Health insurance companies are exposed

By David W. Marshal
TriceEdneyWire.com Columnist

If a person faces any serious medical condition, ideally, the best situation is to be financially stable and never have to depend on the financial decisions made by healthcare insurers. Unfortunately, that is not a realistic option for millions of Americans, especially those who are not extremely wealthy.

Every year, people suffer and even die from preventable or treatable illnesses that hospitals charge too much for the care, and insurers often refuse to pay. Recent data show that patients are now even more likely to have their claims denied, pay more for premiums and medical visits, and face unexpected costs for care they thought was covered under their health plans.

Pam Herd, a professor of social policy at the University of Michigan, says barriers to healthcare access are especially painful. “It’s one thing to be frustrated at the DMV because you have a ton of paperwork to fill out or you have to spend an hour in line,” she says in an NPR interview with host Michel Martin. “It’s a whole other thing to face those barriers when they are the difference between whether you’re going to get life-saving care or not.” Herd’s research shows how barriers in the healthcare system can affect people’s health. It is not just the time people face when dealing with a complex system. “It’s also these sort of other psychological costs that people experience in those encounters: stress, fear, frustration, anxiety.”

With a massive market share in commercial insurance and Medicare Advantage markets, UnitedHealthcare is the largest private health insurer in the United States. Its parent company, UnitedHealth Group, reported $371.6 billion in revenue last year. Under CEO Brian Thompson’s tenure, UnitedHealthcare increased its use of tactics such as “prior authorization,” in which physicians must submit additional paperwork to justify their treatments and prescriptions, based on reports by congressional investigators and federal watchdogs. Industry analysts have said denying claims helped UnitedHealthcare and other insurers cut costs and boost profits.

According to the personal finance platform ValuePenguin, UnitedHealthcare denies 32 percent of claims compared to the industry average of 16 percent. Profits for UnitedHealthcare surged from $12 billion in 2021 to more than $16 billion in 2023 during the period of Thompson’s leadership. Timothy Faust, a healthcare writer and author of “Health Justice Now,” told The Independent that many Americans see medical insurance companies as the primary cause of injustice within the healthcare system. “Health insurance companies ultimately determine, through scandal-laden cost-cutting processes, which care you are eligible to receive and to what extent it will bankrupt your family, and are understandably the entities we most associate with the injustices of American health,” he said.

Recently, UnitedHealthcare’s CEO Brian Thompson was gunned down in an ambush attack outside a hotel in Midtown Manhattan. The calculated manner of the shooting was a shock, but even more shocking was the outpouring of public frustration against healthcare insurers and the lack of personal sympathy for Thompson by way of social media. The shooting opened many wounds while reminding people of their personal horror stories and the denied care they encountered when dealing with healthcare insurers, particularly UnitedHealthcare.

Therefore, some people did not see Thompson as an innocent victim of a senseless murder. Rather, they saw themselves and their loved ones as innocent victims at the hands of health insurance companies driven by corporate greed. Their responses to Thompson’s murder were motivated by an industry’s insensitive tactics, resulting in needless debt, suffering, and death. For those who celebrated the shooting, Thompson puts a name and face on the source of their personal stress, fears, frustration, and anxiety. The public indictment was targeted not only against Brian Thompson as CEO but also against the entire healthcare insurance industry and the profits it generates. It was an indictment against a sector that chooses corporate profits over the health and welfare of everyday individuals.

It should be a wake-up call for several reasons. Luigi Mangione was the man arrested and charged with murdering the UnitedHealthcare CEO, and now he is seen as a folk hero on some parts of social media. “He took action against private health insurance corporations is what he did. He was a brave Italian martyr. In this house, Luigi Mangione is a hero, end of story!” one anonymous person wrote in a post on X (formerly known as Twitter).

The murder of Thompson is wrong, and the same would be true if this type of action ever becomes the norm. Will emotions continue to escalate while people feel helpless, resulting in future copycat murders targeting similar executives? Pennsylvania Gov. Josh Shapiro has already called this “vigilante justice.” The public’s response should be a conscious moment of self-reflection for all corporate executives throughout the industry.

Mangione has exposed America’s pent-up anger and frustration and the failure of America’s healthcare institutions. Days after the Brian Thompson shooting, Andrew Witty, the CEO of the insurer’s parent company, defended its practices to “guard against” what he called “unnecessary care.” In its self-serving definition of “unnecessary care,” the healthcare insurance industry has failed the public. By taking critical medical decisions away from the professional relationship between a doctor and patient, the industry has taken those personal medical decisions and made them into their own billion-dollar profit decisions.

This article originally published in the December 23, 2024 print edition of The Louisiana Weekly newspaper.