An end to America's hidden nightmare for its sick poor?

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Whistleblower tells of America's hidden nightmare for its sick poor

July 26, 2009 -- Wendell Potter can remember exactly when he took the first steps on his journey to becoming a whistleblower and turning against one of the most powerful industries in America. It was July 2007 and Potter, a senior executive at giant U.S. healthcare firm Cigna, was visiting relatives in the poverty-ridden mountain districts of northeast Tennessee. He saw an advert in a local paper for a touring free medical clinic at a fairground just across the state border in Wise County, Virginia. Potter, who had worked at Cigna for 15 years, decided to check it out. What he saw appalled him. Hundreds of desperate people, most without any medical insurance, descended on the clinic from out of the hills. People queued in long lines to have the most basic medical procedures carried out free of charge. Some had driven more than 200 miles from Georgia. Many were treated in the open air. Potter took pictures of patients lying on trolleys on rain-soaked pavements. For Potter it was a dreadful realisation that healthcare in America had failed millions of poor, sick people and that he, and the industry he worked for, did not care about the human cost of their relentless search for profits. "It was over-powering. It was just more than I could possibly have imagined could be happening in America," he told the Observer.

Potter resigned shortly afterwards. Last month he testified in Congress, becoming one of the few industry executives to admit that what its critics say is true: healthcare insurance firms push up costs, buy politicians and refuse to pay out when many patients actually get sick. In chilling words he told a Senate committee: "I worked as a senior executive at health insurance companies and I saw how they confuse their customers and dump the sick: all so they can satisfy their Wall Street investors." Potter's claims are at the centre of the biggest political crisis of Barack Obama's young presidency. Obama, faced with 47 million Americans without health insurance, has put reforming the system at the top of his agenda. If he succeeds, he will have pushed through one of the greatest changes to domestic policy of any president. If he fails, his presidency could be broken before it is even a year old. Last week, in a sign of how high the stakes are, he addressed the nation in a live TV news conference. It is the sort of event usually reserved for a moment of deep national crisis, such as a terrorist attack. But Obama wanted to talk about healthcare. "This is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades," he told the nation.

Obama's plans are now mired and the opponents of reform are winning. The Republican attack machine has cranked into gear, labelling reform as "socialist" and warning ordinary Americans that government bureaucrats, not doctors, will choose their medicines. The bill's opponents say the huge cost can only be paid by massive tax increases on ordinary Americans and that others will have their current healthcare plans taken away. Many centrist Democratic congressmen, wary of their conservative voters, are wavering. The legislation has failed to meet Obama's August deadline and is now delayed until after the summer recess. Many fear that this loss of momentum could kill it altogether.

To Potter that is no surprise. He has seen all this before. In his long years with Cigna he rose to be the company's top PR executive. He had an eagle-eye view of the industry's tactics of scuppering political efforts to get it to reform. "This is a very wealthy industry and they use PR very effectively. They manipulate public opinion and the news media and they have built up these relationships with all these politicians through campaign contributions," Potter said. Potter was witness to the campaign against Michael Moore's healthcare documentary Sicko. The industry slammed the film as one-sided and politically motivated. Secret documents leaked from the American Health Insurance Plans, the industry's lobby group, detailed the plan to paint Moore as a fringe radical. Potter now says the film "hit the nail on the head". "The Michael Moore movie that I saw was full of truth," he admits.

Potter was also working for Cigna when it became embroiled in the case of Nataline Sarkisyan, whose family went public after Cigna refused to pay for a liver transplant that it considered "experimental" and therefore not covered by their policy. Cigna reversed this decision only hours before the Californian teenager died. "I wish I could have done more in that case," Potter said. Such sentiments are rare in an industry that has given America a healthcare system that can be cripplingly expensive for patients, but that does not produce a healthier population. The industry is often accused of wriggling out of claims. Firms comb medical records for any technicality that will allow them to refuse to pay. In one recently publicised example, a retired nurse from Texas discovered she had breast cancer. Yet her policy was cancelled because her insurers found she had previously had treatment for acne, which the dermatologist had mistakenly noted as pre-cancerous. They decreed she had misinformed them about her medical history and her double mastectomy was cancelled just three days before the operation.

Last month three healthcare executives were grilled about such "rescinding" tactics by a congressional subcommittee. When asked if they would abandon them except in cases of deliberately proven fraud, each executive replied simply: "No." To Potter that attitude has a sad logic. The healthcare industry generates enormous profits and its top executives have a lavish corporate lifestyle that he once shared. Treating patients for their expensive conditions is bad for business as it reduces the bottom line. Kicking out patients who pursue claims makes perfect economic sense. "It is a system that is rigged against the policyholder," Potter said. The congressional probe found that just three firms had rescinded more than 20,000 policyholders between 2003 and 2007, saving hundreds of millions. "That's a lot of money that will now go towards their profits," Potter said.

A lot of that money also goes into contributions to politicians of both parties - $372m in the past nine years - and in lobbying groups to run TV ads slamming Obama's plans. Many of these ads deploy naked scare tactics. One report said that the industry was spending $1.4m a day on its campaign. In the face of that, it is perhaps no wonder that the Senate has delayed its vote, dealing a massive blow to Obama. "I have seen how the opponents of healthcare reform go to work... they are trying to delay action. They know that if they keep the process going for months, and turn it into a big mess, then the political impetus behind it will lessen," Potter said.

Potter, who now works at the Centre for Media and Democracy in Wisconsin, says the industry is afraid of Obama's reforms and that is why it is fighting so hard. It wants to deal him the same blow as it did Bill Clinton when it scuppered his attempt at reform in the 1990s. Potter admits that he is worried the industry might win again. "I have seen their tactics work. I have been a part of it," he said. He knows he has no chance of ever working again for a major firm. "I am a whistleblower and corporate America does not tend to like that," he said. But there is one thing Potter is not sorry about: leaving the healthcare industry and speaking out. "I have absolutely no regrets. I am doing the right thing," he said. Comprehensive healthcare reform in the U.S. has been an ambition of many presidents since the early part of the 20th century. None has succeeded in creating a system that gives all Americans the right to coverage. Barack Obama, below, is desperate to avoid the same fate.

What is the current system?

It is a complex mish-mash of systems. Millions of Americans have their own private healthcare plans, either individually or through their employer. About 47 million Americans have none. However, systems do exist to cover the very poor and the old. The system is fiendishly complex and full of loopholes, so even those with coverage can have it withdrawn.

How bad is it?
U.S. hospitals are the best in the world if you can afford them. Many cannot, and an accident or sudden illness can often bankrupt someone.

How does it compare with other countries?

It depends how you measure things. The U.S. spends about 16% of GNP on healthcare, far more than France and Germany, which spend 11 to 12%. Yet those countries provide universal care.

What is the biggest problem?

Critics say the biggest issue is the profit motive that drives U.S. healthcare. This ensures that costs are always rising as the incentive is there to provide expensive treatment. It also gives health insurers the incentive to refuse treatment to claimants, by seeking to withdraw their cover.

What is Obama's solution?

Obama has asked Congress to draw up a government option, allowing all Americans to get some sort of cover. The sheer size of the state plan should theoretically allow it to drive down costs by economies of scale.

What's happening now?

Obama has put his reputation on the line to persuade wavering Democrats and moderate Republicans to vote on legislation by August. The Senate has said this will not happen. That's a major blow, as it puts off the debate until September and could see the political momentum stall.

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Revealed: millions spent by lobby firms fighting Obama health reforms

October 1, 2009 -- America's healthcare industry has spent hundreds of millions of dollars to block the introduction of public medical insurance and stall other reforms promised by Barack Obama. The campaign against the president has been waged in part through substantial donations to key politicians. Supporters of radical reform of healthcare say legislation emerging from the U.S. Senate reflects the financial power of vested interests ‑ principally insurance companies, pharmaceutical firms and hospitals ‑ that have worked to stop far-reaching changes threatening their profits.

The industry and interest groups have spent $380 million (£238 million) in recent months influencing healthcare legislation through lobbying, advertising and in direct political c ontributions to members of Congress. The largest contribution, totalling close to $1.5 million, has gone to the chairman of the senate committee drafting the new law. A former member of Bill Clinton's cabinet says fears that the industry could throw its money behind the populist rightwing backlash against public insurance have scared the Obama White House into pulling back from the most significant reforms in return for healthcare companies not trying to scupper the entire legislation.

Drug and insurance companies say they are merely seeking to educate politicians and the public. But with industry lobbyists swarming over Capitol Hill ‑ there are six registered healthcare lobbyists for every member of Congress ‑ a partner in the most powerful lobbying firm in Washington acknowledged that healthcare firms' money "has had a lot of influence" and that it is "morally suspect". Reform groups say vast spending, and the threat of a lot more being poured into advertisements against the administration, has helped drug companies ensure there will be no cap on the prices they charge for medicines ‑ one of the ways the White House had hoped to keep down surging healthcare costs.

Insurance companies have done even better as the new legislation will prove a business bonanza. It is not only likely to kill off the threat of public health insurance, which threatened to siphon off customers by offering lower premiums and better coverage, but will force millions more people to take out private medical policies or face prosecution. "It's a total victory for the health insurance industry," said Dr Steffie Woolhander, a GP, professor of medicine at Harvard University and co-founder of Physicians for a National Health Programme (PNHP). "What the bill has done is use the coercive power of the state to force people to hand their money over to a private entity which is the private insurance industry. That is not what people were promised."

PNHP blames a political process it says is corrupted by millions of dollars poured into the election campaigns of members of Congress and influencing the discourse about health reform by funding advertising campaigns, supposedly independent studies and patients rights organisations that press the industry's interests. A primary target of criticism is Senator Max Baucus, the single largest recipient of health industry political donations and chairman of the finance committee that drafted the legislation criticised by Woolhander. The committee this week twice voted against including public insurance in the legislation, with Baucus opposing it both times.

Baucus took $1.5 million from the health sector for his political fund in the past year. Other members of the committee have received hundreds of thousands of dollars. They include Senator Pat Roberts, who last week tried to stall the bill by arguing that lobbyists needed three days to read it. Baucus holds dinners for health industry executives at which they pay thousands of dollars each to be at the table, and an annual fly-fishing and golfing weekend in his home state of Montana that lobbyists pay handsomely to attend. They have included John Jonas, who represents healthcare firms for Patton Boggs, widely regarded as the top lobbying firm in Washington.

Jonas, who formerly worked on the congressional staff, acknowledges that political contributions are intended to buy influence and says it works. "It would be very naive to say they're not influenced. The contributors certainly hope they're influencing and the recipients probably ultimately are influenced," he said. "I think it's a morally suspect practice, and then you have to look at its application to see if it's morally bankrupt ... I think what's bad about the system is it's got more and more lax over time. When I started in this practice you did not talk issues at a fundraiser. It was impolite. And then with this need for money, the system has got coarser over time so that they go around the room asking what issues you're interested in, much more of a linkage of dollars to a discussion of the issues now."

The health industry permeates the process in other ways. At Baucus's side, drafting much of the wording of the reform, was Liz Fowler, a senate committee counsel whose last position was vice-president of the country's largest health insurer, Wellpoint, which stands to be a principal beneficiary of the new law. Health companies and their lobby firms also recruit heavily among congressional staffers as a means of maintaining influence. Baucus declines to discuss political donations but told Montana's Missoulian newspaper earlier this year that "no one gets special treatment".

Robert Reich, the labour secretary in the Clinton administration, says the Obama White House, mindful of how the health industry killed off Clinton's attempts at reform, has grown so fearful of industry money that it has quietly reached agreement to pull back from price caps and public health insurance. "The White House made a Faustian bargain with big pharma and big insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads." The pharmaceutical companies are apparently pleased enough that they are now putting $120 million into advertising supporting the emerging legislation.

Jonas described the bill emerging from the Senate as "in realm of what is politically possible". "Is the bill overly distorted by money? I don't think it actually is," he said. "It's a good bill in the sense that it's a net improvement in the system ... [but] it's a bad bill if you think it's supposed to be a comprehensive solution to the U.S. healthcare problems."

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Insurance industry launches attack on Democrats' healthcare reform plan

October 12, 2009 -- The U.S. health insurance industry has launched a last-minute attack on Democratic healthcare reform efforts, releasing a report late yesterday predicting that insurance premiums will rise sharply if a chief proposal becomes law. The report by accountancy PriceWaterHouseCoopers was paid for by America's Health Insurance Plans, a trade group that until now has reluctantly cooperated with president Barack Obama and the Democrats' effort to overhaul the U.S. healthcare system. The trade group had been working behind the scenes to help shape legislation, and Democrats blasted the timing and authorship of the report. The report was released just two days before the Senate finance committee is set to vote on a 10-year, $829 billion bill that is seen as the most likely to win congressional approval. The trade group that funded it was instrumental in sinking president Bill Clinton's healthcare reform effort in the 1990s.

"This report is untrue, disingenuous and bought and paid for by the same health insurance companies that have been gouging too many consumers for too long as they stand in the way of reform yet again," Scott Mulhauser said. "It's a health insurance company hatchet job, plain and simple." The report predicts that under the senate finance committee bill proposed by Democratic senator Max Baucus of Montana, the cost of private health insurance coverage will rise 111% in the next decade, compared to 79% if no action is taken. Taken another way, the Senate finance bill would add an extra $4,000 to the cost of an average family plan in that period, and $1,500 to the cost of the average individual plan. "Several major provisions in the current legislative proposal will cause healthcare costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company chief executives.

The insurance industry report put the added cost down to a flimsy requirement that all Americans obtain health insurance coverage that will continue to allow healthy young people - the most lucrative insurance customers - to avoid purchasing coverage. In addition, the report faults an excise tax on high-value health plans typically purchased for executives but also by some in the middle class, and cuts in payments for existing public programmes that could shift costs to private plans. But Democrats said the report was based on a flawed reading of the Senate finance bill. It does not take into account provisions that would lower the cost of coverage, including tax credits to help people buy private insurance and lowered administrative costs, Mulhauser said. "This is an insurance industry analysis that is designed to reach a conclusion which benefits the industry, and does not represent what the bill does," White House spokeswoman Linda Douglass said.

The Senate finance plan received a major political boost last week, when a research arm of Congress, the congressional budget office, released its own analysis predicting the proposal would lower the U.S. budget deficit by $81 billion over 10 years while extending health coverage to 94% of eligible Americans. That conclusion did little to soften Republican intransigence, however. Republicans have dug in against the finance committee bill and every other proposed by Democrats, keen to prevent Obama from fulfilling one of his top campaign promises. "This partisan finance committee proposal will never see the Senate floor since the real bill will be written by Democrat leaders in a closed-to-the-public conference room somewhere in the Capitol," Senate Republican leader Mitch McConnell of Kentucky said last week. "The real bill will be another 1,000-page, trillion-dollar experiment that slashes a half-trillion dollars from seniors' Medicare, raises taxes on American families by $400 billion, increases healthcare premiums, and vastly expands the role of the federal government in the personal health care decisions of every American."

The Senate finance bill is likely to pass out of the finance committee with at most a single Republican vote, that of Maine senator Olympia Snowe. It will then be merged with provisions from a handful of other bills moving around the Congress, and will be subject to votes in the Senate and House. The Republican opposition seems to be hurting the party's standing with the American public. According to a CBS News poll conducted last week, 69% of Americans think the Republicans are not serious about reforming healthcare, compared to 52% who think the Democrats are. Sixty-one percent of Americans will be disappointed if reform legislation does not pass this year. Despite the raucous, vitriolic opposition to health reform seen this summer among grassroots conservatives, less than a third of the public would be please if reforms do not pass, the poll found. In his weekly radio address, Obama on Saturday praised the "consensus" on the Senate finance bill. "There are some in Washington today who seem determined to play the same old partisan politics, working to score political points, even if it means burdening this country with an unsustainable status quo," he said, "a status quo of rising healthcare costs that are crushing our families, our businesses, and our government".

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U.S. health care fight moves behind closed doors

WASHINGTON, October 14, 2009 — President Barack Obama's historic drive to remake US health care this year moved behind closed doors Wednesday as top lawmakers and the White House strove to merge rival bills before final votes. Democratic Senate Majority Leader Harry Reid was to host a 2:30 pm (1830 GMT) meeting, due to include Obama's chief of staff Rahm Emanuel, to reconcile versions approved by two Senate committees, Democratic officials said. Senate Finance Committee Chairman Max Baucus and Senator Christopher Dodd, who shepherded a version of the legislation through the Senate's Health, Education, Labor and Pensions Committee, were to attend as well, said a Reid aide. The goal is to blend the versions approved by the two committees with an eye on bringing one unified bill to a vote in the coming weeks in the full Senate, which like the House is under the control of Obama's Democratic allies. In the House, the chairmen of the three key committees with jurisdiction over health care said on Tuesday that they were close to merging their versions of the legislation, which is expected to differ from the Senate's final plan. If the House and Senate approve different bills, as seems likely, they would have to thrash out a compromise version and vote again to send the legislation to Obama's desk to be signed into law. Strong opposition remains: The powerful health insurance lobby reportedly planned a television advertising blitz against the plan, while Republicans expressed frustration about being cut out of the talks. Lawmakers of both parties unhappy with the bills also planned to try to amend the compromise versions when they reach the full House and Senate. Democratic unity was far from guaranteed, amid intra-party feuds over how to pay for the massive overhaul and whether to include a government-backed insurance plan popularly known as a "public option." Key senators and Democratic House leaders have said they want the final legislation to include a public option, while swing-vote lawmakers have balked amid growing public unease about government spending. "Now's not the time to pat ourselves on the back. Now's not the time to offer ourselves congratulations. Now's the time to dig in and work even harder to get this done," Obama said Tuesday.

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House of Representatives passes Obama healthcare legislation

November 8, 2009 -- Barack Obama's landmark healthcare legislation was narrowly passed by the U.S. House of Representatives late last night. The vote marks a significant step towards the Obama administration's goal of extending health coverage to millions of people lacking it. The House voted 220-215 in favour of the bill, which will impose tougher regulations on the health insurance industry and provide cover for around 36 million more Americans. In a statement, Obama praised the Representatives and said he was "absolutely confident" that the Senate would pass its version of the legislation. "I look forward to signing it into law by the end of the year," the U.S. president said.

The focus will now switch to the Senate, which is working on its own healthcare bill. Progress has stalled as the Democratic leader, Harry Reid, searches for a way to win the 60 votes required to ensure the passage of the legislation. The two bills must then be reconciled by lawmakers from both chambers before being put forward for final approval. Yesterday, Reid issued a statement that said: "We are energised that we stand closer than ever to reforming our broken health insurance system."

But on Friday the progress of the bill had looked to be in jeopardy after the legislation exposed deep rifts among Democrat representatives. A total of 40 anti-abortion Democrats threatened to oppose the legislation unless changes were made to ensure federal subsidies in the bill for insurance purchases were not used on terminations. Speaker Nancy Pelosi allowed the House to vote on an amendment to the bill, proposing tighter restrictions on using government money for the procedure. The House approved the amendment by 240-194 before voting on the bill as a whole. Pro-abortion Democrats were said to be dismayed at the addition of the abortion controls, but the majority voted in favour of the bill in the hope the amendment can be toned down or removed later in the legislative process.

The final vote late yesterday evening saw almost unanimous opposition to the bill from Republican representatives, with only one, Joseph Cao, voting for it along with 219 Democrats. Figures showed that 176 Republicans were in opposition, with 39 Democrats voting against. John Dingell, a Democrat representative who has introduced national health insurance in every Congress since succeeding his father in 1955, said the bill would offer "peace of mind" to Americans. "It offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," he said. But Republican representative Candice Miller claimed Democrats were intent on passing "a jobs-killing, tax-hiking, deficit-exploding" bill. "We are going to have a complete government takeover of our healthcare system faster than you can say 'this is making me sick'," she said.

The legislation, unveiled last month, would extend healthcare coverage to 96% of Americans. Democrats put the cost of the plan at under $900 billion (£543 billion) over 10 years, although some estimates now put that figure at $1.2 trillion. The bill would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees, and consumers and companies would be penalised if they defied government mandates. The principal mechanism of the bill is the creation of a government-regulated insurance "exchange" under which private companies could sell policies in competition with the government.

The U.S. government provides coverage for the poor, elderly and military veterans, but most Americans rely on private insurance, which is usually provided through their employers. However, according to the U.S. census bureau, the number of uninsured people in America jumped from 45.7 million in 2007 to 46.3 million last year, as unemployment and the recession forced people to end insurance payments.

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Democrats secure final vote to ensure healthcare reforms pass through Senate

December 20, 2009 -- U.S. Democrats were celebrating a breakthrough yesterday that puts a bill aimed at overhauling the American healthcare system on track to be approved by Christmas. A deal to push the legislation through the Senate in the face of fierce Republican opposition was secured after hours of negotiations resulted in the remaining Democratic senator who had been holding out against the bill agreeing to provide the 60th and deciding vote in its favour. Nebraskan senator Ben Nelson, a conservative Democrat, voted in favour after winning tighter restrictions on insurance cover for abortions, as well as increased federal healthcare aid for his state. Securing the pivotal 60th vote caps a year of struggle aimed at turning President Barack Obama's top domestic priority into a reality. "Change is never easy, but change is what's necessary in America, and that's why I intend to vote for healthcare reform," Nelson said yesterday. Because the Democrats nominally control 60 seats in the Senate – the precise number needed to overcome Republican filibusters – every senator in the Democratic caucus effectively has veto power over the bill. No Republican is willing to support it. The legislation is expected to expand government-funded healthcare coverage to roughly 94% of eligible Americans under the age of 65. Obama said in a brief statement yesterday that the U.S. was "on the cusp of making healthcare reform a reality". However, Republicans remain opposed to the legislation. "This bill is a legislative train wreck of historic proportions," said the Senate Republican leader, Mitch McConnell of Kentucky. McConnell complained that it included cuts to the federal healthcare programme for the elderly, home healthcare and hospices, as well as "massive tax increases" at a time of high unemployment. At its core, the measure is designed to spread coverage to tens of millions who lack it, while banning insurance company practices such as denial of coverage on the basis of pre-existing medical conditions. The House of Representatives, the lower house of Congress, passed its version of the legislation last month.

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Obama hails victory in Senate healthcare vote

December 21, 2009 -- Senators trudged through Washington's most severe snowstorm for decades to vote early today on a motion that virtually ensures passage of President Barack Obama's healthcare bill. Democratic senators voted in the dead of night by 60-40 to end Republican blocking tactics. The way is now open for a vote on the $871 billion (£540 billion) bill on Christmas Eve. The bill will extend healthcare to 30 million Americans who at present have no cover, bringing the country close to universal healthcare provision. Obama described it as a "big victory for the American people". "After a nearly century-long struggle we are on the cusp of making healthcare reform a reality in the United States of America," he said. The senators would normally have been on holiday – the House has already closed for Christmas and the New Year – but the Democrats opted to push on so the debate would not spill into next year. After hours of debate, they voted at 1am to end a Republican filibuster. The Republicans are vowing to fight to the end, which would see a further series of votes that could take until 7pm on Christmas Eve. Assuming the Senate passes the bill then, the last remaining obstacle will be reconciling the House and Senate versions of the bill, with a final vote in January. The House version is more liberal and includes a government-run insurance scheme, which the senators have rejected. Although the House speaker, Nancy Pelosi, has said she will not back off on the government-run option, the House Democrats are likely to drop it in order to get a bill that the Senate will accept.

Triumphant Democratic senators described the bill as fulfilling the dream of the late Ted Kennedy, who had long championed universal healthcare. His widow, Victoria, watched the vote from the visitors' gallery. The Democratic leader in the Senate, Harry Reid, secured the 60 necessary votes after doing deals with a conservative Democrat, Ben Nelson, who objected to abortion measures in the bill, and Joe Lieberman, the former Democrat turned independent, who objected to the government-run option and a plan to expand the existing Medicare programme. Lieberman warned the House against trying to make any significant changes to the Senate version of the bill. "It took a lot of work to bring this 60 together and this 60 is delicately balanced," he said. The Republican Senate leader, Mitch McConnell, said. "The impact of this vote will long outlive this one frantic, snowy weekend in Washington. This legislation will reshape our nation, and Americans have already issued their verdict – they don't want it." Obama had courted liberal Republicans, principally Olympia Snowe, but in the end she voted with other Republicans against closure of the filibuster. She said she could not vote for it, because she felt the process was being rushed.