Deadly Spin by Wendell Potter

Deadly Spin: An Insurance Company
Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving
Americans

            Deadly Spin is
a book that strives to take an inside view on the insurance industry and how
Americans’ health care premiums are subject to unrelenting propaganda and
lobbying efforts focused on protecting one thing: profits. For twenty years
Wendell Potter worked as a senior executive at insurance companies and
witnessed how they confused their customers and did away with the sick all for
the purpose of satisfying their Wall Street investors. His change in
perspective can be explained by four major events in his life: first, his college
background and career; second, his corporate job with CIGNA and the movie
Sicko, third, a trip back to his hometown in Tennessee; and lastly, the
premature death of a seventeen-year-old girl in California.

            Potter grew up near the Blue Ridge Mountains of Mountain
City, Tennessee. However, he was born on the other side of the mountains in
North Carolina because there was no hospital in the entire county at the time
in 1951. Neither his mother nor his father was able to finish high school,
having to work instead. His dad spent most of his days working in a factory but
before the birth of his son, built and operated a small country store called
Potter’s Grocery and even built their house right next door to it. Both of his
parents wanted their son to have an easier life than they had had and they knew
it could be possible through a good education. They sacrificed years and years
to save enough money for Potter to attend college. He became the first person
in his family to earn a college degree when he graduated from the University of
Tennessee in 1973. A major influence in his life was his adviser, Sammie Puett.
She was one of the strictest advisers in the Communication Department, but
Potter is very grateful for her and how she pushed him to do his very best.
Although he was a Communication major, he also aided in the future development
of a public relations program at UT and managed to take every PR class the
university taught, especially those taught by Puett.

            After graduating from UT, Potter accepted a job at his
previous internship, the Memphis
Press-Scimitar, choosing to pursue journalism instead of public relations.
After a few months on the job he discovered articles on corruption in the
auto-inspection department and reported on that for the newspaper. In 1978 a
college friend introduced him to a Jake Butcher, a wealthy Knoxville banker who
was running for governor of Tennessee. When he was asked to be Butcher’s press
secretary, he saw that as a ticket back home. Butcher won the Democratic
primaries but eventually lost in the general election. Potter continued to work
for him, but in one of his banks as a lobbyist for the World’s Fair group.
After securing financial backing and a congressional authorization for the
fair, he was able to travel around the world recruiting countries to
participate in it. The event itself took place in 1982 and Potter had fun
writing speeches and press releases for Butcher. Once the fair was over, Potter
still continued to work for Butcher but in the PR department of his flagship
bank in Knoxville. However, four months later Butcher’s entire banking
enterprise collapsed and he went to jail for bank fraud charges.

After
a couple years at Baptist, he was offered to make a lot more money with a
corporate job at Humana in Louisville, KY. His success and experience at Humana
eventually led him to his former company, CIGNA: an anagram of Insurance
Company of North America (INA) and Connecticut General (CG) respectively.

Although
CIGNA was bigger than Humana, it was still primarily known as a property and
casualty company. Potter was hired on to raise awareness of CIGNA’s health care
business. It was becoming a big time player in managed care, which in order to
make money had to keep people out of the hospitals. Potter helped boost CIGNA’s
image by arranging an interview with a reporter from Modern Healthcare to do a feature story on the company. Because of
hours and hours of preparing the executives whom she would interview and making
sure she only interviewed those on an approved list, CIGNA received a glowing
multipage article which boasted about the company and its “customer-focused”
approach to managed care. All throughout his various projects and campaigns for
CIGNA he thought talked about both the uninsured and CIGNA’s members, but only
in terms of numbers because that was all they were to him.

In
May of 2007, Michael Moore’s documentary on the U.S. health care system debuted
at the Cannes Film Festival. Moore had kept a tight rein on the release of the
film that many insurance companies did not know whether the focus would be on
pharmaceutical companies or on the insurance industry. Ever since 2004, when
Moore’s documentary was merely an idea, every PR person in the industry had
been trying to get information on his intentions. Potter worked to prepare
managers at every CIGNA office in the event Moore would show up on their
doorstep. However, AHIP (American Health Insurance Plans) had sent an agent to
screen the documentary and report back to executives from around the country on
a conference call which Potter attended. The agent confirmed their worst
suspicions: the private health insurance companies were portrayed as the
villains and CIGNA especially was in danger. Luckily, due to the rapid-response
teams at CIGNA and many other companies and the extensive preparation for the
interviews to follow the premiere, the documentary did not reach as high of box
office grosses as did Moore’s Fahrenheit
9/11. The media campaign at CIGNA costs hundreds of thousands of dollars
all of which came from the premiums paid by health-plan members—which the
executives believed to be an appropriate use of those dollars.

About
a month after the Sicko campaign, Potter took a few days off to visit his
parents in Tennessee. He learned from the local media that Jonathan Edwards was
coming to Wise County Virginia to address health care concerns at the same time
the Wise County health fair. Edwards was one of the CEO’s least favorite
presidential candidates at the time because he seemed to be intent on becoming
an insurance company basher. Potter felt it was his duty to check out the fair
because one of his responsibilities at CIGNA was to keep the CEO and top
executives up to speed on what the candidates were saying about health care
reform.

Potter
learned firsthand in Wise County, Virginia that what he knew was not the real
story. The corporation Remote Area Medical (RAM), which Potter had only learned
of through the local media in TN, put on an expedition in Wise County to offer
free health care screenings and basic procedures for those who do not have
insurance and access to safe, affordable health care. The website advertises
that people who wish to attend should plan to come early, bring food and expect
to wait in long lines. It wasn’t the average health fair that Potter had been
to before. Everything from pulling teeth to mammograms to cutting off patches
of skin cancer was being conducted by hundreds of volunteer doctors and nurses.
Even though the expedition lasted three days, hundreds of people are turned
away each year because the medical needs of the people fair outweigh what the
volunteers can provide. When RAM’s founder started the company, which primarily
was to provide health care services in Third World countries, never imagined
that they would be holding most of their expeditions in rural areas of the
United States.

This
was the second main event that started to affect Potter’s perspective on the
insurance industry and his job at a large for-profit company. The third and
final event that sealed the deal was the death of a young Armenian American
girl in California who died primarily due to CIGNA denying her coverage for a
life-saving procedure because it was “experimental,” but ultimately too
expensive for the company. Nataline Sarkisyan was a young girl who was very
proud of her heritage and one day dreamed of being a fashion designer. At
fourteen she was diagnosed with leukemia, but after a series of chemotherapy,
it was in remission. She was able to regain her life and celebrate her
sixteenth birthday; however, a year later the leukemia came back. This time she
would need a bone marrow transplant because the chemotherapy would not be
enough. It turned out that her older brother was a perfect match and agreed to
be the donor and CIGNA agreed to pay for it, as long as the procedure was done
at a hospital in CIGNA’s network. The transplant went well in late November of
2007, but serious complications developed, especially in Nataline’s liver. A
week after the procedure, her doctors decided that she had to have a liver
transplant. Around the same day in December, not too long after CIGNA’s
Investor Day (which had cost the company around $250,000), Nataline was sent to
the ICU to wait for her new liver. Knowing that procedures require prior
approval, her doctors contacted CIGNA’s transplant unit and asked for approval.

Her
parents didn’t foresee problems with the insurance company. They were more
worried about whether a liver would become available and be a match for
Nataline. She was covered under a policy her father obtained through
Mercedes-Benz, where he worked. CIGNA administered the health care benefits but
it was Mercedes-Benz who assumed the risk. The transplant unit even requested a
piece of her liver to prove it was failing yet CIGNA refused to pay for the
procedure and sent a message to Nataline’s doctors are UCLA, where hundreds of
transplants are performed each year, that her procedure would be
“experimental.” The Sarkisyans did not know about the cost of CIGNA’s Investory
Day nor did they know about their agreement with Mercedes-Benz, but Potter did.
The German conglomerate would continue to be a customer under CIGNAs plans
provided they keep the medical-loss ratio low. This meant denying coverage of a
procedure for a teenage girl that everyone knew would save her life because it
could potentially increase the MLR and lower CIGNA’s return on profit for
investors. CIGNA eventually, though with much delay, approved the transplant
request, in order to avoid limelight from a massive protest set to attack the
company by Nataline’s mother.

When
Potter pictured his daughter and wife in the same situation as Nataline’s
family, his entire perspective was altered. After this incident, it became
harder for him to stay focused at work and he no longer felt engaged in his
responsibilities. Later on in the summer of 2008, he resigned from his position
and has been an advocate for health reform ever since. This book was a part of
his project to promote awareness of “spin” to the American public and what
people can do to guard their minds from it. He has come to the conclusion that
spin will always be around. Industries will always try to spin their words,
promote one thing and then do exactly the opposite behind the scenes. It may
continue to be around, but with a good knowledge of PR and spin tactics the
everyday consumer can prevent minor and major tragedies such as Nataline
Sarkisyan’s from happening again.