Wednesday, 01 October 2014 / TRUTH-OUT.ORG

Disastrous Rollout of Obamacare Should Shift Focus to Universal Healthcare Part I

Monday, 02 December 2013 13:36 By Jaisal Noor, The Real News Network | Video Report

Jaisal Noor, TRNN Producer: Welcome to The Real News Network. I'm Jaisal Noor in Baltimore.
The disastrous rollout of the Affordable Care Act's Healthcare.gov has dominated news headlines for weeks. Obama administration officials have come under fire from congressional Democrats and Republicans alike, spurring President Obama to allow Americans with canceled plans to keep their coverage for another year.

Now joining us to go beyond the headlines is Wendell Potter. He's a former communications vice president for CIGNA, senior analyst for the Center for Public Integrity. He's the author of the new ebook Obamacare: What's in It for Me? What Everyone Needs to Know about the Affordable Care Act. It's due out in December.
Thank you so much for joining us, Wendell.

Wendell Potter, Author, Fmr. VP Corporate Communications, CIGNA: Thank you, Jaisal.

Noor: So, Wendell, you are a former industry insider. You authored the book Deadly Spin: An Insurance Company Insider Speaks Out about How Corporate PR Is Killing Health Care and Deceiving Americans. You know, it's hard to argue at this point that--the rollout of Healthcare.gov was really an unmitigated disaster. It's a dog's breakfast.

What is driving this? Is it the insurance companies trying to sabotage this health care reform? Or is what they're saying true, that these plans [incompr.] more expensive because they have to cover everybody, and that's also the reason they're saying they have to cancel millions of plans?

Potter: No, the real reason is because we have the world's most complicated [incompr.] system with some of the most seemingly intractable problems. And the Affordable Care Act is a big law that was passed more than three and a half years ago, which is an important important point, because we're all focused on the rollout--the faulty rollout, certainly--of Healthcare.gov, and that overshadows what has gone before.

The Affordable Care Act has been implemented in pieces for the past three and a half years, and a lot of people are already benefiting from that in many ways, including member members of my own family. But certainly the media has been focused on the glitches--or maybe that's probably too mild a term to describe the problems with Healthcare.gov. And the problem's for a number of reasons. One is because we are--The Affordable Care Act does try to actually prop up or bolster up this system of private insurance in this country. And you have hundreds of private insurance companies around the country, some that just do business in some states. So it has--you're asking the federal government to build a website that will accommodate hundreds of different insurance plans or insurance companies with multiple insurance plans. The law itself is pretty complicated, as I noted.
So there are so many moving parts that it was almost inevitable that the rollout would be faulty. There's been nothing like this ever attempted before quite like this, certainly not in the health care [incompr.] in the United States. So it was a big disappointment.

I think that--another problem that I've written about is the fact that the federal government has, over the past several years, put in place some onerous restrictions that essentially keep out some of the best and brightest individuals and companies from even bidding on government work. So that's another problem. And that's not anything to do with the current administration, but something that has happened over the past several years because of laws the Congress passed a long time ago.

Noor: And there's two issues I wanted to talk to about briefly. Some people are saying they're going to have to pay more for insurance under Obamacare, and some people are upset that they're losing their health care coverage. It's millions of people across the country. Can you briefly respond to those two points that have been often raised in the mainstream media?

Potter: They've been raised, but they haven't been explained. We haven't had the proper context.
First of all, we're talking about just the individual health insurance market. The vast majority of Americans might as well just tune out, because it doesn't really affect them at this point. Most of us get our coverage through the workplace, and those of us who do will not have any need, necessarily, go to go to Healthcare.gov. It is for the currently about 14 million Americans who don't get coverage through their workplace, who have had to buy insurance on their own through the so-called individual market. And they're the ones who are, many of them, receiving these notices of discontinuation of their policies.

In many cases, it's because those policies were not good policies to begin with. And many people don't realize that. And, in fact, unfortunately a lot of people have never found out just how inadequate their health insurance policies are until you actually have to use them, if they are in a serious accident or come down with some serious illness that requires a hospital stay. Many people find out that they just have such lousy insurance that it doesn't come close to covering their medical bills. We have more people who file for medical--because of medical bills, file for bankruptcy than any other reason. And that doesn't happen [in any other] developed country in the world.

And a lot of those peoples are people who have insurance who thought they had good insurance, but they don't. They've been lured into plans that have been marketed [incompr.] very slick ways by insurance companies to get them into these plans. The premiums seem to be fairly affordable, and in many cases they are. But people don't realize, they don't read the fine print enough to know that they're not getting--they will not get the coverage they need if they get sick or injured. That's one thing.
The other is that most of the people who are getting these notices can get better coverage and get help from the government to pay those premiums. So the vast majority of people who even today have insurance through the individual marketplace and are getting those notices can get better coverage, and they'll be able to shop for it in ways that they haven't been able to do before. They'll be able to compare one plan with another because insurance companies are finally having to offer information in plain language and in a standard format so that we can do those kinds of comparisons. And the law provides tax subsidies or tax credits and subsidies to help people who are low- and middle-income folks pay for their policy.

So the regrettable thing is that the people who are getting those notices and as they were trying to go onto Healthcare.gov, it just wasn't working. Those problems are being fixed. In fact, I've gotten emails from a lot of people who've told me that at long last [incompr.] have been able to sign up for coverage, and they've been pleasantly surprised that they're able to get coverage that is a lot less expensive than what they've seen before.

Noor: So, Wendell, as a former industry insider, and for people that might not be familiar with this idea of a single-payer health care system, can you explain exactly what the benefits of that would be, and the fact that you're a industry insider, why you believe that might be an alternative to what we have today?

Potter: Right. In a system, a single-payer system, it is a system in which people will pay a lot less for [incompr.] than they're paying now. And here's the reason why. We have a system of--a multiple payer system right now of a lot of competing health insurance companies around the country. And that requires a lot of administrative work that's unknown in a single-payer system.

In a single-payer system, you pay the equivalent of premiums to the government, the federal government, and the government essentially acts as your insurer. You still have access to private doctors and hospitals, as is the case in Canada. It's a single-payer system that they've had for several years now, starting at one of the smaller provinces, and it became such a success in Saskatchewan that the other provinces paid attention, and ultimately it became the way that the whole country went. And that's because you [can save] a lot of money and you can assure access to quality care. Everyone is covered. No one is left out. And that's the reality of a single-payer system.

We in this country have had a system that has been largely controlled by [big] insurance companies and, increasingly, for-profit insurance companies that have as their top motive making money for shareholders, not [getting] people access to care that they need or having universal coverage. So that's a big difference.

The other thing about our current system is that because you have all of these individual private insurance companies, they spend a lot of money on underwriting, on advertising [incompr.] marketing, on what they refer to as medical [management] expenses. All these are unknown and unnecessary in a single-payer system. Plus, doctors and hospitals have to have people who do nothing more than deal with insurance companies. So we spend a large amount of money on health care for activities that don't contribute a thing to our health. They're [incompr.] truly administrative in nature.

Noor: Wendell Potter, thank you so much for joining us for the first part of this discussion.

Potter: Thank you. Thank you very much.

Noor: And stay tuned. In our next part, we're going to appoint Wendell Potter the health care czar of American and see what kind of health care system he would build up from scratch.

This piece was reprinted by Truthout with permission or license. It may not be reproduced in any form without permission or license from the source.

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Disastrous Rollout of Obamacare Should Shift Focus to Universal Healthcare Part I

Monday, 02 December 2013 13:36 By Jaisal Noor, The Real News Network | Video Report

Jaisal Noor, TRNN Producer: Welcome to The Real News Network. I'm Jaisal Noor in Baltimore.
The disastrous rollout of the Affordable Care Act's Healthcare.gov has dominated news headlines for weeks. Obama administration officials have come under fire from congressional Democrats and Republicans alike, spurring President Obama to allow Americans with canceled plans to keep their coverage for another year.

Now joining us to go beyond the headlines is Wendell Potter. He's a former communications vice president for CIGNA, senior analyst for the Center for Public Integrity. He's the author of the new ebook Obamacare: What's in It for Me? What Everyone Needs to Know about the Affordable Care Act. It's due out in December.
Thank you so much for joining us, Wendell.

Wendell Potter, Author, Fmr. VP Corporate Communications, CIGNA: Thank you, Jaisal.

Noor: So, Wendell, you are a former industry insider. You authored the book Deadly Spin: An Insurance Company Insider Speaks Out about How Corporate PR Is Killing Health Care and Deceiving Americans. You know, it's hard to argue at this point that--the rollout of Healthcare.gov was really an unmitigated disaster. It's a dog's breakfast.

What is driving this? Is it the insurance companies trying to sabotage this health care reform? Or is what they're saying true, that these plans [incompr.] more expensive because they have to cover everybody, and that's also the reason they're saying they have to cancel millions of plans?

Potter: No, the real reason is because we have the world's most complicated [incompr.] system with some of the most seemingly intractable problems. And the Affordable Care Act is a big law that was passed more than three and a half years ago, which is an important important point, because we're all focused on the rollout--the faulty rollout, certainly--of Healthcare.gov, and that overshadows what has gone before.

The Affordable Care Act has been implemented in pieces for the past three and a half years, and a lot of people are already benefiting from that in many ways, including member members of my own family. But certainly the media has been focused on the glitches--or maybe that's probably too mild a term to describe the problems with Healthcare.gov. And the problem's for a number of reasons. One is because we are--The Affordable Care Act does try to actually prop up or bolster up this system of private insurance in this country. And you have hundreds of private insurance companies around the country, some that just do business in some states. So it has--you're asking the federal government to build a website that will accommodate hundreds of different insurance plans or insurance companies with multiple insurance plans. The law itself is pretty complicated, as I noted.
So there are so many moving parts that it was almost inevitable that the rollout would be faulty. There's been nothing like this ever attempted before quite like this, certainly not in the health care [incompr.] in the United States. So it was a big disappointment.

I think that--another problem that I've written about is the fact that the federal government has, over the past several years, put in place some onerous restrictions that essentially keep out some of the best and brightest individuals and companies from even bidding on government work. So that's another problem. And that's not anything to do with the current administration, but something that has happened over the past several years because of laws the Congress passed a long time ago.

Noor: And there's two issues I wanted to talk to about briefly. Some people are saying they're going to have to pay more for insurance under Obamacare, and some people are upset that they're losing their health care coverage. It's millions of people across the country. Can you briefly respond to those two points that have been often raised in the mainstream media?

Potter: They've been raised, but they haven't been explained. We haven't had the proper context.
First of all, we're talking about just the individual health insurance market. The vast majority of Americans might as well just tune out, because it doesn't really affect them at this point. Most of us get our coverage through the workplace, and those of us who do will not have any need, necessarily, go to go to Healthcare.gov. It is for the currently about 14 million Americans who don't get coverage through their workplace, who have had to buy insurance on their own through the so-called individual market. And they're the ones who are, many of them, receiving these notices of discontinuation of their policies.

In many cases, it's because those policies were not good policies to begin with. And many people don't realize that. And, in fact, unfortunately a lot of people have never found out just how inadequate their health insurance policies are until you actually have to use them, if they are in a serious accident or come down with some serious illness that requires a hospital stay. Many people find out that they just have such lousy insurance that it doesn't come close to covering their medical bills. We have more people who file for medical--because of medical bills, file for bankruptcy than any other reason. And that doesn't happen [in any other] developed country in the world.

And a lot of those peoples are people who have insurance who thought they had good insurance, but they don't. They've been lured into plans that have been marketed [incompr.] very slick ways by insurance companies to get them into these plans. The premiums seem to be fairly affordable, and in many cases they are. But people don't realize, they don't read the fine print enough to know that they're not getting--they will not get the coverage they need if they get sick or injured. That's one thing.
The other is that most of the people who are getting these notices can get better coverage and get help from the government to pay those premiums. So the vast majority of people who even today have insurance through the individual marketplace and are getting those notices can get better coverage, and they'll be able to shop for it in ways that they haven't been able to do before. They'll be able to compare one plan with another because insurance companies are finally having to offer information in plain language and in a standard format so that we can do those kinds of comparisons. And the law provides tax subsidies or tax credits and subsidies to help people who are low- and middle-income folks pay for their policy.

So the regrettable thing is that the people who are getting those notices and as they were trying to go onto Healthcare.gov, it just wasn't working. Those problems are being fixed. In fact, I've gotten emails from a lot of people who've told me that at long last [incompr.] have been able to sign up for coverage, and they've been pleasantly surprised that they're able to get coverage that is a lot less expensive than what they've seen before.

Noor: So, Wendell, as a former industry insider, and for people that might not be familiar with this idea of a single-payer health care system, can you explain exactly what the benefits of that would be, and the fact that you're a industry insider, why you believe that might be an alternative to what we have today?

Potter: Right. In a system, a single-payer system, it is a system in which people will pay a lot less for [incompr.] than they're paying now. And here's the reason why. We have a system of--a multiple payer system right now of a lot of competing health insurance companies around the country. And that requires a lot of administrative work that's unknown in a single-payer system.

In a single-payer system, you pay the equivalent of premiums to the government, the federal government, and the government essentially acts as your insurer. You still have access to private doctors and hospitals, as is the case in Canada. It's a single-payer system that they've had for several years now, starting at one of the smaller provinces, and it became such a success in Saskatchewan that the other provinces paid attention, and ultimately it became the way that the whole country went. And that's because you [can save] a lot of money and you can assure access to quality care. Everyone is covered. No one is left out. And that's the reality of a single-payer system.

We in this country have had a system that has been largely controlled by [big] insurance companies and, increasingly, for-profit insurance companies that have as their top motive making money for shareholders, not [getting] people access to care that they need or having universal coverage. So that's a big difference.

The other thing about our current system is that because you have all of these individual private insurance companies, they spend a lot of money on underwriting, on advertising [incompr.] marketing, on what they refer to as medical [management] expenses. All these are unknown and unnecessary in a single-payer system. Plus, doctors and hospitals have to have people who do nothing more than deal with insurance companies. So we spend a large amount of money on health care for activities that don't contribute a thing to our health. They're [incompr.] truly administrative in nature.

Noor: Wendell Potter, thank you so much for joining us for the first part of this discussion.

Potter: Thank you. Thank you very much.

Noor: And stay tuned. In our next part, we're going to appoint Wendell Potter the health care czar of American and see what kind of health care system he would build up from scratch.

This piece was reprinted by Truthout with permission or license. It may not be reproduced in any form without permission or license from the source.

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