A Citizen's Syllabus

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Believe the liar

The Washington Post, in August, 2020, published an opinion column by a former health insurance executive. In it, the writer admitted that he and others like him deceived America and steered the nation away from the right decision about health care and health insurance. Their influence persuaded Congress to overlook the best options for health care delivery and to adopt weak measures instead. They did this so the companies they worked for could maximize profits.

The writer, Wendell Potter, was a vice president at Cigna, one of the nation’s largest health insurance companies. Potter writes that the effort to mislead America reached a fever pitch in 2009, as the Congress was considering the Obama proposals for health care reform. He and others opposed proposals that would have diminished profits, but especially against the single-payer system used in Canada and most other developed nations:

I spent much of that year as an industry spokesman, my last after 20 years in the business, spreading AHIP’s “information” to journalists and lawmakers to create the impression that our health-care system was far superior to Canada’s, which we wanted people to believe was on the verge of collapse. The campaign worked. Stories began to appear in the press that cast the Canadian system in a negative light. And when Democrats began writing what would become the Affordable Care Act in early 2009, they gave no serious consideration to a publicly financed system like Canada’s. We succeeded so wildly at defining that idea as radical that Sen. Max Baucus (D-Mont.), then chair of the Senate Finance Committee, had single-payer supporters ejected from a hearing.

Get that? The Democrat chairman of a senate committee refused to even listen to proposals and recommendations for a legitimate policy because profit-seeking corporations had prejudiced him against the idea.

And it wasn’t just congressional insiders who were affected. Most citizens were persuaded that single payer policies were impractical, un-American, ineffective, and more.

Potter’s article asserts that single-payer does work. It has always worked. Evidence from other countries and from smaller-scale programs within the US shows that it works. It you think it doesn’t work, you are deceived. And he admits, it was himself and others like him that did the deceiving.

Their campaign of disinformation ended after the Obamacare program was created and passed into law. And without that aggressive campaign of false information, American citizens have changed their minds. Since about 2016, a majority of Americans support “Medicare for All” — which is another way of saying single-payer health care.

Potter’s story would be just ancient history if it weren’t for the ongoing coronavirus pandemic. The US has more cases than any other country in the world. The US has a rate of coronavirus deaths higher than most other developed countries. And Potter asserts that these grim facts are a consequence of his actions a decade ago. Canada and other countries that employ the system America rejected are dealing with the crisis better than the US:

[N]o one in Canada is turned away from doctors because of a lack of funds, and Canadians can get tested and treated for the coronavirus without fear of receiving a budget-busting medical bill. That undoubtedly is one of the reasons Canada’s covid-19 death rate is so much lower than ours. In America, exorbitant bills are a defining feature of our health-care system. Despite the assurances from President Trump and members of Congress that covid-19 patients will not be charged for testing or treatment, they are on the hook for big bills, according to numerous reports.

That is not the case in Canada, where there are no co-pays, deductibles or coinsurance for covered benefits. Care is free at the point of service. And those laid off in Canada don’t face the worry of losing their health insurance. In the United States, by contrast, more than 40 million have lost their jobs during this pandemic, and millions of them — along with their families — also lost their coverage.

There is much more to say about the health care delivery aspects of this topic. Other writers can explain the pros and cons of single payer. Others can discuss the prospects for further health care reform in coming years, under a re-elected President Trump or under a Biden presidency.

The Congenial Iconoclast has asserted elsewhere that the most important epistemological skill is knowing which sources of information to trust. It seems likely that this case is a massive failure in that regard. American citizens believed lies presented by profit-driven corporations. Some still believe that single-payer proposals are evil, communistic, and hateful. And that is strange, because many of those same citizens are on Medicare (a form of single-payer health care run by the government) and many of them admire America’s military (which is served by a massive and generous single payer program run by the government).

Another part of America does not think single-payer is evil, or impractical, or communistic. But they remain convinced that single-payer is extravagant, or impractical, or unworkable in this country. They are deluded, too, which also signals the success of Potter’s campaign of lies.

It isn’t always possible to know who’s lying and who’s telling the truth. The best indicator of trustworthiness is experience. A person who was truthful in the past can probably be trusted again. That doesn’t help here, though, because few citizens have every heard of Wendell Potter. And it doesn’t help that Potter tells us freely that he lied aggressively and willfully.

It is not difficult to see why Potter lied back in 2009. He was getting paid to do it. And while we can’t know his inner motives today, it is not hard to see why me might change his tune. He’s no longer paid to tell lies. He is, perhaps, a decent guy deep down inside, and he regrets what he did. He can’t go back and change the past. But he can at least set the record straight from now on. That seems to be what he’s doing.

Strange as it sound, perhaps citizens should believe the liar.