[W]endell Potter has been fighting for structural health care reform after fighting against it — from the inside.
In 2008, he left his position as the head of communications for Cigna. The whistleblower has exposed the abuses he saw and participated in while working in the health insurance industry for more than 20 years.
In an interview with VTDigger, Potter discussed his advocacy work, his support for a Medicare-for-All system and his analysis of Vermont’s failed effort during Gov. Peter Shumlin’s administration to create a single-payer program.
Potter spoke last week at a forum sponsored by Vermont Businesses for Social Responsibility and Vermont Health Care for All.
This interview, conducted before the Burlington event, has been edited for length and clarity.
VTDigger: Tell me about growing up in rural Tennessee. When I think of Tennessee, I don’t think of great wealth. Looking back, what impact did growing up there have on what you are doing today?
Wendell Potter: I think it means everything. In fact, I was there just this past weekend, for my 50th high school reunion. And East Tennessee, where I grew up, looks so much like Vermont you could almost not even know where you were sometimes. It looks so, so much alike. People with very different accents, very different. I grew up poor. My mom and dad were very hard working. My dad had a farm and a small country store when I was a little boy, that couldn’t make it. So after that, they took a factory job and did shift work for 25 or more years. And they put a little money aside so I could go to college. That upbringing shaped me and helped shape my values.
One of the pivotal moments in my life came when I went back to visit family in 2007. I read in my hometown newspaper about one of these charity medical events nearby. I went there out of curiosity, and that truly changed my life in a way that it would not have had I not been raised there. I saw people who could have been my neighbors, who could have been family members waiting in lines to get care. This was at the county fairgrounds, and people were waiting to get care in barns and animal stalls. It was astonishing to me, I had no idea. I’d been lucky. I’d gotten a good education and was able to move away, and moved away from poverty really as well. And to see people who were having to get care that way, in such an undignified way, I just realized I had to be part of the problem.
And I knew I was because of what I was doing for a living, which was trying to persuade people that we’ve got the best health care system in the world. That the problem of the uninsured was nothing to be concerned about, that people who are uninsured were that way by choice. I knew it wasn’t true. I came to realize that what I was doing for a living was really misleading people. In my first career, I was a journalist and I was just horrified when I really came to grips with what I was doing because I was doing the exact opposite of what I tried to do as a reporter, which was never to mislead, never to knowingly say anything that wasn’t true. But I was doing that all the time, to perpetuate profits and to enhance shareholder value. And that’s when I came to realize what I was doing and paid well to do. But if it hadn’t been for growing up there, I don’t think I would have felt that way. I don’t think I would have had the same visceral reaction as I did that day.
VTD: It’s remarkable how one event made such a difference. Tell me more about that experience? When you went home that night, what were you feeling?
WP: I remember so much about that. The fairgrounds had a wall so you couldn’t see what was on the inside. I walked through the gate and saw a sea of people in front of me. Many of these people were soaking wet because it had been raining that morning. I knew immediately what was going on. There were tents that were set up on the fairground site, and people were getting care under these tents with everybody to see. And then I could see the barns of animal stalls. I never would have thought that I would be anyone who would ever be talking about an epiphany. But it truly was and it was a sensation of — I’ve often likened it to putting your hand on an electric fence. Because it was an electrical shock, honest to God, and it was a very emotional moment for me as well. It looked just like what you might see on TV at a refugee camp and it was right in my own backyard.
VTD: What was your expectation when you got into the insurance industry?
WP: I was so proud of myself for having gotten a job in the industry. My first real job in health care was working for a hospital system in East Tennessee. And after a couple of years I was recruited by Humana, which was my first corporate job, moved to Louisville and I thought I really had made the big time now, gotten this great job in a big company. I didn’t know much of a difference between a for-profit health care system and a non-profit hospital system.
When I joined Humana, they owned hospitals. One of my (earlier) colleagues said he was sorry to hear that I was going to work for a for-profit company. He had a better sense of what I was going into than I did. I just thought, well, this is a great career move for me. And I continued to think that for quite a long time. I was at Humana when Humana decided to sell off its hospitals to focus on managed care. And soon after that, I was recruited by Cigna and had a 15-year career there. So I was really focused on career growth and material things and was quite impressed with what I was making and what that money could buy. And that’s what became important to me for a while. I’m sorry to say how long.
VTD: How long did it take after the epiphany for you to leave Cigna?
WP: it was six months or so, maybe a bit longer. I can remember making a commitment that day that I would have to find some other way to earn a living. But I didn’t know what that would be. And I thought it’d be kind of foolish to leave my job without anything else lined up.
A couple of weeks later, I was flying with the (Cigna) CEO from Philadelphia to Connecticut on a corporate jet. For some reason I was paying more attention than usual. We were served lunch by a Cigna employee who was using gold-rim China and gold-plated flatware. And we were sitting on leather seats, and it was just, you know, a fine way to travel. I thought back to just two weeks earlier, seeing these people standing in lines to get care in an animal stall. And I thought, my God, what’s happened to me, and I really got serious then about trying to figure out some other way.
My exit strategy actually took a while longer. I settled back into my job for a while. My team and I were handling what we referred to as horror stories. When someone who was not getting coverage would call the media or a lawmaker and, you know, be a squeaky wheel, then my team and I would try to make it go away. But there was one story that wouldn’t go away. And it involved a young woman in California who was 17 years old, Nataline Sarkisyan, who needed a liver transplant. But Cigna was refusing to pay for it, calling it experimental, which wasn’t true because it had been done many times. The medical director also felt that for this particular patient it wasn’t appropriate. It was obviously a judgment call, overruling her own doctors or surgeons.
The family appealed to no avail. Then they decided to try to shame the company. They were able to generate a lot of negative press. The company finally did agree to cover it. I thought I played some minor role in that reversal, felt kind of good about the job that I was doing. You tell yourself these things, maybe I’m doing some good here. But the problem was she died just a few hours after that. And I just could not do that again. I mean, that just sucked everything out of me and my desire to keep working for that company or the industry. So I turned in my notice soon after she died. They asked me to stay on for a little while longer. I agreed to do it. But I walked out and had no regrets. It was a very difficult decision. And I talked myself out of it a number of times because I had a family, and it wasn’t a decision that would just affect me.
VTD: That was more than 10 years ago. Where do you feel your advocacy since then has been most effective?
WP:: I don’t know.
VTD: Well, that’s an honest answer.
WP: I testified before Congress a number of times in 2009 and 2010. I’m told by members of Congress that it made a difference, that Democrats were wavering on their commitment to health care reform. They had not heard anybody like me. Almost everything they had heard about insurance companies had come from their lobbyists. So I don’t know. I know, obviously, the (Affordable Care Act) did pass. And some of the things that I talked about in my testimony were addressed in the legislation. So I’m grateful that that bill passed, I think it did do some good. But I knew as I was watching the legislative process that my old industry was influencing how that bill was being written, not just insurance companies, but pharmaceutical companies and big hospital companies, the AMA (American Medical Association). I’ve often called it a Band-Aid.
Ewe Reinhardt, the late former economist from Princeton, called it an ugly Band-Aid on an ugly system. And it is, I think that’s appropriate, it was something that did some good, though not where we need to be. So in that regard, I don’t think my work is by any means done and probably never will be. I think it’s important to keep going. What I do is point to the shortcomings of that legislation and what has happened since that law was passed, where we are now, what the need still is, and growing, and where we need to go from here. And I’ll say that I’m grateful to have a platform to be able to do this. I feel an obligation to do this, to a certain extent, as a way of making amends for what I did for quite a few years in the industry.
I think where we are right now, there is at long last, a discussion about moving to a single payer health care system, Medicare for All. And Bernie Sanders deserves much of the credit for that, because he has long advocated for that, campaigned for that when he ran for president the last time. It really helped for that notion to get currency and to be considered legitimate. And we’re having that conversation now. I’m for it because it’s the easiest solution.
I think it’s better than the other half measures, the incremental steps, I don’t think those incremental steps would be any easier. And it is just delaying the inevitable. We have to go to this. I think it’s a matter of when, not if, because the current system is completely unsustainable. When I give my talks I provide what I view as the evidence for that.
I think the insurance companies have played their last card; they don’t have any more cards to play. I think the last one was high deductible plans, moving people into high deductible plans, they don’t have the next card. Employers are catching on now too. That’s why I agreed to serve as president of the Business Initiative for Health Policy.
We make the economic case for moving to Medicare for All. So employers are catching on that they’ve been sold a bill of goods by the insurance industry. And more and more of them are joining our organization. We’re new, but we’re getting some notice. And regular folks are catching on too. People are certainly grateful if they have private insurance, but they’re finding that every year it has less value. We try to help people understand just how much less valuable it is, and how we’re all in one way or another vulnerable to this system. And its shortcomings. And why we’ve got to change it.
VTD: You must have looked at what Vermont tried to do. Why, in your view, didn’t it work? Was it political, economic, something else?
WP: I think it was some of all of that. I am cautious here because I don’t live here and I just observed it from a distance.
VTD: Maybe that’s actually a benefit.
WP: It could be.
I don’t doubt the commitment that Gov. Shumlin and lawmakers had. I think two or three things: I think they probably were not focused enough on communicating to Vermonters what would be involved in moving to that. I think it’s exceedingly important to make sure people understand what’s involved. When we’re talking about something that’s publicly financed, that means taxes. You have to condition the environment in a certain way. I know this from my years of PR. I’m not saying that the governor and his staff didn’t try to do that. It just takes time and effort. And then you’re not doing this in a vacuum; you’ve got others who are shooting at you trying to keep it from happening. So it’s hard work, with all the opposition. That’s another thing I talk about is what my old colleagues were up to and how successful they are at scaring people. They can begin to turn public opinion against what is in (people’s) own best interest. I think you certainly saw that here. As I said earlier, you have to figure out how do you raise a tax revenue, I often say you need to help people have a shift in their thinking, to see that what they’re paying now in premiums and to see that as a tax, right? See, that is taxation without representation. You’re paying those taxes; let’s just shift that money into a public fund. It’s hard for people to understand that. And people have this aversion politically to taxes. So it’s hard to do that conditioning of the environment.
Also, I think that even leading advocates would now say that it probably was a heavy lift in a state like Vermont, with one of the major health care systems actually outside of the state. (Dartmouth Hitchcock) serves a lot of people. And certainly you have big employers like IBM who were not on board. I know all about how influential big corporations are and how they throw their weight around and get what they want or try to get what they want. You also have to get waivers from the federal government and all the things that have to be done to make it successful. It was really very hard. So looking back, I guess I’m not shocked. Hugely disappointing that Vermont couldn’t do it. But there were a lot of obstacles. It doesn’t mean that it can’t be done. I know here in Vermont, there are those who are looking to, for example, start with primary care, and make sure that every Vermonter has access to primary care, maybe as a way to start this conversation again and make some significant progress. However, it’s a matter of time that we will get to a single payer health care system, whether the path leads to the states or to Washington, but one way or another, it’s going to happen. There are other states that are looking at it as well, too. So we’ll see.
VTD: Why do you have any confidence that if the system were to switch, that the people who were denying those liver transplants would just be a different category of people, public employees instead of insurance company employees?
WP: What bothers me and what I often tell folks is in the current system, it’s a crapshoot. If (the liver transplant patient who died) had been enrolled in a (public) plan, she might be alive today. But she wasn’t. And the medical director who made that initial decision to deny that transplant was just as much a corporate employee as I was. There was no memo that he got that morning saying you’ll deny X number of transplants this month. But it’s part of the corporate culture — you know that you have your role to play to help make sure the company meets Wall Street’s expectations every three months. And you are constantly reminded of that, because every three months your company releases earnings. And there was always a conference call with the CEO, with all the leadership, how we did the previous three months. So you’re expected to be a part of the team and make sure, without being told directly what to do. And you want to make sure that you get a raise and bonus and stock options. If you’re perceived and known as an outlier, that’s not going to happen. So I guess I would rather take my chances with someone who is not looking to make a decision that could influence his or her own income. And that’s what happens in these big insurance corporations.
And the Medicare that we have now, there is no medical director that is going to make a decision that you are not going to get a procedure, if it’s medically something that’s a covered benefit. There is no CMS administrator who’s going to second guess your doctor. During the debate on the Affordable Care Act, there were the opponents saying the Affordable Care Act would create death panels. There’s no such thing. But they exist in our private system of health insurance. (The liver transplant patient who died) was not an isolated incident. People die every day. We just don’t see it because we don’t see the stories.
VTD: Is the insurance industry any better today than when you left?
WP: No, in fact, I would argue there is probably even more prior authorization requests now than before. One of the things that the Affordable Care Act did, it took away some of the ways that insurance companies were making money, they can no longer refuse to take on a customer because of pre-existing conditions. They can’t charge you more because of a pre-existing condition. There’s a limit on how much they can skim off of your premiums, to go to profits and overhead. All these things have a bearing on a company’s bottom line or their ability to make money. I would argue they’re making money hand over fist now. They’ve done exceedingly well since the Affordable Care Act passed. And I knew that they would look for other ways, it’s kind of like squeezing a balloon. Wall Street demands that they make certain profits. And the last thing you want to do is miss Wall Street’s profit expectations by a penny. So they will do whatever they can to make sure that they meet those numbers. And I’m confident that probably means more prior authorization requirements now than before, and probably more denials than there have been before.
VTD: Talk more about the Affordable Care Act, what it did well, and what it really missed?
WP: Well, we have about 20 million more people who have insurance. It did enable people who don’t get coverage in the workplace to be able to get coverage, and the assurance that they wouldn’t be turned down. For those who can’t afford coverage, there are subsidies to help them pay the premiums and even their out-of-pocket expenses. It allows young people to stay on their family policies until age 26. It does put a limit on how much insurance companies can devote to overhead and profits. So I think those are good things.
It falls short in many ways. It doesn’t get us nearly close enough to universal coverage. We’re back up to 30 million people who don’t have coverage. And there are a growing number of people who are under insured. The Commonwealth Fund tracks this on a regular basis. These are people who are now in such high deductible plans that they can’t really use their coverage. The Commonwealth Fund came out with a study that said about 28% of all of us who get our coverage in the private sector are under insured, and 42% who are getting their coverage on the Obamacare exchanges are under insured. That’s because in some cases, people have no option but to enroll in a plan with a high deductible. And a lot of people just don’t have the money to pay the deductible. And the deductibles keep going up and up every year. It’s not unusual for an individual to have a deductible of thousands of dollars and a family to have multiple thousands of dollars in deductibles that had to be met before their coverage kicks in. We’re seeing the data of people foregoing the care that they need because they just simply can’t afford to pay out of their own pockets.
The other thing is that (the ACA) doesn’t control costs in any meaningful way. If it did, we would see some relief from rising drug prices and hospital charges. The main reason is that the Affordable Care Act left the basic structure of how we finance health care in place, and that is through private insurance companies, third party payers if you will. And we’ve got now decades of experience showing that insurance companies cannot control health care costs. And as I said earlier, I think employers are beginning to see the light on this.
A lot of employees at any insurance company are analyzing medical trends and trying to anticipate how much medical costs will increase in the future. They use that data and information to base their premiums for the next year. They anticipate what they refer to as medical trends for the next year. And then they say, well, we’re going to raise the premiums to cover the medical trend and we’ll tack on enough to meet our profit expectations. So that’s the game that’s going on. They can’t control costs, but they can anticipate them and then just increase their premiums to cover their expenses and have an adequate profit or what they think is the profit that Wall Street wants. As health care costs go up, they’re able to charge higher premiums. That means their revenues are going up. And you’ve got more revenues to work with to convert to profits. I was looking at Cigna just over the past weekend. Revenue has been increasing very steadily over the past 10 years. So has the company’s profits. And the share price has just been going through the roof. If you bought a share of stock in Cigna when I left in November 2008, you could have gotten a share of stock for $8 dollars and 75 cents. Last Friday, it was $157. So if you had $60,000 lying around, you’d be a millionaire today.
VTD: What’s your biggest worry under President Trump?
WP: Trump is bound and determined to try to take us back to the days before the Affordable Care Act was passed. And a lot of Republicans in Congress have tried and tried and tried to repeal it, and they’ve never been able to do it. But through various executive orders, he has been able to whittle away some of the underpinnings of the law or some of the benefits. One of the things that has resulted in more people going without coverage is getting rid of the penalty for not getting insurance. I never liked that penalty in the first place, but it was a way to try to make sure that there were more young and healthy people in the pool. And so that was the reason it was passed. And now that there’s no penalty, more people are starting to take their chances. And I can understand that.
If we go back to before the Affordable Care Act, we will go back to the days where insurance companies are able to market what is essentially junk insurance and people are gullible or uninformed and will enroll in these plans and find out when it’s too late that they’ve got inadequate coverage. It looks like it’s coverage. But there’s really nothing there when the rubber hits the road.
They are illegal now. They’re often referred to as limited benefits plans, that’s one euphemism for them. But even Consumer Reports call them what they are, junk insurance. Many of them don’t cover even hospitalization, or have such low annual limits. So if you have to be hospitalized, you’re on the hook for most of your care. People don’t really understand how care costs and just how quickly a hospital bill can mount up.
VTD: Go back to what you were talking about with Vermont. And what you saw as a lack of conditioning people to a change. What more could have been done at that time? What more could be done now to make people better understand what a Medicare-for-All system would mean?
WP: It’s a good question, because it’s something that we certainly are going to have to try to tackle as we look to do this on a national basis for sure. A lot of businesses in Vermont don’t offer coverage to their workers, small businesses here and elsewhere, have long since given up the idea of offering coverage to their workers, they just can’t afford it.
You’ve got to figure out how to implement it. How do make sure that everyone who is able to pay can do so and do so through some mechanism of raising taxes or implementing some new tax? You have to persuade business owners this is to their benefit as well. You need to establish a vision for how things can be better. The insurance industry right now is in one of its propaganda campaigns, it’s called “coverage at work.” And it is trying to make people think that our employer-based system is sacred. We need to disabuse people of that notion and help people understand just how inadequate today’s insurance really is, how vulnerable we all are to having to file for bankruptcy even with insurance. But we also have to create a vision for how much better things can be, that you can have some peace of mind and not have these limited networks that restrict who you have access to. So you have to paint a vision of what is positive, and how it can be less expensive overall than what the current situation is.
We waste so much. We spend over $3.5 trillion on health care in this country annually, which is mind boggling, way more than any other country. That averages out to that more than $10,000 per person, twice the average of the other developed countries. And our outcomes are worse. We have much more limited access to health care providers. We’re spending so much more than anybody else and getting so much less. You’ve got to help people understand that you can’t do it in a vacuum because you’ve constantly got the incoming propaganda. That’s not an easy thing to pull off. But I’m kind of dedicated to being in the fight here on this.
I think we can also look at some of the failures of what has been tried recently, that hasn’t proved to achieve administrative savings or savings overall, or improve care, like Accountable Care Organizations. They were put out as this great thing that’s going to improve people’s health and bring down the cost of care. And we’re not saying that universally, by any means.
VTD: Why not? Isn’t there an economy of scale involved?
WP: I think there are plenty of ways that we can look at what is working, maybe in other settings, particularly around the world, how other systems operate. Even if we were to stick with fee for service, you still could achieve considerable savings, because in our current system, and I think this is the number that even the American Medical Association, which is not a single payer advocate, (agrees). Doctors spend on average $100,000 a year in their practices dealing with all of the paperwork, all of the administrative detail that is necessary because of our multiplayer system. They have to have staff that does nothing more than work day in and day out with
bureaucrats and insurance companies. Every patient has a different kind of health benefit plan. So it’s an extraordinarily complex and expensive system. And doctors are spending every year more and more money. About a third of what we spend in that three and a half trillion dollars is for things that don’t provide care. In many cases, it’s eaten up by all the administrative expense that’s made necessary by our multi-payer system.
You can save enormous sums of money by moving to a single payer system, the Medicare program. The administrative expenses of Medicare is 2 to 3% compared to double digits on the private side. The analyses that have been done of the Sanders Bill, by a conservative think tank, found that you can save $2 trillion dollars over the next 10 years by going to single payer health care.
VTD: We have a challenge here in Vermont, I’m sure many other states do too, where small rural hospitals are struggling. What can be done to keep those kind of hospitals from disappearing?
WP: I think a Medicare for All program would help keep those essential hospitals that people rely on in business. I was down in Tennessee on a speaking tour six weeks ago, and more hospitals have closed in Tennessee than any other state except Texas. I think 12 over the past 10 years or so. And that’s one state that hasn’t expanded Medicaid; that’s one of their problems. But they’re closing all over the country. With fewer patients, they are not able to maintain some of the profit centers that big hospitals have. Under a Medicare for All system and under a system of global budgeting, you could preserve a lot of the central hospitals and give them a lifeline by determining how much the hospital needs, based on the demographics of the community that it serves, and establish a budget. And make sure that the hospital has an adequate amount of money in a year to treat the patients in that community. The hospitals don’t have to have all the bells and whistles of course, but you need to have the services that are required, that a community deserves or needs to have.
This is probably the same here as elsewhere in Tennessee. If you are in some of these small towns, now you have a heart attack, you’re probably not going to make it because the hospital is so far away, and many pregnant women, there’s no hospital in the county anymore and have to travel long distances to get to a hospital.
VTD: Tell me about your on-line site Tarbell. And why did you choose investigative reporter Ida Tarbell as the symbol of what you wanted to do?
WP: Ida Tarbell was someone who really spoke to me and my own experience. In her career, she sought to hold big corporations more accountable and to investigate power in ways that wasn’t being done. We’re not seeing nearly enough of that in our day and time. She set her sights on John D. Rockefeller, who at that time was the richest man in the world and had the biggest monopoly, the Standard Oil Co. And her reporting was extraordinarily impactful, and thorough. Her reporting contributed to the breakup of Standard Oil. She’s kind of our guiding spirit, we want to do reporting that holds the truth to power and the powerful accountable.
And not just politicians.
We have very inadequate reporting of corporations and corporate power. And that’s what we want to try to do, to help people understand how big corporations spend money to get what they want to influence public opinion, which is what I used to do for a living, to expose that, but also to help people understand how they spend money to influence elections and public policy to protect the very profitable status quo. And so she’s kind of our guiding spirit. We want to do the same kind of reporting in the 21st century that she did in the early 20th century.
VTD: You said practices in the insurance industry are worse than they were when you left, the costs are continuing to rise at what you say is an unsustainable rate. What gives you any hope or promise that the system won’t just continue as it is.
WP: Because it can’t. I mean, it can continue for a while. But I think more and more people are realizing it’s not working for them. Those aren’t the people that make the decisions. That’s why I’m doing what I’m doing. The people who have an inordinate voice and influence are business people. That’s why I signed up to be president of the Business Initiative for Health Policy. Business leaders, like it or not, have more sway have more influence with politicians.
I know from talking to a lot of business owners, a lot of CEOs, that they’re waking up to realizing that this system doesn’t work for them anymore. Even people like Warren Buffett get it. Warren Buffett has said that the American health care system is the tapeworm that is destroying U.S competitiveness. Even big corporations are beginning to realize that the private insurance system is an unnecessary middleman. When I was toward the end of my career at Cigna, before I’d made my decision to leave, I was in a meeting with 50 or so of us and the CEO, and somebody asked him, what kept him up at night. And he said this disintermediation, which is a real fancy word that means getting rid of the middleman.
VTD: Is there any model earlier any industry where things changed as dramatically as what you’re talking about?
WP: They’ve changed quickly in the past. What is different here is that most of the disruption that has happened in the past has happened because of technological innovation or something like that. The emergence of Amazon, or Federal Express or whatever, that is really disruptive. It’s rare to find instances in which public policy has disrupted an industry. But there’s always going to be a first time and this is going to be it. Because we’re spending almost 20% of GDP now on health care. That means that as that goes up, there’s less money available to spend on other things. And our companies are becoming, as I said earlier, less competitive globally. As we’re getting closer to the 2020 elections and as people consider their top issue, it’s health care once again. And the reason is because they’re fearful that the gains that we made with the Affordable Care Act could be taken away. It wasn’t enough, we’ve got to keep going forward. And people are catching on that being in a high deductible plan is not all that great. And they’re finding out themselves what the limitations are.
Whether it is moving you into a high deductible plan, limiting the doctors and nurses that you can see, being more aggressive with prior authorization, the drugs that are available to you. There are different ways that insurance companies are cheating you year after year, a little bit more, devaluing your benefit. People are beginning to catch on to that. I think you’re going to see more grassroots opposition, but also opposition by employers who are just sick and tired of having to shift more and more of the cost of care to their workers.
VTD: The shift seems so gradual.
WP: It’s incremental, and gradual. We don’t pay attention. We don’t really realize what’s been happening, kind of like the frog in that pot of water. So I try to help people in that pot of water. Here’s what’s been happening to you. There will be a tipping point, I don’t know when it’s going to be, but we will reach that tipping point. Because the system just simply can’t go on. When it’s going to be, I can’t predict. But we’ve seen that change can happen pretty quickly. We saw it with marriage equality, and other things that that once you reach a certain tipping point, it’s inevitable. We just can’t pinpoint the date in the future when that’s going to happen. I think it’s going to happen sooner than later. I don’t think we have 10 more years left of the current system. I give it about that much time at most.
