Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans
By Wendell Potter
Bloomsbury Press, 2010
188 pp.; $26.00
Review by George Erickson
Wendell Potter begins his book, Deadly Spin, with a startling admission. After noting that “about 45,000 people die in America every year because they have no health Insurance,” he confesses to being “partly responsible for some of the deaths that make up that shameful statistic.” He continues:
As a senior public relations executive, or “spinmeister,” for two decades with two of the largest for-profit health insurance companies in the United States—Humana and Cigna—it was my job to enhance those firms’ reputations. …I also helped create and perpetuate myths that had no other purpose but to sustain those companies’ extraordinarily high profitability. For example, if you are among those who believe that the United States has “the best health care system in the world” despite overwhelming evidence to the contrary—it’s because my fellow spinmeisters and I succeeded brilliantly at what we were paid very well to do with your premium dollars. …And if you were persuaded that the health care reform bill President Barack Obama signed into law in March 2010 was a “government takeover of the health care system,” my former colleagues and I earned every penny of our handsome salaries.
This, in a country where those who cannot afford any healthcare now number more than 50 million.
Potter was born in Banner Elk, North Carolina—not because his parents lived there, but, ironically, because they didn't have access to affordable, quality healthcare on the other side of the Blue Ridge Mountains in Mountain City, Tennessee. Neither of his parents had finished high school but they both worked and sacrificed so that Wendell could eventually graduate with a degree in Communications from the University of Tennessee in 1973.
After graduation, Potter worked for the Memphis Press-Scimitar, and then Scripps Howard in Washington, DC. His introduction to the healthcare industry came when he signed on with the Baptist Health System of East Tennessee, which included a newfangled service called an HMO. From there it was on to Humana with a big time salary. And then, in 1993, came Cigna, one of the largest and most respected insurers in the country.
Potter thrived at Cigna, one of the companies that began to promote “drive-thru mastectomies” that required patients to be discharged on the same day as their surgeries unless their doctor could prove the need for an overnight stay. Cigna, like other insurers, had also been denying coverage to patients who had failed to report even minor, unrelated conditions via a money-saving practice called rescission. For example, on discovering that one of their clients had experienced heartburn, Blue Cross of California cancelled his policy retroactively after he had undergone surgery to clear blockages in his arteries—leaving him responsible for a $130,000 medical bill. And when a Texas nurse learned she had breast cancer, her policy was cancelled because she had previously had treatment for acne, which the dermatologist had mistakenly called pre-cancerous. The company claimed that she had misinformed them about her history, and her double mastectomy was cancelled for lack of money just three days before her operation.
After fifteen years spinning half-truths, distorting numbers, deceiving patients, promoting ads like the notoriously effective but deceptive “Harry and Louise” spot that helped torpedo President Clinton’s health plan, and setting up special interest groups with friendly sounding names that opposed healthcare reform, Potter looked back on his work and saw an industry corrupted by greed—an industry driven at every turn to deny healthcare coverage to individuals solely in order to increase profits. And then, three events combined to change the direction of Potter’s life.
The first was Michael Moore’s Sicko, the prize-winning documentary Potter and friends had worked hard to discredit by demeaning “socialized medicine,” floating rumors of “death panels” and “government takeovers,” and labeling Moore “an enemy of the American Way.” (There were even calls within the industry for Moore to be “pushed off a cliff” if Sicko became as influential as Al Gore’s An Inconvenient Truth.)
The second came during an eye-opening visit to a remote healthcare “fair” in Wise County, Tennessee, where hundreds of poor and uninsured patients stood in line, day after day, sometimes in the rain, in search of medical and dental care, with some turned away despite their long wait due to lack of equipment or exhausted personnel.
The third and most personal event culminated in December 2007, when a sixteen-year-old girl from Los Angeles named Nataline Sarkisyan, who had been diagnosed with leukemia in 1994, came to Cigna’s attention because she needed a liver transplant. Nataline had already survived chemotherapy and a bone marrow transplant, but her leukemia, which had been in remission, was slowly returning. A week after her marrow transplant, Nataline’s doctors realized that a liver transplant would be needed to save her life, so she was taken to the ICU to wait for a liver, which arrived within a few days.
Not so fast, Cigna said. They would first require a biopsy. Her parents quickly agreed, but by the time the biopsy had been completed, Nataline’s perfectly matching transplant had been given to another patient. Days later another liver arrived, and the Sarkisyans received yet another shock: Cigna had deemed the transplant “experimental” and declined to pay.
The public—led by Nataline’s friends, relatives, and the California Nurses Association—howled. The name “Cigna” was fast becoming a four-letter word, but the company held firm until Larry Rand, their top-drawer PR man backed up Wendell Potter when he bluntly told Cigna, “You have to make this go away. Approve the transplant—now!”
The news arrived in Los Angeles just as a public demonstration was about to begin, so the angry threats of “Cigna will pay! Cigna will pay!” suddenly took on a celebratory tone as the crowd continued to chant, “Cigna will pay! Cigna will pay!”
The Sarkisyans rushed back to the hospital, where they were ushered aside and quietly told that Nataline had, within the hour, quietly died.
When Potter learned of Nataline’s death, he realized that his work had just begun—because his first priority was to “protect, defend and enhance” Cigna’s reputation. But his heart wasn’t in it. Disheartened, he quit drinking and, before long, sought out a colleague who had left Cigna for a lower paying job at a clinic that provided free healthcare to the poor. When he expressed his concerns about leaving Cigna and finding a new way to make a living, she bluntly told him, “You’re just going to have to leap and trust that a net will appear.”
On May 2, 2008, Wendell Potter leaped—and became an outspoken critic of corporate PR and of the distortion and fear generated by our health insurance industry, which he calls a “super-rich, PR juggernaut” with a huge lobbying budget that underwrites deceptively "non-partisan" and "grassroots" organizations.
And then on June 24, 2009, a day Potter calls one of the scariest days of his life, he appeared before U.S. Senate’s Commerce, Science, and Transportation Committee. Leaning toward the microphone, he first recognized the committee chair and then began, “My name is Wendell Potter, and for twenty years I worked as a senior executive at health insurance companies, and I saw how they confuse their customers and dump the sick—all so they can satisfy their Wall Street investors.” And he told the lawmakers that if they passed a healthcare reform bill with an individual mandate but no public option, they might as well call their bill the “Health Insurance Profit Protection and Enhancement Act.”
Potter, who now works at the Centre for Media and Democracy in Wisconsin, closes Deadly Spin by warning that the energy companies are now employing the same tactics of fear, misinformation, and ridicule used in the past to oppose seat belt requirements, efforts to increase gas mileage, and legislation to curb smoking in a well financed campaign to ridicule and minimize concerns about climate change.
Healthcare remains an equally critical issue, and the courageous reckoning provided in Wendell Potter’s Deadly Spin makes it a must-read book.
George Erickson is the author of several books, including the best-seller, True North: Exploring the Great Canadian Wilderness by Bush Plane. His website is www.tundracub.com.