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Behind the Curtain: Wendell Potter on the Industry’s Management of Care and Reform

Stop what you're doing and take out a half-hour to watch this week's superb Bill Moyers' 3-part show, especially the extended interview with Wendell Potter, former CIGNA VP Corporate Communications, for a frank, insider's discussion of how major health plans have worked over the last decade.

Also be sure to watch Moyer's very brief final commentary, describing a dinner that was planned by the Washington Post to connect lobbyists with high-ranking officials working on the health care reform process. His conclusion: we won't get anywhere with health care or any other national problem until "the money-lenders are tossed out of the temple and we tear down the sign they've placed on government, the one that reads 'For Sale.'"

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HospaccxBruce ParsonsRichard SGail NowackyBrian Klepper Recent comment authors
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Hospaccx
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HOSPACCX INDIA – PLEASED TO INTRODUCE OUR COMPANY AS A BANGALORE BASED COMPANY FOCUSED ON HOSPITAL ACCESSORIES LIKE HOSPITAL CURTAINS, CUBICLE CURTAINS, HOSPITAL FURNITURE, AND IV STANDS/HANGER SUPPLIERS IN INDIA.
HOSPITAL CURTAINS SUPPLIERS

Bruce Parsons
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Bruce Parsons

There is a treatment for diabetes which is highly effective in treating all complications of diabetes with a single treatment. The treatment basically mimics in diabetic patients the insulin secretion/liver stimulation of healty patients. This technology has been used safely and effectively for more than 20 years, yet the insurance industry steadfastly refuses to reimburse for the treatment. If insurance companies provided their sickest diabetic patients with this new treatment, it would be a reason for those patients not to enter kidney dialysis and disability from work. Hence by refusing to reimburse for this outstanding new treatment, insurance companies are… Read more »

Richard S
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Richard S

The Moyers segment further crystallized for me why market-based solutions to healthcare financing and reform are simply wrong-headed. Potter made clear the irreconcilable conflict between the ‘medical loss ratio’ of for-profit insurers and the improvements in efficiency and quality that we need so desperately. Those who want to dig further into these issues should read ‘A Second Opinion’ by Arnold Relman,a former editor of the New England Journal. Relman, whose thesis is also echoed by Gawande’s New Yorker article, describes in detail how the corporatization of health care over the past 30 years is at the root of the perverse… Read more »

Gail Nowacky
Guest

Brian – great reply to Nate. I agree with your opinion on the Bill Moyer’s segment. Nate needs to come out of the closet.

Brian Klepper
Guest

Nate,
Since we’ve all been so forthcoming about what we do on a daily basis, I’d urge you to share with us the following information about you and your business interests, particularly since you’ve boasted about how strong a business you run.
Please tell us all:
1) Your full name
2) The names and locations of your 3 TPAs
3) How many total lives are covered through your employer clients’ health plans.
4) The average annual cost per employee of an enrollee in your health plans.
We’re looking forward to learning more.

The Bag of Health and Politics
Guest

The problem with the “thirst for unlimited care” is that patients can’t afford the mundane treatments they need in order to manage their chronic illnesses because insurance throws them off the rolls, knowing that they won’t be responsible for the consequences of denying modest preventative care which costs $10,000 to 30,000 per year or so. They get worse, inevitably ending up as seriously ill patients. Then the systemic desire to make up for the decision to spend the $10,000, or $30,000 in the first place leads us to spend $900,000 on extreme measures to put off the ultimate consequence of… Read more »

Brad F
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Brad F

Brian I was disappointed in the piece. Moyers continues to demonize the for profit MCOs (and they deserve it), but at the expense of distracting the public from where the real bloat is. He did not discuss our thirst for limitless care, supplier induced demand, waste, etc. This kind of journalism is no better than those who espouse the Luntz-oid sound bites from outlets on the right. Using Sicko clips and citing MLRs is not the path to enlightenment in this debate. Unfortunately, he did the same with his piece on single payer a few weeks back. I will say… Read more »

Alexander Saip
Guest

Nate, I don’t think scaling down of for-profit health insurance will destroy healthcare as long as providers will be compensated for their work. Yes, Europeans and Canadians pay higher taxes, but, apart from universal healthcare, they also enjoy much better social services and public transportation system. We, Americans, spend far more on healthcare alone without getting better results. You may want to check my blogs http://betterhc.blogspot.com/2009/05/are-we-ready-for-healthcare-to-go.html and http://betterhc.blogspot.com/2009/04/taming-healthcare-costs.html . From my point of view, healthcare is a special kind of services, which relate to our very basic needs as human beings, and sometimes, to our biological existence, to be considered… Read more »

Gregg Masters
Guest

Nate:
Doesn’t your TPA ever require your attention?
Rather than attempt to demean and minimize the on-point insights of a former CIGNA executive, who is disclosing well established truths about publically traded health plans, you opt for hollow, yet mind numbing and childish slams.
Give it a rest; and please spare us your knee jerk health insurance industry apologist diatribes.

Ronnie Jeanne Amato
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Ronnie Jeanne Amato

The AMA may support Obama on single-payer health insurance if he sees the connection between malpractice insurance and healthcare insurance. Controlling malpractice insurance is just as important as controlling healthcare insurance. Insurance companies and attorneys do not need to take so much money from us for mistakes or malice on the part of physicians. Single-payer healthcare will reduce fraud and put money back into healthcare instead of attorneys and insurance company’s hands. Also, patients do need to be compensated for iatrogenic pain and suffering, but not all in dollars, rather in care and opportunities. We have to think outside the… Read more »

Nate
Guest
Nate

Would a janitor at CIGNA HQ be called an insider? 1:52 The clown can’t even get basic lingo like deductible, co-pay, and responsibility right yet we are to believe he is an insider with an opinion worth listening to? He doesn’t even grasp how hi deductible health plans are being used in the market. 3:00 If he is troubled by the uninsured then why doesn’t he go after Congress for shifting cost from public plans to private? Why doesn’t he campaign for lower state premium tax? Why doesn’t he advocate for fewer state mandates so people can buy affordable plans?… Read more »