The Hidden History of American Healthcare

Why Sickness Bankrupts You and Makes Others Insanely Rich

Thom Hartmann

• Publisher: Berrett-Koehler Publishers
• Year: 2021
• ISBN:
  9781523091652
• Topic: History
• Subtopic: North American History
• Index: History

The New York Times –bestselling author explores the history of American healthcare system, what went wrong, and how it can be remedied.

Popular progressive radio host and bestselling author Thom Hartmann reveals how and why attempts to implement affordable universal healthcare in the United States have been thwarted and what we can do to finally make it a reality. "For-profit health insurance is the largest con job ever perpetrated on the American people—one that has cost trillions of dollars and millions of lives since the 1940s, " says Thom Hartmann. Other countries have shown us that affordable universal healthcare is not only possible but also effective and efficient. Taiwan's single-payer system saved the country a fortune as well as saving lives during the coronavirus pandemic, enabling the country to implement a nationwide coronavirus test-and-contact-trace program without shutting down the economy. This resulted in just ten deaths, while more than 500, 000 people have died in the United States. Hartmann offers a deep dive into the shameful history of American healthcare, showing how greed, racism, and oligarchic corruption led to the current "sickness for profit" system. Modern attempts to create versions of government healthcare have been hobbled at every turn, including Obamacare. There is a simple solution: Medicare for all. Hartmann outlines the extraordinary benefits this system would provide the American people and economy and the steps we need to take to make it a reality. It's time for America to join every industrialized country in the world and make health a right, not a privilege.

PART ONE

How Bad Things Are in America

How the Insurance Industry Bought Joe Lieberman and Killed the Public Option

Want to deny affordable health insurance to millions, leading to thousands of unnecessary and/or early deaths, all in order to keep your profits high? Just hand Joe Lieberman $1,182,070 over the course of his political career and you own the guy. He’ll make sure to kill a public option, all with a smile.¹

As Paul Begala wrote of the time Lieberman killed the Obamacare public option, “Connecticut Senator Joe Lieberman is identified as (I-CT). But the ‘I’ does not stand for ‘Independent.’ It stands for ‘Insurance Industry.’”²

New York Times staff writer David E. Rosenbaum reported, about a previous Lieberman pro-insurance-industry action in 2000, “Many of Mr. Lieberman’s friends said he had no alternative but to take this position because it was the one favored by the insurance industry. The industry is important to Connecticut’s economy and has generously donated to Mr. Lieberman’s campaigns over the years.”³

And, of course, it’s not just Joe Lieberman. Every single Republican in both the US House and Senate voted against President Barack Obama’s plan to provide affordable health insurance to every American, and odds are, every single one of them was well rewarded for the effort.

That said, the Affordable Care Act was always an unnecessarily complex Rube Goldberg effort.

President Obama and his Democratic colleagues knew that if they tried to offer the American public any sort of non-profit or Medicare for All health coverage, the trillion-dollar for-profit insurance, hospital, and pharmaceutical industries would unleash a scorched-earth campaign against them, from which many would never politically recover.

Conservatives on the US Supreme Court in 1976, 1978, and 2010 radically rewrote American campaign finance law to give billionaires and large, powerful industries political life-and-death power over even the most august of politicians.⁴

Ever since Senator Bernie Sanders of Vermont raised the profile of Medicare for All, dozens of Democratic politicians have candidly said, some to me in private and a few in public, that it would be a great thing for the American people, would save hundreds of billions of dollars a year, and would save lives . . . but can’t pass because it’s “politically impossible.”

That’s code for our elected representatives lacking the power to overcome multimillion-dollar pressure campaigns launched by well-funded and highly profitable corporations and the think tanks and media organizations that also take their money.

As a result, any sort of reform that didn’t increase profits for the largest industries—particularly the health insurance industry—was doomed to fail, at least during normal times. Thus, President Obama took the plan that the Heritage Foundation, a conservative think tank, had put together in the 1980s,⁵ which Mitt Romney put into place as governor of Massachusetts in 2006.⁶

It was an improvement on the status quo, but only a slight one.

Obamacare: Rube Goldberg Meets Health Insurance

As with most politicians interested in producing the best healthcare outcomes for the nation at the lowest cost, there was a time in his political career that Illinois state senator Barack Obama was an outspoken advocate for a national single-payer Medicare for All type of health insurance system like Canada’s.

“I happen to be a proponent of a single-payer universal healthcare program,” Obama said in a June 30, 2003, speech.

“I see no reason,” he added, “why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on healthcare, cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single-payer healthcare plan, a universal healthcare plan. That’s what I’d like to see.”⁷

By the time he was running for president in 2008, his need for campaign cash from wealthy corporate-related donors had grown and his thoughts had “evolved.”

“What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system,” Obama told the American Medical Association on June 15, 2009, half a year into his first term.

“I’ll be honest,” he said. “There are countries where a single-payer system may be working. But I believe—and I’ve even taken some flak from members of my own party for this belief—that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run healthcare, know this—they are not telling the truth.”⁸

Instead of Medicare for All, Obama suggested what 2016 Democratic presidential candidate Pete Buttigieg called “Medicare for Anybody Who Wants It,” also known as the “public option.”

Additionally, he suggested expanding Medicaid and having the state governments administer health insurance portals to make buying for-profit health insurance more convenient (since he was going to require everybody in the country not covered by Medicaid to purchase this product), along with government-funded subsidies for part of the premium costs.

The federal government subsidies would have the effect of keeping the multibillion-dollar profits of the for-profit health insurance companies high, while not inflicting the entire expense on taxpayers/consumers.

He campaigned for president in 2008 on what came to be known as Obamacare or, more properly, the Affordable Care Act, and the public Medicare option part of his plan brought along enough of the progressive Democratic base that this virtually unknown Midwestern politician was able to defeat the massively funded and establishment-supported Clinton machine to take the Democratic nomination and then the White House.

Even half a year into his first term, President Obama continued to promote the idea of everybody in America being able to choose to purchase Medicare instead of a for-profit plan from one of the giant insurance corporations.

On July 18, 2009, for example, he said, “Any plan I sign must include an insurance exchange—a one-stop-shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest.”⁹

House Speaker Nancy Pelosi was totally behind the public option and even brought former Aetna insurance industry executive Wendell Potter to testify before Congress on its behalf. He wrote in 2015,

In an effort to keep the public option idea alive, House Speaker Nancy Pelosi invited me to testify during a Sept. 16, 2009, meeting of the Democratic Steering and Policy Committee Forum on Health Insurance Reform.

Knowing the industry as I did, I told the committee that if Congress failed to create a public option to compete with private insurers, “the bill it sends to the President might as well be called ‘The Insurance Industry Profit Protection and Enhancement Act.’” Pelosi insisted that Congress had no intention of [failing to include a public option].¹⁰

True to her word, Speaker Pelosi got the bill through the House of Representatives with the public option intact. But she had no control over the US Senate, where Joe Lieberman became the deciding vote, and he chose to kill the Medicare option, presumably at the behest of his funders.

As Lieberman told Fox News: “A public option plan is unnecessary. It has been put forward, I’m convinced, by people who really want the government to take over all of health insurance.”¹¹

And we definitely can’t have that. After all, it may make us as efficient and effective at delivering healthcare as the rest of the developed world and save millions of lives over a few decades . . . but would cut off the hundreds of millions of dollars that health insurance industry executives take home every month. And, probably too, it would cut off their campaign contributions.

Wendell Potter: A Good Man in a Bad Job

Killing other people is probably the greatest taboo among humans, even when done indirectly or by proxy; it’s why murder is the plot device for so many novels, TV shows, and movies. We’re fascinated by things that are so grotesque, so far out of the everyday experience, so frightening, that most of us can barely imagine them in our own lives.

Yet far outside the realm of mobsters, warriors, and hit men, our nation harbors a small but very affluent class of people who take actions every day—proactive, knowing, intentional actions—that contribute to the deaths of their fellow Americans.

Wendell Potter was one of those people until he was so overwhelmed by his conscience that he resigned his solidly six-figure salary to take on the very corporations that had paid him to promote policies that led to other people’s deaths.

In his 2010 book Deadly Spin, Potter tells the story of his awakening, the moment that pushed him over the edge from being a health insurance industry insider to a whistleblower.¹²

It was March 5, 2009, and President Obama was promoting what would become the Affordable Care Act. Potter, then the director of public relations at health insurance behemoth CIGNA, was “channel surfing for some news about [Obama’s] healthcare reform summit . . . at the White House that day.”

On MSNBC, host Tamron Hall was interviewing Zach Wamp, then Tennessee’s Third District representative in the US House. “It’s probably the next major step towards socialism,” Wamp told Hall and the TV audience. “[T]his is literally a fast march towards socialism where the government is bigger than the private sector in our country, and healthcare’s the next major step, so we ought all be worried about it.”

Wamp then turned his rhetorical guns directly on low-income Americans and undocumented immigrants.

“The forty-five million people that (sic) don’t have health insurance,” he said, “about half of them choose not to have health insurance. . . . How many illegal immigrants are in this country today, getting our healthcare? Gobs of ’em!”

Potter felt his stomach drop. “As I listened to Wamp’s rant,” he wrote, “I knew exactly where he’d gotten his talking points: from me.

“He was using the same misleading, intentionally provocative, and xenophobic talking points that I had helped write.”

Potter had served not only as the head of PR for CIGNA but also as a member of the Strategic Communications Advisory Committee for AHIP (America’s Health Insurance Plans), the industry’s largest trade and lobbying group; it was in that capacity that he’d written much of what had become Wamp’s talking points.

That same night, AHIP’s president, Karen Ignagni, also showed up on TV, telling President Obama how the insurance industry was on board with his effort.

“We want to work with you,” she told Obama. “You have our commitment. We hear the American people about what’s not working. We’ve taken that seriously.” The industry had billions in profits at stake and, with Ignagni, was rolling out the biggest of the big guns.

“Ignagni,” Potter wrote, “is one of the most effective communicators and—with a salary and bonuses of $1.94 million in 2008—one of the highest-paid special interest advocates in Washington. . . . She is smart, telegenic, articulate, charming, a strong leader, and a brilliant strategist. . . . Princeton economist Uwe Reinhardt commented, ‘Whatever AHIP pays her is not enough.’”

Like Potter at that time, she was another of that small group of people who are more than willing to take money to promote policies that lead to the deaths of tens of thousands of Americans every year, according to Harvard University.¹³ All to enhance corporate profits.

While watching Wamp use his talking points and seeing his AHIP boss, Ignagni, essentially lie to Obama marked the decision point for Potter, the process, for him, had begun a bit earlier, in December 2007, when his company, CIGNA, had refused to pay for a liver transplant for a Los Angeles teenager named Nataline Sarkisyan.

Her community had come together to protest CIGNA’s decision, and the protests were picked up by a prominent local TV station, KTLA; from there the story went national.

Potter, as head of PR for CIGNA, took it on, although in this case it was so obvious that the insurance company’s decision was a PR disaster that he argued within the company that they should just pay for Nataline’s transplant and have done with it.

“For the first time, I started paying close personal attention to the case,” Potter wrote in Deadly Spin. “As the father of a daughter just three years older than Nataline, I couldn’t help putting myself in their shoes, wondering what life would be like for my wife and me if we were fighting with an insurance company to get it to cover a lifesaving transplant for our daughter, Emily. Just thinking abou...