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Rob Johnson:
Welcome to Economics & Beyond. I’m Rob Johnson, President of the Institute for New Economic Thinking.
I’m here today with an extraordinary gentleman, Wendell Potter who, through my friend Guy Saperstein and others, I’ve corresponded with for years, but this is the first time we’ve met. And it’s electronically in person, I would say. Wendell has been a journalist. He’s been a public relations wizard in the realm of healthcare and insurance. He is an activist now, and he is what some have called a whistleblower. And in this crisis, the pandemic is, how do I say, a hot button, but in this crisis of healthcare, which has been boiling in the United States, I have not read or heard anybody more sensible. And so I’m very glad to have you here today. Thanks for joining me, Wendell.
Wendell Potter:
Oh, Rob. Thanks very much. It’s a pleasure to be here. A pleasure to finally meet you.
Rob Johnson:
Yeah, me too. What I would say is you’ve unmasked things at the relationship between money and politics, and you’ve also understood and expressed in many contexts, the incentives that executives have, the relation to Wall Street and finance, the relation to lobbying in government. And when we have a health care system, which the OECD says is more than double what most advanced economies pay per capita, and the World Health Organization ranks it something around 38th best in performance, we got work to do. I’m not, how you say, there’s some things wrong. I don’t want to just growl. I want to see the light at the end of the tunnel. And that’s why I asked you to join me today. But where are me? Where are we? Start, my dad was a doctor. Let’s start with diagnosis. Then we’ll get to remedies. Where are we now?
Wendell Potter:
Well, we’re very much in a crisis mode. We all know, obviously, that we’re in a pandemic, but we are also in a healthcare crisis that I don’t think many people are aware of. And it shows up in many different ways. The companies that I used to work for are enormous companies now, far bigger than they were when I was there. They’ve grown so big, largely because of public resources, that in a sense, the government is bailing them out and making them the monsters that they are now. And paying very little to what they’re doing. One of the ramifications of the growth of these companies, and frankly some of the work that I was doing before I left the industry. People are functionally uninsured in this country, people who think they have health insurance. But millions and millions and millions are finding out when it’s frankly too late, that their health insurance that they and their employers in many cases have been paying a lot of money for, is just completely inadequate.
And they, in many cases, wind up in bankruptcy or in debt for the rest of their lives, even with insurance. So it’s a lot worse than it was when I left in many regards. I think there is some hope possibly even in the private sector, that some things can change that will disintermediate, if you will, the big companies that I work for. They are big middlemen companies that extract enormous sums of money. In recent years the big health insurers, and I used that word insurers deliberately, but it’s not really accurate anymore.
They’ve joined up, they’ve bought or been bought, by other big parts of the healthcare system. Primarily pharmacy benefit management companies, which is itself a big middle man. So you’ve got these enormous companies that are even more in charge of our healthcare system than ever before. Two of those big companies are now in the Fortune five in this country. And so it just goes to show you how big these companies have grown, how enormous they are and how well they are rewarding their shareholders while the rest of us are having a hard time getting the care that we need, even a harder time than ever before, in many cases.
Rob Johnson:
I saw recently you have a Substack column that I find very nourishing, and you’ve written about Anthem, and you’ve written about United Healthcare recently, and what proportion of their growth in profits seems to come from government, from Medicaid like institutions. And so it’s not what you might call willy-nilly in the private sector. And I imagine they’re paying real close attention to the regulators who are appointed to fundraisers for senators and congressmen. And the kind of money in politics that you’ve written about in your books seems, how you say, quite potent, quite dangerous. And then I guess I’ll add an extra dimension that haunted me as I was preparing for this. They can charge you insurance premiums, but they can, in a kind of power discretionary way, cancel your coverage if you have a serious affliction on a kind of discretionary basis. They don’t even have to honor ex-post, what ex-ante, you paid a lot of money for.
Wendell Potter:
It is true. It’s not quite as blatant as it was before, but it happens because of the way that insurance companies have structured health benefit plans over the past several years. The Affordable Care Act sought to make illegal, and it did make illegal, some of the most egregious practices of health insurance companies. But I knew when the bill was passed that it was going to set up a situation which these big companies would find other ways that they can make the profit margins and the earnings per share that investors expect them to make. And we’ve seen that play out. You’re mentioning money and politics is especially appropriate because it is at the heart of why we can’t make much progress beyond the Affordable Care Act. And some would say that that didn’t represent a lot of progress.
It represents some, in my opinion, but it also created, or set up some unintended consequences. One of which is enabling these big companies to have even a tighter grip on our healthcare system than ever before. And they do it largely because they spend so much money on campaign contributions and lobbying at both the federal and state levels. And even the local levels. They spend a chunk of every dollar that we pay them, that it goes into a pot that then goes to lobbying, and campaign contributions, and propaganda campaigns like the ones that I used to help develop and carry out.
Rob Johnson:
Yeah. I remember when I was younger, I started my career in the Republican Senate Budget Committee, working for Pete Domenici. And one day I was sitting on the floor with Bob Dole, who at the time was the majority leader, and he was quite an affable man. He came over and we were waiting about a half an hour before things started. And he said, “Well, what’s on your mind being a senior economist and everything?” I said, “I don’t understand why, because you’re all concerned about budget discipline.” These were during the Reagan years, and they’d done all the tax cuts, and what have you.
I said, “You guys are all concerned. Why don’t you stop fundraising and make a public allocation for people to run for president, and penalize the people who own the radio stations and so forth? Because you grant them their license, they should have to contribute some bandwidth as a public service for the elections. And if you take all the money out of politics, then people aren’t going to do so much pork. You can run a more balanced budget because you guys are having to run deficits to survive.” And he started laughing and then he looked at me and he said, “Darn, I just don’t think it’s feasible.” But it was kind of, he was playful about it. He wasn’t offended. It just felt like the pork was running wild, and this is ‘84, ‘85, ‘86.
Wendell Potter:
And it continues to run wild. I mean, there have been some things that have been done that might limit the pork a little bit, but not very much. I was a reporter in Washington, for a few years. Just prior to that time, I was covering Congress and The White House for Scripps-Howard Newspapers back in the mid to the late seventies. And Howard Baker was the minority leader and then majority leader at that time. And I got to know him very well because he was from Tennessee, where I’m from. At one point, this issue came up in a campaign of his, and he said, and his opponent said that, “It would be great if we had a system in which no one could give me money unless they could vote for me.” And if we had a system like that, in which no one other than the people who could vote for you as a member of Congress or a Senate, it would do a world of good. We wouldn’t see this rush of money that flows into every campaign from out of state to buy these elections.
Rob Johnson:
Yeah, I have to protect his name, but there was a former Senator who was a friend of mine. And when he retired, I went out to lunch with him and I said, “Okay, why you doing this?” And he said, “Because I can’t look in the mirror when I spend 70% of my time raising money all around the country and the world to do things that harm my constituents that elected me.” And he said, “It’s obvious that for me to survive I got to do things that damage my constituents. I don’t want to live like that.”
Wendell Potter:
Wow. That’s very interesting. I have sometimes said that I finally decided I couldn’t keep doing what I was doing in the insurance business. It was when I looked in the mirror and said, “Who are you? How did this happen to you? This was not a career that you could ever have imagined.” And certainly when I was a reporter, couldn’t even comprehend doing what I ultimately wound up doing as someone who’s leading the big PR shops of within enormous insurance companies.
Rob Johnson:
That’s interesting just going to your, which you might call your life trajectory. My name’s Robert Johnson, so they talk about the crossroads in the blues music with my namesake, so that’s what I’m getting at. You have this experience in a Republican family in Tennessee, your father, I believe had fought in the war. And then you go to college in that ’60s era, you become a journalist, the product is illumination for the population of what’s going on, what would interest them, I would say, in an idealistic way. And then you make the shift for public relations for, I think it was Humana and then Cigna, and then after you do that, you live inside, you understand that, you break away. So I would say there are two crossroads I’m interested in. When you chose to go in to the insurance private sector, what was on your mind? What was the magnet? And when you chose to break out, what were the forces in play at that crossroad?
Wendell Potter:
I’ve never been asked that quite that way. And I will have to admit that for the first question, it was money, an advancement in a career, maybe attaining a lifestyle that I aspired to attain that was more than my parents could ever have imagined. I mean, I think that was probably more of what was on my mind than anything else. Ultimately later though, the reason I left that was it was a crisis of conscience. It was a realization that I was chasing something that was… Would’ve embarrass my parents, would have, they would’ve been so ashamed to a certain extent, of knowing what I was doing for a living and how I had changed from the boy who had grown up in their household.
And I think that my coming from that family, from that part of the country, played a huge role in my ultimate decision to walk away. I found myself in a situation which I had to face people who could have been people I grew up with who were waiting to get care in barns and animal stalls. And I probably wouldn’t have had that reaction had I not grown up in, quite frankly, a low income, working class family, a farming family in a small rural area of Tennessee.
Rob Johnson:
So at some level at this, the second crossroads, which I think is very tender in it, I think it has a lot to do with what you’ve done since. You reached a place of conflictedness between what you were being asked to do on behalf of the company and what the company, and in the context of our political economy, was doing to people.
Wendell Potter:
That’s exactly right. I had this realization that what I was being paid quite well to do in my corporate career at these insurance companies was the exact opposite of what I tried to do in my career as a journalist. And I was always proud of that career, even though I left it at a fairly young age. I never wanted to, and never did, intentionally mislead anyone with anything that I wrote as a journalist. Never to my knowledge, left anything out to obscure anything that was important or relevant, just to make a point in any story that I wrote, or even any commentaries that I wrote. But I realized that’s what I was being paid precisely to do in my job at Humana, and then Cigna, was to mislead people, was to present some facts and figures and purposely leaving some other facts and figures out that were very important for people to know. And doing this to enhance shareholder value. That was exactly what it was.
That is the one thing that is most important for these companies. And it’s not certainly unique to the health insurance business, but if you are an executive of a company whose stock is on the New York Stock, if you’re a New York Stock Exchange company, or publicly owned company, that’s for most of these companies, that’s what drives them. And I saw that up close. I think that the position I had gave me visibility into corners of the business that most people don’t get for that, there is that. And I just could not continue doing it and looking myself in the mirror, and remembering who I was, how I was raised, and what I tried to do in my first career.
Rob Johnson:
Well, that’s beautiful. I think there’s a very interesting dilemma, which I once heard you explore with Paul Jay on The Real News Network. And that was when you had this consciousness, that things were off course in terms of a moral purpose, you said you realized that you couldn’t stay and reform from within, that you would be distanced as opposed to going outside, writing books, shedding light, carrying the expertise from your experience, which gives you credibility. But that was the only way to make the difference.
Wendell Potter:
That’s true. I came to realize there is, is not possible to change things from within these big companies. And I would go so far as I say, even the CEO and the executive suite really can’t do that. If you are in a company that is large and has shareholders that essentially are large institutional investors, there is no way that you can change a company in this, in a way that is significantly different from what your few competitors are doing. And we’ve seen that play out in just recent days. I’ve also written a piece about Cigna’s recent earnings report, or the reported earnings for 2021. Aetna more recently announced, and if you look at all of both Aetna and Cigna’s announcements, you’ll see that they did very, very well in 2021. But Wall Street wasn’t happy with what they were saying that they thought they would be earning in 2022.
So of both of those companies got big hits on their stock prices on the day that they announced earnings, a significant loss of market capitalization, just because they were signaling, or saying, that they expected to earn X in 2022. And that was a bit less than what Wall Street’s financial analyst were expecting those companies to do. So it’s all about the expectations of these big investors. It’s not so much about, “Well, thank you for making us so rich last year. How rich are you going to make us this year?” That’s what really controls these companies. And I was in a position to observe that, to see that play out day in and day out. My name was on every earnings release at Cigna for 10 years. So I know what motivates the CEOs, and the CFOs, the investor relations people, because those are their bosses.
And the other thing is they have a vested interest in pleasing Wall Street, because certainly the CEO, his or her compensation is so tied to the financial performance of the company. One of my talking points when I was having to try to justify the CEO’s salary was that 90% of his compensation was as, we call it, at risk, which meant that yeah, he made his salary was like one or $2 million a year. He made a lot more than that through stock grants and stock options that the company gave him. And that was depending on how well he led the company to meet Wall Street’s expectations. And if you had a day like Cigna had and Aetna had recently their compensation took a big, big hit, because they’re shareholders as well, too. So that’s something I don’t think people realize, that people who run these companies they have financial interest. Their net worth fluctuates depending on how well they are leading those companies to meet the needs and expectations of one stakeholder. And that stakeholder is the shareholder.
Rob Johnson:
Yeah. I always tell people, and I used to work, I was in the hedge fund industry for a number of years, that the song that I thought companies should sing to themselves was an old soul song by the Shirelles called Will You Still Love Me Tomorrow? Yesterday never mattered anymore.
Wendell Potter:
It’s perfect.
Rob Johnson:
Will you still love me tomorrow?
Wendell Potter:
It’s absolutely the truth. And it changes in a minute. I mean, it’s not been so long ago that we were looking at 2021 and how well investors did, but yeah. What have you done for me? What are you going to do for me now?
Rob Johnson:
The dilemmas that you raise about not being able to repair inside. So you leave, you wrote Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans. I think I was 2010, 2011, around that time.
Wendell Potter:
It was toward the end of 2010. Yeah, it was.
Rob Johnson:
I bought that book for my dad, by the way.
Wendell Potter:
Oh, good.
Rob Johnson:
At the time. But I guess where I want to go with this, the dilemma is, okay, you can’t repair on the inside. Now you come outside. When you’re outside something has to change the contours in which the company performs to get it to change. Your book in 2016 is called Nation on the Take: How Big Money Corrupts Our Democracy and What We Can Do About It. So I want to say you’re now outside. From inside you can’t reform them. How can you get government, which is on the take from big donations, to enact the reforms this society needs? And where I’m going to take this is if they can’t do it, that despair, that frustration, that unfairness will destroy the credibility of government, the credibility of expertise. And I would say, fans the flames of the attraction of authoritarian demagoguery. And I think we are in the midst of that right now. So how do you take from coming out, how do I say, bearing witness with expertise, but then seeing the systemic problems? What kind of recipe can you and I concoct to put us on a healthier trajectory?
Wendell Potter:
Well, first of all, I share your concern. Well, another reason why is that people like I used to be, and others like me, at big corporations spent a lot of money over the years, trying to get Americans to not trust their government, or to think of the government as just taking our money and not making very good use of it. And politicians not behaving as we would want them to behave. And there was a purpose for that, and that was to get people to think that any kind of government regulations, for example, would be a bad thing. And that taxes are a bad thing because big companies try to avoid both as much as possible. So they’ve done a very, very good job. And I hate to admit I was unwittingly a part of that, to get Americans to distrust the government.
And it is why in many of the anti healthcare reform campaigns, almost all of them, to be honest with you, regardless of what is being proposed, my old industry and its allies will say that what is being proposed is a government run healthcare system. Or is a proposed government takeover of our healthcare system. Those terms were used, and are continued, still used because of just what that dynamic that I described. Big corporations have really over decades, got us to think the way we do about our government. And it’s getting worse as you said, because the way that our political system has evolved. Some to a certain extent, because the Supreme Court decisions that have made it even more likely that big corporations will call the shots. Because of that, people are frustrated. And they’re seeing that the people that we elect to represent our interest are not able to deliver on their promises.
And we are so easily, I think, confused about what is in our best interest, and so gullible because of changes in the way we get our news and information. It’s almost setting up a perfect storm that can make it much more likely, I think, that we’ll be drifting into an authoritarian kind of regime for who knows how long. And it worries me a great deal because it is at the heart of what the problem is, is all the money that is awash in our political system that keeps change from happening, and to protect a status quo that is extraordinarily profitable for a few of the incumbent industries and companies.
Rob Johnson:
Yeah. I’ll recommend a book. There’s a scholar at Columbia University who had come out of University of Chicago named Bernard Harcourt. And the name of his book is The Illusion of Free Markets. And what in essence, kind of the meta perspective, is that capitalism gets its moral license from being embedded in a democracy. But when the institutions have to be managed and the servant becomes the master, the contortions and the distortions don’t look anything like that free market competitive model that’s used in academic world to justify the system. Simplest answers, or simplest window in, is when you don’t enforce antitrust then you’re not dealing with a competitive market any longer.
But there are many, many dimensions in which you might call contradictions to those underlying simplistic assumptions that makes it very, very important that something be there, which we’ll call government, to shape things. One of the things that haunts me, and some of our friends through Guy Saperstein have been able to explore, is the notion that the left has lost confidence in government. It used to be, there was a team that worshiped free markets, and there was a team that kind of, what I’ll call had FDR nostalgia, Lyndon Johnson nostalgia, and said, “We believe in the government, a mixed economy, the Polanyi’s great transformation about creating balance.”
Then there’s the free market people. There was a man named Stuart Zechman, who was a musical writer and Carol Avedon, I think, shared with us that he had done a podcast years ago where an Obama official, who was unnamed, was on Politico. And this Obama official said, “You can’t pretend we’re in an environment anymore like Franklin Roosevelt. People don’t believe in government.” And Zechman, who was I believe a musician, went and looked at the Gallup surveys from which this anonymous individual was quoting his evidence and found that the people on the left didn’t believe in the free market, because they believed that the government was captured by the corporate sector. And I remember just feeling like, how do you say, understanding the disparagement of government or the notion of inefficiency that came from watching the Soviet Union, or part windows of Maoist history in China, got transformed into disparaging, unnecessary condition for a healthy political economy in the United States. And I think we got a lot of work to do now.
Wendell Potter:
We really do. And I think there’s reason to have that concern if you are on the left of seeing just how big corporations and large special interest have captured government, have captured the regulatory apparatus, and certainly control the electoral process to a certain extent, to a large extent, more than I think most people realize, because of the way that they can just pretty much call the shots when someone’s running for elected office. Certainly through the enormous amounts of money that are spent to influence public policy.
When the Affordable Care Act was being debated, the pharmaceutical industry spent more during that time lobbying Congress and The White House than any industry had ever spent on any prior legislation. But we’re saying that now, as you know, those records are being challenged just about every year as members of Congress try to look to where do we go from here? And I think progressives are seeing that even at the state level where there has been hope that maybe progress could be made there. Those hopes are dashed, but, and again, it is because of money that is controlling the actions of the people that we vote for.
Rob Johnson:
Well, in your recent work, I know you’re starting, how do I say, activism on a number of fronts that you had shared with me in an earlier conversation. Center for Health and Democracy, Business Leaders for Healthcare Transformation. And one, I think you called it Loops or Loop-n, what was it? Lower Out-of-Pocket Now.
Wendell Potter:
Yeah, Lower Out-of-Pockets Now, and the acronym is Loop.
Rob Johnson:
Yeah. And so I can see, how would I say, you’re not giving up the fight. We talked a little bit from a kind of what I might say, mildly despondent perspective of capture in the discouragement that Zechman uncovered. What are you doing in these organizations to carry on?
Wendell Potter:
Well, they are distinct. One, I’ll start with a business group first. Business Leaders for Healthcare Transformation seeks to bring the voice of business leaders, particularly those that are concerned about the cost of health insurance, or providing coverage to their workers. And also many employers that just have long ago been priced out of the health insurance market. They can’t afford to offer coverage for their workers. So that is an organization that tries to make sure that policy makers and the public broadly understands that there is a large swath of our business community that is not in league with U.S. Chamber of Commerce, and outfits like The National Federation of Independent Business, which purport to represent the interest of businesses in this country. They don’t. And I know that because in my old job, I used to work very closely with those organizations, get them to carry out our propaganda campaigns, and they’ll do it for a dollar, for well, more than a dollar.
It costs quite a bit to get those organizations to carry water for you, but that’s what happens. So with that organization, we are looking to bring the business voice, to helping define some solutions to make our healthcare system more rational. Center for Health and Democracy, the word democracy is very important for the reasons we’ve been talking about. What can we do through that organization to help people understand just how our political system has been taken over by the special interest, the big corporations, the big industries. And that’s why we have this healthcare system that we have and why it is so hard for those that we vote for to make any improvements in it.
As part of that work this year we’ll be looking at campaign contributions at both the state and federal level to show, for example, which Democrats are taking money from the political action committees or the big companies like the ones I used to work for. Just within recent days, we saw that my old industry, the health insurance business, through one of its front groups called The Better Medicare Alliance, crow about getting 340 members of Congress to sign a bill, sign a letter, to the Secretary of HHS and the Administrator for The Center for Medicare and Medicaid Services to protect Medicare Advantage, to make sure that that is funded because Americans love it so much.
That’s an example of how they’re able to get politicians in their pockets. They gave money to these members of Congress, Democrats and Republicans alike, gives them the opportunity and the industry to say, “This is bipartisan support for Medicare Advantage.” When what’s really going on here is keeping a cash cow being fed. The Medicare Advantage program in particular is the new cash cow for these big companies. And that is where, in many cases, we as taxpayers are bailing out these big insurance companies. They are no longer growing on the private side, on the commercial side. In fact, their membership in the employer sponsored plans and other plans that people buy on their own has been diminishing for years. Now most of their money is coming from us as taxpayers.
We try to expose all that to educate the public, to put pressure on policy makers. One of the things I want to do going forward is also to shine a light on some things that’s going on in the private sector that might make some things better for us in certain regards. Because it is so hard to change policy and to influence policy makers, I think it’s important to look at what can be done in the private sector to disintermediate the big companies that I used to work for. And I think that’s a possibility. I think we need to focus attention on both the public and the private sectors to change our healthcare system. If we just a look to try to influence legislation, I’m just afraid that we’re not going to be able to make much progress. We haven’t seen much progress over the past several years because of, again, all the money that the incumbents are able to throw into the system to protect their profits.
Rob Johnson:
Let me ask you a question. We have a lot of young people still in school. I look at universities today. I’ll speak about California public school system, University of Michigan, University of Virginia. The public support for education is down. Lots of pharmaceutical and healthcare companies are doing laboratories at major universities as a source of revenue. There’s a lot of, how would I say, wealthy donors and alumni who’ve worked in the healthcare industry. Are we illuminating these dilemmas in university curriculum to the degree that we need to so that people are preparing to become citizens? People are preparing to address these challenges in lockstep with your efforts? Or is this one of those silences that anthropologists tell you, “Study the silences because the silences reveal where the truth is and where the power is and they’re not in the same place.”
Wendell Potter:
Well, they’re not, I think that’s really an important question. Also, worries me a great deal. Even at the level before college, I think that we long ago have stopped teaching civics, stopped providing training and information about how to be a good corporate, a good civic participant and a good citizen. And I don’t think you’re seeing that at the college level as much as is needed and what we might would’ve, might have seen in years past. I think the whole idea of liberal education is one that probably is not as attainable as it once might have been. I think there is too much of an emphasis on training people to go into the workforce to do X job, and not nearly enough focus on making sure that someone has critical thinking skills, for example.
I think that has been a significant change in our educational system over the years, that is a really dangerous, dangerous change in our system. I think it is why so many people, or a reason why so many people are so gullible. Why they are so easily persuaded to believe things that are not true. They’re not equipped to think critically and to understand how they’re being taken advantage of. It’s hard to understand that in the first place, but in the absence of any kind of training about how to do it, I think we’re, maybe we suck.
Rob Johnson:
Yeah. The late, and very famous, Canadian author Jane Jacobs’s last book was published in 2004. It was called Dark Age Ahead. And the third chapter was called Credentializing Versus Educating. And I remember reading that feeling quite unsettled, but I think there’s another dimension now, which is when people are at that place between learning, curiosity on one side and credentials on the other, part of what drives them towards the credentials is the fear of economic insecurity if they aren’t conformist. And so we’re not in, what you might call, a free environment. And this anxiety, “Will I have healthcare? Can I afford a car?” All these kind of things, in this advanced nation, often relates to the kind of data that the Economic Policy Institute in Washington puts out, which is productivity’s been going up and more than 100% of the gains have gone to essentially about 8% of the population.
The median income in America is lower than it was in the mid 1980s, according to those studies. And so something’s happening in terms of distribution inside that’s heightening fear. And I remember there’s a wonderful psychologist named Howard Gardner, who I’ve never met, at Harvard. And he wrote a story once in Washington Post about why cheating is so rampant at his university called Harvard. And he said, “You’d think these people are already on the conveyor belt to success.” But he said, “The stakes between being in the one 10th of 1%, and even in the 10 to 20th percent, were so high, that many people took the risk of cheating and being caught in order to, what you might call propel their credentials and record to a higher level.” And I thought that was really an interesting symptom of the anxiety which young people face in the world today.
Wendell Potter:
I think you’re right. One thing that might seem and hopefully could counter that is from what I am hearing and reading, maybe more of a sense of social justice among millennials and people who are younger. And maybe less a feeling of being driven to have houses bigger than our parents or the biggest, most expensive car model. Maybe that can help counter that. But I think it is absolutely right. The economic insecurity is a very big thing and a very real thing at all levels of our society, unless you’ve a pretty well assured of being left a lot of money by your parents.
And it also is leading I think, to something called diseases of despair in this country, in which people are almost hopeless. They can’t see how they can get ahead. They work in many cases two or three jobs and it’s just not working out for them. They’re not. And they’re seeing things on social media and on TV and other traditional media about things that others may have, or that they should have, but they don’t. And I think it just really leads to these diseases of despair and contributes to the fact that our lifespan in this country is actually shortening rather than increasing.
Rob Johnson:
So when will how do I say, the silences that surround the universities and the ability of people to become citizens, sophisticated, insightful, is one dimension. But you were in the PR realm when you were in the private sector. And while I might be the ultimate audience, you’re dealing with the media. Television, radio, print journalism, what’s going on in that spin factory? What is their, you might call, choice of what to illuminate, and choice what to look the other way create in terms of our awareness on healthcare?
Wendell Potter:
The changes in the media have really worked in the favor of the big corporations and the big, special interest. And I keep using that term because sometimes corporations is not adequate to describe what’s been going on. Just back to schools for a minute, dental schools, for example, get a lot of money from alumni and are very much beholden to organized dentistry. And the curricula at some of the dental schools, and I know from some of the advocacy work that I’ve done, is largely controlled by alumni and by the money that comes in to provide some financial resources for these dental schools, to keep the school from, as an example, expanding the dental team to include mid-levels like we have in medicine. So, that’s one thing also that’s going on. There is a lot of money that controls what is being taught by the various schools in this country, whether I’m talking medical schools, or dental schools, or business schools.
The media, I’ve watched kind of its slow motion collapse after I left the media and then went into public relations work. Then we saw the effects of social media. What happened to advertising dollars, both in broadcasting and print media. We saw the consequence of so many publications being shut down or having to lay so many reporters off. Thousands of reporters lost their jobs and have lost them over the years. There are far fewer reporters left to do important work. So the idea of watchdog journalism has just about disappeared, unfortunately.
When I was at Cigna, over the 10 years that I handled financial communications there, I saw fewer and fewer and fewer reporters calling every quarter when we would announce earnings. There just were very few reporters who had an understanding, or the ability, to follow these companies’ financial reports. And you’re seeing that now. You don’t even see stories in the Wall Street Journal and the New York Times on a regular basis about the earnings, based on the earnings releases or the performance of big companies. That has really been a problem that has enabled, and a reason why the big corporation are able to get away with what they do.
There’s been very little scrutiny, very little watchdog journalism, so that feeds into the problem that we’ve got here. And if the public is not getting that information, the business leaders are not, policy makers are not. So it skews reality and people are just not seeing what they need to see in terms of how these companies operate and how they are really controlling our healthcare system. That was frankly, a reason why I started Tarbell a few years ago, was to try to bring some investigative reporting back into the healthcare space and to try to reestablish some accountability. And I continue that work even with the nonprofits that I’ve formed since then. You’ve got to do the job in some regards that once was done, maybe not all that well, but that we used to rely on traditional media to do. We’ve got to provide information that the public is not getting and figure out ways to get that information into their hands. Whether we’re talking about regular folks or people who are running businesses or who we vote for.
Rob Johnson:
Well, that’s a very, how do I say, very powerful mission. And a very important mission is in when we, how do I say, cycle back to that place called Capitol Hill. There are two currencies there, dollars and votes. And if the votes aren’t coming from a highly informed, and at times assertive population, then we’re not going to get to that policy that we need.
Wendell Potter:
We’re not. And here’s the reality. You know it as well as I do. And I guess most people do even though they don’t spend time on Capitol Hill. Not only are the campaigns influenced by money, but day in and day out, any number of reporter, excuse me, lobbyists walk into a congressman’s door. It’s a constant presence. And regular people don’t have that kind of representation. The news and information they get about insurance companies largely comes from their lobbyist, and behind those lobbyists were flags like I used to be. I used to be a part of that effort to funnel, or equip our lobbyists with talking points, to get members of Congress and staff to think and behave the way we wanted them to. So, that goes on day in and day out. It makes it even more difficult when you are able to see it and participate in it to a certain extent, just how little the chance is that legislation will pass that will do most of us a lot of good, when that same legislation might result in a penny smaller earnings per share next quarter.
Rob Johnson:
One of the areas, I think it’s partly demographic, partly related to vulnerability and age, that people are talking about increasingly is elder care. And that, how do I say, interfaces with medical treatment and healthcare, but there’s, we might call a more holistic dimension. And I know there have been what you might call lots of concerns about the quality of the experience in large corporate network nursing homes, where at least some family members of the elders that I know have said, “I feel like they’re warehousing my father or grandfather, grandmother, or my mother, and they’re extracting money warehousing them, but they’re not treating them like humans.” And obviously the people in the field who are there in person carry some responsibility. But are you seeing in elder care the same kind of pressures that you’re seeing in medical care and pharmaceuticals and so forth, where what you might call the money force field is taking people away from what you might call heart based kindness and caring?
Wendell Potter:
Oh, I absolutely do. I think it’s useful to keep in mind that Humana got its start as a for-profit company that bought up a lot of nursing homes around the country. And a lot of these nursing homes are part of big for-profit chains, or smaller for-profit operations. And they’re driven by making money, by making a profit, more than they are to make sure that the people that they’re caring for are getting the care that they need in an appropriate environment. I have some experience because as my mother got old, I was not able to care for her. We lived hundreds of miles apart and she needed skilled nursing care. So she had to be in a nursing home for some time. What I found was what you were describing to a large extent. But the nursing staff, I mean they were compassionate people trying to do their best, but it’s not the place where you would want to be, to be honest with you. It’s not an ideal situation.
We haven’t focused enough attention or enough resources to make sure that people can stay in their homes rather than going to these institutions. We need to have a focus on how can our folks, as we get older, you and me, Rob, as we get older, be able to remain as independent as we can, to stay in our homes as long as we possibly can. And the forces are frankly kind of against that. There are movements though, and efforts to try to make sure that the Medicare program, for example, is changed to be able to provide more funding for, to people who want to stay in their homes, and the Medicaid program too.
Because it’s extraordinarily expensive to have people living in these institutions for however long they live. And most of them never get a chance to go home. They’re there for months, if not years, and it’s extraordinarily, extraordinarily expensive. In many cases, the expense falls to us, not only as sons and daughters of those who are in those facilities, but to all of us as taxpayers, because there’s no, in many cases, no real viable alternative, except to that, almost that kind of warehousing.
Rob Johnson:
I guess in talking with you over this better part of an hour, I want to focus for a moment on you because I see all of us having to navigate through the quality of life. And we’re all in that balance. You know, they say life is a fine balance between hope and despair. Rohinton Mistry wrote a book called The Fine Balance in India years ago, but that was the parable it came from. And when despair, as an elder, or despair if you have to go to the doctor, or despair if all of a sudden you’re rendered unconscious, and you go to the doctor and the doctor’s part of a syndicate of people that will pick an anesthesiologist who’s out of network so they can charge you a couple hundred thousand dollars and pay it. We all live, without quality healthcare and elder care, with more anxiety, which is damaging our health in ways that emerge. So when I say coming back to you, you exhibited courage.
You left the material comfort, which you might call the tribal core of people you’d worked with for a period of time. And you didn’t just go surfing in Costa Rica or Southern California. You turned around, you wrote books about this. You wrote books about this. You’ve organized people about this. When one looks at a life, I have two young grandsons and four children, and I have to not just speak in kind of antiseptic or abstract terms. I got to point to them role models. Wendell you’re one of the guys I’m going to put on their radar. You really have given yourself to a wholesome purpose. And I think in the broad scheme of things, the quality of your life that I experience in listening to you and in observing your actions is such that that’s what I would like my children to feel. It’s more important than that car or that jewelry or those shoes or that cottage. You use your time on earth in a beautiful, courageous and generous way.
Wendell Potter:
Well, I’m so honored, so humbled. And if I do have a legacy, it may not be that I’ll see our healthcare system improve measurably. I hope so. I hope there’s some things that I’m able to do working with others to advance the ball, to achieve a better healthcare system. But I would like to think that people can look at what I’ve tried to do, and the change that I made, as an example, that you don’t have to stay in a soul killing job. It’s important to look yourself in the mirror from time to time, and ask that question, “Who are you? And are you doing what you think you’re on this earth to do?” That gets a bit spiritual. And I’ve often talked about this as a spiritual journey. You’ve got to do that, I think.
What I’ve found that I was doing was kind of compartmentalizing parts of my life. My career, I was making quite a bit of money, but I would allow myself to think that, “Well, you’re providing for your family. And most of what you’re doing probably is helping other folks.” You tell yourself stories and you want to make sure that you are telling yourself a story that enables you to get through the day, and go on day by day. But if you can take that moment of time and begin to question what your boss or company leadership is saying. Realize that it is, even though it’s extraordinarily difficult and scary to make a change, it can be much more rewarding when you do. I’ll have to admit, I did have a little bit of money saved up before I walked away from my job, but I also had a house, a mortgage, car payments, two kids in college.
So you’ve got to get to the point of realizing that it’s not all about the money. It’s about leaving a legacy to a certain extent for those who come after you. And I’m doing what I’m doing, as much in a sense almost selfishly, for my son and my grandchildren and for others. I want to try to do something to help make this world a better place. And maybe a world in which my grandkids are not having to pay a fortune to get the healthcare they need, even with insurance. So you do a little bit that you can that I… Now I’m rambling to get back to your point. I appreciate that. I do hope that people will take the time to do some introspection, to examine their lives and what they’re doing and what they’re trying to get out of this life and what’s important. I think if more people would stop to do that, I think we’d be in a much better place.
Rob Johnson:
Well, I often conclude. In my life, my parents were both musicians. My mother was a singer and worked as a Development Director of the Detroit Symphony. And my father was a jazz pianist and led a band while being a physician. And so I always let music tell me what do I feel? And I often hear songs, sometimes over and over, but I often hear songs that remind me of what I’m experiencing. And today the song that came to mind is about Psalm number 40 in the Bible that was written by Bono and the band U2. And the song goes like this, “I waited patiently for the Lord. He inclined and heard my cry. He brought me up out of the pit, out of the Miry clay.” He then says, “I’ll sing, I’ll sing a new song.” And repeats this.
But the next verse, and he’s paying tribute to the Lord, “You set my feet upon a rock and made my footsteps firm. Many will see, many will see and hear, I will sing, sing a new song. I will sing, sing a new song.” You transformed yourself and you sang a new song for us all to hear. Thank you. You are a beautiful spirit. And like I said, my two grandsons, and there may be more on the way, and my four children they’re going to know about you. I couldn’t give them a better gift.
Wendell Potter:
Rob, I don’t know what to say. I’m so honored. I’m so grateful. Thank you so much. Thank you for having me on. Thank you for this conversation. Thank you for your heart.
Rob Johnson:
Thank you. I’m grateful for you. And it’s a joy to be able to illuminate you and your example and your work, which is still, it’s not over. It’s in process, and your elders are already cheering and your kids are going to be cheering, if they’re not. And it’s, there’s still more to do. I’d like to be there at your side, helping you and helping you find the people to help you. And hopefully this podcast will play a little bit of a role in that.
Wendell Potter:
So grateful.
Rob Johnson:
We’ll come back in a few months to make another episode and check in on how things are going. Call me anytime when things, how do I say, feel urgent and we need to shine some light and I’ll join you.
Wendell Potter:
Thank you so much, Rob. I’ll take you up on that. You can be certain of it. Thank you.
Rob Johnson:
And check out more from the Institute for New Economic Thinking at ineteconomics.org.
