An Insider Switches Sides in the Health Care Wars
Wendell Potter: A Daniel Ellsberg for the health care wars?
Wendell Potter, a 20-year PR exec at CIGNA, finally found his footing in the human race one day in the hills of Virginia, near where he grew up, when he visited a temporary health care encampment set up by Remote Area Medical (RAM) to offer lifesaving care to local residents—in the animal stalls of an abandoned barn. To Potter, it was like “a M.A.S.H unit,” “a refugee camp,” and despite his front row seat at the health care table, he finally confronted starker realities than even his opposition could imagine.
The result? A fine new book, a book which some call the “if you only read one book in 2011 make it this one”—a book of startling honesty and plain speaking about how Big Heath Care won the war on health care reform. “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans,” is the kind of book that delivers its knockout punch through the accretion of fact after fact, episode after episode, from the inside, the way Wikileaks deconstructed diplomacy.
How do you win a spin war? You combine a boatload of powerful people with a vested interest, buckets of money, diligent research, and weekly “marching order” calls—in short, you get a pro game plan and stick to it. What does it feel like to be on the inside? A little bit like Mad Men if the characters of Mad Men had all gone to grad school to study polling and sociometric analysis. Spin wars begin with two components: ideology and polling data. Potter says that for politicians ideology—and he is speaking of conservative ideology here—precedes deliberation. The job of a spin doctor is to know the subject’s ideology and feed him factoids that are fundamentally consonant with his worldview.
Polling provides those factoids. Every sound bite is pre-tested for effectiveness with voters who fit a target profile. And much of the testing is supported by years of polling data. So government takeover, for example, comes from a storehouse of research that affirms it as the gold standard in effectiveness, both with legislators and their voters.
Fear is the driver—no surprise there. People, silly fools, fear government takeovers more than corporate takeovers. So, as Potter readily acknowledges that death panels exist in the persons and committees of medical directors and review panels at publicly held health insurance giants, he serves as a credible interpreter of the damage done by his previous side. Potter alleges that the death panel function within corporate insurance carriers is denial of coverage, not care, but that the two are synonymous because the cost of lifesaving care for, say, a child’s liver transplant, is beyond the means of 99.99 percent of the population.
Potter describes how industry-wide PR teams would hold weekly conference calls to disseminate the message of the week. Contract lobbyists in Washington would spoon-feed the message to their constituents (our legislators) on the Hill. And thus you heard the endless feedback loop of sound bites 24/7 coming from anti-reform legislators as if they actually thought this stuff up. Well, most of the stuff anyway. Death panels seems to have been a bit more viral, at least to Potter’s telling. Today, he sounds disgusted by the term. (I know, it’s ironic that his sensibilities can be offended in this manner at this point, but more on that in a minute.) The power of these revelations does not lie in the facts themselves—many of us guessed at all of this—but in the verisimilitude of the narrative.
Potter seems to have had a complete change of heart. This is one of the more astounding elements of the book. Potter drank the Kool-Aid long ago. He acknowledges that. And he rationalized that he was doing right by keeping score of the cases in which his advice to CIGNA—based solely on the exigencies of public image and corporate self-interest—helped to win the day for some poor, sick person who had paid for a policy, been rejected for lifesaving care, and then went to the media. (All other supplicants need not apply.)
His epiphany seems real enough. It reminded me of accounts of Bobby Kennedy visiting Appalachia and being shocked out of his privileged cocoon by the depths of poverty he found there. That this wretched—(what used to be called “grinding poverty—state of affairs now exists on the health care front, well, that should shock all of us. But I was referencing a similar health care intervention event in Long Beach just last fall. We need more of these. We need them staged in the public parking lots of abandoned shopping centers, and in horse barns if necessary. We need to reveal the presence of those whose need is so desperate that we can overcome the lies of government takeover and the best health care system in the world. And in this, today, Potter agrees.
As to Potter, I accept his change of heart. Why wouldn’t we welcome effective communication weapons in the face of a new round of onslaughts against civilized health care delivery mechanisms that we face today, specifically the coming fight to defund what they cynically call ObamaCare? (The term must have tested well.) Let Potter wrestle with his conscience—and provide us with a compelling insider’s narrative in the process.
(Wendell Potter appeared as a guest on the January 19, 2011 Midmorning show on KNOW, an Minnesota Public Radio affiliate in the Twin Cities hosted by Kerry Miller. Potter's remarks on the program provided the indirect quotes that are referenced in this post.)