A former health insurance executive for Cigna opened up in The New York Times Wednesday about his experience that left him "disgusted" — and forced him to leave the insurance industry.
This comes amid a flurry of national conversation on the ethics of health insurance, and the denials of claims for the sick and vulnerable, kicked off by the murder of UnitedHealthcare CEO Brian Thompson and a subsequent internet phenomenon of people openly celebrating the crime and the alleged assassin.
"It began in 2005, during a meeting convened by the chief executive to brief department heads on the company’s latest strategy: 'consumerism,'" wrote Wendell Potter, who worked as Cigna's vice president of corporate communications.
"Leading the presentation was a newly hired executive. Onstage, he was bombarded with questions about how plans with high deductibles could help the millions of Americans with chronic conditions and other serious illnesses. It was abundantly clear that insurance companies would pay far fewer claims but many enrollees’ health care costs would skyrocket."
Initially, Potter wrote, he "drank the Kool-Aid" and convinced himself all of this was just standard business. But then, he took a trip to see a free clinic in Appalachia near where he grew up — and what he saw shocked him.
"At a county fairground in Wise, Va., I witnessed people standing in lines that stretched out of view, waiting to see physicians who were stationed in animal stalls," he wrote. "The event’s organizers, from a nonprofit called Remote Area Medical, told me that of the thousands of people who came to this three-day clinic every year, some had health insurance but did not have enough money in the bank to cover their out-of-pocket obligations. That shook me to my core."
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Potter's job included explaining to the media why various patients were being denied care — but one case in 2008 was the last straw for him. It was the case of "Nataline Sarkisyan, a 17-year-old leukemia patient in California whose scheduled liver transplant was postponed at the last minute when Cigna told her surgeons it wouldn’t pay.
Cigna’s medical director, located 2,500 miles away from Nataline, said she was too sick for the procedure. Nataline’s family stirred up so much media attention that Cigna relented, but it was too late. Nataline died a few hours after Cigna’s change of heart." As a father himself, Potter couldn't live with what the company did to Nataline and her family.
Two years after Potter's resignation, Congress passed the Affordable Care Act, landmark legislation that reined in many of the health insurance industry's worst abuses and established a baseline of consumer rights. But many problems continue — and the truth, said Potter, is that "shareholders, not patient outcomes, tend to drive decisions at for-profit health insurance companies."
