Churning for Dollars — There Ought to Be a Law
By Donna Smith
Common Dreams, July 27, 2014
Remember Liz Fowler? She was the WellPoint executive who took a brief sabbatical from her direct paychecks from the private health insurance industry to write the Affordable Care Act while working for Senator Max Baucus. Once that project was wrapped up, Liz went to work briefly for the U.S. Department of Health and Human Services as she transitioned her way back to work as a lobbyist for health industry giant Johnson & Johnson.
I met with Fowler once in Washington, D.C. I was part of a delegation of people hoping to be heard on single-payer, improved and expanded Medicare for all for life health care reform, and she had the most sincere, concern-filled gaze I had ever seen in D.C. as she did her best to show support for those who wanted something other than the profit-based, market driven reform we got. She was a marvelous actress. Once her work was done in achieving victory for the health insurance industry through the Affordable Care Act/Obamacare, Fowler set off for greener again (and received plenty of cash).
Now, in Colorado, we’re seeing Patty Fontneau, the CEO of the health insurance exchange, making her departure to return to private industry. Fontneau will take a position as president of health insurance giant CIGNA’s private exchange business. Prior to heading up the exchange, she worked for a law firm and in finance. No doubt her new role at CIGNA will provide her an income that supports the lifestyle to which she became accustomed while earning nearly $200,000 annually (plus bonuses) as the head of the Colorado exchange. It’s a safe bet she never had to apply for or worry about any tax credits or subsidies to cover her own health insurance premiums.
The only time I ever met Fontneau was after I complained to the exchange board in a public meeting about the delay in receiving a Medicaid denial so I could get on with shopping for and signing up for a policy on the exchange. Her staff and Medicaid managers wanted to make sure I knew it was my error that caused the delay. (It wasn’t.) And I never really got the gaze of concern and sincerity that Fowler had mastered at the national level.
So, what’s wrong with all this cross-pollination of private and public interests and executives in our health care industry? It is an affront to the basic common sense of most Americans and Coloradans to ask us to think that executives like Fowler and Fontneau have not been rewarded for their loyalty and success in protecting the big business interests that drive our health system. These are not people who devote themselves to public service of any kind for very long — being a public servant doesn’t generally pay enough to keep them anchored to the public good over private profits and interests.
I wish there were some kind of law that prevented this sort of churning of industry executives in and out of positions funded with public dollars — or at least some sort of tax penalty or fine that had to be paid when the connections are just too obvious to be anything but rewards for being a friend to big business. Our health care system will continue to see this sort of executive churning and reward system until we transform the system into one that is about health care and not about massive profits for the health care industry.
Health care needs to be treated as a public good and a human right. CIGNA certainly is not in the business of providing that. Health insurance is not health care. Health insurance is a financial product sold to us to protect health and wealth which may do neither thing very well at all. So we weren’t duped by Fowler or Fontneau as they worked to help the health industry from the inside or as they left to do similar work more directly from outside the public administration of Obamacare. We patients and private citizens were always the means to an end — higher profits for the health industry and bigger salaries for those who help make it so. As an old adage goes and has ever stayed true, "Follow the money."
On Wednesday, July 30, Medicare will celebrate its 49th anniversary. This nation and our state have benefited madly from the success of the Medicare program over the years as more seniors and the disabled were spared from poverty and suffering by having access to affordable health care. Improved and expanded Medicare for all for life would help end the same sort of trauma for all of us, and it would stop the process by which private industry profits are the top priority in our health care system.
Health Care for All Colorado will celebrate Medicare’s anniversary with an action on July 30th, and it’s a safe bet that very few health care executives or even those working on health care and currently earning a salary funded with public dollars will join in our action. They have other masters to serve, after all, and we the patients and more common folk of Colorado are not among them. And so long as we have private, for-profit health insurance companies calling the shots in our health system, we can expect they will run the show inside our state houses as they influence and own our elected officials and inside our doctors’ offices as they dictate what care we can and cannot have.
Donna Smith is the executive director of Health Care for All Colorado and the Health Care for All Colorado Foundation.