Ex-Cigna Executive Tells Why He Left Insurance Industry to Champion Uninsured

Whistleblower recalls change of heart, says industry stymies health care reform.

August 15, 2009, 7:24 PM

Aug. 16, 2009— -- For 14 years, Wendell Potter flew high in the world of the Cigna health insurance company. He was chief public relations executive for Cigna, helping craft strategy to burnish the company's image and defend it against criticism. He said he was a loyal, dedicated employee who genuinely believed in the company and in the health care industry.

Then, in the summer of 2007, while visiting his hometown in rural eastern Tennessee, he saw an item in the local newspaper about a "health expedition" being held across the nearby state line in Wise, Va. He was curious, so he drove there to have a look.

What he saw shocked and appalled him. Hundreds of people were lined up in a drenching rain at a fairgrounds to see the volunteer doctors who were there to treat them for free. Potter learned that many of these people had no health insurance and, in some ways more stunning to him, many who did had deductibles so high or coverage so restricted they were essentially "underinsured."

In his mind, he began to see a connection between the policies and practices of American health insurance companies, such as Cigna, and the plight of the line of people at the fairgrounds.

About six months later, Potter was involved in the controversial case of a 17-year-old girl, Nataline Sarkisyan, who had been denied Cigna coverage for a liver transplant her doctors said she needed to live. Cigna declined to cover it because it was deemed an experimental procedure. As company spokesman, Potter had to defend the decision.

Eventually, the company relented and agreed to pay for the operation, but it was too late. Sarkisyan died.

Shortly afterward, Potter resigned and left the company in May 2008. For a long time, he kept his grievances and doubts to himself. But when the Obama administration put forth its health care reform plan this year, Potter said he witnessed the health care industry doing what it had done in 1993 when the Clinton administration attempted to enact health care reform: fight it while claiming publicly to endorse reform.

Former Cigna Exec Describes Health Care Epiphany

Potter became angry and decided to speak out against the industry in which he had worked and prospered for 20 years. Recently, he testified before a congressional committee, denouncing what he said was an industry determined to reduce costs at the expense of the insured to placate Wall Street's demand for ever larger profits.

Last Friday, I sat down with Wendell Potter at his home in Philadelphia. Potter is now a senior fellow for health care at the Center for Media and Democracy. He talked about that fateful trip to Virginia in 2007.

Potter: I went to what I'd read in the paper [was] some kind of health care expedition across the state line in Wise, Va. Out of curiosity, I went there and I was just struck like I'd never been affected before by something I saw. [I] walked through the fairground gates and I saw these thousands of people who, many of whom had slept in their cars the night before, and had lined up before dawn to make sure they got a chance to get through the fairground gates and get care that was being delivered by doctors who were volunteering their time.

I knew there were 45, now almost 50 million people without insurance, but you don't really think of it in human terms. I didn't until I saw that. To see it in the way I saw it was just a sudden realization of what really happens to so many people in this country because they don't have insurance.

Claiborne: Do you remember how you felt when you saw this?

Potter: Yeah, I do. Talking about it is, it's hard to express sometimes because it was so emotionally riveting. I walked through the fairground gates. Again, it was just like something rushed at me. I just felt that I had been hit by lightening or something. It was almost-- Some people say this must've been your road to Damascus story. And it was, to a certain extent, because it was almost as if for the first time I was able to see something that I hadn't seen before.

Claiborne: Did you agonize over this and what to do in the ensuing months?

Potter: I did. I did.

Claiborne: And what were the competing thoughts?

Potter: Well, the competing thoughts were that I can't do this. I'm a spokesman for this industry, and here I am being very skeptical.

Ex-Health Insurance Spokesman Discusses High-Profile Claim Denial

We talked about the Nataline Sarkisyan case.

Claiborne: What was the explanation for denial of benefits?

Potter: That it was experimental in that case.

Claiborne: Was that legitimate?

WP: I'm not a judge [of medical decisions]. I can't be a judge of that. It was--

Claiborne: Well, what did you think at the time?

Potter: I thought that her doctors probably knew best about what was in her best interest and what might save her life.

Claiborne: But you had to represent the company line?

Potter: The company line. And the company did say, and truthfully, that it would send the case to external review, which it did do. And other doctors did review it. And agreed with the company, initially, that it was, would've been an experimental procedure that had not been proven effective.

Claiborne: When Nataline, 17 years old, died, how did that affect you personally?

Potter: Oh it was just, just awful.

Claiborne: Why did you finally quit?

Potter: I just finally reached the point that I was so uncomfortable doing what I was doing, I would look in the mirror literally and I'd say: 'Who are you? How did this happen to you? How did you get to this place?' And it got to be so agonizing that I thought, 'Well, I don't have another job, but I can't keep doing this.'

Claiborne: When and why did you finally decide to speak out, to burn those bridges?

Potter: It was when I started to see that the industry was up to the same old tactics, the same dirty tricks that it's pulled many times to try to kill health care reform. It's part of a duplicitous P.R. strategy. The strategy is to say those things that the president, the Congress and the public want to hear. And they want to be perceived as the good guys, as an industry that is fully committed to reforming the health care system in a comprehensive way.

Claiborne: And you don't believe they do?

Potter: Oh, I know they don't. I know they don't believe it.

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