By Joseph Burns
Now that election day is only about a month away, one of the most important issues the country faces is how a new Congress and a potentially new administration will address the need for health insurance reform.
For health care journalists writing about Health Policy now and what might happen in 2021, it’s instructive to consider what Wendell Potter, a former public relations executive for health insurers, would suggest when covering this issue. The founder of Tarbell, a donor-funded and subscription-driven health care news site, Potter is one of the co-founders of Business Leaders for Health Care Transformation, a coalition of business leaders supporting the idea of a health care system that covers everyone with essential services regardless of income.
This past year, Potter has written op-eds for The Washington Post and The New York Times about his role promoting the false narratives for health insurance industry about Health Policy. Also, Potter is the author of “Deadly Spin, An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans,” which Bloomsbury Press published in November 2010.
As a former executive for Humana and Cigna, Potter has good advice for health care journalists. During a recent telephone interview, he recommended following one of the most basic tenants of good journalism: “Be skeptical whenever you get any statement or press release from an insurance company.”
Health insurers will spin news and news reporters, he warned. “In response to questions, they will use language that tries to make them appear to be good corporate citizens,” he said. “They do that to obscure the reality that these companies are profitable and yet many of their practices are designed to make it difficult for people to get the care that need.”
In July, he wrote a Twitter thread that serves as an example. A 17-year-old California girl died in 2007 after her health insurer refused to pay for a liver transplant. The insurer’s statements about the case were the equivalent of offering thoughts and prayers while failing to offer a substantive explanation of the decision not to pay for the transplant, he said.
“In response to a specific question, insurers will often — and maybe usually — not answer the question directly,” he noted. “They’ll give a blanket statement that has little or no value to the reader or the viewer.” Despite such lack of clarity, journalists may feel obliged to use what insurers offer in such cases but should not do so without adding context.
Another tactic that insurers’ PR departments and trade associations use is to insist that journalists send questions by email rather than do a telephone or in-person interview to eliminate the need to answer probing or follow-up questions, he added. “They do that so they can just send out pablum in response to questions,” he explained.
When reporters get such statements, they should add perspective that serves readers, listeners, or viewers, by explaining that the insurer refused to answer all questions or provide specifics.
Another tactic insurers and many large corporations use is to obscure or minimize facts that make them look bad. See, for example, a press release from UnitedHealthcare, the nation’s largest health insurer with 45 million members, about its second quarter earnings.
In that release, “UnitedHealth Group Continues Efforts to Combat COVID-19, Reports Second Quarter Performance,” the insurer devoted the first two paragraphs to its response to the pandemic to benefit its members and providers. “They wanted reporters to use that information rather than focus on the windfall profits they made during the second quarter and in the first half of this year,” Potter explained.
In the third paragraph, UnitedHealthcare reported that earnings were higher than anticipated in the second quarter because members deferred routine care and elective surgeries while the health system was mostly shut down.
To show how high net earnings and its profit margin were in 2020, it helps to know that in the first quarter of 2019, UnitedHealthcare had revenue of $60.6 billion, net earnings of $4.7 billion and a profit margin of 5.4%. Then, in the second quarter of this year, UnitedHealthcare had revenue of $62.1 billion (slightly higher than what it had in 2019) but net earnings and its profit margin were almost double at $9.2 billion and 10.7%.
“The company expects these results will be offset in the quarters ahead by the assistance measures already taken, the resumption of deferred care and future COVID-19 cost and economic impacts,” United added. This statement raises a question journalists can ask when UnitedHealthcare reports its third-quarter financial results in the coming weeks.
In addition to being skeptical about press statements, journalists should question the validity of statements from think tanks that health insurers fund with their earnings, Potter suggested.
“Both think tanks and trade associations will try to scare people away from Health Policy measures that might benefit consumers,” Potter commented. “They cherry-pick data and tell anecdotes that can’t be verified.” To counter these tactics, journalists should at least provide context about where such think tanks and trade groups get their funding.
One of those groups is the Partnership for America’s Health Care Future, which opposes Medicare expansion. For more on this group, see articles from The New York Times and Politico.
“It bears repeating that we should not simply accept what these groups say without at least doing our own research,” Potter said.
Insurers also will use code words and phrases to put Health Policy proposals in a negative light. See, for example, this op-ed Potter wrote for The New York Times in January. Insurers warn that Health Policy could restrict the ability of Americans to have a say in their care by limiting their choice about health insurance plans or physicians.
“It’s a good little talking point, in that it makes the idea of changing the current system sound scary and limiting,” he wrote. “The problem? It’s a P.R. concoction.”
“Insurers promote the idea that Americans don’t want a one-size-fits-all health care system,” he told me. “That sounds good. But it’s actually code words to people who have the financial means to afford good health insurance, meaning that Health Policy is a zero-sum game.” By providing coverage for those who are uninsured or underinsured, there will not be enough left over for other members of society.
“In fact, we need a one-size-fits-all health care system because all Americans should have access to the health insurance coverage the coverage that we need when we need without bankrupting any of us,” he commented.
Looking ahead to 2021, Potter predicted that insurers will use scare tactics to put Health Policy in a negative light. In a recent op-ed in The Washington Post, he explained how in his former work in PR, his efforts to frighten consumers contributed directly to a climate in which fewer people are insured today.
“After the new Congress is sworn in, we will see a concerted effort by the industry to shape the debate about health care reform.,” he said.
For more on this topic, see these articles:
Health Policy Resources for Covering the 2020 Elections, Kaiser Family Foundation, September 2020
Health Care and the 2020 Presidential Election, Kaiser Family Foundation, August 2020
“AMA drops out of industry coalition opposed to Medicare expansion,” Politico, Aug. 15, 2019
“Why Some CEOs Figure ‘Medicare For All’ Is Good for Business,” Kaiser Health News, June 7, 2019
