6
5
2
Wendell Potter: It's an easy thing to do, and certainly something that the industry could afford. These big for-profits make billions of dollars in profits a year, and you know, they could spend a few million dollars on trying to make their communications clearer, without missing it.
Rob Kall: Well, let's be clear; the non-profits make billions in profits, too. They just label it differently; it's framing.
Wendell Potter: Rob, you're correct, and a very good point that you make.
Rob Kall: Ok, so we talked about the secrecy. But there's also a kind of a problem in transparency as well, and dealing with the companies that they provide the insurance to. That's another issue as well, isn't it?
You talked about how they don't...they resist or refuse to provide information on what it's actually costing them to provide the insurance. You mentioned in one case, a company was paying an amount and it only cost the insurance company twenty percent of that for the year to insure. Yet they raised their rate twenty-two percent, I think.
Wendell Potter: Exactly. And there's some irony there. (In) that particular case...the employer was the Harris County, Texas Medical Society and Harris County is (in) the Houston area. And it took a state law...Texas finally passed a state law that made insurance companies provide the information that would tell employers how much of their premium dollars was actually being paid out in claims. And they found out that, even though their insurance company was demanding that their rates increase 20 percent for the next year, they had only paid out 9 percent - 9 percent - of the premium dollars the year before for medical claims. So, in other words
Rob Kall: Is there any regulation of these nonprofits or for-profits? Or is there any kind of a guideline on what percentage paid out should be - how they should base how much the rates are or the increases or what have you?
Wendell Potter: No. There really isn't. You know...there are...regulations on the books but not one that particularly addresses that in the way that I think it should. In California, for example, last year, when there was an effort to try to reform the system at the state level in California, one of the things that was advocated, even by the governor and a lot of state legislators, was setting - or requiring that insurers pay at least 85 percent of every premium dollar for medical care - or to pay claims. The legislation ultimately failed for a variety of reasons but mainly politics. But almost no state has been able to pass a bill like that because the insurance lobbies are so powerful at the federal and state levels.
Rob Kall: Well, we're going to talk about this, insurance lobbies, in a couple minutes.
Is there anything that so far we've talked about that you want to kind of wrap up a bit in terms of where we need to be going and heading with health insurance for Pennsylvanians, for Philadelphia, in terms of our legislators or for our senators?
Wendell Potter: Yeah. I think...there's a - it's before the Pennsylvania legislature; it's certainly before Congress. I think people need to get themselves as informed as they can and be active and write or call their state representatives or senators and members of Congress. This is vitally important. Health care can be complex. But there are a few things that I think are very important.
At the federal level, President Obama, when he was a candidate, campaigned on - a part of his platform was creating a public insurance option that would be available for people to enroll in as an alternative to a private plan. And the health insurance industry is adamantly opposed to that. They're trying to kill it. It's very important legislation that needs to be passed. And the President needs to hold firm on that, and he needs support.
Rob Kall: Okay. So what we need to do...is...to contact (our) state legislator in the state Senate and the state House, (our) member of Congress in Washington, and (our) two state - two U.S. Senators. And you tell them that you want the public option.
Now, I think we should be going all the way and going for single payer health care like all the other major nations in the world have. That's the only civilized thing to do. And anything less than that is shameful. And it allows for and will continue to allow for people to be uninsured and people to go bankrupt.
Now, another thing that you mentioned, when you spoke to Congress last week, was the increase in the uninsured.
Wendell Potter: Correct.
