Editorial: Follow the money in health care

When the White House insider ‘Deep Throat’ told reporter Bob Woodward of The Washington Postto “just follow the money” to unravel what became the Watergate scandal, Americans were reminded of the power of money to corrupt and influence.
Today, that influence is primarily wielded by corporate America. From the purchase of high-paid lobbyists, to blatant advertisements meant to befuddle and distract, to news stations like Fox that deliberately tell lies and view news as entertainment, money is the driving factor behind many policy decisions that, ideally, should be decided because of the public good, not a corporation’s bottom line.
Wendell Potter, a long-time industry insider and former head of corporate communications at insurance giant Cigna when he decided to quit his job a couple of years ago, came to Vermont last week to share his knowledge and speculate on ways the health care insurance industry will try to influence Vermont’s health care reform debate. In a question-and-answer interview with the Addison Independentprinted last Thursday, Potter offered much the same advice as Woodward was given four decades ago with a slight twist: to understand how aspects of public policy are tweaked, misconstrued, misunderstood and ultimately defeated, just follow the money.
“The health insurance industry is dominated by a cartel of very large, for-profit health insurance corporations and their primary mission is to enhance shareholder value,” he said. “Vermonters need to be on guard. There will notbe a lot of visibility by the health insurance industry. They’ll be funneling a lot of money to their allies to influence the debates in Montpelier and they’ll try to influence elections next year in the state.”
What’s interesting about the industry’s tactics is that they can be so good at what they do the public rarely senses their involvement. It was the industry who successfully tagged the public option as “government run health care” — a term that eventually led President Obama to omit the “public option” provision in the health care bill approved by Congress. While the bill still accomplishes some reform, Potter says the health insurance industry got much of what it wanted.
The industry wanted two things, Potter said. “One. To require Americans who are not eligible for an existing public program like Medicare or Medicaid to buy a private health insurance plan. That was their top objective. Two. To make sure that there was not a public option created by the bill.
“They got both. This legislation guarantees that the insurance industry will get billions of dollars in revenue that it otherwise would not have from people who are now (starting in 2014) forced to buy insurance.”
And without a public options component, which would have positioned a government-run insurance company to create competition for the for-profit insurers, the industry stands to gain a healthy profit. That’s partly because the for-profit model for health insurance does not benefit the consumer as much as it benefits the shareholder. The model in the health insurance industry is to pay out as little to the consumer as possible compared to the premium paid in. Companies that pay out even less than the industry average are rewarded in the stock market.
When you think about it, it’s not rocket science. Nor is it illegal. It’s how our system works.
What’s important is that the public understands this is the game that will be played in Vermont (Potter says the industry is worried and will spend lots of money to influence the debate). The public’s role is to be aware  that the health insurance industry will try to sabotage current plans. They will lie, confuse and belittle, make false allegations, distort outcomes — whatever necessary to defend their profits.
As we listen to pros and cons, Vermonters need to keep an open mind about all things on the table, beingparticularly aware of the money trail and to whom it benefits.
Angelo S. Lynn

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