Clif's Book World

I've long been puzzled why many Americans seem to be more frightened by government provided health insurance than they are of private health insurance companies. Even many of those who are currently covered by Medicare are alarmed at the prospect of "socialized medicine" that may result from implementation of a public option of health insurance. Do people really trust their insurance companies that much?

This book partly explains why many people have unrealistic fears that cause them to support political positions that are contrary to their own best interests. This book reveals "... the techniques employed by practitioners of the dark arts of PR--from the use of 'third-party advocates' to the creation of front groups, from the staging of PR 'charm offensives' to the selective disclosure of information and misinformation--which influence people's thoughts and actions in ways that advertising cannot." The millions of dollars spent on public relations and spin controls over many years by the private insurers have created a reality distortion field that continues to pervade the American political scene.

The author of this book, Wendell Potter, worked many years as a former VP of corporate communications at CIGNA and thus writes from a unique perspective as one who has a working knowledge of the tactics used by the masters of spin. These credentials make him the perfect mightmare for the health insurers.

Mr. Potter describes his personal journey that led to an epiphany that he could no longer in good conscience continue to work for CIGNA.

Quotation from page 2:
"Had it not been for a series of events that occurred in 2007--events that, as someone raised as a Southern Baptist, I can't help believing were part of some kind of divine intervention--I would probably still be spinning for health insurers."

Quotation from page 70:
"Quite unexpectedly, this spur-of-the-moment outing was starting to feel personal and even spiritual--and I didn't consider myself to be much of a spiritual kind of guy. It was clear to me at that moment that I was having an epiphany. ....

Quotation from page 72:
SCALES BEGAN FALLING FROM MY EYES
Among the many reasons I finally left my job at CIGNA was that with each promotion, I got a better understanding of how insurers get rid of enrollees they don't want--the very people who need insurance--when they become a drain on profits. I could no longer in good conscience continue serving as a spokesman for an industry whose practices ... were swelling the ranks of the uninsured."

The book provides a rundown on how the health insurance business has consolidated into fewer large nationwide companies and how their profit margins have increased along with their premium rates. It goes on to describe the ways in which the balance sheets are made to look good and the resulting inflation of executive bonuses.

One statistic I found of special interest was the change that has occurred in the medical-loss ratio (MLR) which is the percentage of income that is actually paid to policy holders. In 1993 the average MLR was 95% and by 2007 it had dropped to 81%. Meanwhile the MLR for Medicare stayed at 97% over the same time period. So what's wrong with a public option?

The author tells what it was like to write press releases in the face of insurance "horror stories" that he knew were pure spin and simply not the truth. After he quite his job the author describes the relief of being able to tell the truth.

"Telling the truth is very cathartic. I highly recommend it." (pg.210)

His play-by-play write ups of the Clinton and Obama attempts to pass meaningful health care legislation enable the reader to see what was occurring behind the scenes in the halls of corporate power and perhaps understand those events for the first time. The author was working against insurance reform during the Clinton administration and was working for reform during the Obama administration. He is thus able to tells of experiences on both sides of the issue.

Toward the end of the book the author reviews the "fundamental tools of the spin business." The tobacco companies were early practitioners of the art of spin and manipulation of public opinion, and other types of business such as health insurance, petroleum, and coal mining have since learned the tricks of the trade.

Regarding the future the book notes that with the decline in the number of newspapers, there are now more and better-paying jobs available in public relations than in journalism. We are thus facing a future where there will be more paid spinmeisters than professional news reporters.