
在联合健康保险公司(UnitedHealthcare)首席执行官布莱恩·汤普森被枪杀后,《财富》500强中的医疗保健公司因其经营策略而受到关注。随着医疗保健公司的道德和动机遭到质疑,信诺集团(Cigna)前企业传播副总裁温德尔·波特在《纽约时报》上撰写了一篇客座文章,揭示了他在2008年离开公司的原因。
波特写道:“我在信诺担任健康保险主管期间经历了一场良心危机,之后就辞去了这份工作。”
推动“消费主义”
波特透露,他对公司的看法从2005年开始发生变化。当时作为美国最大的健康保险公司之一,信诺提出了一项以“消费主义”为重点的倡议,他说这项倡议旨在让患者在保险偿付之前承担更多的医疗费用。
波特写道,他的工作是开展一场公关活动,游说记者和政客们将信诺的新政策视为“期待已久的解决保费不断上涨问题的方案”。
他表示:“但根据我的研究和常识,我知道需要大量成本分担的保险计划对富裕和健康的人以及保险公司的股东来说是有利的,但对其他人来说可能是灾难性的。”
亲眼见证保险公司“重利润轻患者”的做法
波特描述称,随着信诺和其他健康保险公司提高其保险计划的成本,即让客户在保险报销之前支付更高的免赔额,他对自己在公司的角色越来越感到不确定。
波特在弗吉尼亚州长大,他对家附近集市上的一个免费诊所进行了一次“即兴走访”,这让他看到了美国医疗保健系统存在的实际问题。
波特写道:“我看到人们排着长队,等着在牲畜厩舍里驻扎的医生看病。”他走访了诊所的工作人员,他们告诉他,每年有成千上万的人来这个为期三天的诊所就诊,其中一些人有健康保险,但根本无力承担自付费用。
波特写道:“我不得不接受一个事实:美国的医疗体系让绝望的人们要等待数月甚至更长时间才能在牲畜厩舍里得到护理,或者让人们背负上沉重的医疗债务,而我正在这样一个体系中扮演重要角色。”
联合健康保险公司首席执行官被枪杀暴露出美国保险业的问题
在波特的文章发表之前,一位著名的健康保险公司首席执行官被谋杀,这引发了广泛的抗议,人们对医疗债务、拒赔、高免赔额和保险覆盖范围不足感到愤怒。现在这些问题比以往任何时候受到的关注更多。
波特写道:“联合健康保险公司首席执行官布莱恩·汤普森的不幸遇害重新激起了一场关于医疗行业将利润置于患者之上的讨论,而我的前同事们长期以来一直试图压制这种讨论。”
波特称,在他职业生涯的早期,保费和免赔额并不那么昂贵,保险公司也没有那么咄咄逼人。然而,随着时间的推移,来自投资者的压力越来越大,他们要求保险公司减少支付患者索赔的费用。现在,索赔获得批准变得更加困难。他表示,理赔过程“迫使患者和他们的医生在进行手术前通过复杂的审批程序,有时甚至拒绝他们接受必要的治疗。”
促使波特辞职的原因正是信诺拒绝为17岁的白血病患者娜塔莉·萨尔基相接受必要治疗报销费用。他称这起事件是“促使我决定离职最重要的原因”。
波特表示,由于信诺拒绝支付费用,萨尔基相原定的肝移植计划在最后一刻被推迟,信诺声称她“病情过于严重,无法进行手术”。
在再次面临紧要关头时,信诺决定支付费用,但为时已晚。他写道,她在他们改变主意后几个小时就去世了。
波特写道:“作为父亲,我无法想象她的父母当时是多么绝望。几周后,我递交了辞呈。”
他说道:“出于良心,我无法继续作为这个行业的代言人,因为它让美国人越来越难以获得通常能挽救生命的医疗护理。”
当《财富》杂志向信诺寻求置评时,信诺发表了如下声明:“自从波特先生近20年前在这里工作以来,世界、医疗保健和我们的公司都发生了巨大的变化。他的说法毫无事实依据,并引用了未具名的个人,我们只能推测他的目的是为了卖书为自己谋取利益。他的观点并不能反映公司的情况、我们的承诺以及我们对支持客户和患者健康的关注。我们一直在努力改善对患者及其护理的支持,并致力于尽自己的一份力量,为美国建立一个更可持续的医疗保健模式。”(财富中文网)
译者:刘进龙
审校:汪皓
在联合健康保险公司(UnitedHealthcare)首席执行官布莱恩·汤普森被枪杀后,《财富》500强中的医疗保健公司因其经营策略而受到关注。随着医疗保健公司的道德和动机遭到质疑,信诺集团(Cigna)前企业传播副总裁温德尔·波特在《纽约时报》上撰写了一篇客座文章,揭示了他在2008年离开公司的原因。
波特写道:“我在信诺担任健康保险主管期间经历了一场良心危机,之后就辞去了这份工作。”
推动“消费主义”
波特透露,他对公司的看法从2005年开始发生变化。当时作为美国最大的健康保险公司之一,信诺提出了一项以“消费主义”为重点的倡议,他说这项倡议旨在让患者在保险偿付之前承担更多的医疗费用。
波特写道,他的工作是开展一场公关活动,游说记者和政客们将信诺的新政策视为“期待已久的解决保费不断上涨问题的方案”。
他表示:“但根据我的研究和常识,我知道需要大量成本分担的保险计划对富裕和健康的人以及保险公司的股东来说是有利的,但对其他人来说可能是灾难性的。”
亲眼见证保险公司“重利润轻患者”的做法
波特描述称,随着信诺和其他健康保险公司提高其保险计划的成本,即让客户在保险报销之前支付更高的免赔额,他对自己在公司的角色越来越感到不确定。
波特在弗吉尼亚州长大,他对家附近集市上的一个免费诊所进行了一次“即兴走访”,这让他看到了美国医疗保健系统存在的实际问题。
波特写道:“我看到人们排着长队,等着在牲畜厩舍里驻扎的医生看病。”他走访了诊所的工作人员,他们告诉他,每年有成千上万的人来这个为期三天的诊所就诊,其中一些人有健康保险,但根本无力承担自付费用。
波特写道:“我不得不接受一个事实:美国的医疗体系让绝望的人们要等待数月甚至更长时间才能在牲畜厩舍里得到护理,或者让人们背负上沉重的医疗债务,而我正在这样一个体系中扮演重要角色。”
联合健康保险公司首席执行官被枪杀暴露出美国保险业的问题
在波特的文章发表之前,一位著名的健康保险公司首席执行官被谋杀,这引发了广泛的抗议,人们对医疗债务、拒赔、高免赔额和保险覆盖范围不足感到愤怒。现在这些问题比以往任何时候受到的关注更多。
波特写道:“联合健康保险公司首席执行官布莱恩·汤普森的不幸遇害重新激起了一场关于医疗行业将利润置于患者之上的讨论,而我的前同事们长期以来一直试图压制这种讨论。”
波特称,在他职业生涯的早期,保费和免赔额并不那么昂贵,保险公司也没有那么咄咄逼人。然而,随着时间的推移,来自投资者的压力越来越大,他们要求保险公司减少支付患者索赔的费用。现在,索赔获得批准变得更加困难。他表示,理赔过程“迫使患者和他们的医生在进行手术前通过复杂的审批程序,有时甚至拒绝他们接受必要的治疗。”
促使波特辞职的原因正是信诺拒绝为17岁的白血病患者娜塔莉·萨尔基相接受必要治疗报销费用。他称这起事件是“促使我决定离职最重要的原因”。
波特表示,由于信诺拒绝支付费用,萨尔基相原定的肝移植计划在最后一刻被推迟,信诺声称她“病情过于严重,无法进行手术”。
在再次面临紧要关头时,信诺决定支付费用,但为时已晚。他写道,她在他们改变主意后几个小时就去世了。
波特写道:“作为父亲,我无法想象她的父母当时是多么绝望。几周后,我递交了辞呈。”
他说道:“出于良心,我无法继续作为这个行业的代言人,因为它让美国人越来越难以获得通常能挽救生命的医疗护理。”
当《财富》杂志向信诺寻求置评时,信诺发表了如下声明:“自从波特先生近20年前在这里工作以来,世界、医疗保健和我们的公司都发生了巨大的变化。他的说法毫无事实依据,并引用了未具名的个人,我们只能推测他的目的是为了卖书为自己谋取利益。他的观点并不能反映公司的情况、我们的承诺以及我们对支持客户和患者健康的关注。我们一直在努力改善对患者及其护理的支持,并致力于尽自己的一份力量,为美国建立一个更可持续的医疗保健模式。”(财富中文网)
译者:刘进龙
审校:汪皓
In the wake of the shooting of UnitedHealthcare CEO Brian Thompson, Fortune 500 health care companies are in the spotlight for their practices. As people call into question the ethics and motivations of health care companies, Wendell Potter, former vice president for corporate communications at Cigna, penned a guest essay in the New York Times revealing what led him to leave the company in 2008.
“I left my job as a health insurance executive at Cigna after a crisis of conscience,” Potter wrote.
A push for ‘consumerism’
Potter revealed that his perspective on the company began to shift in 2005, when Cigna—one of the largest health insurers in the country—put forward an initiative focused on “consumerism,” which he says aimed to push more health care costs onto patients before their insurance coverage kicked in.
It was his job to develop a public relations campaign to lobby reporters and politicians to see Cigna’s new policy as “the long-awaited solution to ever-rising insurance premiums,” Potter wrote.
“But through my own research and common sense, I knew plans requiring significant cost sharing would be great for the well-heeled and healthy—and insurers’ shareholders—but potentially disastrous for others,” he said.
Prioritizing ‘profits over people’ firsthand
Potter described that as Cigna and other health insurance companies raised the costs of their plans—leaving customers with higher deductibles to reach before coverage would kick in—he grew uncertain of his role at the company.
It was an “impromptu visit” to a free health clinic at a fairground in Virginia near where he grew up that opened his eyes to the tangible issues with the American health care system.
“I witnessed people standing in lines that stretched out of view, waiting to see physicians who were stationed in animal stalls,” Potter wrote. He spoke to the clinic workers, who told him that of the thousands of people who came to the three-day clinic each year, some did have health insurance, but simply could not afford to cover their out-of-pocket costs.
“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,” Potter wrote.
UnitedHealthcare CEO shooting brings insurance issues to the forefront
Potter’s essay comes in the aftermath of the murder of a prominent health insurance CEO, which spurred widespread outcry over consumers’ frustration with medical debt, denied claims, high deductibles, and inadequate coverage is being discussed now more than ever.
“The tragic assassination of the UnitedHealthcare chief executive Brian Thompson has reinvigorated a conversation that my former colleagues have long worked to suppress about an industry that puts profits above patients,” Potter wrote.
Earlier in Potter’s career, premiums and deductibles were not as costly—and insurers were not as aggressive, he said. Over time, however, pressure grew from investors to spend less on paying out patients’ claims. Now it is more difficult to get a claim approved—a process, he said, that “forces patients and their doctors through a maze of approvals before getting a procedure, sometimes denying them necessary treatment.”
The catalyst for Potter’s resignation was exactly that—Cigna’s denial of necessary treatment for 17-year-old leukemia patient Nataline Sarkisyan. He called it the event that “contributed most to my decision to walk away from my career.”
Her scheduled liver transplant was postponed at the last minute after Cigna declined to pay, claiming she was “too sick for the procedure,” Potter said.
In another last-minute decision, Cigna decided to pay—but it was too late. She died a few hours after they changed their mind, he wrote.
“As a father, I couldn’t imagine the depth of despair her parents were facing. I turned in my notice a few weeks later,” Potter wrote.
“I could not in good conscience continue being a spokesman for an industry that was making it increasingly difficult for Americans to get often lifesaving care,” he said.
When Fortune reached out to Cigna for comment, it responded with the following statement: “The world, healthcare, and our company have each evolved massively since Mr. Potter worked here almost two decades ago. He offers unsubstantiated claims and cites unnamed individuals with a self-interested goal that we can only presume is to sell books. His opinions do not reflect our company, commitment, and our focus on supporting the health of our customers and patients. We are constantly working to improve our support for patients and their care, and we are committed to doing our part to build a more sustainable healthcare model for America.”