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A reformed health executive speaks 

Wendell Potter became visibly emotional once in our nearly 90-minute visit. It happened when he talked about Nataline Sarkysian.

She was a 17-year-old Armenian-American girl in southern California whose dad worked in an auto assembly plant. She died about this time two years ago from complications of leukemia.

Her doctors at UCLA had wanted to get her a liver transplant, but the CIGNA health insurance corporation, for which Potter was vice president for communications, declined to provide coverage. It said the procedure was experimental.

But then the family landed a high-profile attorney and live coverage on CNN for a demonstration outside a CIGNA office in California. Potter, watching in his Philadelphia office, got informed by his bosses that, suddenly, CIGNA would cover the procedure.

Potter managed to get word of that to the family. He saw someone whisper the news to the mother right there on his television set.

The demonstration turned happy. But then, in a matter of hours, before she could get the transplant, Nataline died.

Potter had a corporate spin job to do, and, as was his custom, he did it dutifully and well.

But he also had a daughter about Nataline's age.

An old newspaperman in Memphis, Potter already had spent 2007 growing disenchanted with the corporate culture in which he thrived. He began to understand this: Through the health insurance industry's becoming for-profit and consolidated in a half-dozen or so corporations, health care was getting essentially dictated by Wall Street investors concerned about profit margins.

In the summer of that year, he had gone home to northeastern Tennessee to visit his parents. Seeing a notice in the local newspaper, he decided to drive up into southwestern Virginia to look around a free health clinic.

He was surprised to learn from many of the patients that they actually had health insurance, but couldn't afford to reach the annual deductibles — which had been steadily raised to shore up profit margins for Wall Street — so that full reimbursements could ensue.

By May 2008, he quit. He was 58 and the company portrayed his departure as a retirement. It was partly that, but more a conversion.

Now Potter goes around the country trying to get people to listen to him about how the health insurance industry he so recently and ably served is, while not malevolent or intentionally abusive, dysfunctional as both a human and long-term business enterprise.

He was in Little Rock to speak at Philander Smith College. He was visiting with me at the state headquarters of the Arkansas State AFL-CIO. He was interested in Arkansas because Blanche Lincoln is a swing vote who resists the solution that he says is vital — a public option government insurer to enter the health insurance marketplace and force CIGNA and the rest to lower costs, cut executive salaries, improve coverage and ground a few corporate jets.

Lincoln's idea for regional nonprofit cooperatives won't do any real good, he says. You need more muscle than a regional co-op can muster to pry your way into the health insurance market, he says.

The challenge, he says, is to change the very business culture, which a full nationwide public option could facilitate.

If we merely order up new customers for the existing health insurance industry and reform rules on pre-existing conditions, then we'll proceed inevitably, he says, to a kind of Armageddon.

The day will come, he says, when people won't be able to afford health insurance and employers won't be able to provide it and government will be bankrupted by it and the health insurance industry's investors will be wondering where all the money went.

“Fear-mongering works,” Potter says, lamenting the other side's warnings of “government takeover” and a “slippery slope to socialism.”

Those are superficially incendiary phrases. The more appropriate fear, Potter says, is that we're all one layoff away, and a week's hospital stay away, from bankruptcy.

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