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The Insurance World From An Inside Perspective

Posted on in Personal Injury

As a private citizen and a personal injury lawyer, it is obvious to me that health insurance reform is necessary. This is not to say that the health insurance industry is the only area in need of reform in order to improve the current health care system, but it is certainly a substantial contributing factor.

Trudy Lieberman interviewed ex-insurance company head of communications, Wendell Potter, for the Excluded Voices series in the Columbia Journal Review (6/24). In the interview he revealed the reasoning behind his choice to leave the insurance giant, CIGNA, bringing to light several inconsistencies characteristic of the industry not known by most people. Many of the inconsistencies are driven by the pressure to please shareholders and to make profits, which almost always contradict the best interest of patients.

He references one example when he was in Virginia where hundreds of people were waiting in line to receive free medical care in animal stalls; many had camped in the rain overnight because they could not afford the care they needed. He then got on a private company plane, and once realizing that people’s insurance premiums were paying for his flight, he felt he had to leave the industry.

Mr. Potter also discusses the ways insurance companies are able to purge expensive policy holders by either finding a pre-existing condition unknown to the patient and claiming it was not disclosed, or by increasing premiums so high that individuals or companies can no longer afford to have benefits; both are “common industry practices” that leave people without necessary coverage.

As a former head of communications, Mr. Potter also provides insight into the tactics of deception employed by insurance companies. He says the insurance companies will outwardly act as though they support reform but will use political connections to kill parts of reform they don’t like behind the scenes through “third party advocates.”

Clearly, the profit maximizing incentives are not appropriate for an industry that deals with a fundamental human need. The current health insurance system is not functioning in a way that equitably supplies a necessity, so it is time to at least consider other alternative approaches.

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