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I Was a Health Insurance Executive {Cigna}. What I Saw Made Me Quit.
New York Times ^ | Dec. 18, 2024 | Wendell Potter

Posted on 12/18/2024 7:46:40 AM PST by Cronos

Mr. Potter is the former vice president for corporate communications at Cigna.

I left my job as a health insurance executive at Cigna after a crisis of conscience. It began in 2005, during a meeting convened by the chief executive to brief department heads on the company’s latest strategy: “consumerism.”

Marketing consultants created the term to persuade employers and policymakers to shift hundreds, and in many cases thousands, of dollars in health-care costs onto consumers before insurance coverage kicks in. “Consumerism” proponents contended that if patients had more “skin in the game” they would be more prudent consumers of health care, and providers would lower their prices.

.. It was abundantly clear that insurance companies would pay far fewer claims but many enrollees’ health care costs would skyrocket. After about 30 minutes of nonstop questions, I realized I’d have to drink the Kool-Aid and embrace this approach.

...At a county fairground in Wise, Va., I witnessed people standing in lines that stretched out of view, waiting to see physicians who were stationed in animal stalls. The event’s organizers, from a nonprofit called Remote Area Medical, told me that of the thousands of people who came to this three-day clinic every year, some had health insurance but did not have enough money in the bank to cover their out-of-pocket obligations.

That shook me to my core. I was forced to come to terms with the fact that I was playing a leading role in a system that made desperate people wait months or longer to get care in animal stalls, or go deep into medical debt.

...One story involved Nataline Sarkisyan, a 17-year-old leukemia patient in California whose scheduled liver transplant was postponed at the last minute when Cigna told her surgeons it wouldn’t pay.

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; US: California; US: Tennessee
KEYWORDS: insurance
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"The average amount insurers spent on medical care dropped from 95 cents per premium dollar in 1993, the year I joined Cigna, to approximately 85 cents per dollar in 2011, after the Affordable Care Act restricted how much insurers can profit from premiums."
1 posted on 12/18/2024 7:46:40 AM PST by Cronos
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To: Cronos

My doctor several years ago told me to not go with Cigna.

“They don’t pay for squat and take forever to pay for what they do.” he said.

They are not even accepted at our local Medical Center. They accept only Medicare, Blue Cross, United Healthcare and WellCare...............


2 posted on 12/18/2024 7:49:19 AM PST by Red Badger (Homeless veterans camp in the streets while illegals are put up in 5 Star hotels....................)
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To: Cronos

Get the government out of the equation.
Get your employer out the equation.
Allow people to shop nationally for health insurance, just like car insurance.
Accept the fact that not everyone can get everything they want. That is true for everything in life. Don’t try to fix it, because you can’t.


3 posted on 12/18/2024 7:52:10 AM PST by ClearCase_guy
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To: ClearCase_guy

Exactly.


4 posted on 12/18/2024 7:53:36 AM PST by No name given ( Anonymous is who you’ll know me as)
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To: Cronos
Lost in all of this is the fact that, at least in Alabama, one used to be able to get catastrophic only coverage. Premiums were very low, but most services in a normal doctor visit weren't covered. So people had skin in the game and didn't go to the doctor or ask for treatments that were unnecessary. But they had the coverage needed for life-saving procedures.

In other words, you could get health insurance with low premiums but higher deductibles like you can get car insurance. And just like with my low car insurance I save a little to the side to pay for the eventual car repairs, that's how people used to save for deductibles for eventual health costs.

5 posted on 12/18/2024 7:54:59 AM PST by Tell It Right (1 Thessalonians 5:21 -- Put everything to the test, hold fast to that which is true.)
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To: Cronos

In 1960, health care costs were 5% of GDP.

Then, government got involved, and now health care costs are approaching 20% of GDP.

Coincidence?


6 posted on 12/18/2024 7:57:32 AM PST by E. Pluribus Unum (The worst thing about censorship is █████ ██ ████ ████ ████ █ ███████ ████. FJB.)
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To: Red Badger

How does Humana stack up?


7 posted on 12/18/2024 7:57:40 AM PST by central_va (I won't be reconstructed and I do not give a damn...)
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To: Cronos

I don’t know about other states, but her in NY - one is CAPTIVE to the crony-capitalist/fascist, state-controlled Obamacare “marketplace.”

Leftists blaming “health insurance cos” is like blaming I. G. Farbenindustrie AG for WWII.


8 posted on 12/18/2024 8:00:18 AM PST by PGR88
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To: Cronos

Mr. Potter


https://en.wikipedia.org/wiki/Mr._Potter

With that my first thought was fake news. We should all be that jaded.


9 posted on 12/18/2024 8:01:19 AM PST by PeterPrinciple (Thinking Caps are not longer being issued, but there must be a warehouse full of them somewhere)
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To: Cronos

You can bet that health insurance executives will see a bump in pay to cover the risk with the job.


10 posted on 12/18/2024 8:01:41 AM PST by Carry_Okie (The tree of liberty needs a rope.)
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To: Cronos

What has screwed up insurance coverage is almost solely GOVERNMENT INVOLVEMENT.


11 posted on 12/18/2024 8:01:55 AM PST by fwdude (Why is there a "far/radical right," but damned if they'll admit that there is a far/radical left?)
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To: Red Badger

I’ve had Cigna for many years. Only once did I have an issue filling a prescription which they declined to pay for. I appealed and a month later, I got a check in the mail to cover my cost. However, that experience left a bad taste in my mouth, so I joined my wife’s Aetna plan. We’ll see if I did the right thing.


12 posted on 12/18/2024 8:02:41 AM PST by PUGACHEV
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To: Cronos

The NY Slimes Stooge opinion is Irrelevant .
2005 was before the Barry and VJ rammed thru Obama Deathcare which was partially destroyed but changed everything .
Obamacare ruined the insurance plans for millions and made clain processing a disaster .
He is a sad dinosaur born again lefty .


13 posted on 12/18/2024 8:02:58 AM PST by ncalburt ( Gop DC Globalists are the evil)
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To: central_va

Don’t know, haven’t had it for decades..................


14 posted on 12/18/2024 8:04:07 AM PST by Red Badger (Homeless veterans camp in the streets while illegals are put up in 5 Star hotels....................)
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To: Tell It Right

Only pay for what you need:)


15 posted on 12/18/2024 8:05:04 AM PST by Cold Heart
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To: ClearCase_guy

Ditto what you said:

Get the government out of the equation.
Get your employer out the equation.
[I would add, get your union out of the equation]
Allow people to shop nationally for health insurance, just like car insurance.
Accept the fact that not everyone can get everything they want. That is true for everything in life. Don’t try to fix it, because you can’t.

On the other hand, the essential idea Cigna was wirking on - if consumers had more skin in the game - was not as wrong in principle as it was wrong in the existing environment, where the health care industry pricing is based on four things - medicare is the elephant in the room, medicare reimbursements are most often too low, health care billings reflect the fact of trying to compensate for how low the medicare reimbursement rate is, which leaves private insurers and consumers fighting/trying to square the circle left by medicare.

I fully understand how if consumers had more skin in the game, consumers, not insurers, would be who the health care industry would have to be responsive too, but the elehant in the room drives everything away from that being possible in the present environment.


16 posted on 12/18/2024 8:10:19 AM PST by Wuli
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To: fwdude

The insurance companies loved the government when they made auto insurance mandatory. $$


17 posted on 12/18/2024 8:10:52 AM PST by dragnet2 (Diversion and evasion are tools of deceit)
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To: Cronos

The more I read this, it is written by ai.


18 posted on 12/18/2024 8:14:43 AM PST by PeterPrinciple (Thinking Caps are not longer being issued, but there must be a warehouse full of them somewhere)
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To: ClearCase_guy

“Allow people to shop nationally for health insurance, just like car insurance.”

You can’t really shop nationally for car insurance, the insurance that you can purchase is governed by the laws of the state you live in.


19 posted on 12/18/2024 8:15:33 AM PST by JSM_Liberty
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To: PGR88

Writing to be understood by others?


20 posted on 12/18/2024 8:17:25 AM PST by EliRoom8
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