a poor, rural area near where Potter himself grew up.

The insurance executive was there on reconnaissance: former U.S. Sen. John Edwards, who was planning a run for president, planned to campaign at the health fair. The fair had been arranged by Remote Area Medical, a nonprofit that provides access to doctors, nurses and dentists for people around the world with little recourse to medical care.

That category, Potter realized as he looked out over hundreds of people who had been waiting in the rain for hours, included people in the very region where his family lived, most of whom had jobs, and many of whom had nominal insurance policies that were nonetheless insufficient to get them the care they needed.

The experience was "life-changing," Potter writes.

"When I saw that, it was unavoidable to me," he said last week. "I couldn't escape knowing that the practices of our insurance companies made it necessary for those folks to stand in those long lines."

On his book tour, and especially in the self-described insurance capital of Hartford, Potter said he was calling for a "suspension of disbelief" - for all parties to put aside the question of what reforms are politically feasible, and consider simply what new system would best provide medical care to all those who are still in need.

Reception from Potter's former industry has been chilly.

CIGNA has essentially ignored him since he decided to become a public critic of the company and the insurance industry, Potter writes, and the assertion held true for this story.

The Day first asked the company to comment on Potter and his book on Monday, but heard nothing. Asked again for comment on Thursday, a CIGNA representative said that a public relations executive - someone in charge of handling what Potter once had been, a phone call from a reporter asking about the latest "horror story" - would call with a response.

No call ever came.

A spokesman for the industry trade group, America's Health Insurance Plans, sharply criticized in "Deadly Spin" for its executives' efforts to thwart health reforms that might eat into company profits, e-mailed a curt response to Potter's remarks and the book.

"The hard-working men and women in our industry go to work every day to help make coverage more affordable and improve the quality and safety of care for millions of patients, and they do not deserve to be vilified to advance a political agenda," said the spokesman, Robert Zirkelbach.

Potter says he hasn't tried to vilify insurance industry employees, and describes, even in the Sarkisyan case, a feeling of intense satisfaction among workers when they feel they have helped the sick get desperately needed care.

"You don't think of yourself as someone who's doing anything that's wrong or evil, and you think that what you're doing - and it very likely does - will have a positive impact on someone's life," Potter said. "You can get that sense of satisfaction ... but that's in the weeds.

"You're not able to see what your company is doing and what is happening in the overall system. You're not able to have that perspective until you can see it from the executive suite."

He described, again, the roles he had played, helping "to set up front groups" opposing changes in law and regulations, and defending to financial reporters his company's efforts to hold down its expenses on medical care - the proof that the company profits would stay high, and that its share price, including for those stock options paid to executives like himself, would not fall.

Such work helped to kill the health care reform push of President Bill Clinton in 1993, Potter said. He quit in the early days of Barack Obama's presidency, he said, as history began to repeat itself.

"I just really didn't want to be a part of an effort to defeat it again," Potter said.

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