I’ve been going through my stack of books and after reading A Dance With Dragons by George R.R. Martin, I finally got around to reading Deadly Spin by Wendell Potter. (How’s that for a juxtaposition of reading topics?)
Deadly Spin details Mr. Potter’s end years at CIGNA as their chief spinmeister. He talks about how insurers use front organizations to get out their message and sway the public and legislators. Throughout his telling of this “playbook”, he talks about how he came to the decision to leave CIGNA, testify in favor of health care reform, and write his book. It’s incredibly well-written and researched, complete with many source citations – which I fully appreciate.
But…..(and there’s always a but…)
I didn’t find the information to be particularly shocking. I was hoping for a bit deeper dive into the seedy underbelly of the insurance industry. Most large for-profit companies and industries have lobbying groups and industry groups to promote their interests. Of course, the insurance industry has one too. So, I was really hoping for a lot more juicy details.
However, I did work for Aetna for a time and I’m wondering if that made me jaded about the health insurance industry? At Aetna though, I was just a peon. I never really felt that they were “evil” and never did I feel that anything that I was involved in was unethical. The one thing that they did do, which I always thought was unusual, was to send out mass emails to the employees about specific political issues and urge the employee’s to call their or write to Congress. They were even complete with a template letter and handy link.
So, no, I wasn’t surprised by Deadly Spin. I’ve read a few “follow the money” type articles and almost all special interest groups are tied back to some major corporation or organization. I think that an interesting accompaniment to Mr. Potter’s book would be someone from underwriting explaining how they manipulate the numbers.
The one part of the story that doesn’t fully sit right with me is about Nataline Sarkisyan, a young girl who was denied a transplant in 2007. Mr. Potter condemns CIGNA’s actions in the decision and also find fault with ERISA, a law which among other things allows employers to be self-insured. Neither in Deadly Spin nor any of the media reports I read at the time, does the employer ever seem to take any blame. That is an omission that still has me baffled.
See, I actually got to work on one of CIGNA’s “horror stories” from an employer’s perspective. Someone from 60 Minutes had called about a story that Ed Bradley was going to be doing about CIGNA denying a treatment that was deemed experimental for one of our employees. Similar to Nataline’s story, our employee would die without the treatment. We were given until the end of the day to review the case and decide if we wanted to overturn CIGNA’s denial. The conference call that we had with CIGNA included tons of people: our entire CIGNA account team, a nurse case manager, multiple medical directors, attorneys, and someone from PR. More than anything else on that call, CIGNA tried to sway us to approve the treatment. (We found this somewhat amusing since we had already decided to approve it prior to the call but they wouldn’t let us speak for the first 30 minutes!)
I can’t imagine that a similar conversation didn’t occur with Mercedes-Benz, the company the Sarkisyan’s had their insurance through. Yet, for all of ERISA’s short-comings, Mercedes-Benz could have told CIGNA to pay it at any point. It was Mercedes’ money, not CIGNA’s – but they have managed to escape blame free. And that is the deadliest spin of all – insurance decisions are often left to not just one for-profit entity but several -the insurance company, the employer, and often the hospital – none of whom is it in their financial best interest to side with the patient.
Did any of you read Deadly Spin? What did you think? Were you surprised by anything in the book?
thanks for share!