Tuesday, December 11, 2012

Deadly Spin by Wendell Potter

*** This is a book that I read and wrote a report on just a little over a year ago in my Insurance class. Much of my learning for that class did not take place inside the classroom but rather outside of it when I read this book and researched articles in my spare time. The situations and stories you will read about just barely scratch the surface when it comes to the major problems the U.S. healthcare system faces today. I don't kow everything there is to know about the issues but I know much more now than I did two or three years ago. If you like what you read in this summary, I would encourage you to find this book and read it all the way through - you won't regret it. I have certainly changed a lot from when I first read this book, finished college (officially a year ago on December 10th) and began my search for a professional job. It's been quite a ride so far and I can't wait for what's just around the corner - a new year! ***

Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans
            Deadly Spin is a book that strives to take an inside view on the insurance industry and how Americans’ health care premiums are subject to unrelenting propaganda and lobbying efforts focused on protecting one thing: profits. For twenty years Wendell Potter worked as a senior executive at insurance companies and witnessed how they confused their customers and did away with the sick all for the purpose of satisfying their Wall Street investors. His change in perspective can be explained by four major events in his life: first, his college background and career; second, his corporate job with CIGNA and the movie Sicko, third, a trip back to his hometown in Tennessee; and lastly, the premature death of a seventeen-year-old girl in California.
            Potter grew up near the Blue Ridge Mountains of Mountain City, Tennessee. However, he was born on the other side of the mountains in North Carolina because there was no hospital in the entire county at the time in 1951. Neither his mother nor his father was able to finish high school, having to work instead. His dad spent most of his days working in a factory but before the birth of his son, built and operated a small country store called Potter’s Grocery and even built their house right next door to it. Both of his parents wanted their son to have an easier life than they had had and they knew it could be possible through a good education. They sacrificed years and years to save enough money for Potter to attend college. He became the first person in his family to earn a college degree when he graduated from the University of Tennessee in 1973. A major influence in his life was his adviser, Sammie Puett. She was one of the strictest advisers in the Communication Department, but Potter is very grateful for her and how she pushed him to do his very best. Although he was a Communication major, he also aided in the future development of a public relations program at UT and managed to take every PR class the university taught, especially those taught by Puett.
            After graduating from UT, Potter accepted a job at his previous internship, the Memphis Press-Scimitar, choosing to pursue journalism instead of public relations. After a few months on the job he discovered articles on corruption in the auto-inspection department and reported on that for the newspaper. In 1978 a college friend introduced him to a Jake Butcher, a wealthy Knoxville banker who was running for governor of Tennessee. When he was asked to be Butcher’s press secretary, he saw that as a ticket back home. Butcher won the Democratic primaries but eventually lost in the general election. Potter continued to work for him, but in one of his banks as a lobbyist for the World’s Fair group. After securing financial backing and a congressional authorization for the fair, he was able to travel around the world recruiting countries to participate in it. The event itself took place in 1982 and Potter had fun writing speeches and press releases for Butcher. Once the fair was over, Potter still continued to work for Butcher but in the PR department of his flagship bank in Knoxville. However, four months later Butcher’s entire banking enterprise collapsed and he went to jail for bank fraud charges.
After a couple years at Baptist, he was offered to make a lot more money with a corporate job at Humana in Louisville, KY. His success and experience at Humana eventually led him to his former company, CIGNA: an anagram of Insurance Company of North America (INA) and Connecticut General (CG) respectively.
Although CIGNA was bigger than Humana, it was still primarily known as a property and casualty company. Potter was hired on to raise awareness of CIGNA’s health care business. It was becoming a big time player in managed care, which in order to make money had to keep people out of the hospitals. Potter helped boost CIGNA’s image by arranging an interview with a reporter from Modern Healthcare to do a feature story on the company. Because of hours and hours of preparing the executives whom she would interview and making sure she only interviewed those on an approved list, CIGNA received a glowing multipage article which boasted about the company and its “customer-focused” approach to managed care. All throughout his various projects and campaigns for CIGNA he thought talked about both the uninsured and CIGNA’s members, but only in terms of numbers because that was all they were to him.
In May of 2007, Michael Moore’s documentary on the U.S. health care system debuted at the Cannes Film Festival. Moore had kept a tight rein on the release of the film that many insurance companies did not know whether the focus would be on pharmaceutical companies or on the insurance industry. Ever since 2004, when Moore’s documentary was merely an idea, every PR person in the industry had been trying to get information on his intentions. Potter worked to prepare managers at every CIGNA office in the event Moore would show up on their doorstep. However, AHIP (American Health Insurance Plans) had sent an agent to screen the documentary and report back to executives from around the country on a conference call which Potter attended. The agent confirmed their worst suspicions: the private health insurance companies were portrayed as the villains and CIGNA especially was in danger. Luckily, due to the rapid-response teams at CIGNA and many other companies and the extensive preparation for the interviews to follow the premiere, the documentary did not reach as high of box office grosses as did Moore’s Fahrenheit 9/11. The media campaign at CIGNA costs hundreds of thousands of dollars all of which came from the premiums paid by health-plan members—which the executives believed to be an appropriate use of those dollars.
About a month after the Sicko campaign, Potter took a few days off to visit his parents in Tennessee. He learned from the local media that Jonathan Edwards was coming to Wise County Virginia to address health care concerns at the same time the Wise County health fair. Edwards was one of the CEO’s least favorite presidential candidates at the time because he seemed to be intent on becoming an insurance company basher. Potter felt it was his duty to check out the fair because one of his responsibilities at CIGNA was to keep the CEO and top executives up to speed on what the candidates were saying about health care reform.
Potter learned firsthand in Wise County, Virginia that what he knew was not the real story. The corporation Remote Area Medical (RAM), which Potter had only learned of through the local media in TN, put on an expedition in Wise County to offer free health care screenings and basic procedures for those who do not have insurance and access to safe, affordable health care. The website advertises that people who wish to attend should plan to come early, bring food and expect to wait in long lines. It wasn’t the average health fair that Potter had been to before. Everything from pulling teeth to mammograms to cutting off patches of skin cancer was being conducted by hundreds of volunteer doctors and nurses. Even though the expedition lasted three days, hundreds of people are turned away each year because the medical needs of the people fair outweigh what the volunteers can provide. When RAM’s founder started the company, which primarily was to provide health care services in Third World countries, never imagined that they would be holding most of their expeditions in rural areas of the United States.
This was the second main event that started to affect Potter’s perspective on the insurance industry and his job at a large for-profit company. The third and final event that sealed the deal was the death of a young Armenian American girl in California who died primarily due to CIGNA denying her coverage for a life-saving procedure because it was “experimental,” but ultimately too expensive for the company. Nataline Sarkisyan was a young girl who was very proud of her heritage and one day dreamed of being a fashion designer. At fourteen she was diagnosed with leukemia, but after a series of chemotherapy, it was in remission. She was able to regain her life and celebrate her sixteenth birthday; however, a year later the leukemia came back. This time she would need a bone marrow transplant because the chemotherapy would not be enough. It turned out that her older brother was a perfect match and agreed to be the donor and CIGNA agreed to pay for it, as long as the procedure was done at a hospital in CIGNA’s network. The transplant went well in late November of 2007, but serious complications developed, especially in Nataline’s liver. A week after the procedure, her doctors decided that she had to have a liver transplant. Around the same day in December, not too long after CIGNA’s Investor Day (which had cost the company around $250,000), Nataline was sent to the ICU to wait for her new liver. Knowing that procedures require prior approval, her doctors contacted CIGNA’s transplant unit and asked for approval.
Her parents didn’t foresee problems with the insurance company. They were more worried about whether a liver would become available and be a match for Nataline. She was covered under a policy her father obtained through Mercedes-Benz, where he worked. CIGNA administered the health care benefits but it was Mercedes-Benz who assumed the risk. The transplant unit even requested a piece of her liver to prove it was failing yet CIGNA refused to pay for the procedure and sent a message to Nataline’s doctors are UCLA, where hundreds of transplants are performed each year, that her procedure would be “experimental.” The Sarkisyans did not know about the cost of CIGNA’s Investory Day nor did they know about their agreement with Mercedes-Benz, but Potter did. The German conglomerate would continue to be a customer under CIGNAs plans provided they keep the medical-loss ratio low. This meant denying coverage of a procedure for a teenage girl that everyone knew would save her life because it could potentially increase the MLR and lower CIGNA’s return on profit for investors. CIGNA eventually, though with much delay, approved the transplant request, in order to avoid limelight from a massive protest set to attack the company by Nataline’s mother.
When Potter pictured his daughter and wife in the same situation as Nataline’s family, his entire perspective was altered. After this incident, it became harder for him to stay focused at work and he no longer felt engaged in his responsibilities. Later on in the summer of 2008, he resigned from his position and has been an advocate for health reform ever since. This book was a part of his project to promote awareness of “spin” to the American public and what people can do to guard their minds from it. He has come to the conclusion that spin will always be around. Industries will always try to spin their words, promote one thing and then do exactly the opposite behind the scenes. It may continue to be around, but with a good knowledge of PR and spin tactics the everyday consumer can prevent minor and major tragedies such as Nataline Sarkisyan’s from happening again.

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