The recent assassination of health insurance executive Brian Thompson, CEO of UnitedHealthcare, outside a New York hotel has sent shockwaves across the nation. The response to the crime revealed an underlying anger directed at a trillion-dollar industry.
The term “prior authorisation” appears to lack the ability to evoke strong emotions.
On a sweltering day in July, over 100 individuals assembled outside UnitedHealthcare’s Minnesota headquarters to voice their dissent against the insurance company’s policies and the denial of patient claims.
Companies can evaluate proposed treatments through a process known as “prior authorisation” before deciding to cover the costs.
During the protest, authorities apprehended eleven individuals for obstructing a roadway.
According to police records, participants in the rally organised by the People’s Action Institute travelled from various states, including Maine, New York, Texas, and West Virginia.
Unai Montes-Irueste, the media strategy director for a Chicago-based advocacy group, highlighted that the individuals participating in the protests have firsthand experience with denied claims and various issues within the healthcare system.
“Individuals face denial of care, subsequently navigating an appeals process that is notoriously challenging to succeed in,” he stated.
The frustration simmering among many Americans regarding the healthcare system—a complex network of providers, profit-driven and nonprofit entities, insurance behemoths, and government initiatives—came to the forefront after the reported targeted killing of Thompson in New York City on Wednesday.
Thompson was CEO at UnitedHealthcare, the insurance division of the health services provider UnitedHealth Group. The company is the largest insurer in the United States.
Authorities continue their search for the suspected killer, with the motive still unclear. Investigators have disclosed that messages inscribed on shell casings discovered at the crime scene may provide crucial insights.
Investigators have uncovered the terms “deny,” “defend,” and “depose” on the casings, suggesting a potential link to strategies that critics argue insurance companies employ to evade payouts and bolster profits.
An examination of Thompson’s LinkedIn history uncovers significant frustration among users regarding denied claims.
A woman reacted to a post in which the executive highlighted his company’s efforts to reduce the cost of medications.
“I have been diagnosed with stage 4 metastatic lung cancer,” she stated. “We have recently decided to part ways with UnitedHealthcare due to the numerous denials for my medications.” Each month brings a new justification for the denial.
According to a statement made to US broadcaster NBC by Thompson’s wife, he had previously received threatening messages.
Paulette Thompson reported, “There had been some threats.” “Essentially, there seems to be an absence of adequate medical coverage.” Details remain unclear at this time.
“He mentioned that there were individuals who had been making threats against him.”
A security expert warns that rising costs in various industries will likely increase threats directed at corporate leaders.
Philip Klein, the head of Texas-based Klein Investigations, expressed his astonishment that the executive did not have security arrangements for his recent trip to New York City despite having provided protection during Thompson’s speech in the early 2000s.
“A significant wave of anger is currently sweeping across the United States,” Mr. Klein stated.
“It is imperative for companies to recognise that their executives may be vulnerable to threats in any location.”
Mr. Klein reports a surge of calls following Thompson’s death. Leading companies in the United States often allocate substantial budgets, reaching into the millions, for the personal security of their top executives.
Following the shooting, various politicians and industry leaders voiced their shock and offered condolences.
Michael Tuffin, president of the insurance industry organisation Ahip, expressed his deep sorrow and shock over his friend Brian Thompson’s passing, stating he was “heartbroken and horrified” by the news.
“He was a dedicated father, a reliable friend to numerous individuals, and a forthright colleague and leader.”
UnitedHealth Group has reported many supportive messages from diverse stakeholders, including patients, consumers, healthcare professionals, associations, government officials, and other concerned individuals.
However, reactions from individuals online, including those who are customers of UnitedHealthcare and other insurance providers, varied significantly.
The responses varied significantly, including sharp humor—one prevalent jest was “thoughts and prior authorisations,” a twist on the familiar phrase “thoughts and prayers”—and critiques regarding the volume of insurance claims denied by UnitedHealthcare and other companies.
Industry critics expressed a stark lack of sympathy for Thompson at the deepest reaches of the debate, while others marked his passing with celebrations.
The surge of online outrage appeared to transcend traditional political boundaries.
Expressions of hatred emerged between self-identified socialists and right-wing activists, who harbour suspicions regarding the so-called “deep state” and the influence of corporate power. Accounts emerged from everyday individuals recounting their experiences with insurance companies rejecting claims for medical treatments.
Mr. Montes-Irueste, representing People’s Action, expressed his astonishment upon hearing the news of the killing.
He stated that his group conducted its campaign in a manner that was both “nonviolent” and “democratic,” acknowledging the pervasive bitterness expressed online.
“The healthcare system is fragmented and dysfunctional, leading to intense emotions from individuals navigating its shortcomings in diverse ways,” he stated.
Mr. Tuffin, the Health Insurance Trade Association leader, strongly criticised any threats directed at his colleagues, characterising them as “mission-driven professionals dedicated to making coverage and care as affordable as possible.”
The posts highlighted numerous Americans’ frustration with health insurers and the broader system.
“The system is incredibly complicated,” stated Sara Collins, a senior scholar at The Commonwealth Fund, a prominent healthcare research foundation.
“Navigating and comprehending the process of obtaining coverage can pose significant challenges for individuals,” she stated. “All may appear well until illness strikes, and you need your plan.”
According to recent research by the Commonwealth Fund, 45% of insured working-age adults encountered charges for services they believed should have been free or covered by their insurance. Alarmingly, fewer than half of those individuals who identified potential billing errors took the step to contest them. Seventeen per cent of those surveyed reported that their insurance provider refused to cover treatment that their physician had advised.
The complexity of the US health system is matched by its high costs, which frequently burden individuals directly.
According to Ms Collins, the prices set for medical services result from negotiations between providers and insurers. This process often results in charges to patients or insurance companies that need to accurately reflect the actual costs of delivering healthcare.
“There is a significant prevalence of individuals reporting that their healthcare expenses are beyond their means, regardless of the type of insurance they hold, including government-funded programs like Medicaid and Medicare,” she stated.
Individuals are burdened with medical debt due to their inability to settle outstanding bills. This phenomenon is distinct to the United States, where a significant medical debt crisis is currently unfolding.
A recent survey conducted by researchers at the health policy foundation KFF revealed that approximately two-thirds of Americans believe insurance companies bear significant responsibility for the escalating healthcare costs. Most insured adults, 81%, have rated their health insurance as either “excellent” or “good.”
Christine Eibner, a senior economist at the RAND Corporation, a nonprofit think tank, noted that insurers have been progressively denying treatment coverage in recent years, often utilising prior authorisations to refuse coverage.
According to her, the premiums amount to approximately $25,000 (£19,600) for each family.
“Additionally, individuals encounter out-of-pocket expenses that can easily reach into the thousands of dollars,” she stated.
UnitedHealthcare, along with various other insurance providers, is currently the subject of a series of lawsuits, media investigations, and government enquiries regarding its operational practices.
In a significant legal resolution, UnitedHealthcare settled a lawsuit filed by a college student facing chronic illness last year. The case, highlighted by the news organisation ProPublica, revealed that the student was burdened with $800,000 in medical expenses after his doctor-prescribed medications were denied coverage.
A class-action lawsuit is currently underway against the company, alleging that it employs artificial intelligence to terminate treatments prematurely.
