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David Pakman: The last time we spoke to Wendell Potter, Louis, former VP of Corporate Communications
at Cigna, I was very pessimistic about the possibility of anything at all single-payer,
and now we've been hearing about the possibility of Vermont starting their own single-payer
health care system, and Wendell's here to talk to us about it. Great to see you, Wendell.
Wendell Potter: Very good to talk to you.
David: So my... my surprise when I first heard about this was that with something that is
typically associated with conservative politics, that is, the so-called power of the states,
we're seeing possibly the most progressive intrastate single-payer health care proposal
that I recall. What was your thought when you first heard about this proposal?
Potter: Well, I was pretty excited, because it looks like certain things could actually
happen in Vermont. The governor is in favor of single payer, the legislature, both chambers
are controlled by Democrats and there's a majority support for it there, and there's
a grassroots movement in the state that really is supporting single payer. I was up there
a couple of months ago and spoke, actually, in the legislative chamber there, or in one
of the hearing rooms, and... with a lot of the advocates, and there's a lot of optimism
up there.
David: There are two potential legal hurdles that I've been reading about. The biggest
one seems to be the ERISA restrictions and this kind of prohibition of states from enacting
legislation related to employee benefit plans. And what I'm reading is they will be able
to get around that because this potential plan would actually sever the tie between
employment and health insurance so that it wouldn't violate those laws. What's your reading
of that?
Potter: Well, I think that's right, and certainly ERISA is a big stumbling block or a big hurdle
that has to be crossed or dealt with, and I think that the administration and the lawmakers
there are trying to work that out. And ironically, maybe not ironically, but just as a matter
of fact, some of the most vocal opposition to single payer has come from the employer
community, the big employer community in Vermont, led primarily by IBM, which is supposedly
the largest private employer in Vermont. But ERISA is a federal law, and to be able to
implement this statewide, it has to abide by federal law, of course, as well. So it
is something they have to deal with, and I think that they have some creative solutions
there.
David: Are we to expect a full-fledged attack from insurers, I mean, pulling out all the
stops in terms of front groups convincing people single payer would actually be bad
for the people, lawsuits, potentially? My sense is we're going to see everything under
the sun to prevent this from happening.
Potter: We will. We will see a lot of this going on all over the state. What will happen
is that if the bill passes, and I think there's a good chance it will, we can expect that
the insurance companies will be spending a lot of money to try to elect more Republicans
to the legislature next year. This is a multi-year project, it will be implemented in stages
and probably can't be fully implemented at least until 2017 because that's when the federal...
the current federal health care reform law really gives the states permission to go beyond
that in a significant way.
David: And there is the possibility, I think that they're trying to pass a bill that could
move the opt-out up to 2014, but as it stands now, it is 2017.
Potter: That's right. And it possibly could be moved up, but I wouldn't give the chances
of that move up... I wouldn't say that it will likely happen. It's... there's a possibility,
but more than likely, Congress won't approve that.
David: Is this going to be something that insurers and possibly pharmaceutical companies
and other corporations will pose specifically because of the potential lost profits in Vermont,
or more likely because of the door that it's opening up in terms of precedent to other
states where more than 625,000 people actually live?
Potter: It's the latter. The big for-profit insurance companies don't have a big presence
there. The largest insurer is a Blue Cross plan that operates as a non-profit. Cigna
is one of the large for-profit companies, the company I used to work for, it has a presence
there, but most of the membership there is not in for-profit insurance companies. And
of course, as you noted, it's not a very big state. So they are interested because they
don't want a single state to fall. They know that if Vermont does this and it works well,
and I think it would, then other states would take notice too and undoubtedly try to do
the same thing. So that's their worry, that this could really get... take hold there,
as well as be emulated elsewhere in the country.
David: You know, I have to ask myself, when I hear about this and hear about the opposition
that we're no doubt going to see, if insurers and Republicans and all of the players that
we hear so much from that say regularly single payer will not work and it will be bad really
believed that, wouldn't they be... wouldn't it be in their interest to let it happen in
Vermont, since it is a low-population state, and prove once and for all that it won't work
and then they don't have to worry about it anymore? In other words, some part of them
must assume this could actually work, right?
Potter: Oh, it's not just some part. I mean, they know it could work, and they know it
could work well. And that's why they're so afraid of it. So you can't believe their rhetoric.
They will certainly continue to say anything that they can negative about single payer,
as they have for many years, and we can expect that the campaign that we will see waged against
them in Vermont will come largely from the insurance industry, although not directly.
They will be using their third-party allies, the employer groups and front groups and others,
to wage war against the idea there. But they know that it could work, and that's what really
is so... that's what really makes them so afraid.
David: All right. Wendell Potter, former VP of Corporate Communications at Cigna. The
book is "Deadly Spin". Still, actually, it may be... yeah, we have it right here, over
my shoulder. We just keep it here just in case. At any time we might need it, you know?
Potter: Terrific. Refer to it many times.
David: OK, thanks, Wendell. We'll talk to you soon.
Potter: Thank you, David.
Transcript provided by Alex Wickersham and www.Subscriptorium.com. For transcripts, translations,
captions, and subtitles, or for more information, visit www.Subscriptorium.com, or contact Alex
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