Wendell Potter has some issues with the Patient Protection and Affordable Care Act, often called “Obamacare.” But the alternatives, he thinks, would be worse.
“It does an enormous amount of good to force change on an industry that should have changed many years ago and simply cannot change itself,” the former insurance executive said of the controversial law. “I’ve called it the ‘end of the beginning’ of reform. It’s by no means the perfect reform.”
Potter, a public relations executive with Cigna and Humana, broke with the industry and penned a 2010 book, “Deadly Spin,” exposing how insurers have gamed the system to boost profits and deny coverage. He’ll be speaking about insurance and health care reform 7 p.m. Wednesday at Stargazers Theatre, 10 South Parkside Drive. The event, sponsored by the Community Health Partnership and the Marcy Morrison Fund at Temple Shalom, is free and open to the public.
The individual mandate, requiring everyone to have insurance through an employer, government program or to buy it on their own, is at the heart of both the controversy over the reform act and a Supreme Court case challenging the constitutionality of the Affordable Care Act. Potter sees the mandate as a giveaway to insurance companies to get them on board with the legislation. He would rather have seen a public option, in which the government directly sets up an insurance plan like Medicare that is available to everyone.
“The law was constructed around the individual mandate,” he said. “I’m not happy that the insurance industry was able to get its friends in Congress to strip out the public option.”
Potter argues that many of the proposed alternatives to the Affordable Care Act would be unworkable, including the wider adoption of health care savings accounts and high deductible plans.
“It really cannot be made to work,” Potter said, adding that such plans leave many people either under insured or become unaffordable. “Those plans are wonderful for people who are young and healthy and have money that’s disposable. They’re wonderful tax shelters. Most American families just don’t have the money to put into those savings accounts. “
As Potter sees it, for-profit insurance companies are a driving force behind escalating health care costs.
“What has happened is we have this notion that the free market can and should work in health care just like in every other sector of the economy,” he said. “What has happened is that not only is our health insurance the most expensive in the world, so is health care. We have a system that is completely out of whack because of the profit motive.”
There are nonprofits and integrated health care models that offer an alternative to for-profits, he said, but they lack the financial resources to break into new markets. Because of those barriers, Potter believes it will take government action to really reform the system.
“It cannot be done solely by the private sector,” he said. “I used to believe it could, but we’ve seen many decades now of evidence that it cannot work.”
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