Backlash

A reckoning for the health insurance industry

I was on the phone with my clear-eyed brother in the hours following the assassination of Brian Thompson, the late CEO of United Healthcare. As I was decrying what at the time looked like a professional hit, my brother was the first person I heard expressing the backlash against monopolistic insurance companies. Backlash which has overtaken all forms of media in the interceding days.

I was still on the page where we mourn for an apparently decent family man whose wife and two boys are now without husband and father. But my brother, like a large swath of Americans who have also had Kafkaesque experiences with Big Insurance, had jumped past pity, and landed squarely on retribution.

During my time fighting an aggressive cancer, I had very little out of pocket expense. There was never any trouble with the insurance company. Later in the year, I crossed the age threshold and entered the Medicare rolls, and likewise, was never made to get prior authorization, nor were any claims denied.

I now assume my experience was exceptional, because there are a lot of very angry people out there who hope that this apparent revenge-killing will result in actual insurance company reform.

In some ways, this moment is a true test of the self-proclaimed populists, symbolized by the President-elect. He spent his first term trying to destroy the Affordable Care Act without the replacement that he has alluded to for the last eight years, and when confronted during election season said only that a plan was in the works. That sounds a lot like Infrastructure Week to me.

Still, if the new Republican Party actually has concern for those at the lower end of the socioeconomic scale, those who, according to all reports, are the ones most likely to be subject to the denial, delays, and defenses of Big Insurance, this tipping point moment will be their crucible.

At this writing, police appear to have caught up with the perpetrator in Altoona, PA—that was inevitable. But the authorities ran into a few hurdles as the shooter quickly achieved underdog or folklore status to the degree that a woman who stayed at the same NYC hostel reportedly told police she didn’t get a good look…because United Healthcare had denied her new glasses.

The always well-researched Doug Porter did some leg work for us:

“The New York Times ran with the headline: Torrent of Hate for Health Insurance Industry Follows C.E.O.’s Killing, a phenomena they could have picked up on earlier by visiting a couple of infusion centers.

• The author Joyce Carol Oates weighed in on social media, after an initial version of this story was published, saying that the outpouring of negativity “is better described as cries from the heart of a deeply wounded & betrayed country; hundreds of thousands of Americans shamelessly exploited by health-care insurers reacting to a single act of violence against just one of their multimillionaire executives.”

• The shooting has also prompted patients and family members to weigh in publicly, sharing wrenching horror stories of insurance claim reimbursement stagnation and denials — painful recountings of insurance company interactions that have become all too familiar in a nation facing a health care crisis.”

Prominent healthcare consultant, John Parikhal, had this to say:

“Based on my experience and observations, health care can be reformed. But, in part, it requires that the super-rich help out a lot more. By paying taxes into the system. Would Musk or Bezos miss a few billion? No. But the Trumpers are going to CUT taxes for the rich. AGAIN. They are doing this to destroy the medical system we have (as imperfect as it is) because of their twisted ideology. They say so out loud!

“One thing everyone has to deal with is the awful truth that every insurance based or socialized medical system has to make choices. Some people die because a rare (or uncommon) condition costs too much money that could be used to help 1000 mothers have safer pregnancies, etc., etc. Someone else makes the choice. Insurance or government employee. And if it affects us personally, we scream loud. That’s one of the reasons things don’t get fixed. The exception makes for great TV outrage while America is behind Botswana for maternal deaths in childhood.

“It’s complicated.”

And from Pro Publica:

“More than 200 million Americans are covered by private health insurance. But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment. Many people, faced with fighting insurance companies, simply give up: One study found that Americans file formal appeals on only 0.1% of claims denied by insurers under the Affordable Care Act.”

The National Institutes of Health (NIH) points out that most denials are a form of unqualified medical practice, and the trend is toward more denials, not fewer.

©2024 Jon Sinton