1151: Wendell Potter | Killing Health Care and Deceiving Americans

1h 8m

Former healthcare executive Wendell Potter reveals how insurance giants sacrifice patient care for profits and deploy deceptive tactics to fight reform.

Full show notes and resources can be found here: jordanharbinger.com/1151

What We Discuss with Wendell Potter:

  • Wendell Potter was a healthcare insurance executive at Cigna and Humana, and became a whistleblower after witnessing Americans seeking healthcare at a fairground in animal stalls, revealing how profit motives override patient care.
  • Insurance companies prioritize shareholder value over patient needs, with executives compensated primarily in stock, directly incentivizing them to deny claims and care to maximize profits.
  • Companies create "front groups" with misleading names like "Healthcare America" to manipulate public opinion against healthcare reform, using fear tactics to protect industry profits.
  • When denied coverage, patients should appeal decisions, enlist their doctors' help, and consider becoming a "squeaky wheel" through media attention, as companies often reverse denials when facing public scrutiny.
  • There is growing bipartisan support for healthcare reform and breaking up massive healthcare conglomerates. By understanding your rights, documenting communications, and persistently appealing denials, you can better navigate the system while supporting meaningful change.
  • And much more...

And if you're still game to support us, please leave a review here — even one sentence helps!

This Episode Is Brought To You By Our Fine Sponsors:

Want to hear a conversation with an ex-royal/ex-SEAL who fights to end human trafficking and illegal organ harvesting? Check out episode 868 with Remi Adeleke!



See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Listen and follow along

Transcript

Experience the joy of bonding.

The Disney Baby Playlist offers low-stimulation nursery rhymes, instrumentals, and Disney favorites perfect for tummy time, car rides, and playtime.

Just say Alexa, play the Disney Baby playlist on Amazon Music.

That's Alexa.

Play the Disney Baby Playlist on Amazon Music to listen.

This episode is brought to you by Progressive Commercial Insurance.

As a business owner, you take on a lot of roles.

Marketer, bookkeeper, CEO.

But when it comes to small business insurance, Progressive has you covered.

They offer discounts on commercial auto insurance, customizable coverages that can grow with your business, and reliable protection for whatever comes your way.

Count on Progressive to handle your insurance while you do, well, everything else.

Quote today in as little as seven minutes at ProgressiveCommercial.com.

Progressive Casualty Insurance Company, coverage provided and serviced by affiliated and third-party insurers.

Discounts and coverage selections not available in all states or situations.

The Care Credit credit card lets me pay over time for just about anything my dog needs, from food to vet care.

But, but what if, hypothetically speaking, I got a bird?

Nope, a horse.

Well, I got good news for my hypothetical self.

Care Credit is accepted at more than 270,000 locations and works for, wait for it, all animals.

And the even better part is, it also works for me.

I can use it for spa trips, dental treatments, and more.

Care Credit offers flexible financing for all my hypothetical hypothetical animals and hypothetical needs.

Visit CareCredit.com to apply and find a location near you, subject to credit approval.

Coming up next on the Jordan Harbinger Show, we repurposed that front group, Healthcare America, to try to get Americans to believe that what was being proposed would not be in their best interest.

It was paid for exclusively by big insurance companies.

Welcome to the show.

I'm Jordan Harbinger.

On the Jordan Harbinger Show, we decode the stories, secrets, and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you.

Our mission is to help you become a better informed, more critical thinker through long-form conversations with a variety of amazing folks from spies to CEOs, athletes, authors, thinkers, performers, even the occasional Hollywood filmmaker, legendary actor, or Emmy-nominated comedian.

If you're new to the show or you want to tell your friends about the show, I suggest our episode starter packs.

These are collections of our favorite episodes on topics like persuasion and negotiation, psychology and geopolitics, disinformation, China, North Korea, crime occults, and more.

That'll help new listeners get a taste of everything we do here on the show.

Just visit jordanharbinger.com slash start or search for us in your Spotify app to get started.

All right, today on the show, Wendell Potter, a former healthcare executive, turned whistleblower, essentially.

He's the former head of corporate communications at Cigna.

I don't think that exists anymore.

It's Humana or something now.

Wendell's job was spin, namely to convince the public, that's us, that the U.S.

had the best healthcare system in in the world.

Not true, that insurance companies were needed and universal coverage was bad for us somehow.

Today, we'll explore why his conscience finally broke, how and why he left his job to speak out about all this.

We'll also uncover some healthcare horror stories, learn how the insurance system really works.

Well, it actually works against us and for the shareholders, surprise, surprise.

We'll learn how that works from the inside, and we'll learn how healthcare insurance companies manipulate public opinion, politics, and even the media to get us to vote against our own interests.

All right.

Here we go with Wendell Potter.

So it's hard to know where to begin with something like this, but essentially you're a healthcare slash insurance company whistleblower.

Is that an accurate descriptor?

Yeah, there aren't too many others, but I worked as a health insurance company executive for 20 years, and I was in positions of responsibility that gave me...

great visibility into how these companies work.

And I left after a crisis of conscience and ultimately became a whistleblower.

So tell us what you did at the companies that you worked at.

So what was the job?

What did it entail?

I worked for two of them, Humana for about four and a half years, and then Cigna for a little over 15 years.

So all together, about 20 years at these big giant corporations.

And I was in the communications department.

When I left Humana, I was running that company's communications department.

And then I was recruited to Cigna and was running that communications department.

I was vice president of corporate communications.

My job was to handle financial communications.

I was the company's chief spokesperson.

I was a gatekeeper for any media that wanted to talk to anybody at Cigna.

Also, my staff and I wrote talking points for our lobbyists.

So I was involved in lobbying, government affairs work.

financial communications.

I worked with the investor relations team.

All of that gave me this great visibility into this industry.

I also worked with their chief medical officer and all the clinical staff at the company as well, too.

So it was a unique position.

Very few people in any company get that kind of visibility into how the company really operates and what motivates the C-suite.

It's a unique bit of visibility, right?

Because if you just worked in the claims department, you'd have this siloed view.

If you just worked in some other department, you'd have a siloed view.

But this was, all right, here's what we're doing, but here's what we need to say what we're doing, or here's how we need to spin this and say what this means.

We're raising this and this cost is going to be higher.

How do we make this sound not just like it's greed?

We have to say something else.

And so you did have a front row seat to all that.

And some of the corporate spin examples that you gave in the book, and if people buy the book, please use the links in the show notes.

It helps support the show.

Some of the examples you gave was the first one that really stood out was that the USA has the best healthcare system in the world.

And as somebody who's lived in Europe, I'm always wondering how that's possible.

I mean, look, maybe for certain super high-end cancer care or something like that, sure.

But if you just have a cold or you want to go to the doctor or you have an infection, I had an infection.

I won't, I'll spare people the details, but I went to the ER in Hawaii.

I was there for seven hours and it cost me $4,000.

Jeez, I'm not surprised.

They gave me an antibiotic and an ultrasound.

The ultrasound, by the way, was like 50 bucks or something.

And then the doctor examining it was $2,000.

And then the sitting in the emergency room was $2,000.

So it was like this weird thing where walking in was two grand and the care was either, oh, that's totally reasonable and in fact cheaper than I thought.

And then also simultaneously, how on earth is this that expensive?

Because he looked at the report and went, yeah, that looks fine.

That was two grand.

But the guy actually doing the ultrasound was somehow 60 bucks or whatever it was.

It just, it's totally nonsensical.

And the tablet I took was $3.

That's reasonable.

But then the prescription writing was like $400.

None of it made sense.

No.

It makes no sense.

We have a system in place that a lot of Americans just think that it is the way things must be and the way the rest of the world must operate.

But it's entirely different.

And we're unique in the world in that we did not have any plan to create a healthcare system that's logical and fair and has some mechanisms to control costs.

Instead, we just let this system kind of develop without any oversight from the federal government or even from state governments for that matter.

It's very much of patchwork and inefficient.

I don't think anyone could possibly design a system that would be any more inefficient than ours.

It was ridiculous.

I called to find out why it was so expensive.

And even the people in the billing department, they were like, I don't know.

I don't even know what these notes are or anything.

And I was like, can't you tell me what this thing is?

Because it says something like rec div in, you know, $2,000, whatever.

And I Google it and it's, this could be anything.

And the guy's like yeah, it could be all these different things.

That just means means somebody looked at something or whatever and then i said fine i want to take eight years to pay this off because i'm offended by how much it costs and he goes sir you got to be reasonable and i was like i have to be reasonable you just charged me four thousand dollars for somebody to look at my ball sack i'm like no i am being reasonable i'm just being as reasonable as i freaking can right now man i'm losing my mind yeah you did have a unique position man essentially like an undercover investigative journalist who spent what 20 years on assignment that's pretty unusual i even said that i was undercover for 20 years i was a reporter my first career.

I was a newspaper reporter.

And in Washington, I mean, I'm talking to you from Washington today.

I still spend a lot of time here.

And I was an investigative reporter and was lured into this kind of work because it pays more.

Yeah, I can see that.

So they did pay you pretty well.

Why'd you stop doing the job?

What was the breaking point that made you leave what I can only assume is a decent six-figure health insurance job with some stability?

Yeah, it was a very good job, a senior level corporate job.

I thought for a long time that I'd pretty much arrived.

It was at the top of the game of my profession, one of the country's biggest corporations.

When I first started working in the industry, I was a real believer that these companies could really help manage people's care efficiently and fairly.

And then, what I saw toward the end of my career in particular, because of this visibility we talked about, that's not what motivates these companies at all.

It is not making sure that you have the care that you need and can afford.

It is what Wall Street expects because our healthcare system increasingly is controlled by Wall Street, by big shareholders.

Big shareholders, they're almost always institutional investors that invest millions, if not billions of dollars.

And a handful of Wall Street financial analysts who work for big banks.

They're the ones who really run the show.

And almost no one knows that.

I wouldn't have known it either had I not been given the responsibility of handling financial communications.

I was the guy who was on the phone, the Wall Street Journal or Bloomberg, where the New York Times had a question about the company's financial performance.

So I had to know how the company made money, where the money came from, and what it did with it.

And most of the calls were how shareholders fared.

I answered calls in particular from reporters when the company would announce quarterly earnings.

So I pretty much knew going into a call whether investors are going to be happy or not happy with their performance over the past three months.

That's what the C-suite pays attention to.

Far more important to them.

What is more important is what Wall Street, what investors are going to think about your financial performance, about how much money you made over the past three months.

That just seems like a fundamental conflict of interest, right?

We have companies that want to be profitable, but also have to pay for cancer treatment for people that are dying.

And they can either choose to put the money in the profit or they can choose to pay for the person's liver transplant or whatever it is.

And it just seems like that should be not legal.

And look, I'm as capitalist as anybody out there.

I used to work on Wall Street, but this is one area where I go, hey, you know what?

Maybe like we don't try to profit off of kids who have leukemia.

Yeah, that's exactly right.

This is not a typical industry.

And I'm with you.

In almost anything else, I don't have that kind of a problem with capitalism.

Wall Street's interest is in this.

But it's very different when you're talking about someone's health.

And your point is also correct in that if your first goal is to make sure that you're paying attention to shareholder return and that is your top stakeholder, that means you're going to be doing things that in many cases makes it more difficult for people to get the care that they need.

And we're seeing that especially these days.

Wall Street, frankly, over the past year or so, has not been as enamored with these companies as they had been.

And so these companies are having to ratchet up some of the things that they do.

that make it more difficult for us to get the care that we need.

There are things that they do that falls into the category of what they refer to as prior authorization.

They make your doctors get permission in advance before treating you.

They will often kick some doctors and hospitals out of their networks.

And if you go out of network, you'll have to pay a lot out of pocket.

Out-of-pocket costs is another thing.

We're paying more and more for premiums every year, but also having to pay even more and more out of our own pockets.

in many cases thousands of dollars before our coverage will kick in.

All of this is just to make sure there is plenty of money left over to make investors happy.

Yeah.

Look, I got that giant ER bill and what they said next time was, oh, next time make an appointment.

And I was like, the doctor told me to go to the ER if this gets infected.

It was a post-surgical thing.

So you basically, you told me to do it this way.

And they were like, sure.

I just think it's also, by the way, kind of your fault it got infected.

I had surgery at this place and the instruments weren't clean enough or something.

I don't know.

I mean, is this really my fault?

It's not like I didn't take a shower for a week.

This is not entirely on me.

All right.

Looking back, do you think working in this industry fundamentally changed you?

Because some of the campaigns you ran, the fear-mongering stuff, which we'll talk about in a second, it seems like that would just eventually get under your skin.

It did.

And sometimes I wonder why I did it as long as I did and why other people who are in.

those roles and who have people who have my job now at these companies, why they stay there.

What you do is compartmentalize it as long as you can.

You can say, I'm making a lot of money.

I have a family.

I got a mortgage, I got car payments, got kids in school.

So I'm earning money, helping my family have a good lifestyle.

That's one way of looking at it.

And you can certainly become aware of things that you question and think this is not ethically the way I think things should be done.

Or one of the things that my staff and I did, we handle what we referred to as high-profile stories or horror stories, we call them internally.

And we were the front line for the company.

When a reporter would call the company because somebody was complaining about not getting approval for something or not getting a claim paid, we were the entry for the reporters into the company.

One of the main things that we did was day in and day out, handle these kinds of calls.

And eventually you get numb to that.

It becomes routine.

But every now and then, one will hit you that wakes you up.

And that happened to me.

And I think had it not, I probably might have stayed on until retirement.

But I I had a wake-up call or two.

I really did.

Yeah, I think a lot of people would like to hear what that wake-up call actually was because it seems like up until that point, you're thinking of people as what, numbers?

Because otherwise, how do you sleep at night at this point in your career, right?

Yeah.

That begs another question.

How do insurance companies justify policies that deny care to patients who desperately need it?

What's going on when it's like, this girl has leukemia, but it's like, how do they make that policy and justify it?

They have set themselves up.

And we as Americans have gone along with this as being the way it has to be.

Insurance companies have established themselves as the ultimate decider as to whether or not you'll get a procedure, a treatment, even a medication, because they are the ones who presumably can make a determination as to whether or not something is medically necessary for you.

So they have inserted themselves.

squarely between you and your doctor.

This was not always the case.

It certainly was not the case at all when I was younger, but it has become the norm, the routine, and most people have grown up with this system thinking this is the way it needs to be.

But you have, in many cases, an insurance company employee could be thousands and usually is thousands of miles away from where you are and where your doctor is, making a call as to whether or not you're going to be eligible for coverage for something that could save your life.

Whether we're talking about a cancer treatment or a transplant or something like that, it's usually the big ticket items, but not necessarily.

Sometimes they'll nickel and dime you to death because these companies have millions of people enrolled in their health plan.

So every nickel, all that adds up.

But it's mainly when someone gets sick.

Most of us in a given year, thank goodness, are relatively healthy.

We don't test the limits.

of our health care plan and don't go on vacation, go to Hawaii and have something happen to you.

Things do happen to you ultimately, but they get away with what they get away with because in a given year, most of us think we're going to be just fine.

If I get sick, if I get injured, I've got good health insurance, no problem, until they do get sick or injured and find out they do, in many cases, have a very big problem.

So tell me about this wake-up call that you had, this horror story that finally made you, I don't know, lose enough sleep to quit.

Is that how it happened?

Yeah, there were actually a couple of things that happened within a few months of each other.

I grew up in Tennessee and I went back to visit family in the summer.

It was in July.

And I picked up my hometown newspaper where I had actually worked as a young reporter, as an intern.

There was a story on the front page that said that there was a big outdoor health care clinic that was being held a few miles from where I grew up at a county fairgrounds.

And I was curious.

I'd been to county fairgrounds all my life growing up.

And they said thousands of people were expected to converge on this county fairground in Wise County, Virginia.

I grew up in that part of Tennessee that's right up against the Virginia state line.

I went there out of curiosity.

I borrowed my dad's car and drove there because I'd never heard of anything like this.

And I can't tell you, it was almost like there was some divine intervention that drew me to that story and compelled me to go to this place as if I needed to see it.

I've often said that the road between Kingsport, Tennessee and Wise County, Virginia was my road to Damascus.

Because when I got to that fairground site and walked through the gates, I saw something I just just couldn't imagine ever seeing, witnessing in this country.

There were people who were lined up by the hundreds in many lines, and they were soaking wet because it had been raining before I got there, but they weren't about to leave their place in line.

Many of these folks had spent the night, sometimes two nights or more, in their cars waiting for this event to start.

And many of them, I found out later, by the way, had health insurance.

But what I saw when I paid attention to these lines was that that in many cases, they were leading to animal stalls.

Volunteers had cleaned up the animal stalls.

This is a county fairground.

And just weeks before, they, you know, they had prized horses and pigs in these animal stalls.

They had doctors who were volunteering their time, then nurses treating people in animal stalls.

And it just did something to me.

I couldn't believe that I was seeing it.

that this is what so many Americans had to resort to to get the care that they needed.

I came to realize almost instantly that I had to accept some responsibility because what I did for a living was to mislead people about our healthcare system,

about how it operates, and to make people think that it has to be this way, doing this for the benefit of our investors.

For quite a long time, my top job objective was to enhance shareholder value.

So even in my job, that was job number one for me, what I was measured on.

At first, I thought, well, what's wrong with that?

Until I saw people face to face.

And then I realized what's wrong with that.

Because what I was doing for a living was making it necessary for people to get care that way.

If you told me that was happening in fairgrounds in Gaza or Ukraine, I would say, well, that makes sense.

It's a war zone.

But when it's rural United States, we need to go sleep in our car at the fairground because we need medical care.

And it's going to be in the horse stall, but they brushed all the crap out and put a blanket down.

So it's fine.

That's just like, we are living in the third world unless you have a ton of money.

And I'd love to hear about some of the shocking practices that you witnessed that the public might never expect.

I've experienced a little bit of this.

For example, I have two small kids.

When we were looking into giving birth at the hospital for my wife, of course, we looked into midwives and doublers and stuff like that to make it a little bit easier.

And they were like, hey.

you're super healthy.

You're young.

You're low risk.

You should give birth at home.

And I was like, look, we are not this kind of hippie.

And they said, nah, here are the statistics of complications in hospitals.

And here's the experience.

And they're going to rush you out of the room.

They're going to rush you into the room first.

They're going to induce you, even if you're not ready.

Then they're going to rush you out because they want another person to go in that room literally a few hours later or the next day or the next night.

That's their profit motive.

But if you're at home and you start having labor pains at 11 p.m., we'll just wait until the baby's ready.

And so we literally just paid the midwife, Dr.

Indoula, to have the birth at home.

And we told the hospital, which was close by, to be on standby in case anything happened.

It took a couple days, right?

But meanwhile, if we went there, it's like, well, they induce you.

Then they've got to do a C-section because the baby's not actually ready.

These kinds of little things that give the hospital more profit result in massive operation suffering expense for the patient.

That was just one, but I am quite sure that there are lots more that maybe the average Joe who's having a couple of kids doesn't actually experience.

I think that's exactly right.

And even the insurance industry plays some role in what you were describing there.

Early on in my career at Cigna, we got a lot of bad publicity because the company began to implement a policy of refusing to pay for more than 24 hours in the hospital for a delivery or a mastectomy.

The media at the time, and this was in Connecticut, started calling this drive-through.

deliveries and drive-through mastectomies.

The insurance industry had decided, or my company had decided, that new mothers didn't need to stay in the hospital more than 24 hours.

It was perfectly fine for them to be discharged and go home.

And there were a lot of OEGYNs who were balking at that, and that's what made it initially a local story, but ultimately a national story.

That was because of pressure from the insurance industry, because the insurance industry didn't want to pay for more than 24 hours for a new mother in the hospital, regardless.

Now, the company said, well, those are just guidelines.

That's not set in stone.

But that was the expectation.

And that's what would happen to you unless you or your doctor went to the trouble of objecting and saying you needed to have more time in the hospital.

But hospitals, where we spend most of our health care dollars, it's extraordinarily expensive.

And we've seen in recent years hospitals combining, becoming these massive businesses of their own.

It's not just a single hospital anymore.

Any hospital in the country almost is always now a part of a big system.

And they started doing this, in my view, largely in self-defense because insurance companies, like the ones I work for, began to consolidate and become massively bigger.

And they did that on my watch.

I managed a lot of communications around the acquisitions that my companies made.

And hospitals decided if they're going to play this game, we have to play that game too.

We've got to get bigger to be able to negotiate in a reasonable way with these guys.

And so you've had this arms race that has been going on now for several years as as insurance companies got bigger, hospitals combined to bulk up, and it's all about the money.

It's all about who can get the most money.

Dr.

Jordan here, you are going to die.

When you hear about the great deals on the fine products and services that support this show, we'll be right back.

Imagine a place where innovation and lifestyle perfectly align.

In Michigan, you can be part of our rapidly evolving automotive and clean energy industries while enjoying life to the fullest.

By day, shape the future in our thriving tech hub.

By night, discover beautiful natural wonders, accessible housing, exciting nightlife, and an inclusive community that welcomes all.

Whether you're developing next-gen technology or exploring your next favorite restaurant, Michigan offers the perfect balance of work and play.

Ready to make your career and life aspirations a reality?

Live your best 9-to-5 and 5-to-9.

You can in Michigan.

Work, play, and find inspiration.

You can in Michigan.

Learn more at themichiganlife.org.

That's themichiganlife.org.

Every Monday and Wednesday night, it's true crime on TV1.

Love, betrayal, murder, fatal attraction, all new.

Every Monday night at 9.

Then Wednesday night at 9.

Loyal, ride or die, fad girls.

It's love to die for with all new episodes of For My Man.

Twisted Love, Twisted Endings, Desire, Deception, Betrayal, True Crime with Fatal Attraction and For My Man every Monday and Wednesday night on TV1.

Back to school season means new schedules, supplies, and carpool rides.

It's a lot.

Ollie helps you prioritize your wellness in the chaos of getting the kids back to class.

How about a daily multi to support your immune system?

There's one for mom and dad.

Need something to help you keep your cool when when nothing goes as planned?

Grab goodbye stress.

Looking for digestive and immune system support?

Probiotic mango does both.

And when it feels impossible to shut it all down, Ollie Sleep helps you get the rest you deserve.

Choose the number one gummy supplement brand this school year.

Shop Ollie.com or retailers nationwide.

These statements have not been evaluated by the Food and Drug Administration.

This product is not intended to diagnose, treat, cure, or prevent any disease.

If you're wondering how I managed to book all these amazing folks every single week, it is because of my network, the circle of people I know, like, and trust.

You're probably not booking for a podcast, but it doesn't matter.

You need it in your personal life, you need it in your professional life.

And we know from relationship science that those who live longer and happier have a strong network, that circle of people around them that cares for them and that you can care for yourself.

This course, Six Minute Networking, teaches you how to build that and how to maintain it in a few minutes a day.

It is not cringy.

It's not sort of mechanical stuff.

It's quite fast.

Just some tips and tricks I've learned learned over the past couple of decades.

And many of the guests on the show subscribe and contribute to the course.

Come on and join us.

You'll be a smart company where you belong.

You can find the course, again, for free.

No tricky, weird stuff.

I don't need your credit card information, for example.

You can find the course at sixminutenetworking.com.

All right, back to Wendell Potter.

There's some tales in the book that are just wild.

One example, I think, was reinsurers, which are essentially insurance companies of insurance companies, I guess.

They're trying to cancel people's insurance by trying to find things that people didn't disclose.

And the example, and tell me if I made this up or if this is in the book, but the example was: we won't pay to treat your cancer essentially because you never disclosed that you had heartburn in the past, which no one is going to disclose that.

Nobody's going to necessarily remember that.

Maybe they went to the doctor about it once five years ago because it got really bad, but then, you know, it's gone.

And then you get cancer, and it's like, oh, well, you didn't say that you had this, so it's a preexisting care.

I mean, this stuff is insane.

This is absolutely crazy.

There's also this concept purging.

Tell us how this works.

Purging occurs when a company like Cigna looks at its book of business and decides that these people are no longer profitable.

They're using too many healthcare goods and services.

So they're sick.

They're going to the doctor more often.

Right.

But also businesses, particularly small businesses that are trying to provide coverage to their workers, if one employee of a small business gets sick, then that will mean that when the policy comes up for renewal at the end of the year, the insurance company is likely going to say, you had one sick employee that costs us a lot of money, so we're going to raise your rates significantly for next year.

And if that happens fairly often or significantly, and the insurance company is having to pay out more than the underwriters had initially thought, they'll jack those premiums up.

more than that employer can afford.

And that's why you have fewer and fewer small employers in this country able to offer coverage.

It's dropped over the years significantly.

A lot of people are employed and they work for small companies and those companies are just no longer able to stay in the insurance game.

They can't offer benefits like they did 10 years or so ago.

And that's been very prevalent.

Once again, it's all about the money.

These companies are always looking to see how much they're having to pay out in claims.

And they know that investors do not like that because the more they pay out in claims, the less is available to reward their shareholders.

Yeah.

The whole employers paying for your healthcare thing never made any sense to me.

So if I'm unemployed, now I don't have health care also, it seems like that's when I might need it the most, or maybe I'm unemployed because I'm sick.

I mean, none of this makes any sense.

And then, of course, my employer is like, gosh, how can I do this the cheapest way possible?

That's not going to result in good health care for anybody who's there unless you're in the C-suite and they have to say, hey, we've got the best healthcare in town.

So come work for us.

If you're bagging groceries at Target, they're just going to go, either either we don't offer this at all for your level, or yeah, you've got what's below bronze plan, right?

If you go to the doctor and it is, you're going to pay for the first $50,000 of expenses out of pocket.

And if you get hit by a car, we'll cover 10% of it.

I mean, it's just going to be crap.

None of this makes sense.

And developed nations the world over all have nationalized healthcare.

And I'm not one of those people who's like the government should control everything.

I'm the opposite.

But man, even underdeveloped countries have nationalized healthcare in some way.

And we could have two tiers.

You want to out the nose?

Fine.

You could have a little better care, but like, why are people just having no care whatsoever?

The results are similar.

When I was in that emergency room in Hawaii, I can almost promise you by just by looking around that I was the only person who paid a bill after that.

I don't want to be rude about it, but the people who were in there, these were not people who had $4,000.

I think I might have been the only sober person in the ER that day.

There was a guy who didn't even know where he was, and it wasn't because he was old and senile.

It's because he had consumed whatever he had consumed for a long long time.

We had a swollen leg as a result.

Probably fell.

It's just one of those things.

So we're paying for this anyways.

We're just paying for it in the most inefficient, ridiculous manner possible.

I was looking at some history.

In Germany, Otto von Bismarck, who was, let's say, what, 100 plus years ago, he wanted nationalized healthcare because he said, hey, the backbone of a strong working class is going to make Germany strong.

No country can be strong whose citizens are sick and weak and poor.

This is over 100 years ago.

This guy was like, hey, man, I think we should look at this.

And we still haven't managed to even eke out a semblance of this.

It's insane to me.

Germany, to this day, has one of the best healthcare systems in the world.

And it's not a pure single-payer government-run system either, but they do have a mechanism of making sure that everybody has coverage.

That's critical.

What you were describing, and I know it's right, you can go to any ER anywhere in the country, and you'll find a similar situation.

You'll find people who are there.

You know that they're not going to have money to pay out of pocket.

In fact, 40% of of Americans have fewer than 400 bucks in the bank.

That's right, I forgot about that.

And how can you expect them to pay up to $10,000 out of their own pocket?

In many cases, people have that kind of exposure before their coverage kicks in.

Most of us in this country have coverage.

We're not at universal by any means.

About 92% of us have coverage.

That's fairly close.

But with a country this big, that means we have about 30 million people who still don't have insurance, for one thing.

But they get sick, they go to the hospital, and we are having to pay more in premiums and taxes because of that.

But then you have this other situation of people who have insurance, but they have these high out-of-pocket deductibles they have to meet before their coverage kicks in.

They don't have that money either.

Even though they and or their employers are paying premiums, when they get sick, if it's a big bill that they have to pay out of pocket, they can't do it.

So the rest of us are having to pay for it.

It makes no sense whatsoever.

Our employer-based system began accidentally.

It was during the World War II era when employers were trying to figure out how they could attract scarce talent.

They began offering health care benefits, and it just took hold.

And that is where the majority of us still, if we have private insurance, get it.

But that's eroding as well, too.

That's not growing either because small employers can't participate in this anymore.

And even large employers are saying this is not sustainable.

It's bound to collapse at some point.

It's just a matter of when, in my view.

It doesn't make sense.

You want to attract talent, feed them lunch, and put a gym in the place.

Don't say, oh, by the way, we're going to pay for your kidney transplant should you ever need one.

I do not want to rely on my job at LinkedIn or who knows at Ford.

So I remember one of the other insane examples of refusing to pay for something to cut costs.

There was a girl, she was deaf, I believe, and had needed cochlear implants.

And they said, she's got one already.

So you're going to let her walk around with one ear that hears?

Are you insane?

Who's the person in the meeting that's, I have an idea?

That person is a psychopath.

You really almost have to be a psychopath to go, this person needs a kidney transplant.

Both kidneys?

Because I heard you can survive with just one.

You can survive with just one.

All right, then denied.

Who is that person?

That person will always be anonymous.

You will never know who that person is.

By design, that person remains anonymous.

You'll never know the person's name.

That particular little girl who needed the cochlear implants, she was insured by Cigna.

One of the jobs that I had was to discredit Michael Moore when his movie Sicko came out.

I had to know what the movie was about.

So I flew from Philadelphia to Sacramento to the first screening of that movie to know how Cigna was being portrayed.

And that was one of the cases that was in the movie.

And I knew it was a real one.

And you're exactly right.

Somebody at the company decided, well, this little girl can get by with just one, even though she needed two.

She can manage with just one.

This happens all the time because these people can remain anonymous and they're so far removed.

They never examine the patient.

They might see some paperwork or at least something scanned to them, faxed to them, whatever.

In many cases, still facts.

But they're at such a distance, they have no real understanding of what that patient is going through.

I'm not justifying it, but this this is one reason why the CEO of United Health got killed by Luigi Mangione, because how much was that guy getting paid?

It was like tens of millions of dollars.

Yeah, this is typical.

And that was another thing that I had to handle when I was at Cigna, executive compensation.

And big companies have to disclose what the top paid executives are paid.

And the compensation is extraordinary.

Here's the other thing about that.

90%, and this was a talking point that I used, and reporters bought it and thought that justifies the big paycheck.

90% of his compensation, I would say, was at risk.

In other words, he was paid in stock grants, the stock options.

When you stop and think about that, that means that he's more beholden to Wall Street, to these investors, than anybody else in the company.

So his motivation is always to make sure that those shareholders are happy.

If the company reports earnings that disappoint Wall Street, then your net worth is going to decrease.

And this guy, Brian Thompson, who was murdered, was one of the top executives.

And similar deal.

You're paid primarily in stock.

And he was in New York that day on December the 4th at United Health's Investor Day.

It's something I used to plan for Cigna.

It's the day that the top executives go to New York City.

It's really a kind of a dog and pony show with the biggest investors who persuade them that the company is in great financial shape and the future is bright.

And that's what he was in New York to do, was to spend a day with the top shareholders of the company.

Yeah, I heard also, and look, I'm not trying to slander a dead guy here, but it looks like he manipulated some share buybacks, which is where you use company money to buy back shares to raise the share value and ended up backdating something.

And he made a ton of money off those options.

And I think he may have even gotten sued by the investors or something and had to give back somebody.

There was some controversy there, too.

But for me, it's just this dude took a bullet in the back of the head or whatever it was because he basically just died for money.

That's really all it was in many ways.

It's a shame.

It's a tragedy.

You're right.

He was under investigation for something along the lines that you described.

The CEO of United retired.

Oh, it's been more than 15 years, but he was in the news because he was found to have backdated some shares to inflate the value so that he would get more money when he cashed out.

And he was forced to give back about a half a billion dollars that he had hoped he could walk away with, but he was manipulating the dates so that he could maximize his payout.

And that means that he was not spending that time figuring out how to give better health care.

He was sitting around screwing around with Google Sheets or Microsoft Excel or whatever it is to figure out how he could maximize his compensation.

These guys, they're not working for us in any way at all.

They're working for themselves.

They're working for the shareholders.

This job should not exist.

Should not exist at all.

I'm not saying nobody has to run a company.

What I'm saying is that he should be figuring out how to make health care cheaper, how to negotiate bigger, look, $500 million a lot of cochlear implants for little kids who need them, right?

But he would rather, I don't know, put a shiny hood ornament on his boat or whatever.

It's just disgusting.

Honestly, that's why I think so many people were behind this guy, Luigi.

Like, look, murder is bad, but man, how many deaths is this guy responsible for with all his shenanigans and screwing around?

Look, I'm not saying he deserved to die, but I can completely understand why somebody killed somebody like this and why there's going to be more of this.

And keep in mind, you're dealing with people day in and day out who have medical issues, in many cases, mental health issues.

Sometimes they're associated with the pain and agony you've been going through.

And this seems to have been the case for this particular young man.

But it's becoming increasingly impossible to deal with these companies if you've been denied something.

And we saw that just triggered this outpouring of storytelling.

on social media, people going to social media, sharing their stories, their horror stories with the world.

And it was stunning how fast that began to develop.

I wasn't shocked when I stepped back and looked at it because even when I was in the industry, I knew that people despised our industry.

We spent an enormous amount of money, and these companies still do on image advertising and product advertising.

But we did surveys and we would ask people, what can we do to get you to like us better, essentially?

And it was always, the answer was, pay our claims and get out of our lives.

But they can't do that and satisfy Wall Street.

So they've got to do what they do.

That's right.

How about we just get out of your life without paying the claim, meet you halfway?

No.

That's right.

Yeah.

If you die early, okay.

It's not bad.

Not a bad deal for us.

I've got a couple of friends.

One of them, he had a tumor on his leg and it started growing.

And I don't remember all the details, but it was like, hey, if this isn't right, oh yeah, we'll do a test.

Oh, you know what?

This test says we need to do another test.

Great, let's do it.

Yeah, it's going to take three or four months.

What do you mean?

Back and forth.

And finally, she said, look, this thing is continuing to grow.

We're documenting everything.

I've got all my calls recorded.

I've got all my emails saved.

I got all my letters saved.

If he dies, I'm going to the media.

And they were like, oh, look, you can take that test on Monday.

Wow, that's cancer.

We better shoot radiation at that thing.

Done.

He's fine.

That really makes me think the squeaky wheel gets the grease in managed healthcare.

So glad you said that.

Does this mean if I get a denial someplace, I need to go on this podcast and just basically shit talk an insurance company?

Because I will do that if I have to.

Do that because some version of that is what you need to do.

I've told people whenever I have a chance, be a squeaky will.

The problem is, when you're really sick, it's hard to be your own advocate.

It's hard to be that squeaky will.

You've got to find the energy somewhere to do it.

It's good to have an advocate, someone you know, someone and your family or a friend to help you with this when you're not at your best.

But yes, be a squeaky will.

There was one story in particular, one horror story that was it for me that I ultimately turned in my notice, involved a girl in Southern California who needed to have a liver transplant.

And Cigna medical director, 2,500 miles away in Pittsburgh, said he didn't think it was medically necessary for her, even though the surgery was scheduled.

A liver had been found.

The family had arrived at the hospital.

to wait for the procedure, but instead the parents were taken aside and said, sorry, we can't go forward because Cigna has not given us clearance to do this.

Long story short, the family decided to make a big deal out of this, and they were able to get reporters in LA to start calling me.

So, what's the deal here?

Why is Cigna not paying for this girl's transplant?

And it just mushroomed.

It became a huge PR problem for the company.

These companies don't like it, and they have people like me on staff who dealt with these day in and day out.

And they do want these stories to go away.

So, more often than not, when a reporter calls somebody in the media, probably someone with a big social media following these days, that can make a difference because these companies want to try to make these stories go away.

And they often will reverse a denial.

That's so interesting and also really crappy at the same time because what this is showing, and by the way, this girl, I think her name was Netaline.

So they didn't approve it and then they gave the liver to somebody else because Signa was sitting on their ass for so long that she didn't get the liver in time.

And so reversing that denial, that's great.

Good for you, jordan with a huge podcast what about for people who don't do media for a living and have success internationally with a giant footprint oh well you're just out of luck my kids get to live and yours are screwed because you're an engineer somewhere that hardly seems fair and what it also shows is they'll reverse the denial because they know it's bullshit and they know it's unfair and they go wow this makes us look like the assholes that we actually are We should probably say that this is an administrative error and turn it around, but this is an exception to the rule rule.

And we can afford to do it only because, wow, are people pissed off at us?

And that's going to reflect poorly in the stock price.

And we're going to have to spend a lot of time fighting it in the media.

Or it's going to come up in another interview when our CEO is interviewed by Squawkbox or whatever.

If that's what has to get done, it's even worse because it's like, yeah, we're doing bad stuff.

We hope that we can cover it up.

But when it does leak out, we'll just make it look like an accident and then go right back to doing the exact same thing to everybody else who couldn't get their name in the paper.

It's exactly right.

Because the vast majority of us don't get our names in the paper.

We don't know you.

We don't know how to get on your show.

We don't know how to do these kinds of things.

It's only the occasional ones that really break through that can get a reporter interested in taking your case and making a call on your behalf.

And they get away with this day in and day out because people don't know how to be a squeaky will.

I say, give it a go, do the best you can, but that's hard.

It's hard to do that.

And you're facing such odds.

And I always encourage people to never take no as your first answer, always begin an appeal process.

But the industry makes it so damn difficult.

A lot of people don't know that they have rights to appeal.

They just assume it's going to be such an ordeal, or they feel so lousy that they don't do it.

As a consequence, a small percentage of people actually fight back.

They never file an appeal.

They don't become the squeaky will.

And they suffer.

And in many cases, die early.

It's the way it is.

Tell me about the lobbying and the politics.

What is astroturfing?

What are you creating here with these sort of front groups to be against policies you don't like if you're an insurance company?

You're essentially inventing groups that purport to be consumer organizations or patient organizations that are nothing of the kind, but you name them in certain ways to make people think they're legitimate.

One in particular that comes to mind that I was a part of, we called it Healthcare America.

We created it for two reasons.

One was back to Michael Moore.

We set it up to discredit him by having this outfit, which was run by a big PR firm in Washington.

The people thought there might be some real consumer folks involved with it.

There was nothing of the kind.

But it turned up press releases.

It would get quoted in the newspaper saying that Michael Moore was out of step with American society.

He was advocating for a government takeover of healthcare, things like that, just to discredit a movie.

But when Congress got down to business to try to pass health care reform legislation in the early days of the Obama administration, we repurposed that front group, Healthcare America, to try to get Americans to believe that what was being proposed would not be in their best interest.

It was paid for exclusively by big insurance companies.

But Americans don't know that.

You see these advertising, you see things on TV, particularly during election years, and think that whatever that advertisement is from some legitimate organization, more often than not, it's some industry that has found some name and some outfit that they create and pay for and hire a PR firm to run that's behind it.

I remember hearing that Obamacare was going to have death panels and there'd be people that would decide whether you live or died.

And then I remember hearing people in Congress say, there's going to be death panels.

They're going to decide who lives or dies.

And ironically slash diabolically, the healthcare companies have these pretty much already.

And that's the problem.

They would actually be going away in many ways under Obamacare's or the ACA.

But healthcare companies were like, oh, what are people afraid of?

Some random person 2,500 miles away deciding whether you can live or die?

Yeah, we already have that.

Let's just say that's what they're going to do.

If you vote for this thing, it's going to make us less money.

And it's like, all right, great.

Dust off the logo from the bullshit thing we did in the 90s or whenever Siko came out in the early aughts.

It's really gross how much lobbying and politics influences decisions made by Congress, but also healthcare insurers.

I noted in the book, you mentioned an acquaintance of mine, Mark Garagos, who was trying to sue Cigna, and he was unable to do so because there's a law that basically says you can't sue healthcare companies and states can't protect consumers against them.

Tell us how this incentives kind of work because it almost looked like the incentive was insurance companies decide if they want to pay and it's actually better if you just die and then they don't have to.

Or am I misreading that?

It's ridiculous.

And it goes back to what we were talking about earlier about employers providing access to coverage.

There's this law that was passed in the mid-70s to protect people's pension benefits, make it unlawful for employers to abscond with your retirement money.

It's been interpreted over the years to apply to health benefits, and it gives employers enormous protection from state laws.

It makes them exempt from state laws, but it also makes it impossible for people to sue an insurance company or an employer and have much chance of recourse because the law says that all you can get is maybe a decision that the benefits were not administered correctly.

So consequently, very few lawyers will take this case on.

I think Mark Garagos didn't fully appreciate the protections that employers and insurance companies have because of this law.

And he was not able to get any money for this family.

It was Ned Lean's family.

He was involved in that case.

That does not surprise me.

I was going to say, it's really sick and twisted in that an insurance company can say, hey, we didn't pay for your treatment and then you died, but you would have to prove that you died from that thing that we didn't pay to cure.

And if you can't prove that, it's not our fault.

And not only can you not sue us, you paid us premiums and then we denied your coverage.

So we actually made out pretty well not paying for your cancer coverage.

Now you got to prove that you died from that cancer.

Well, it says here you died from cardiac arrest and sepsis.

Maybe the cancer caused that, but can you prove that?

No, you can't.

So go fly a kite.

That's what it sounds like.

Now you see why these companies make so much money, how they're able to pay their CEOs $20 plus million dollars every year and report profits of one company, like $30 billion a year.

It's just stunning how much money they're making.

Sorry, we can't get you that critical liver transplant, but rest easy because I can get you some deals and discounts on the fine products and services that support this show.

How about a mattress or something?

We'll be right back.

You're tuned into Auto Intelligence, live from Auto Trader, where data, tools, and your preferences sync to make your car shopping smooth.

They're searching inventory.

Oh, yeah.

They find what you need.

They're going to find it.

We can make a budget for you, Walet, to help you succeed.

Pricing's precise and true.

So true.

It's smart and car shopping.

Just for you.

Oh, it's just for you.

Find your next ride at autotrader.com, powered by auto intelligence.

Ever notice that everyone always wants more of a good thing?

More rewards, more savings, more special offers?

Well, when you become a new member of the Fuel Rewards Program at Shell, that's exactly what you get.

More.

Join today to save 10 cents per gallon on your first bill, 20 cents on the second, and 30 cents on the third.

Then enjoy everyday savings afterwards.

Want more?

Then head to Shell where members get more.

Offer ballot from 421.25 through 103125 at participating shell locations.

Offer must be redeemed within 60 days of registration.

Limit 20 gallons.

Restrictions apply.

Visit fuelrewards.com slash join25 for more information.

When it's this hot, you need a snack that's cool, fun, and delicious.

Like Mai Mochi ice cream.

Mai Mochi is little scoops of ice cream and flavors like strawberry, mango, and cookies and cream wrapped in soft dough.

It's creamy on the inside and chewy on the outside, like a sweet ice cream dumpling.

Mai Maimochi is gluten-free and only 70 calories apiece.

The perfect guilt-free snack.

This summer, grab a purple box of Maimochi ice cream and feel joyfully chill with the coolest treat around.

If you like this episode of the show, I invite you to do what smart and considerate listeners do, which is take a moment and support our amazing sponsors.

They make this show possible.

All of the deals, discount codes, and ways to support the podcast are searchable and clickable over at jordanharbinger.com slash deals.

If you can't remember the name of a sponsor or you can't find the code, email us, jordan at jordanharbinger.com.

We're happy to surface codes for you because it's that important that you support those who support the show.

Now for the rest of my conversation with Wendell Potter.

It sounds like big tobacco all over again.

These front groups that you'd created, it's interesting, right?

Your industry, your former industry, I should say, completely lacks credibility.

So you really need these front groups to message for you because nobody freaking trusts you anymore.

It's interesting how these companies sort of whip up what sounds like mostly kind of older people's.

If you tell my parents that their healthcare is going to suffer in some way, they're going to be really upset about it.

They're the ones who actually call their congressmen when something is wrong.

I'm like, wow, people do that?

I thought that was just something that you hear on the internet, right?

Pharma, insurance, politics, tobacco, that's what y'all have in common is nobody trusts you.

So you have to be like, organization for a more secure America.

Secure for what?

Well, we're talking about the shareholders, but nobody has to know that.

Women secure and it sounds like something you should vote for.

Okay.

It's like when you look at the ballot and it's Fair Education America, and it's like, this group is just a bunch of old people who want to pay less taxes.

No, how is that fair?

What are you talking about?

It's just a bunch of crap.

I'm a little bit fired up because it's really making me angry just reviewing all this stuff all over again, these charm offensives.

And you get a shady talk show host like Rush Limbaugh, who did untold damage, and you just have them parrot your bullshit for you for money.

That's

exactly.

You were able to throw money at influential folks to get them to carry your water for you.

You mentioned the tobacco industry.

That was a playbook that we followed, chapter and verse.

And part of it is to form these front groups because if your industry has no credibility, you've got to have some outfit.

And some allies too.

They will go to organizations like the U.S.

Chamber of Commerce and others that people hold with greater respect and believe are credible organizations that represent small businesses.

And I can assure you, the U.S.

Chamber is not quite that.

We worked with the U.S.

Chamber and a lot of big organizations.

We wanted to ally with them and let them carry our water for us because we couldn't do it ourselves.

What about the polls and survey data?

You mentioned this in the book.

Essentially, they select certain people in a certain way and get the results that they want.

Tell me how this works.

Yeah, we were always constantly surveying people to find out what they were thinking about public policy as it pertains to health care.

We would want to make sure that we understood how susceptible they were to agree with the Michael Moores of the world.

How likely are they to say that we need to go to a single-payer health care system?

And our surveys showed, even when I was in the industry, that a majority of Americans were okay with that.

So our job would be to dissuade Americans, to get people to fear that.

And so our pollsters were also messaging experts, and they would also know how to ask some questions to get people to change their opinion or to see it from a different different perspective and then that would enable us to do our talking points and to scare people in a certain way for example

if you were to go to a medicare for all or a single-payer system in this country by definition it is going to be paid for with tax dollars and every study you've ever seen will show that we can attain universal coverage in this country and pay less for it than the system we have now.

But you have to pay more taxes.

So you would shift from paying premiums to private insurance companies to pay more that would be dedicated to health insurance.

The insurance industry knew how to manipulate people to fear a tax increase.

You would obscure the fact that they wouldn't be paying premiums, but get them to be opposed to paying additional taxes.

So that's just an example of how you do that.

You poll people to find out what they currently think, and then you figure out how can you scare the shit out of them?

How can you develop a messaging campaign campaign to get them to fear what your opponents are advocating for?

It is gross.

And I can see why you had a crisis of conscience when it comes to this.

Do you think Americans are finally reaching a breaking point with the healthcare system?

Because it seems like we should have a long time ago, but here we are, still same old crap.

I do.

It's hard, certainly, to sustain any kind of movement, if you will.

When Brian Thompson was murdered, there was a lot of publicity around that.

I think there will be as that goes to trial.

I think it's not a dead subject by any means yet.

But I am seeing for the first time, I think in my lifetime, more bipartisan interest, at least here in Washington, to address some of these big problems.

You're not going to see Republicans embrace Medicare for all.

That's just not going to happen.

But they are beginning to pay attention to some of the practices of this industry and seeing how they're ripping off their constituents.

So I'm seeing that.

And in fact, I'll be meeting with every time I come to Washington with Republican offices because they run the town now.

And I am seeing and hearing receptivity to doing something and working across the political aisle with Democrats to try to reform this industry.

Will we reform it enough?

It's going to take a while.

It's going to be a while.

But I do think that we Americans are seeing this for what it is, seeing how it's rigged against us and how they are profiteering.

And I think that will lead to meaningful reforms.

I do.

Can we draw a straight line between the insurance industry and the rising cost of health care?

Because I think we've been hinting at that, but people are probably wondering, wait a minute, how come this insurance company that puts profits for us, how come they're making the actual cost of things higher?

They don't set the prices or do they?

I mean, how do those things connect?

They don't necessarily set the prices.

In other countries, there is a national mechanism that does have some price setting and responsibilities.

In this country, we've taken an approach of essentially saying that's for insurance companies and hospitals and doctors to fight it out.

And it has obviously hasn't worked very well for us because prices keep going up and up and up.

What people need to realize is that insurance companies don't have all that much of an incentive to bring the unit cost of goods and services down because as it goes up, as I say in the hospital goes up, as the prescription goes up, despite what an insurance company complains about, they benefit because they're the only game in town.

We don't have a public option.

We don't have anything that really competes with private insurance companies.

They're the only game in town.

They all work as the cabal, and they're able to raise premiums every single year.

The average cost of family premium that you get through an employer is now $25,000.

And that's not accounting for the out-of-pocket cost.

So that's how much a policy for a family costs.

And that family can also be on the hook for $18,400 as a maximum out-of-pocket.

So you can be paying paying all this much in premiums and all this much in out-of-pockets, also.

So the way it is structured now almost guarantees that the cost of health care will go up.

Drug companies, hospitals, physician practices, they're going to raise their prices because they know they can.

These companies, the insurance companies, don't have as much of an incentive as they would like us to believe to control those costs.

What they do control, or try to, the lever that they often say that there are two ways to control prices.

One is to do something about the unit cost of goods and services, how much a drug cost, or to limit access to that drug or treatment.

And that's where they're really good at.

And they have said it's our fault that we want to use too much health care.

So we need to have more skin in the game.

That was a phrase that, sadly, I helped get out there to get people to believe that people needed to pay more in deductibles because we were using, I said back then, too much healthcare.

It's nonsense.

People don't necessarily love to go to the doctor.

There may be some hypochondriacs, but they're few and far between.

People who love to go to the doctor love to go to the hospital.

And who do you know who takes unnecessary cancer drugs?

It just doesn't happen.

That's insane.

What advice would you have for somebody who's trapped in, let's say, medical debt and feels like, hey, the system is stacked against me?

You mentioned appeals and stuff like that before.

Is that where you start?

That's very important.

It's where you start.

Again, don't take no for an an answer.

If you get a bill from a hospital, call the hospital and call your insurance company and say, this can't be right.

How can this be the bill that I'm being charged?

Because often sometimes there is just an error or a clerical mistake or the insurance company hasn't filed the claim yet.

And so you're getting a bill from a hospital.

Just don't pay that first bill.

Start inquiring and appeal a denial.

If you are told that the insurance company that you have is going to be refusing to pay for something your doctor says you need, fight that.

Know what your appeal rights are.

Ask your doctor to help you because the doctor has an incentive to join you in this.

Doctors, unfortunately, are having to spend more and more time every day fighting insurance companies to get approvals and to get paid appropriately, but you need to enlist them as well, too.

What a waste of their time.

Imagine you're a surgeon and you got to spend three hours a week writing a letter saying, no, really, I need to take this person's infected kidney out immediately.

As a doctor, you've got to be sitting there looking at your computer going, how did I end up having to do this?

This is insane.

Yeah, they don't tell you that in medical school, but that's the reality of their lives.

And a lot of them are getting burned out.

They're retiring early.

They're using this term moral injury to describe what it's like in many cases to be a doctor in America.

It's crazy.

I don't even know what you would call it, but my parents have this and a lot of my friends have this where you have your insurance and you have your doctor, but then you pay like a yearly membership almost to your doctor.

And your doctor goes, all right, I'm basically dropping everybody who doesn't pay for this membership.

So you're paying $1,500 a month for your insurance or whatever it costs, but then you're paying, I don't know, five grand a year or four grand a year to be on the list of the people whose phone calls get answered by the doctor.

I don't totally get what it is, but the way the doctors have justified it, because I originally was annoyed and I was like, what the hell are you doing?

What do you mean you're going to charge my parents more?

He goes, I'm not getting paid half the time by Medicaid or the insurance company.

I'll give your parents the medicine they need.

And then I go to bill it and they're like, well, actually, we're going to give you 40% of this because of reasons.

And so he just gets screwed.

And he's like, you know what?

I'm only going to take people that have good insurance and I'm only going to take people who pay this.

And that's going to offset all of the nonsense.

And then I have some stability in my income.

And I'm not basically loaning the government or the insurance company my money, which I understand.

I wouldn't want to be a doctor like that either, dealing with that nonsense.

Yeah, I know.

That is a growing thing that you described.

They used to be called concierge medicine.

I guess a more appropriate term from their perspective is direct access or something like that.

And you can have quicker access to a physician.

In mental health, this has been happening for quite a long time.

A lot of psychiatrists and therapists don't accept insurance because they don't get paid enough.

They haven't historically, and it's just too much hassle to deal with them.

So in the mental health space, probably a majority of clinicians are out of network, but you're seeing that increasingly in medical care as well, too.

And even in primary care, there's a growing movement of direct primary care, direct access to primary care.

If every American had access to primary care, we'd be a lot healthier country, but people, they don't have it.

And in many cases, they're stuck.

in these high-deductible plans and don't go even when they get sick.

And that can lead to complications down the road.

We can go on forever about how the incentives are just so perverse in this country.

But what you described is a growing thing and more appealing to physician practices.

If you could dismantle one part of the current system, what would it be and why?

I know there's a lot of rot, but you got one thing in mind that you'd target first?

I would dismantle these big corporations that I work for.

They're far bigger now than they were when I was in the industry.

They've embarked on something called vertical integration.

Insurance companies are not just insurance companies.

Now they increasingly own physician practices and clinics.

You might not even know that the doctor that you're going to is employed by United Health Group.

These companies need to be broken up.

And that is one thing that there's growing bipartisan support for in Congress is to look at the makeup of these companies.

United Health Group is the largest.

It's a $400 billion company.

It's the fourth largest company in America now.

It's grown so much in recent years through acquisitions, Increasingly, in recent years, buying up physician practices all over the country, getting deeper and deeper into home health care, into hospice care and pharmacy benefits.

People get annoyed at drug companies for the cost of medications, but increasingly insurance companies are taking a bigger chunk out of the pharmacy supply chain than the drug makers are getting.

In other words, Insurance companies now are taking a bigger chunk than what the drug makers are making because they have this thing called a pharmacy benefit manager that's a huge middleman that they own.

And three big insurance companies, including Signa, where I worked, control 80% of the prescription market.

It's an incredible scam.

And that's another reason why I spend so much time in Washington is to educate the lawmakers.

This is what's going on, guys.

You need to do something.

You need to pay attention.

Break these guys up.

So that would be one thing that I would say right off the bat that we need to do is break up these big giant conglomerates you're like a reverse lobbyist do you ever run into the other lobbyists that you used to work with and like oh crap window potter's here go to the bathroom and walk out the back door every now and then i do and they all know me i'll tell you that they they know who i am if i don't know them they sure know who who i am yeah oh hey isn't boss isn't that the guy whose picture is on the dartboard in our office yes it is That's him.

What would you say to current healthcare insurance executives who are feeling conflicted about their work?

They're listening to this podcast because their daughter made them promise they would listen and now they're in their car in the parking lot crying.

Or hopefully, what do we say to these people who are thinking like they knew, they've known, and this is the wake-up call that they can't overlook?

I hope they will.

I hope they'll listen to this.

And I hope it'll be something that triggers something with them like happened to me that you want to leave this life feeling that you made a right decision somewhere along the line, that you weren't just in it to make money, to get the latest new car or the next vacation house.

Something is more important than that.

And having a career that is honorable and focused in ways that is not just enriching yourself, and in particular, in this business, in which you are playing an active role in making it difficult for people to get the care that they need, there's something wrong with that.

And I hope people who are involved, certainly in high levels, will have their come to Jesus moment like I did too.

Folks at the lower levels of these companies are so far removed from an understanding of how the companies operate that they just don't have that kind of visibility or awareness.

But I can assure you, the executives damn well do know what's going on.

Yeah, that's interesting.

Of course, after Luigi's little incident there, they took their pictures off the website, which I get it.

They were scared.

And I remember thinking, you should be scared.

You're kind of responsible in part for a lot of deaths.

You're just sitting there in your Nantucket house being like, oh, I hope this never catches up with me.

Now it's not so clear-cut.

Sure, get bodyguards.

That's not going to help.

What you need is a more fair system.

It sounds like you think there's hope for a more equitable healthcare system in the U.S.

We're not too far gone.

Is that accurate?

If I didn't think that I wouldn't keep doing what I'm doing, I just think it's worth the fight.

I can't tell you what the odds are.

I just don't think that what we're currently doing can last forever.

And I think that we're seeing from this murder, just this understanding of this wrath, this rage is just right below the surface.

People hate this.

And if they can figure out how to, and I think it's partly on me and some other advocates to help organize that, make sure that those voices continue to be heard, but also do what I do as well, speaking out, meeting with lawmakers, educating them, because I can assure you, the companies will spend a lot of your premium dollars on campaign contributions and lobbying.

But I do think there is hope, and I think it's worthwhile to stay in the game here.

What do you think needs to finally happen for Americans to have access to affordable health care?

I mean, it sounds like you think the government has to basically make this happen because the companies aren't going to self-organize and do this themselves.

That's for damn sure.

That's the thing.

What I really want policymakers to understand, because you've got these perverse incentives, when you have a system that increasingly is controlled by shareholders, it is not going to work.

I'm a capitalist, but they just need to understand it does not work in healthcare like it does in other sectors of the economy.

And that has to change.

Even as recently as the 90s, most insurance companies were still on a nonprofit basis.

I'd be happy if we could turn the clock back or have these companies spin off their insurance operations into nonprofits.

Like it was prevalent for decades.

That's how they started.

The Blue Cross plans, every single one of them, are nonprofit.

Many of them still are.

A lot of them have converted to for-profit status.

Anthem Blue Cross is part of a big, gigantic corporation.

But we were doing a lot better when health insurance was operated on a non-profit basis.

We really went down the wrong road when we allowed these companies to go to for-profit status.

And now we're seeing the consequences of that.

So I would like to see that being addressed.

And again, it hasn't been all that many years ago in which we had a very different environment.

Wendell Potter, thank you so much for coming coming on the show today.

I know you're on the road in Washington scaring lobbyists.

So I appreciate you taking a little bit of time out from that to come talk to us.

My pleasure, Jordan.

Thank you so much.

Hell of a good interview.

I really appreciate it.

And thanks for having me on.

Yeah, you got it.

Thank you very much.

You're about to hear a preview of the Jordan Harbinger Show about a guy who went from Nigerian royalty to the rugged streets of the Bronx.

Remy Adeleke's life was thrown into chaos after a corrupt government stripped his family of their legacy, dive deep into his captivating journey from being surrounded by drugs and drive-bys to his inspiring pursuit to become a U.S.

Navy SEAL, even though he didn't know how to swim.

There's a saying in Nigeria, every day is for the thief.

Corruption was my dad's demise.

They knew that my father would not stop fighting them.

They killed my dad.

I went from riches and wealth to the bronze, man, and it was really, really rough.

Once you make the decision to join the Navy, in my opinion, you're giving up any fear of of death.

One day I got approached by another human trafficking nonprofit that actually employed former SEALs and former agency guys to go into other countries to rescue kids trapped in sex trafficking, but specifically kids who are being purchased by Americans.

When I got down there, my eyes would just like open fully, and I just remember being appalled.

The parents would sell their daughters to traffickers in the North.

I just remember being disgusted.

It's such a global issue.

but human trafficking is a blanket term.

Under human trafficking, you have sex trafficking, you have organ harvesting, you have forced marriage, you have forced labor.

You know, I made the film in order to be able to expose more people to this atrocity of organ harvesting.

But the perception of these traffickers is that they're these scraggly, evil-looking, uneducated, you know, on the corner type people.

And the reality is a majority of people involved on the organ harvesting side of things are highly educated learning people.

The truth needs to get out there.

But that's not all.

Remy's fight is far from over as he confronts the dark underworld of human trafficking and illegal organ harvesting.

To uncover what drives the man who refuses to be defeated, check out episode 868 of the Jordan Harbinger Show.

All things Wendell Potter will be in the show notes at jordanharbinger.com.

Advertisers, deals, discount codes, ways to support the show, all at jordanharbinger.com slash deals.

Please consider supporting those who support the show.

Also, our newsletter, Wee Bit Wiser, is practical.

It's a two-minute read every Wednesday-ish.

It'll have an immediate impact on your decisions, your psychology, and your relationships.

And if you haven't signed up yet, I invite you to come check it out.

It's a really good companion to the show.

JordanHarbinger.com/slash news is where you can find it.

Don't forget about Six Minute Networking as well over at sixminutenetworking.com.

I'm at Jordan Harbinger on both Twitter and Instagram.

You can also connect with me on LinkedIn.

And this show is created in association with Podcast One.

My team is Jen Harbinger, Jace Sanderson, Robert Fogarty, Ian Baird, and Gabriel Mizrahi.

Remember, we rise by lifting others.

The fee for the show is you share it with friends when you find something useful or interesting.

The greatest compliment you can give us is to share the show with those you care about.

If you know somebody who's interested in the healthcare system or might find a conversation like this interesting, definitely share this episode with them.

In the meantime, I hope you apply what you hear on the show so you can live what you learn.

On this one, I hope you never have to apply what you heard on this show.

But in the off chance that you do need it, I hope this comes in handy.

And we'll see you next time.

This Labor Day, gear up, save big, and ride harder with Cycle Gear.

From August 22nd to September 1st, score up to 60% off motorcycle gear from your favorite brands.

RPM members get 50% off tire mount and balance with any new tire purchase.

Need to hit the road now?

Fast Lane Financing lets you ride now and pay later with 0% interest for three months.

And here's the big one: August 29th through September 1st only.

Buy any helmet $319 or more and get a free Cardo Spirit Bluetooth.

Supplies are limited.

Don't wait.

Cycle gear.

Get there.

Start here.