A few days before Christmas in 2007, Wendell Potter was in his office at the health insurer Cigna’s building in Philadelphia, watching CNN. A protest was being held outside Cigna’s Glendale, California, office—not, as one might expect, to demand health care reform, but to force the company to save the life of a young woman with Cigna insurance, Nataline Sarkisyan. Years earlier, Sarkisyan had been diagnosed with leukemia, and now, at 17, she’d developed complications; without a liver transplant, she would only have days to live. Cigna initially refused to cover the procedure, calling it “experimental.” But after a nightmarish week, Potter finally got some good news: His bosses at Cigna had agreed to reverse their decision and approve payment for the transplant.
This welcome news came too late. Sarkisyan died on December 20, hours after the company approved the payment for her transplant. As Cigna’s lead communications flack, Potter tried to spin the horrible story as best he could, working with APCO, the public relations and lobbying firm that once helped Philip Morris discredit the science on smoking. Together, they launched a PR blitz to absolve Cigna of responsibility for Sarkisyan’s death. Years later, after Potter had left Cigna and launched a campaign to eradicate the very industry he’d spent almost 20 years of his life propping up, he would write that he was “disgusted” with himself after Sarkisyan’s death.
Potter had been unhappy for a long time; for many years, he drank heavily to cope with the daily pressures of working with lobbyists and trade associations in D.C. to “push back against any kind of reform we didn’t like.” But Sarkisyan’s death was different. Though she was hardly the first person in America to succumb to the cruelties of its private insurance system, she was the first whose death Potter had to answer for. Usually, Potter could stop a story in its tracks simply by telling the reporter that, because of patient privacy regulations, he couldn’t confirm that Cigna had ever covered that person. Once the story ceased to exist, the same went for the patient. This time, though, “I did know, and had to know, what happened.” He had convinced himself the story would “have a happy ending.” When she died, he said, he was “devastated.”
Potter left Cigna four months after Sarkisyan’s death and pivoted to advocating for health reform. He spoke out repeatedly—both in testimony to Congress and in a 2010 book, Deadly Spin—about the tactics of the health insurance giants whose sole focus often seemed to be “Wall Street’s profit expectations.” Cigna, he said, often “purged their unprofitable accounts,” raising the premiums of businesses with unexpectedly high costs (that is, sicker employees) until they simply had to stop offering health care. His insider account is a potent weapon. Through two new advocacy groups—Business for Medicare for All and Medicare for All Now, both founded last year—Potter is waging war not only to win the public over to his cause, but also to enlist the business leaders who, up until now, have wanted nothing to do with government-sponsored health care.
The moral case for Medicare for All is well established, as cases like Sarkisyan’s make clear; Bernie Sanders, for instance, argues that health care is a human right. But in making a case for Medicare for All, Potter has identified another effective argument: that many businesses will find Medicare for All more affordable than the private marketplace jungle.
Any business owner, regardless of their political leanings, knows that health care costs are skyrocketing. Today, the average premium for a family plan is more than $20,000. Only 47 percent of firms with between three and nine employees now offer health insurance.
Medicare for All’s price tag will depend entirely on the details of the plan, though taxes will almost certainly go up. But even if businesses do have to pay more in taxes, they will at least no longer have to foot the bill for their employees’ rising premiums; they may even save money in the long run, in part because the government would have unprecedented leverage to negotiate lower rates for providers.
A few big businesses have been won over to this argument. Bastian Lehmann, the CEO of Postmates, and Ben Cohen and Jerry Greenfield, of the Vermont ice creamery, are among Business for Medicare for All’s almost 3,000 members. Most of the rest are small-business owners who have struggled to keep up with health care costs. Bram Kleppner, for instance, the CEO of one small Vermont business, Danforth Pewter, ran the numbers on the Sanders financing plan and found that it would save him between $50,000 and $100,000 a year, which would cover the cost of opening a new store, maybe even hiring a few new employees.
Of course, not all businesses feel this way. Some oppose Medicare for All on principle (as Potter put it, there will always be those who are “against the government being more involved … in health care or many other aspects of their lives”). Others oppose it for more pragmatic reasons: Big firms are able to recruit—and keep—top talent because they offer better health insurance than smaller companies.
Potter still believes, perhaps naïvely, that the business community can be persuaded to sign on to tax increases and give up a powerful form of control over their employees. But some on the left wonder if he’s looking at the problem in the right way: According to Matt Bruenig, the founder of the People’s Policy Project, the true victims in our current health care system aren’t employers; they’re employees, who earn less because their companies have to spend so much on insurance premiums.
Still, Congress responds to pressure from business above all else, so why not exploit it? The landscape of the Medicare for All fight would look very different if businesses got on board. And having Wendell Potter at the helm makes the argument for universal health care all the more compelling. His career arc, from slimy industry insider to whistle-blower and advocate, has lost him some friends; Democratic Speaker of the House Nancy Pelosi, with whom Potter said he worked during the Affordable Care Act fight, no longer calls him to shoot the breeze. But that’s fine, too, he said, because things change. “It’s just a matter of time”—and putting in the work.