After ‘crisis of conscience,’ ex-Cigna exec hopes to set the record straight on health care

Wendell Potter, founder of Tarbell.org

THIS SUMMER, A NEWS SITE CALLED TARBELL will make its debut and join a growing number of health-journalism startups. Named for the famous early 20th century muckraker Ida Tarbell, whose landmark expose of Standard Oil led to the breakup of the company, Tarbell.org will strive to produce similarly consequential investigative journalism, and pledges to “uncover how lobbyists and special interests affect you.”

Wendell Potter, Tarbell’s founder, oversaw public relations for Humana and served as head of corporate communications for Cigna from 1997 until 2008, when he left after what he called a “crisis of conscience.” Potter said he realized that much of what he had been doing during his insurance career was misleading the public.

The strategy of big insurers, Potter says, was to move everybody into high-deductible plans. “I was expected to promote them, to persuade reporters and the public that they were great for everybody,” he says. “And that was not true.”

After Potter left Cigna, he wrote the book Deadly Spin, in which he detailed deceptive insurance practices and revealed how the industry operated. Potter also wrote a column and provided analysis for the Center for Public Integrity, and examined “the marriage of great wealth and intense political influence” in last year’s Nation on the Take, a book that Nicholas Kristof called “eye-opening.”

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I recently spoke with Potter about Tarbell’s ambitions and health journalism’s “forest-for-the-trees” problem, among other topics. Our conversation has been edited for clarity.

In my corporate job, I had to convince people that we had the best health system in the world, and there was little reporting that challenged that.

What prompted you to start a new journalism venture?

It’s important to make amends for my corporate career. I learned how big corporations operate, and feel I have a big obligation to help people understand things that are purposely obscured.

I got a lot of questions and comments (in response to his CPI columns) that made it abundantly clear that people needed a greater understanding of how the health system worked. A lot of questions led me to realize how the players spent millions of dollars to influence how the ACA came together, either by direct lobbying [or by] influencing elections and public opinion.

What is your goal for Tarbell?

The ultimate goal is to help readers understand how large corporations, trade associations, and other large institutions affect their lives every day in ways very few people understand. We’ll report on how they spend money to influence the way we think, act, and vote, and how they influence elections and public policy. It will follow the flow of that money. We want to connect the dots for people. Our stories will be probing and provide answers to questions that are beyond the routine of regular reporting.

For example, most reporting on money and politics focuses on politicians on the take. We’ll focus more on the check writers like my former employers in the insurance industry. And we’ll show how the billions of dollars they spend to protect or enhance a profitable status quo affect the rest of us.

How are you going to do that?

In my corporate job, I had to convince people that we had the best health system in the world, and there was little reporting that challenged that. Similarly, there was little reporting about how systems abroad operated. In reporting about the Affordable Care Act, some of the best reporting was done by foreign journalists like those from Al Jazeera. I was interviewed (by Al Jazeera) and was really impressed with the way the story was put together. They provided important context that helped viewers understand the US healthcare system.

Our system is what we grew up with, and we don’t have a frame of reference on how it could be different. You would be hard-pressed to see how our system compares with others.

Why is that so?

It’s a “you-can’t-see-the-forest-for-the trees” problem. Most reporting is done at the tree level, and much of it, too, is of the he-said, she-said variety. It’s rare to see reporting above that level. We don’t often see stories that ask why our health system is so incomprehensibly complex, expensive, and our outcomes so poor compared to other countries. How did it get to be that way? Who benefits from the complexity and lack of transparency? How can it be different? We also have a commitment to solutions journalism. We won’t just be reporting on problems, but [will] point to possible solutions.

I also want to take those kinds of stories that come from the states and give them a national exposure. For example, there has not been adequate reporting on the tricks the beverage industry has used in fighting the soda tax initiatives across the country, and how a left-right coalition came together in Tallahassee to do something about local political corruption.

Give me an example of a statehouse story that’s going unreported now.

Two come to mind. The Ohio Hospital Association is trying to block implementation of a bill sponsored by a Republican lawmaker that would require providers to be more transparent about what they charge. The American Dental Association and state dental societies are trying to block bipartisan legislation that would allow the equivalent of nurse practitioners to practice dentistry.

How does Tarbell fit into the health-journalism landscape?

We will look to really engage our readers as stories are being considered—letting readers tell us about story ideas.

We will be building an interactive platform, and want readers to be in conversation with other readers as well as with our reporters. Some of this will tell us what stories to pursue. There will be greater transparency in how [our] journalism is produced. We also want to help instill in readers the need for greater civic engagement. I don’t see other journalism organizations doing that.

How will Tarbell distinguish itself from other investigative journalism sites? Who do you think of as your competitors?

We will be looking at corruption through a different lens. I want this to be an entirely different approach. There’s little consistent reporting on the motives of the rich and powerful, the entrenched special interests who spend whatever it takes to get what they want. I want to get at how my former employers make sure there’s little understanding of how the big corporations go about doing what they do and what they are getting in return. At its core, Tarbell will be looking at those who really have the power in this country. It’s an illusion that Congress and the president have that control.

I don’t know of anyone who is doing what we hope to do, broadly speaking. Existing media that do some of what we will do would be ProPublica, CPI, Vox, BuzzFeed, The Intercept, and The Marshall Project.

The information is presented from an investor’s point of view, not how these corporations affect people’s lives.

How will you attract audience attention through the noise out there?

We’ll go way beyond longform journalism with multimedia. We won’t be another journalism platform that reports on Donald Trump’s tweets. All the reporting on tweets and the constant attention to controversies obscure what is going on in the government agencies. There’s very little reporting on how industries influence the way regulations are written and implemented.

How would you report on the regulatory process?

By looking more closely at the FDA and how the pharmaceutical industry influences it. What does “regulatory capture” mean? Where do regulators get their information? There’s very little understanding of how the industry lobbies regulators.

What are some industries you really want to pursue?

I want to really explore the insurance industry—how it developed and perpetuates its own existence. It’s not a single story but an ongoing one. It’s the same thing with the drug industry. How do you get readers to see it from a different perspective? That’s what we’ll be doing.

What about the business of health care, which has been historically undercovered?

There is some reporting by The Wall Street Journal and Dow Jones, Bloomberg and Reuters, but the best of it has a steep price tag. When someone spends $10,000 a year for a subscription, they get something for their money. Almost all of the reporting on this topic is being done by the wire services, which have a business model that only business elites can afford. The information is presented from an investor’s point of view, not how these corporations affect people’s lives. When I was doing PR, I rarely got questions from reporters about how a corporate action affected people.

What’s your business model?

It’s a reader-funded subscription model. Our main source of revenue will ultimately come from readers. We will consider them as members because we want them to be part of something. We are patterning Tarbell after very successful reader-funded sites in Europe, like MediaPart in France, Krautreporter in Germany, and De Correspondent in The Netherlands. Sebastian Esser, the founder of Krautreporter, is on our board of advisers.

How much will you charge?

We’re still looking at the price, but likely $75 a year.

They spend enormous sums to make sure their messages are well-crafted and focus-group tested. I want people to understand why we believe the stuff we believe.

Are you considering sponsored content or native advertising?

When you do that, you enable industries to influence public opinion. They use Politico and STAT to influence public opinion, and lawmakers to get what they want. It’s annoying and corrupting. Yes, it does bring in revenue, but they are doing readers a disservice. Even if readers are aware of it, it influences them.

We have raised money from individuals and family foundations for the start-up, but I don’t see foundation funding as a major revenue source in the long term. I don’t want to be in the position of being foundation-funded exclusively because their donations often have strings attached. A lot of foundations didn’t have the appetite for some of the reporting CPI was doing on Medicare Advantage plans. A lot of funders don’t get the importance of Medicare and Medicare Advantage plans. Foundations are interested in health but not so much in systemic problems. If you’re dependent on foundations that restrict funding to certain topics, they can starve reporting needed in other areas.

What are other subjects besides healthcare are you focusing on?

Financial journalism. We got into this a little bit in Nation on the Take, which I wrote with Nick Penniman. The same things are missing in this coverage as in healthcare. There’s not enough reporting and discussion about how policy gets made. There’s just not enough understanding.

I want to share with people the techniques and the money that is used to create fake grassroots organizations, and how money is funneled to those organizations for advertising and PR campaigns to shape public opinion. The Coalition for Medicare Choices funded by the insurance industry, and Health Care America funded by the drug companies. They spend enormous sums to make sure their messages are well-crafted and focus-group tested. I want people to understand why we believe the stuff we believe.

There’s a prevailing view that the public isn’t interested in the nitty-gritty of how the system works. How will Tarbell break through?

I’m convinced there are enough people in this country who want the kind of information we will produce. I think there are enough people who can make our business model viable, and who have a hunger for the type of reporting we will provide. The information just has to be provided in ways that are appealing and captivating. That’s what the European sites are doing. If they can pull it off, so can we.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.