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The arrest of a suspect in the assassination of UnitedHealthcare CEO Brian Thompson on a street in midtown Manhattan leaves some questions unanswered. But the gleeful reaction to the executive’s slaying leaves nothing subject to interpretation. Many Americans feel they have been treated so shabbily by the health insurance industry that they despise it and want its leaders to die — and they’ve been willing to say so loudly and publicly.
I’m 61. I can’t recall the demise of any public figure being greeted with as much glee and dark humor, including the killing of Osama bin Laden. Which makes psychological sense. If someone is trying to kill you, you hate them.
Health insurance companies are trying to kill us.
While Americans were shocked and some even traumatized by the 9/11 attacks, most individuals didn’t feel personally threatened, much less harmed, by al-Qaeda. On the other hand, an insurer like United, which is reported to deny a whopping 32% of in-network claims, wields the power to overrule doctor’s orders, harass sick people at their most vulnerable and, given the sky-high health costs in this country, put medical treatment — the ultimate nondiscretionary expense — out of reach. Rare is the health insurance customer who can’t tell a horror story of being unfairly turned down for reimbursement for a doctor’s visit or procedure, usually after being given the runaround over preauthorizations, procedural codes, doctors erroneously listed as in network, and other Soviet-style nonsense.
Sometimes health insurers decide that people — people like you — shouldn’t receive lifesaving care. Patients die every year due to the health insurance industry’s sinister profit model, which heavily relies upon quotas for automatic — or, in many cases, automated — denials.
Even when health insurance works as advertised, it feels like a scam. You pay a monthly premium, yet even when you have a legitimate claim, you probably won’t be able to collect a reimbursement due to high deductibles that can exceed $10,000 a year. Insurers’ online directories of in-network health providers are years out of date; most of the doctors listed no longer accept the company’s insurance (or never did), have moved their practices or are retired or deceased. “In a 2023 analysis, researchers surveyed nearly 450,000 physicians in the Medicare provider database that appeared in online physician directories for UnitedHealth, Elevance, Cigna, Aetna, and Humana,” Jacobin reported. “They found that only 19 percent had consistent addresses and specialty information across all the directories in which they were found.” (Failing to keep these lists up to date is illegal under the 2022 No Surprises Act, but the federal law is not enforced.)
There ought to be more difference between the experience of being uninsured and paying for insurance.
Health insurance companies create misery that feels intensely personal. The fact that a procedure or medication ordered by your physician, whom you know and has examined you personally, can be overruled by an anonymous individual who has never laid eyes upon you in a completely opaque process can be maddening. Insurers want to make more money and are willing to let you and your loved ones suffer great pain, and perhaps even death, in order to maximize revenues.
“Our role is a critical role, and we make sure that care is safe, appropriate, and it’s delivered when people need it,” UnitedHealth Group CEO Andrew Witty reassured employees in an internal video following Thompson’s killing. “We guard against the pressures that exist for unsafe care or for unnecessary care to be delivered in a way which makes the whole system too complex and ultimately unsustainable.” He hasn’t learned a thing.
This, of course, is bullshit. Companies like UnitedHealthcare are leeches, a net negative to the patient experience. No one believes they are “guarding” us against any danger whatsoever. They aren’t fighting “complexity”; they are the complexity. They add an additional, unnecessary layer of bureaucracy between sick people and health care providers, with only one goal: profits.
The obvious solution is to abolish the medical insurance industry and join the 69% of the world’s population that has some form of universal health care. For the foreseeable future, however, massive donations by the health insurance lobby both to Democrats and Republicans make it highly unlikely that something like Medicare for All, popular among voters of both parties, will be enacted anytime soon.
Still, the staggering hatred by health insurance consumers for the current system creates a political opportunity for the politician or party willing to push through three simple reforms to protect health insurance consumers from the industry’s most predatory practices.
First, if a physician is listed as a member of a health insurance company’s network, an insured patient’s experience should be frictionless. In network, no claim for a visit, test, procedure or medication should ever be denied. Preauthorizations should never be required.
Second, if an insurer believes one of its network member physicians is overprescribing or otherwise abusing the system, the dispute should be resolved between the insurance company and the doctor. An insurer can sue a rogue doctor, kick them out of their network, whatever, but leave sick patients out of it.
Third, failure to update lists of in-network physicians should inconvenience the insurance company that fails to fulfill its responsibilities and comply with federal law, not those of us seeking medical care. We deserve truth in advertising. If an insurer lists a doctor as being in-network on their website or elsewhere, patients should be reimbursed for visiting that doctor under the doctrine.
As President-elect Donald Trump formulates his policies for his second term, I hope his powerful instinct when it comes to gauging public opinion has taken note of our hatred of the for-profit health insurance industry. Pushing through these three reforms would enjoy bipartisan support and begin to fulfill his pledge to fix the badly broken American health care system.
Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, co-hosts the left-vs-right DMZ America podcast with fellow cartoonist Scott Stantis.
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Include car insurance company’s in the hated category.
They have clairvoyant parasites with crystal balls, which exactly knows what have happen in a accident, you, the driver, do not know anything.
The parasites are simple “Jews”, that’s white greedy people, like the nazis.
The parasites have reach a critical mass, with mass murder in the hospitals.
Hang the parasites !
Why was he really killed? I heard it was because he was going to testify about Covid. Or maybe it was something else. But no way this or any other publicized killing is a Robin Hood killing. Would that it were, perhaps. But it weren’t.
None of these things will ever happen, lets just be realistic. All of the suggestions made here are very good, and honestly should happen, but they won’t. The big “health” insurance companies are probably now meeting with top management consulting companies, PR firms, an army of world-class lawyers, and of course, the politicians they have in their pocket to devise a plan to avoid any real, actual change, such as the suggestions described in this article.
It’s almost like saying that the Democratic party will change, or become the, “party of the working class American” after their embarrassing and colossal defeat in November. Anyone who follows politics knows real, meaningful change, (whatever that may mean), will NEVER happen. Congress is totally bought and paid for, it’s been that way since the federal reserve act in the early 1900’s.
What will happen will probably be similar to what the “medical” insurance companies will do: dazzle the near brain dead, dopamine addicted, incompetent American population with a dizzying PR campaign complete with heated, fully scripted arguments in congress that should be reviewed as some of the best theater of the decade! They will just convince and pacify the public, like soothing a crying infant. In the end, they win.
One of your better columns Rall but unlikely to change anything going forward because as you write
.If you want any hope of fixing healthcare in the USA, the ONLY way to do that is to remove the Congressional blockade.
And the only way to do that is to REMOVE MONEY FROM POLITICS!
The first action that must occur is to fund political campaigns from public funds. That means every candidate for any particular office gets the same amount of public monies to spend on their campaign. Due to the finite limit of such funds (which would likely have to be collected via a new tax assessment on everyone), political campaigns would have to be reduced in time to perhaps no longer than 12-16 weeks.
Corporate and PAC contributions to politicians or on behalf of candidates would have to be completely banned and IF individual contributions were allowed, they would need to be capped at a low level (less than $500/person?).
This would throw a big wrench into the current politician election horse race business model but would, of course, be strongly resisted by all those who profit from the current arrangement – from corporations to politicians to lawyers to political pundits to the media.
ONLY this action in total would solve the problem of corporate ownership of our politicians and finally allow politicians to make decisions based on the merits, rather than who gave them the most money.
However, the probability of this happening at any time in the foreseeable future is next to zero. Therefore, most of you poor people are going to have to wait until you age into Medicare to unshackle yourself from the insane USA healthcare/insurance beast.
What to do? Declare a national health care emergency and beg Cuba for help.
At least now the head of United Healthcare recognizes that there are problems in the health system, but he does not say that among them is having turned it into a business as if it were a butcher shop.
You only have to visit any medical service center to see this and the worst tragedy is that they have managed to loot Medicare, the medical insurance for the retirement of workers, seeking more profits for the rich.
They are already thinking of leaving the population without vaccines as an unnecessary expense.
Yeah, No shit. Idiot Rall is still posturing the tired old fake bullshit.
Dumb asshole, we know better.
With people like Elizabeth Fowler, principal author of the Affordable Care Act, brought in through the revolving door for any “reforms” if things get beyond show hearings.
Ban TV advertising for elections. That’ll remove the need for all that money. Re-ban pharmaceutical advertising and legal services advertising as well.
excellent meanju you’re starting to make some sense.
AIPAC’s neck would be first on the chopping block.
Here’s my humble insurance reform – do away with it. In the late 80’s, when the Philadelphia Inquirer was must read, they printed a series on healthcare. Back then 85 cents out of every dollar spent went to insurance and insurance compliance. No doubt it is considerably more today. Unfortunately the authors wrongly advocated for Medicaid for all. Not me, I’ve been an advocate for the end of health insurance since reading the article. I’ve talked exactly no one into it. “How would I pay for my treatment?” Well for one thing doctors like to live really well. They need patients. So lesser prices to attract patients, along with cures and healing might become things again. OK you will likely have to figuratively blow up the price fixing cartel known as the AMA.
Federal law requires that Health Insurance companies pay out 80-85% of the premiums that they collect. In its statutory language, this is called the Medical Loss Ratio. UnitedHealth Care, whose CEO was murdered due to this poor understanding, only makes a 3.63% profit on the premiums and pays out between 80-85% of its premiums. The rest is overhead. The reason they engage in delay, deny, and defend is that health care providers play a game with them, trying to charge the insurance company for unnecessary procedures, and unreasonable costs. Last Spring, I was charged by a rural hospital $9500 for an endoscopic exam that took 15 minutes. That’s outrageous. $9500 for a 15 minute procedure! Worse yet, it was charged to me, instead of to Medicare, because Federal Law allows rural hospitals (which struggle financially) to charge patients the difference between the actual charge and the negotiated charge. She said Health Providers such as her hospital always try to charge as much as possible before negotiating the charge down with the insurance company. The culprit is usually these health providers trying to maximize pay for their doctors, staff, and overhead, not the insurance companies. At 3.63% profit, UnitedHealth Care is not making huge profits like people are claiming. The public doesn’t apparently did not understand this, and neither did the killer.
I’ve purchased my own health insurance for years. Two big problems are ignored. One, if you rely on your employer to purchase your insurance it it almost certain you will get bad insurance because employers don’t want to pay the cost of a good plan. Two, when purchasing on the private market, it is impossible to know exactly what you are buying until you actually make a claim. When i aged into Medicare I bought an Advantage plan from UHC, I had sudden catastrophic heart failure and, one thing and another, my bill exiting the hospital was 150,000.00. My out of pocket was 1500.00. My advice is don’t kill insurance salespeople, your boss is probably at fault for your coverage problems. Of course, best of all would be to follow Dick The Butcher’s advice.
A couple of articles on employer paid health insurance, which IMO, should be made illegal.
It’s good that your Medicare Advantage plan worked for your serious illness. There are many horror stories. Here are a couple of articles:
Alternative plan:
1. Legalize the sale of drugs — all of them — to the general public. The only exceptions would be some antibiotics for the sake of preventing bacteria becoming resistant.
2. Legalize the practice of medicine, for profit, by the general public. All titles and degrees would be retained, but be only advisory. To call yourself a doctor is fraud. To receive treatment from anyone willing to provide it is freedom.
3. Shift the system of licenses and titles away from the class-based system towards one based on promotion by experience. Somebody who wants to practice medicine has to start as a paramedic and work his way up.
Take a chainsaw to the bureaucratic state. Entire agencies should be disbanded.
I’m not a fan of vigilante justice, but still, we have been letting the super rich get away with literal murder for far too long.
The Sackler family, which pushed the big lie that Oxcontin was not addictive, are responsible for at least tens of thousands of deaths and who knows how much suffering in general. Yet the Sacklers will retire in comfort.
In China Zheng Xiaoyu was convicted of taking bribes to let questionable medicines be sold. He was executed.
The Intermediate People’s Court in Shijiazhuang sentenced Zhang Yujun and Geng Jinping to death, and Tian Wenhua to life in prison, on 22 January 2009. Zhang was convicted for producing 800 tons of the contaminated powder, Geng for producing and selling toxic food (from wikipedia).
China is far from perfect, but – perhaps we could learn a few things from them?
Start with something simple: repeal the Health Maintenance Organization Act of 1973, which, effectively, turned the health care into another corporate, for maximum profit industry.
I’m eighty-five years old. Never do I recall having a problem with my health care insurance coverage. In my wild and wooly youth, plus now when not so youthful, I’ve been hospitalized many times yet never a question regarding coverage.
Coverage was provided through my employment, and when I was self-employed, coverage was provided through my wife’s employment. Of course, there was always a copay, but it was a reasonable amount, in my opinion.
My most recent ER visit was due to smashing my finger in the garage door. It broke the skin wide open and required five stitches. The total bill was three thousand seven hundred seventy-five dollars. I paid one hundred-five dollars out of pocket.
Break up the AMA monopoly. Allow cash only medical centers to form, and the whole bullshit system Will come crashing down.
What sort of clown believes the covid scam was
‘the Pandemic of the century” ?
Couple of broad-stroke things you could do to improve health-care provision (short of burning the whole system down and starting over)…
— Get rid of the idea of “national” as in coast-to-coast, coverage. USA is simply far too big and far too populous and diverse for there to be much “national” of anything. Split the country up into say ten or twelve regional healthcare “sectors” or regions or zones, whatever, and make that the basic administrative unit instead of anything nation-wide. The standards and costs and so forth would all stay the same, or close to it, from sector to sector, and interstate issues would be handled specially, it’s just that at the administrative level, everything would be shrunk to more manageable scale, with fewer levels, closer to the ground, easier to understand and oversee. You could also revert to state by state but that opens up a different can of worms.
— Just plain get rid of the idea of a profit motive and shareholder accountability in the health sector. The health companies would simply exist to serve the public’s health needs, not make a profit. There would still be plenty of high-paying administrative jobs and executive careers and useless diversity hires all with lots of goodies, just with reasonable caps, just no obscene bonuses and cut-throat cost-cutting.
— Stake out about two dozen or so catastrophic long-term conditions, things which cost a fortune and ruin families, like Alzheimer’s and Parkinson’s and MS and various sorts of cancers, and nationalize (single-payer) care for people with these particular diagnoses. (Sort of like what the Muscular Dystrophy mafia do by making that illness their single issue and concern.) IOW take those long-term care costs off the table for the insurers, so they don’t have to bottom-line everything by putting gigantic cost concerns in the same kettle as more run-of-the-mill concerns. There will of course be complaints from people with nasty conditions who don’t make the golden list, but in the long run their care costs will also come down from the common benefit of the real wealth-destroyers being taken out of the way.
— Separate out worker’s comp/disability evaluations and claims from regular civilian run-of-the-mill claims, and scrutinize them with separate standards. Worker’s comp is a fraud funhouse on an epic scale; having to answer to its own court-martial style board of review might put the fear of God into all of them.
There are about a dozen very harsh, draconian, cauterize-the-wound-with-fire things that you could do with respect to immigration issues that would involve loading screaming babies into catapults while sane people look on and applaud, but leftard soft-heads like TR will never listen, they’ll simply stuff wads of fair-trade organic coffee grounds in their ears and chant LA-LA, CAN’T HEAR YOU, LISTENING TO THE NEW BURMESE VERSION OF HAMILTON! So, the country burns to the ground anyway, but at least you were warned.
how about a national healthcare plan that everyone pays a premium into somehow or another then when they get sick they stop paying until dead or cured. that will give the doctors some motivation won’t it?
“Never” is a long time. You have likely been on Medicare for the last 20 years and so are unlikely to have had any major issues or problems.
Medicare is the best thing since sliced bread! I have never had a service declined and I make regular use of Medicare to check out stuff and enhance my health, not just to fix things.
If we want to take money out of Congress campaigns, then you have to start somewhere.
That somewhere has to be the length of the campaigns. There has to be a har dlimit of no more than 6 months of campaigning. This means no political ads allowed in any media form until the 6 month window begins. Also, no political mailers or any other political advertising expenses until the window opens.
This is simple and straightforward. The rest will follow with these changes.
Someone needs to start a non-profit to drive this forward. Bleating about this on places like TUR is not going to effect any changes.
Unless you name the parties involved, all that will happen is Obamacare 2.0, 3.0, 4.0…etc.
1) Doctors, Nurses groups: Their clearly stated goal is a UK style system (bad) while maintaining their inflated salaries that can only be sustained by the current US inflationary system.
2) Big Pharma, Big “health tech”: Will point out the insane labor costs above, but will not mention they are subject to price controls elsewhere, but not in the US. In fact, IMO, they have been able to get a price floor through extending patents.
3) “Insurance” companies just sit back and find ways to make money in this dysfunctional environment, and happen to be the most popular target for obvious reasons. But if you focus solely on them, it will only get worse.
Nobody likes vertically integrated HMOs (Group Health, UPMC), and yet they match “universal systems.” It’s clear too many people don’t really know the roll of the relevant parties.
The US system has the worst of both worlds. A quarter of all government spending is medicare/medicaid, and fraud is a problem, because the “center right” party refuses to concede that health is like education.
So the Republicans refuse to work with Democrats on that issue. Most center right parties run on making the government insurance system more strict, to incentivize out of pocket costs for normal services. The compromise is Medicare part C “vouchers.” But that is a nonstarter, since Democrats don’t want school vouchers.
I’m surprised NOT ONE Progressive took the time to understand the implications of the “public (government) option” when the “private option” for education is largely restricted.
Most self-identifying Progressives don’t think beyond the level of adolescent identity politics.
Big Sick sent in Elizabeth Fowler to write the “worst of both worlds.” But all the Establishment had to do was call it “Obamacare” – which the vain Nobel Peacenik was happy to accept – and they’re still slurping it up.
Yes, all promises should be written on a black and white index card. Congressmen should be held accountable to them. But actually, have a representative govt is ridiculous when you can easily send every important policy decision to online referendum. There are a million ways to improve the pseudo-democracy. It’s obvious nobody important actually wants one though they seem to truly believe their own ‘democratic’ hogwash.
LOL at non-profit drive. Only profit matters. Well, I guess if the non-profit drive paid a handsome salary to members of its board of directors and executives it might have some impetus.
The problem with privatized health care is that some doctors will make sure you stay sick for as long as possible to maximize their profits.
The problem with taxpayer funded healthcare is that some doctors won’t care about helping you with your problems since they get their monthly paycheck no matter what happens to you.
Yes, because people being denied services never happens in “universal health care” countries. Just ask Adam Burgoyne. But you will need a medium to do that.
Medicare part C “Advantage” is a copy of the Swiss system.
You can’t have it both ways: Vertically integrated systems like Kaiser (KFF is related) match universal systems, in order to keep costs down, and prevent overtreatment (yes, it exists).
If you are going to guarantee a degree of coverage, any type of universal system will restrict choice.
The people (Raw Story) pushing this nonsense are Medicare shills. I try not to be a shill, and admit Big Pharma, Big Medical Device are abusing the patent system, and manipulating prices. Any device, and you will see the price difference between, say Germany, and the US.
You’re right about employer driven plans. But there is no need to make them illegal, all that needs to be done is tax parity with private purchase plans.
Assuming no Obamacare credits, employers right now, $700 monthly premium results in a $700 “pre-tax” credit (dollar for dollar). If the same employee, or self employed, spent that $700 insurance premium privately, and they itemize deductions, they only get maybe 30% max back. The “Employer Benefits” industry fools people into thinking they are getting something for free, when in reality, benefits are lost cash/wages.
With the old Samuelson Economics textbook the first lesson was scarcity. Finitude stinks. The problem with medical care is resources are finite, but when people are sick their demand for service is infinite. Insurance, with various rules, presents something of a compromise.
People today forget the rapid evolution of medical care following the Civil War and into the twentieth century. Until the 1970s surgeons were king. The development of sulfa drugs and penicillin allowed. treatment and cure for surgical infections. Medicare was originally a plan designed to pay for surgery for senior citizens.
Medicine evolved so that today much of it is chemical and pharmacological. Big drug companies love to get people on maintenance medications (for high blood pressure, type 2 diabetes, birth control, etc.) Drug companies hate cures because a cure ends demand for the drugs.
The reality we face as a society is that we cannot pay for all the medical care people want. We ration care today by price (co payments, deductibles, denied claims) with the understanding that medical care will bankrupt some and price others out of the system. Rationing today kills poor people, unemployed people, and the lower middle class with bad employer insurance.
The question going forward is who should not receive care? Mr Rall’s proposed insurance fixes won’t solve the scarcity problem. America is becoming a poor nation. We will soon have to decide money cannot be spent on care for some people because we need that money to do things like fix roads, bridges, rail lines, electric lines, water lines, sewers, schools, and other things.