11 Mar 2011

NHS reform: ‘Don’t follow the US example’

As the Coalition pursues its plans for fundamental reform of the NHS, Wendell Potter warns that Britain must be careful not to follow America too far down the road of the profit motive.

David Cameron signs his NHS pledge during the General Election campaign (R)

As someone who knows firsthand how the profit motive can wreck a healthcare system – leaving millions of people without coverage and millions of others unable to pay for care even if they do have insurance – I was alarmed to learn about the reforms to the NHS that Prime Minister David Cameron is advocating.

As Channel 4’s recent investigation revealed, those reforms could very easily incentivize GPs to make decisions based on profits instead of clinical need.

To understand how devastating that could be to the people of England, all one has to do is look at the American healthcare system.

Until 2008, I was a top executive at one of America’s largest health insurance companies, CIGNA. The higher up the corporate ladder I climbed – to become head of public relations – the more I could see the often-devastating and even lethal consequences of insurers’ relentless quest for profits. I could not in good conscience continue promoting an industry whose routine practices – put in place to assure profitability – contribute to the unnecessary deaths of many of our citizens.

I could not in good conscience continue promoting an industry whose routine practices – put in place to assure profitability – contribute to the unnecessary deaths of many of our citizens.

In America, private insurers routinely refuse to sell coverage to people who have chronic conditions. There also are no constraints on what doctors and hospitals can charge their uninsured patients. As a consequence, many people who don’t have coverage forego needed care every day.

More than 45,000 Americans die every year because they have no health insurance. Thousands of others lose their homes or have to declare bankruptcy because they can’t afford to pay their medical bills. Many of the people being forced out of their homes do have private insurance, but in many cases the only policies they can afford often don’t come close to covering their health care costs.

Soon after I left my corporate job, I started talking and writing about how insurance companies really operate in the United States, beginning with testimony before the U.S. Congress. I testified that during my 20-year-career, I saw how insurance companies confuse their customers and dump the sick – all so they can satisfy their Wall Street investors.

Nothing like the NHS exists in the United States. Consequently, Americans must seek coverage from private insurers, and often their only options are large investor-owned companies whose stock is traded on Wall Street. Almost 40 percent of Americans are now enrolled in health insurance schemes operated by just five large, for-profit insurance corporations, two of which – Humana and CIGNA – I worked for during my two decades in the industry.

In addition to refusing to sell coverage to people with chronic illnesses, insurers also routinely cancel their customers’ policies when they get sick. They also frequently refuse to pay for care that doctors recommend for their patients. By engaging in these practices, insurers can avoid paying claims. The fewer claims they pay, the more money is available to reward top executives and shareholders.

Motivated by money

It is not just executives of American insurance companies who are motivated first and foremost by the desire to make money. The same is true of many healthcare providers in the United States. The overriding objective of many physicians and hospital executives is the same as it is for the people who run the insurance companies: profit.

In their never-ending propaganda campaigns to preserve the status quo in the United States, insurers and their business and ideological allies – including many doctors – scare Americans into believing that healthcare reform we really need would send the country down “the slippery slope towards socialism.”

Why? If the United States were to implement a programme like the NHS, corporate profits and some physicians’ incomes might take a hit.

The US has the most expensive healthcare systems in the world and one of the most inequitable. More than 51 million Americans are now uninsured, and the number continues to rise.

I know from the often heart-breaking stories I’ve heard from many of those people that they would love to see the US embark on that slippery slope toward a system like the NHS. And I know that they, like me, would hate to see England head down a slippery slope of its own-towards American-style health care.

Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.