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‘Occupy Wall Street’ Should Also take Aim at Health Insurance Companies
iWatch News / News Analysis
Published: Monday 10 October 2011
“Over the past few years, many of the largest health insurance firms have converted from nonprofit to for-profit status and have been acquired by huge corporations whose stock is traded on the New York Stock Exchange.”
The lobbyists for U.S. health insurers surely have to be feeling a little uneasy knowing that thousands of Occupy Wall Street demonstrators who have been marching and protesting in Washington as well as New York and other cities might target them in the days ahead. After all, the headquarters of the insurers’ biggest lobbying and PR group, America’s Health Insurance Plans (AHIP), at 601 Pennsylvania Avenue, N.W., is just blocks away from Freedom Plaza, where the demonstrators have set up camp, and problems with health insurers appear to be near the top of the list of protesters’ concerns.
Health Care for America Now, an umbrella advocacy group that played a key role in the health care reform debate, last week analyzed the 546 comments that had been posted by then on “We are the 99 percent“ Tumblr site. It found that 262 of the comments mention such problems as getting denials for doctor-ordered care from their insurance companies and having to forego treatment because of hefty out-of-pocket costs.
In my book, Deadly Spin, I wrote about how the “Wall Street takeover” of the American health care system has created many of the problems mentioned in the Tumblr site. I also described how AHIP offices have often been command central for developing and implementing coordinated efforts to derail health care reform efforts in the past and how the organization helped shape major provisions of the Affordable Care Act, which Congress passed last year.
Over the past few years, many of the largest health insurance firms have converted from nonprofit to for-profit status and have been acquired by huge corporations whose stock is traded on the New York Stock Exchange. Today, more than one-third of all Americans are enrolled in a health benefit plan owned and operated by just five large insurers — a group that last year hauled in nearly $12 billion in profits. These companies have grown so big and powerful that they now often determine who has access to affordable care and who doesn’t. Their business practices, condoned by investors and Wall Street analysts alike, have contributed to the growing number of Americans without health insurance— more than 50 million of us at last count.
I worked for two of those large companies, Humana and CIGNA, during my nearly 20 years in the insurance industry, and I participated in many strategy meetings at AHIP’s offices in Washington where plans were hatched to influence public policy.
I am now watching how AHIP is getting Obama administration officials to write the regulations required by the Affordable Care Act in ways that benefit insurance companies more than consumers. And I have talked to administration officials who have quit their jobs in disgust as the White House has repeatedly sided with insurers rather than consumer advocates, as important regulations were nearing completion.
Here’s an example. Earlier this summer, the administration announced rules pertaining to new rights we supposedly now have, thanks to the Affordable Care Act, to appeal decisions made by insurers that don’t go our way. When the Department of Health and Human Services quietly released the regulations in late June, consumer advocates realized that insurers had, for all practical purposes, written them.
As Sabrina Corlette of Georgetown University’s Health Policy Institute wrote, the administration narrowed the range of issues consumers can appeal, gave insurers up to 72 hours, rather than 24 hours, to made decisions on emergency care claims and weakened a provision requiring health plans to provide enrollees with information about their appeal rights in understandable language. Administration officials also cut in half the number of days patients have for appeals and allowed insurers to frequently choose their own “judge and jury” when their enrollees request an external review.
Just last week, AHIP’s muscle was on display when the Institutes of Medicine released guidelines for the Obama administration to follow in establishing the “essential benefits package” that all health plans will have to offer on the health care exchanges, or insurance marketplaces, beginning in 2014.
In January, an AHIP executive warned the IOM about making the benefits package too “rich.” Insurers want the package to be as skinny as possible, which will enable them to continue selling plans that, in many cases, are inadequate for many peoples’ needs.
The IOM’s recommendation is almost exactly what AHIP suggested.
So if the Occupy Wall Street demonstrators want to show up in front of the offices of some of the most important and influential people in Washington, whose strings are pulled by a handful of people on Wall Street, they will not want to miss 601 Pennsylvania Avenue, N.W. Trust me on this.
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ABOUT Wendell Potter
Former CIGNA executive-turned-whistleblower Wendell Potter is writing about the health care industry and the ongoing battle for health reform. Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans.
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17 comments on "‘Occupy Wall Street’ Should Also take Aim at Health Insurance Companies"
vwzwen
5NWLM3 cprogxtxtuod
That really cpratues the spirit of it. Thanks for posting.
October 11, 2011 6:54am
I see the insurance companies as being the culprits!!! I am a private practice mental health practitioner who had a 40% pay cut in 1997 when the AMA signed that they would accept insurance reimbursement in line with Medicare/Medicaid. I began accepting $60.00 a session from 1997 till now in 2011. No raises, increases for inflation, ect. Just the flat rate of $60.00. Also, no longer out of network benefits, incredibly high deductibles and reduced amounts of sessions. I have yet to hear managed care come out of a politicians mouth, and, this is an industry that exists to just deny one's access to one's benefits!!!!!! Please put the focus on the industry that is making health costs astromnomical. It's not the practitioners!!!!!!!
October 11, 2011 12:01am
The only thing I am disappointed at about Wendell Potter's exposes about the health care battle is that he did not discuss the role of Rick Scott.
Scott is the man who led the health care industry fight against universal care. He was the head of the health care provider that during his tenure as CEO paid the largest Medicare fraud fine in history.
The Democrats made a great mistake not pointing this out and making a big issue out of it. If we had somebody like this on our side do you think Karl Rove would not take advantage of this? I am not an advocate to follow Rove, the man who got George W. the Schlemiel Bush elected, who created Rick Perry and is now trying to destroy him. But unlike a lot of stuff Rove feeds us this is the truth about Scott.
By the way, it does not stop there. The PR company that ran the anti health care reform battle for Scott was the same one that ran the Swiftboaters Lie campaign against Sen. John F. Kerry during the 2004 presidential campaign.
When you don't challenge sleazeballs like Scott, you always pay a price. The Democrats sure did. Scott got elected governor in 2010. Although if judge the polls it's clear Floridians are having buyer's remorse. His popularity is bouncing around in the 30 percentile.
Ray A. Cohn
October 10, 2011 11:39pm
Please read and e-mail to as many people as possible. This guy was an insider for both Cigna and Humana. He has written a great book, Deadly Spin, that exposes what the health care insurance companies are doing. He is absolutely right.
If we protest to expose the special interests, we might as well expose one of the worst. Why do we have the most expensive health care system in the world -- about twice as costly as the rest of the industrialized world -- yet rank 37th in quality? Why do we have health care rationing as we have roughly 43 million uninsured? And why do about 45,000 a year die because of it?
Yet these deadly spin masters spin that what we would have if we had a public option? We should tell them to look in the mirror. That is what we have now. I strongly recommend you read his book.
Obamacare is a good start. That is why I am for it. History proves that it is much easier to amend a program when it's enacted than starting from scratch.
The late Sen. Ted Kennedy said one of his biggest regrets was not working with President Richard M. Nixon on a plan Nixon proposed that was based largely on HMOs. Tricky Dickey I (Dick Cheney is II) was a close friend and ally of Henry Kaiser. Kennedy said if the plan had been enacted it would have been much easier to get universal health care later with amendments.
Also we should work to get universal heal care enacted at the state level. Vermont has actually done that and is asking for a waiver under Obamacare. Now Montana is also asking a waiver under Democratic Gov. Bryan Schweitzer. The guy has a popularity rating of about 70 percent. A very interesting situation since, unlike Vermont, this is a conservative state.
I believe once universal health care operates in one or two states it will be so popular the American people will demand it.
Ray A. Cohn
Ray Cohn
October 11, 2011 12:04am
Just a misspelling correction. The governor of Montana is Brian Schweitzer, I pushed the post button prematurely. Ray A. Cohn
October 10, 2011 11:20pm
Please read and e-mail to as many people as possible. This guy was an insider for both Cigna and Humana. He has written a great book, Deadly Spin, that exposes what the health care insurance companies are doing. He is absolutely right. If we protest to expose the special interests, we might as well expose one of the worst. Why do we have the most expensive health care system in the world -- about twice as costly as the rest of the industrialized world -- yet rank 37th in quality? Why do we have health care rationing as we have roughly 43 million uninsured? And why do about 45,000 a year die because of it? Yet these deadly spin masters spin that what we would have if we had a public option? We should tell them to look in the mirror. That is what we have now. I strongly recommend you read his book.Ray Cohn
October 10, 2011 11:17pm
Don't stop with health care insurance companies. Go after the whole medical, pharmaceutical, health insurance, industrial, personal injury legal complex. It's all one gravy train of vested self interests in which every passenger blames the other and everybody gets rich except the patients who foot the bills.
October 10, 2011 7:23pm
Keeping it honest: Remember the Movie: “Wall Street?” Isn’t Greed supposed to be NOT good? So many news articles stating that American protesters have “no clear “agenda? It seems crystal clear to the middle class America that they are frustrated by the lack of concern that exists for the people in this country who need jobs and hope to support themselves and families. Millions of unemployed people looking for work in this country are being ignored and slowly erased by mega-corporations including Big Oil, Banks, Computer Co., Drug Insurance Companies, whose only concern is for their obscene profits far exceed anyone’s understanding! The beauty and treasured tradition of America allows people the freedom to unite and speak out to draw attention to these huge social injustices. It’s about time that Americans did and said, “we are mad as hell and we are not going take it any longer!” Are you listening Mr. Cantor, you and your war on the Middle Class of America? For the record, “Greed is Not good”; it’s ugly, selfish, obscene and destructive for our society. After all, We are a still a democracy, not aristocracy, nor a Banana Republic! Just look around this great county! " It's no surprise that the Romney campaign and his republicans in the Congress are raising money from Wall Street by saying they want to repeal consumer protections sand allow Wall Street to write its own rules, AND the recipients of dollar tax payer bailout with no conditions and used it for non-performance bonuses!
October 10, 2011 5:44pm
The Health "care" Industry has carefully withdrawn from the Public Eye.
Get Out there and expose them!!
They wrote the laws and made it legal to steal
They write the laws to enrich themselves
They are the vested interests
Who are THEY?
The 1%
(Mz M)
October 10, 2011 5:31pm
The Health "care" Industry has carefully withdrawn from the Public Eye.
Get Out there and expose them!!
They wrote the laws and made it legal to steal
They write the laws to enrich themselves
They are the vested interests
Who are THEY? The 1%
(Mz M)
October 10, 2011 4:26pm
I must admit that I was negligent in not adding the Health Insurance Companies and the Pharmaceutical Companies to my list of Corporations, Companies, Organizations that have to be included in "We the 99% People" protest movement.
October 10, 2011 3:07pm
I had hoped that passage of the Affordable Health Care Act would bring about needed reformes in the health care industry, but now agree with the effort to repeal this law. The only ones winning out of this is the insurance companies. There is no provision to prohibit them from raping us on premiums while not providing the care you think you have paid for in that premium. Everyone in America needs to go uninsured and use the health care system on a negotiation principle in the same way you get your car fixed or your house painted. The charges presented to us by health care providers needs to be clearer in explanation and reasoning with charges spelled out prior to implimentation.
October 10, 2011 8:25pm
Absolutely, the insurance are the death panel group for Americans. And guess what, those top executives that are rich are probably sociopaths. They are sickos, just because there rich does not mean they have normal minds. Pray for them, but take away their toys. Our life does not belong in their hands.
October 10, 2011 8:21pm
We need one payer health care insurance paid for by our tax dollars instead of tax dollars for killing innocent people in other countries.
October 10, 2011 2:29pm
Look at the salaries of these so called health care providers. They are way out of line and why our insurance cost so much. This is the real death panel group.