United We SCAM

26.5 million Americans are insured by UnitedHealth Group, making it the largest insurance company in the U.S. with a whopping 14.4% market share and $287 billion in revenue last year – that’s more than the total income of most countries in Europe! In this episode, we take on this insurance behemoth and how it has systematically rigged our economy and our government – in addition to providing Americans with overpriced, inadequate health coverage.

Our guest is Wendell Potter, the former Vice President of Corporate Communications for the health insurance company Cigna. In 2008, he resigned and became one of the industry’s most prominent whistleblowers, testifying against corrupt practices in HMOs before the U.S. Senate. Since then, he has become a prominent advocate for Medicare for All and universal healthcare, and authored three books – including Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans – and countless articles.

Show Notes

Wendell shares the story of his career path, his work for the dark side as a PR executive for the health insurance industry, and his conversion to a Medicare for All activist. Wendell ultimately left the insurance industry after a crisis of faith about his contribution to an unjust system.

Wendell helps us dive into one particular evil giant of the health insurance industry: UnitedHealth. We discuss UnitedHealth’s huge, rapid growth from a small player into a corporate giant (the fifth largest company in the U.S., right behind CVS/Aetna), primarily through mergers and acquisitions. They are notorius for denying claims and cutting reimbursements to providers. They have not only acquired competitors, they’ve gobbled up physician practices, clinics, dialysis centers and tech companies.

(Incidentally, UnitedHealth also acquired the Lewin Group, a economic analysis firm that did most of the economic feasibility studies of single payer healthcare for state legislatures.)

One of UnitedHealth’s biggest divisions is Optum, which doesn’t sell health insurance, but does include their pharmacy benefit management (PBM) business, as well as data services. This past year was the first year that Optum’s contributed more to profits than the health plan business.

UnitedHealth is making extraordinary profits. They could use this money to lower costs for policy holders and approve more care, but instead they reward shareholders and buy back shares of their own stock, which inflates earnings per share, benefitting shareholders and top executives.

We move on to discuss the political arm of UnitedHealth and their fellow industry giants, and hear about Wendell’s front row seat to the industry’s efforts to kill the Affordable Care Act. America’s Health Insurance Plans (AHIP) the insurance industry’s trade association, funnelled $100 million into anti-ACA advertising, PR and lobbying campaigns.

UnitedHealth is a founding member of a newer industry front group, the Partnership for America’s Healthcare Future, that in the post-Bernie era has been dedicated to killing any single payer (or even public option) legislation at the federal or state level. Anything that threatens their profits, even legislation far short of single payer, is in their crosshairs, branded as “government run” healthcare.

The health insurance industry’s messaging playbook uses the same arguments no matter what: scare people that single payer will raise their taxes and cost thousands and thousands of health insurance industry jobs.

For M4A advocates to effectively message against this, Wendell says to focus on the fact that people will pay less money and have more choice in terms of doctors and facilities. Focus on the barriers health insurance puts up between patients and care: narrow networks, prior authorization, and huge deductibles. Advocates should also villainize the insurance industry in particular, put them on the hot seat, and tell more stories about the harm the industry does.

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