(NewsNation) — A former top insurance executive has revealed systematic practices within the health care industry that prioritizes shareholder profits over patient care, leading to claim denials and treatment delays that have left millions of Americans struggling with medical debt.
Wendell Potter, ex-vice president of corporate communications at Cigna, told NewsNation on Wednesday that insurance companies routinely use tactics like prior authorization to restrict patient access to needed care, enriching shareholders while potentially endangering lives.
“It’s all about how you can reward shareholders and what you have to do that is detrimental to the people who enroll in your health plans,” Potter said on NewsNation’s “Elizabeth Vargas Reports.”
The comments come in the wake of the killing of UnitedHealthcare CEO Brian Thompson, which has sparked a national conversation about health care industry practices.
In an op-ed, Potter pointed out that at investor conferences, “The word ‘patient’ is rarely if ever mentioned, while ‘profit margin’ and ‘shareholder value’ are uttered frequently.”
Americans owe “at least $220 billion” in medical debt
Recent data from the Kaiser Family Foundation underscores Potter’s criticisms, revealing Americans owe at least $220 billion in medical debt, with approximately 100 million people struggling with health care costs despite having insurance.
The industry’s practices have drawn widespread condemnation, with public figures like podcaster Joe Rogan describing health insurance as a “dirty, dirty business.”
Potter, who left his corporate role after experiencing what he calls a “crisis of conscience,” said there was an urgent need for systemic change. He cited examples of patients facing critical treatment delays, including a tragic case of a 17-year-old who died after her liver transplant was postponed.
United Healthcare, the nation’s fourth-largest company, has seen its stock price surge over 2,000% in the past decade.
A recent KFF poll reveals that 97% of registered voters believe insurance companies bear significant responsibility for high health care prices.
‘Delay Deny Defend’ book climbs to No. 2 spot amid Luigi Mangione arrest
Authorities continue to build their case against Luigi Mangione, the 26-year-old suspect who fatally shot Thompson.
On social media in particular, some users gloated about the killing, a reaction they framed as rooted in their enmity for the health insurance industry. That, in turn, brought rebukes from others who condemned those responses as inhumane, especially in the circumstances.
Interest in health care reform has surged, reflected by the book “Delay, Deny, Defend” climbing to No. 2 on Amazon’s bestseller list.
The phrase “Deny, Defend, Depose,” etched on bullets and shell casings at the crime scene, has become a flashpoint, prompting Amazon to ban merchandise featuring the words after products like mugs and sweaters surfaced online.
Meanwhile, the murder has alarmed corporate leaders nationwide, with executives ramping up security amid fears of copycat attacks. Wanted posters targeting health insurance executives have appeared in New York City, heightening concerns in the corporate world.
The NYPD’s crime lab announced it successfully matched Mangione’s firearm to three shell casings recovered at the Midtown Manhattan crime scene. Investigators have also uncovered a spiral notebook with detailed “to-do lists” related to the assassination.
Among the entries, Mangione reportedly considered using a bomb but opted for a targeted shooting to “avoid killing innocents.” One passage read, “What do you do? You wack the C.E.O. at the annual parasitic bean-counter convention. It’s targeted, precise, and doesn’t risk innocents.”
Mangione, currently held in Pennsylvania, faces second-degree murder charges and is fighting extradition to New York.
Doctor calls out claim denials amid UnitedHealthcare CEO shooting
Dr. Saju Mathew, a 20-year veteran primary care physician, told NewsNation Monday that insurance companies are increasingly blocking critical medical procedures through complex “prior authorization” processes.
“We as doctors have been crying, screaming on the top of our lungs regarding how lots of insurance companies are denying claims on a daily basis,” Mathew said on “NewsNation Now.” He cited examples of patients being unable to obtain routine tests like mammograms without extensive bureaucratic hurdles.
Mathew said that UnitedHealthcare denies one in three claims, a trend he says is symptomatic of a broader industry problem. The company reported $281 billion in revenue last year.
“But it’s just not UnitedHealthcare. It’s really all insurance companies,” he said.
Can the US health care industry be fixed?
Sen. Elizabeth Warren, D-Mass., said in an interview that the “visceral” response to the killing should serve as a warning “to everyone in the health care system,” adding that “people can be pushed only so far.”
“The visceral response from people across this country who feel cheated, ripped off, and threatened by the vile practices of their insurance companies should be a warning to everyone in the health care system,” Warren told HuffPost.
Mathew argued that meaningful change would require congressional action, suggesting legislators should mandate transparency about insurance denial rates and restore medical decision-making power to physicians and patients.
“No. 1, we should be able to make sure that people understand which insurance companies have the highest denial rate,” Mathew said.
The physician called for removing insurance companies’ ability to arbitrate medical necessities, particularly in critical procedures like knee replacements for patients with severe arthritis.