Deadly Spin By Wendell Potter Bloomsbury Press. 288 pages. $26. Reviewed by Matthew Rothschild
I've often wondered how people can front for RJ Reynolds, or ExxonMobil, or Massey Coal, or Goldman Sachs. If you consider yourself a decent person, it must take, at least at first, a lot of apologetics. After a while, I assume that self-delusion can be a comfort, and a hefty paycheck has been known to go a long way. And once you're ensconced in the upper reaches of these enterprises, I imagine it gets harder and harder to leave on principle.
But that's what Wendell Potter did, and we're a better country for it.
Potter is the guy who spent two decades as a top PR man for Humana and CIGNA, but finally got fed up with the cruelty of the private health insurance companies. After he quit, he went public, testifying before Congress in 2009 and getting a nod from President Obama in a speech to that body.
I've met Potter a couple times. He's a sweet, thoughtful, soft-spoken man, and that makes him all the more credible as a whistleblower.
Now he's telling all in a book called Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.
He starts off with a startling confession: "About 45,000 people die in America every year because they have no health insurance. I am partly responsible for some of the deaths making up that shameful statistic."
He reveals how he helped devise a strategy to defeat the Patient's Bill of Rights, how he sharpened the talking points of the industry executives when they were denying people care, and how he set up groups "to promote the industry's political agenda."
The chapter on Sicko is particularly illuminating. He tells how petrified the industry was of Michael Moore's movie, so much so that in internal memos, corporate officers were told not to mention his name but to refer to him only as "Hollywood." Potter reveals that the insurance companies sent a representative to see the premiere in Cannes to know what they would be up against.
The PR guys from the biggest health insurance companies met to discuss how to respond to Sicko. The first step was to "position health insurers as part of the solution, not part of the problem," he writes. The second step was to recruit non-industry people to say that "Moore was a nut whose ideas on reform would be a disaster for the country." The goal of this part of the strategy, he writes, "was to make Moore radioactive to centrist Democrats in particular."
The PR strategists came up with a "worst-case scenario," Potter explains. "If Sicko showed signs of being as influential in shaping public opinion on health care reform as An Inconvenient Truth had been in changing attitudes about climate change, then the industry would have to consider implementing a plan 'to push Moore off the cliff.' They didn't elaborate, and no one asked what they meant by that. We knew they didn't mean it literally -- that a hit man would be sent to take Moore out." (But I wonder exactly what they did mean because Moore told Amy Goodman that he and his family had received some ominous threats.)
Potter says the industry settled on a successful strategy of stressing the term "government takeover," and he believes "the industry's behind-the-scenes campaign against the movie" succeeded in reducing Moore's box office numbers.
He also writes, wryly, that "not a single reporter had done enough investigative work to find out that insurers had provided the lion's share of funding" to set up a front group that peddled the industry line.
Potter's critique of the mainstream media, which he provides along the way, is worth noting. He says that he and other industry PR people "talked every day" to reporters from The New York Times and The Washington Post. And he boasts that it was easy to pull the wool over reporters' eyes.
He tells of a 2006 CIGNA press release that hailed the benefits of so-called consumer-driven plans with high deductibles. The release relied on an in-house study that had cherry-picked the youngest and healthiest people.
"Not a single reporter called me with questions about the methodology of the CIGNA study," he said. "I wasn't surprised. With cutbacks in newsrooms, there were fewer reporters covering the health insurance industry than in years past, and the ones who were left were often so busy that they had little time to probe. I was frequently amazed at how little media scrutiny there was of the industry and at how much my colleagues and I could get away with in dealing with reporters. More often than not, they were quite willing to settle for what we fed them, even if it was pablum."
Like media critics Robert Mc Chesney and John Nichols, Potter points out that journalists are now outgunned by PR agents.
"Today, we have arrived at a precarious moment," he writes. "The number of credible news organizations, particularly newspapers, is declining. At the same time, the number of people, the amount of power, and the level of funding behind public relations efforts are greater than ever."
In this relatively short book, Potter covers a lot of ground. He provides a history of PR in the United States. He discusses the PR strategies of other industries, including tobacco and oil. And he offers advice on how to overcome spin.
Plus, he devotes a chapter to the efforts, over the last century, to reform health care. Here he discusses Obama's law, which he criticized severely but ultimately supported as being better than nothing.
But he also shows how the companies moved swiftly to get around some of the language of the new law. In a section entitled "Bernie Madoff Should Have Been an Insurer," Potter explains how the industry is manipulating the part of the law that says it must spend 80 to 85 percent of premiums on medical care itself and not administrative costs or profits.
"Within days of President Obama's signing the law, WellPoint told Wall Street analysts that it had decided to 'reclassify' certain categories of costs that it had previously counted as administrative expenses and move them to the medical-spending side of the equation ... without making any actual changes in behavior."
For me, the most compelling part of Deadly Spin is not the policy discussion but the human story of how this one man chose to blow the whistle.
Potter says he had two epiphanies. One occurred just a month after Sicko arrived in the United States. Potter went to see a campaign event that John Edwards was holding in Wise County, Virginia, a few miles from where Potter grew up. Edwards had chosen as a backdrop the Wise County fairgrounds, where a group called Remote Area Medical was offering free care.
"Nothing prepared me for what I saw when I walked through the gates," he writes. "Hundreds of people, many of them soaking wet from the rain that had been falling all morning, were waiting in lines that stretched out of view. As I walked around, I noticed that some of those lines led to barns and cinder block buildings with row after row of animal stalls, where doctors and nurses were treating patients."
What made the scene especially hard for Potter to take was the fact that he had just been working on a campaign claiming that a huge portion of the people who don't have health insurance simply don't want to have it -- that they were, as he was suggesting in his CIGNA materials, either healthy, young adults or "lazy, irresponsible bums." Potter couldn't square what he was writing at his desk with what he saw with his own eyes.
The second event occurred a few months later. It concerned a seventeen-year-old girl named Nataline Sarkisyan in Los Angeles, who needed a liver transplant. Her family's CIGNA insurance policy was all paid up, and it covered liver transplants. But CIGNA refused to pay for the transplant on the grounds that her condition was too grave and the surgery would be experimental. The family refused to take this lying down, so they made some noise, talked to a reporter, and got the California Nurses Association involved. By the time CIGNA relented and approved the transplant, Sarkisyan's condition had badly deteriorated. She died just hours later.
This was too much for Potter. "I didn't feel up to the task of spinning," he writes. "I felt, instead, burned out."
There was a reason for that. "I had strayed from my own moral path," he writes.
Today, Potter, who works for the Center for Media and Democracy, is a happy man. "I'm smiling a lot more," he told me. Or, as he put it in his book, "Telling the truth is very cathartic. I highly recommend it."
Matthew Rothschild is the editor of The Progressive.
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