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Wendell Potter, Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans. New York: Bloomsbury Press, 2010, 277 pages, $26.00

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“About 45,000 people die in America every year because they have no health insurance. I am partly responsible for some of the deaths making up that shameful statistic.”

Those two sentences open a book by Wendell Potter called Deadly Spin: An Insurance Company Insider speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans. Part expose and part memoir of the author’s experience in the health care industry, the book’s as dramatic and suspenseful as a good novel.

"The book has a dual purpose, to expose the health insurance industry and the public relations industry."
Deadly Spin chronicles Potter’s experience as a senior public relations executive for 20 years with two of the largest for-profit U.S. health insurance companies, first Humana and later CIGNA. His job was to influence public opinion on and enhance the reputations of the two companies. He was “one of the industry’s top public relations executives and media spokesmen,” Potter says. When he left CIGNA, in May 2008, commanding a six-figure income, he was busy helping “create and perpetuate myths the purpose of which was,” he says, “to sustain those companies’ extraordinarily high profitability.”

The book has a dual purpose, to expose the health insurance industry and the public relations industry. As a top-ranking insider in an industry that differs from advertising in that it promotes opinions, not products, Potter is in the perfect position to do both.

Potter writes, “I believe … the twenty-first century will be dominated by the retrenchment of democracy and the unbridled growth of corporate power, enabled by [the] increasingly unchallenged propaganda.”

In a personal and honest manner, Potter details the “spin” he wrote daily. Gradually he began to understand that his job was to create lies about the industry that made it look good to the public.

Two events pushed him hard along the path to becoming a whistleblower. The first was witnessing the thousands of people without health insurance who attended a one-time, free medical clinic in Virginia. Potter was shocked at what he saw, scenes he thought were common only in third-world countries, as people waited outside in the rain for hours to see a medical practitioner caring for them in animal stalls at the county fairgrounds. Potter began to understand that the reality of health care in this country is far different from how he portrayed it in the PR material he wrote routinely.
"Gradually he began to understand that his job was to create lies about the industry that made it look good to the public."
What clinched Potter’s decision to quit his job was a second incident, in which CIGNA denied approval for a liver transplant for a 14-year-old, who died soon after the insurer nixed the transplant.

It was Potter’s job, in the latter case, to hide the truth, that the company didn’t want to spend money on the transplant because doing so would hurt its bottom line.

Potter noted that his PR campaigns had “two active fronts” in relation to health care reform: one, “a highly visible ‘charm offensive’ geared to present to the world an image of the industry as an advocate of reform,” and two, a “secret, fearmongering campaign using front groups and business and political allies as shills to disseminate misinformation and lies, with the sole intent of killing any reform that might hinder profits” for CIGNA’s leading executives.

One of Potter’s most pressing tasks was to discredit Michael Moore’s film Sicko, which threatens the insurance industry because it demonstrates that only a single-payer, universal health care plan is a rational and equitable solution to the health-care crisis. (Since then, Potter has apologized publicly for his role in defaming Moore and the film.)

Potter defines the techniques the industry uses to get what it wants. One is “’crisis management,’” “the organized, orchestrated communications response to a negative event” that damages the insurer’s reputation. Another is “astroturfing,” creating fake grassroots organizations “so that a carefully crafted campaign or event seems to be happening spontaneously,” he says.

Before he became a whistleblower, Potter says, he believed that fearmongering and phony grassroots initiatives were justified because reform would be “bad for the country -- and for the companies that enabled [him] to pay [his] mortgage.”

In the health care reform debate, those PR techniques and others functioned to convince many people “to take positions contrary to their own best interests,” Potter points out.
"What clinched Potter’s decision to quit his job was a second incident, in which CIGNA denied approval for a liver transplant for a 14-year-old, who died soon after the insurer nixed the transplant."
Deadly Spin includes lively chapters on the history of health-care reform and failure and on “managed care” (HMOs) and “consumer-driven care,” calculated to increase the industry’s profits at the expense of the people who pay their premiums to receive health care when they need it.

Another scheme the industry uses is the “medical loss ratio (MLR),” which assumes that the money the company pays out in medical claims is a loss. When an insurer lowers its MLR, it’s spending less on health care and increasing profits. Potter says the industry wants people to think that health care reform would result in a “government takeover” that would destroy choice for the insured when really it is the “unfettered invisible hand of the marketplace” that restricts choice.

As with other books of its kind, readers expect Deadly Spin to conclude with solutions to the injustices and misinformation it illustrates. Deadly Spin leaves readers hungry for structural solutions, for a vision of a postcapitalist society, but Potter ends the book anemically:

“I believe that one day… all big corporations … will ultimately become more socially responsible.” If we’re vigilant, Potter contends, “we can force even the biggest and most powerful corporations to be more honest and transparent in the way they do business and in the way they treat us, their customers, and in the way they treat our planet.”

It’s up to activists among readers to carve out solutions.

“Americans are confronted daily -- even hourly -- with the daunting and growing challenge of deciphering truth from spin,” Potter says. He recommends that one always “look behind any public argument to see how your emotions are being manipulated.”

He counsels further, “Be skeptical.”

Linda Greene can be reached at .

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The Jan. 16 screening of Sicko at the Buskirk-Chumley Theater in Bloomington begins at 3 p.m., is free and open to the public, and sponsored by Hoosiers for a Commonsense Health Plan, Howard's Book Store, WFHB Community Radio and The Ryder

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