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General News    H2'ed 7/7/09

Health Insurance Whistleblower Wendell Potter-- Interview; Details How Insurers Screw Insureds

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Rob Kall: And so one or two people being ill, out of hundreds, could affect the insurance coverage of a whole workforce?

Wendell Potter: It could. And this points up a big problem that has developed with the way that we have our insurance structured in this - in this country. The insurers try to cherry-pick the healthiest people to cover. That's what they want, which means that people who are sick and needing it, needing coverage, are often the ones who are excluded from getting it and can't afford it or kicked out. It makes no sense in the world. But it's the way our system operates.

Rob Kall: Has there been any effort to establish anti-cherry-picking laws, so to speak?

Wendell Potter: Well, going back to something you said at the top of the show, health insurers have said and were saying back in 1993 that, "Oh, yeah, we - we agree that cherry-picking and not covering people because of preexisting conditions is wrong. But we'll change. We won't do that anymore." So that was something they promised then. They never fulfilled that. And it was never anything that they intended to make good on. And they're saying the same things now.

When you have a debate on health care reform, it's something that has some energy behind it for a while. And something will either pass or fail. And then Congress or the state legislature will move on to something else. And it usually takes years and years before the problem becomes so critical once again that there's another big effort for reform.

Rob Kall: You know, in my conversation with John Conyers, I learned that it was not really just one bill that he had, HR676, there were five bills that would have to be passed to cover all the different issues involving health care. It would seem to me that some of these horribly inappropriate policies, like the cherry-picking, or the rescission, where insurance companies go back and review application information years later after they take in all the money while the people have been healthy, seems like those are simple things that are so obvious that I cannot imagine any member of congress arguing against; why can't they just do that first? Is it that the lobbyists are so strong that they cannot even move against such unfair practices?

Wendell Potter: Yes, it is the strength of the lobbyists, and members of congress, who are so influenced by the lobbyists of special interests, just turn a blind eye to what needs to be done. They get big campaign contributions from these companies, and often the lobbyists themselves make significant contributions. A lot of the lobbyists are former members of the house or the senate, or staff members, who have developed good relationships with current members, so the insurance industry looks for people who are ideologically aligned with their political and ideological points of view; you have money, that makes a big difference, and you have people who are also being able to make persuasive arguments just because of relationships they have developed over the years.

Rob Kall: Are there certain members of congress who have reputations among the insurers as being the most helpful, the most in bed with them?

Wendell Potter: There are; I will not necessarily name names right now, but there are many; and I would not think it would be an overstatement to say that many of them are shills for the industry.

Rob Kall: Why won't you name names?

Wendell Potter: Maybe I will do that as time goes by, in my blog, because I think it is important for people to be aware and right now I am not at my desk and I don't have a list of members of congress who have received a lot of contributions; but one in particular I think that you need to be mindful of is Senator Max Baucus, who is chairman of the senate finance committee. He has received more contributions from the insurance industry and from the pharmaceutical companies, from the health industry combined, than any other member of congress.

Rob Kall: Is this a guy, Baucus, who they talk about? Behind the corporate doors, or the "non profit" doors of the Blues, do they talk about any of these guys, with a "hey, we've got him covering us" or anything like that? Have you ever heard any conversations along those lines?

Wendell Potter: Well typically yes; I mean, the health insurance industry knows which members of congress it can count on and keeps a list of those, and they know which members of congress are never going to see eye-to-eye with them, so what you typically have when you have a debate like this, they have the votes that they can almost always count on, and there are some members who have not really declared, or who might be persuaded one way or the other, so those are the ones they really go after to try to really pressure into seeing things from their point of view. That is the way things are done in Washington.

Rob Kall: So you are talking about the ones that are not completely bought yet?

Wendell Potter: That's right.

Rob Kall: So when they have these conversations, are there any words to describe them, or characterize them, that are used within the doors of the health insurance industry?

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