The brazen murder of UnitedHealthcare CEO Brian Thompson sparks social media attacks on his company and the U.S. health insurance industry, which serves as the gatekeeper to the nation's $4.5 trillion health care system. unleashed his contempt.
One commenter wrote that trying to file a claim with UnitedHealthcare, one of the country's largest insurance companies, is a “humiliating and terrible job.” “I'm guessing this person (the shooter) may be a disgruntled policyholder.”
Another complained: “CEOs are handing over fists and making money by denying care. I feel terrible for his family but I can't say I'm surprised.” leaked.
Social media is often filled with hate and “good ostracism” after high-profile murders, and while there have been instances of violence against medical workers in the past, the reaction this time feels different. said the experts.
Wendell Potter, a former CIGNA executive turned health insurance industry whistleblower, said the midtown Manhattan murders were a crime that the public only knew about through impersonal delays and denials of needed medical services. He said public anger towards the industry had exploded.
“I've heard stories of people over the years who have been extremely frustrated because of denials or delays in care, but this is a great time for people to feel angry at someone who has just been informed of everything. It was an opportunity to vent and hit it out of the blue,” Potter said.
“Sadly, it's misplaced anger,” he continued. “This system is rigged against Americans who need care and those who have health insurance, in large part because of the role Wall Street plays in our nation's health care system. .”
Why are people so angry about the health insurance industry?
Mr Thompson's death also sparked an outcry against health insurance companies on social media, with complaints about claim denials and perceived greed within the industry.
Investigators are still working to identify and locate the gunman who killed Thompson and determine his motive. Multiple media outlets reported that authorities found three shell casings inscribed with the words “denial,” “defense,” and “resign.” This phrase reminds me of the title of a book criticizing the insurance industry published in 2010, “Delay Denial Defense: Why Insurance Companies Don't Pay Claims and What You Can Do About It.”
Before President Obama's signature Affordable Care Act went into effect last year, health insurance companies denied or limited coverage based on a person's medical history, or for expensive illnesses such as cancer. In many cases, insurance plans were canceled retroactively.
Such “cancellation” is currently not allowed, except in cases of fraud or intentional misrepresentation. The 2010 health law requires insurers to spend at least 80% to 85% of their premiums on medical care or refund customers if they don't meet the criteria.
However, other consumer complaints remain. Claim denials and networking are among the most common problems faced by Americans who say they've had problems accessing health insurance, according to a 2023 poll from KFF, a health policy nonprofit. It is reported that finding a provider is difficult.
Health insurance issues can be complex and confusing, causing people to put off seeking medical care, “which can lead to very long-term negative health outcomes,” said Ashley, director of research methods at KFF.・Mr. Kerzinger said. “I know it's causing people a lot of anxiety,” she said.
Some say the private health insurance industry is a function of the design of the U.S. health care system.
“Insurance companies are vilified for a lot of things that are actually decided at a much higher level,” said Lauren Adler, deputy director of the Center for Health Policy at the Brookings Institution. “The way the U.S. health care system is set up requires insurance companies to make unpopular decisions such as denying some care, requiring prior authorization, and trying to control costs. No one likes cost control.”
What is UnitedHealthcare's record of claim denials?
UnitedHealthcare does not publicly say how often doctors, hospitals and labs are required to get the insurer's permission before denying claims or approving care.
But lawsuits and Congressional reports provide clues about insurers' business practices.
An October Senate committee report found UnitedHealthcare's denial rate for post-acute care “jumped from 10.9% in 2020 to 16.3% in 2021 and 22.7% in 2022.” did.
In July, nearly a dozen people protested outside UnitedHealthcare's headquarters in Minnetonka, Minnesota, “protesting the company's systematic practice of refusing to authorize and pay for treatment,” according to the People's Action Institute. I was arrested. In a statement, the organization expressed its condolences over Mr Thompson's death.
A lawsuit filed in 2023 against United Healthcare, its parent company UnitedHealth Group, and subsidiary NaviHealth alleges that the insurance giant used artificial intelligence to improve claims for seniors enrolled in private Medicare plans. He claimed to have refused. The lawsuit alleges that seniors are denied access to skilled nursing and rehabilitation centers and that insurance companies make “draconian and unrealistic” decisions about what patients need to recover from serious illnesses. claimed to have used AI.
At the time the lawsuit was filed, UnitedHealth told USA TODAY that NaviHealth's AI program was not used to determine coverage. The case is ongoing.
Potter said denying claims and delaying payments are both strategies used by health insurance companies to limit the amount they pay out in response to pressure from Wall Street.
When UnitedHealthcare parent company UnitedHealth Group reported quarterly results in November, the insurer paid out more claims than Wall Street expected, cutting government payments for private Medicare plans and cutting state Medicaid payments. It warned about low reimbursement from the program. The company's stock price fell 8% after the insurance company cut its earnings forecast for next year.
“From an investor's perspective, the company was being punished because it was paying too much for care,” Potter said.
Healthcare workers face workplace attacks and violence
Mr. Thompson's death is the latest in a series of violent attacks and threats against health care workers, including doctors and nurses, and industry executives, beyond anger directed at insurance companies.
Research shows that healthcare workers are approximately five times more likely to experience workplace violence than employees in other industries, putting them at increased risk of becoming victims of gun violence. Meanwhile, threats to top executives have increased, leading health care companies to spend hundreds of thousands of dollars to protect them.
Unlike mass shootings, where the perpetrator does not know the victim personally, attacks in medical settings are typically purposeful, targeted, and often associated with medical or surgical outcomes. Research has shown that this is accompanied by resentment.
“The risk of workplace violence is a serious occupational hazard for nurses and other health care workers,” a recent study by National Nurses United found. “The countless assaults, assaults, aggression, and threats of violence that occur on a daily basis in health care settings are indicative of a frightening trend of increasing violence faced by health care workers across the country.”
According to a study published in 2019 by researchers at Maine Medical Center, about 20% of fatal shootings involving health care workers are motivated by a grudge against the doctor due to health risks.
Chris Pearson, CEO of security firm Blackcloak, said executives at Fortune 500 pharmaceutical companies became victims of swatting after drug price hikes and that his own customers in the health care industry He said he has seen himself physically confronted by people trying to hold him accountable for his decisions. .
Although violence is rare, it is common for consumers to become dissatisfied with their insurance companies.
According to a KFF poll, half of people who reported problems accessing health insurance reported not receiving recommended treatment, experiencing worsening health conditions, or paying more in premiums than expected. However, these all turned out to be a direct result of the problem.
While most people, especially healthy people, say they are satisfied with their insurance company, “people are much more negative about the health insurance industry as a whole,” Kerzinger said.
“As healthcare costs increase, there is a lot of discussion about who is responsible and what is not covered,” she says.
Contributor: Christopher Cann, USA TODAY. Reuters
