The Atlantic: America's Health-Care Fury Isn't Going Away

[Dennis Donovan]

The Atlantic - (archived: https://archive.ph/FGyJl ) America’s Health-Care Fury Isn’t Going Away

The anger that the UnitedHealthcare shooting unleashed came from a very real source.

By Nicholas Florko
December 5, 2024, 5:03 PM ET



Two very ugly, uniquely American things happened yesterday: A health-care executive was shot dead, and because he was a health-care executive, people cheered.

UnitedHealthcare CEO Brian Thompson was murdered yesterday outside his hotel in Midtown Manhattan by an unknown assailant. In response, a post on X wishing that the murderer would never be caught racked up 95,000 likes. Social media was littered with jokes about Thompson’s pending hospital bills, and the tragedy of him not returning to his “mcmansion.” The mood was summed up by the journalist Ken Klippenstein, who posted a chart on X showing that UnitedHealthcare refuses to pay a larger percentage of users’ health-care bills than any other major insurer. “Today we remember the legacy of UnitedHealthcare CEO Brian Thompson,” he wrote.

There’s no excuse for cheering on murder. But Americans’ zeal for the death of an insurance executive demonstrates both the coarsening of public discourse and the degree of rage Americans feel over the deficiencies of the U.S. health-care system. Gallup polling shows that just 31 percent of Americans have a positive view of the health-care industry. Of the 25 industries Gallup includes in its poll, only oil and gas, the federal government, and drug companies are more maligned.

America’s entire health-care system is designed in a way that makes some level of fury unavoidable. Although the governments of most wealthy industrialized countries provide all of their citizens some level of insurance, the majority of Americans rely entirely on the whims of private health insurers. The system is supposed to keep costs down enough to turn a profit. The insurance industry’s eagerness to save money by denying people care is a feature, not a bug, of this country’s system. Americans, in their anger toward Thompson and other health-care CEOs, are expressing frustration with a system that causes real and preventable harm. Those cheering Thompson’s death are arguing that taking away sick Americans’ pills or denying them needed surgeries is immoral and should be punished by death.

That logic is indefensible, but people do have a reason to be angry: Roughly half of Americans report difficulty paying for their health-care costs. A single denied insurance claim can force a patient into financial ruin, and health insurers have gotten more clever at finding ways to deny claims. Until Congress intervened in 2020, patients were frequently being saddled with unexpected medical bills for hospital visits all because the specific doctor on rotation, unbeknownst to them, was out of their insurance network. And even less egregious maneuvers, such as step therapy, which requires patients to try cheaper medications before insurers will pay for more expensive therapies, can delay treatment needed to stave off suffering.

UnitedHealthcare is particularly infamous for its aggressive use of these tactics. Reporters at the health publication Stat (where I worked until this September) spent the past year documenting the myriad ways UnitedHealthcare has extracted profits at the cost of patients’ lives. They found, for example, that the company has used AI algorithms to justify kicking elderly patients out of nursing homes, despite evidence that some of those patients still needed round-the-clock care. Doctors who worked for United (which has also been buying doctors offices) told Stat that the company applied pressure to see more patients, and diagnose them with additional conditions, presumably to increase the company’s profits. United has also faced lawsuits from patients and from the federal government regarding its aggressive business tactics. (United has refuted the claim that it relied solely on AI to deny care, and has said in response to Stat’s reporting that it trusts its doctors to “make independent clinical decisions.” )

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[PuraVidaDreamin]

1. This could very well be a tipping point

in history. This is not going to be a smooth period of history.

[uponit7771]

2. I wont celebrate CEOs death but I wont be crying too much either.

[Coventina]

3. I disagree: The logic is entirely defensible.

If I was on the jury, I doubt I would convict.

I had a coworker who was murdered by Cigna.

They do REAL murder and harm. This is no abstract at all.

[dalton99a]

4. Murderous parasites have no empathy and deserve none

[Solly Mack]

5. People are angry and rightfully so. Some people will act on that anger.

[Turbineguy]

6. After my Mother died

There were a couple of claims dating back several months. They simply refused to pay them. Since I was only a few years away from Medicare myself I thought, fine don't expect me as a customer.