December 5, 2024 - 8:00pm
On Wednesday morning Brian Thompson, the 50-year old CEO of insurance giant UnitedHealthcare, was shot and killed by a masked assassin wielding a silenced handgun as he left his Manhattan hotel to attend the company’s annual shareholder conference. The bullet casings were later revealed to contain the words “delay”, “deny”, and “defend”, which also happened to form the title of a book exposing common malpractice within the insurance industry.
UnitedHealthcare is America’s largest insurer, raking in $372 billion in profits last year and holding 2,200 subsidiaries, through which an estimated 5% of US gross domestic product passes each day. Thompson personified the vast influence of this industry and the differing reactions to his death have laid bare the glaring asymmetries between the powerful and the powerless.
Healthcare industry leaders, including those from corporate rivals Blue Cross and Aetna, were quick to offer condolences for the fallen fellow executive, filling the New York Times’s obituary with laudatory remarks: “Every interaction with him felt extremely genuine”; “He was so smart, [a] talented leader, very well-respected, with such a bright future.” Amy Klobuchar, a Democratic senator from Thompson’s home state of Minnesota, condemned “this horrifying and shocking act of violence”, a sentiment echoed across the aisle by Florida Republican Rick Scott, who tweeted that he was “praying for his family & the UnitedHealthcare team”.
These are, of course, ordinary and respectful things to say in the aftermath of any violent death, but the contrast with popular reactions on social media sites could hardly have been more drastic. Users let loose with a combination of rage and glee at Thompson’s demise, with some applauding the gunman as a modern-day folk hero and others highlighting the dollar amounts contributed by UnitedHealthcare to office-holders like Klobuchar and Scott, in posts that garnered tens of thousands of likes.
Against one news anchor’s reminder that Thompson “was a human being with a family” came the reply that “the people who died because United Healthcare denied them coverage are also human beings with families.” Online personalities, ranging from progressive journalist Ken Klippenstein to Right-wing podcaster Tim Pool, acted as one in drawing attention to the controversies generated by Thompson’s tenure. These included the fact that UnitedHealthcare had the highest claim denial rates among major insurers at 32%, or that the AI model it used to review policies for elderly patients was “known by the company to have a 90% error rate [which had the effect of] overriding determinations made by the patients’ physicians”.
UnitedHealthcare had also been embroiled in an antitrust investigation by the Department of Justice: Thompson sold his stocks before the case was made public, prompting a suit by a firefighters’ pension fund for fraud and insider trading. This angle has already generated much discussion on the same social media channels, with one X user asking: “Was he about to take a plea deal and reveal all about congressional favours that gained them their monopoly?” This kind of speculation will likely only multiply in the days ahead.
Even in times of simmering anger on the part of the many against the few, America’s corporate class has always been relatively well-protected from popular reaction by a political culture that, more often than not, looks past their excesses and gives them the benefit of the doubt. That the murder of a CEO should elicit such unbridled celebratory reactions from masses of ordinary internet users would suggest that something may have changed, quite possibly heralding a new and more vengeful chapter in America’s ongoing populist revolt against elites of all stripes.
Both the MAGA Right and the post-Bernie Sanders Left were born in this insurgent atmosphere. Finding intelligent — and, needless to say, non-violent — ways of harnessing the vivid passions unleashed by Thompson’s killing will be essential to any constructive progress, which reformist forces across the political spectrum should now prioritise. Otherwise, darker and bloodier alternatives await.
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SubscribeAnother class divide (elite vs the workers) among the many other divides: left vs right, black vs white, rich vs poor, uneducated vs educated, straight vs LGBTQ, immigrants vs non-immigrants, etc. America is truly fragmented. Empire falls easily with class struggle and self-destruction. Trump is right: America is no longer great! He has an herculean amount of work ahead and only God knows if he can begin to succeed.
If the allegations of malfeasance against Thompson are true then many would argue that he got his just deserts. If untrue it is murder. The body politic aligned with big business in the US always has the fear of retribution from a lone actor. This has nothing to do with a class divide as some UK glued to the road actors would see it. This is the US in the raw, an unpredictable mass of freedom loving people intolerant of injustice.
Even if the allegations are true it’s still murder. The appropriate response to malfeasance is prosecution, not being gunned down in the street. It is a worrying development when the only solution to antisocial actors that occurs to many people is killing them.
Fair point. But tell that to the folk’s families that died, lawfully, due to the UH’s denial, defend, and delay tactics. Let’s see how they feel.
It is more worrying that the government is so entrenched with the Corporate big shots that meaningful prosecutions are not possible. Regulatory capture is the order of the day. When the “prosecutions actually happen, the Corporations are being “fined” millions when the profits from their offenses is in the Billions. that isn’t justice…that is just the Government taking it’s cut of the loot.
Look at Chase…they just about destroyed the entire worlds banking system, the CEO Dimon is now a 5 times felon, and yet he has come and gone as he pleases into the White House through at least 3 administrations. Neither he nor any of the bankers ever go to prison.
So, the bottom line is that when there can be no justice, people have the right to bring their own..this is exactly why the 2nd Amendment exists. It isn’t murder, it’s self defense. The shame is that they have pushed it so far that this is all that is left, and that this is just the start of things.
Never in history has such a large divide between the haves and the have-nots been allowed to stand. The warnings have been deafening since 2008. We elected a Populist twice now,. how much clearer can the people be. According to history something is about to change one way or another. either the Congress will free itself from the corruption and its Fascist partnership with the elites and get to work doing their duty…or people will start picking up the many torches and pitchforks lying about.
It would be very ugly I think. I don’t think that the Oligarchy realizes that the people have been very patient. But people have been losing jobs, income, homes, and now even their lives to these insurance schmucks. When it boils over they won’t likely be able to offer an apology and throw out a few thousand dollars in “Stimulus” to turn off the anger. when it goes it will likely go till the extinction of the elites. (see the French Revolution)
No, I am not wishing for this, but this what I see coming, and I’ve been saying it for a decade now. 2008 was an outright attack on we the people and we have waited for someone to take legitimate action to right the ship, but it just gets worse and worse…that help is not coming.
No class divide? Tell that to average earning Americans paying 9k per year for an individual and 25k per year for an average family for health insurance. And then getting denied coverage with all these clauses in insurance contracts, deductibles, copayments etc. The health insurance business is a scam, that’s why it’s so profitable. Collect maximum premiums, hire doctors to minimize the payouts. This has to be one of the most morally bankrupt industries playing with people’s lives. Over 500k people annually end up in bankruptcy due to medical bills. And it’s not the rich, it’s the middle class. What a system.
That is a reasonable argument. However class mobility i.e. movement between classes is more prevalent in the US than the UK. Significant individual action towards injustice whether lawful or not is a feature of American society and is more effective than the UK model of hoping to be saved by your “betters”. I would never defend the US healthcare nor pharmaceutical companies.
According to which index is social mobility higher in the US than the U.K.? Neither is great. But some indexes at least rate the US lower than the U.K., and much lower than other European countries.
Americans may think they have higher social mobility, but that doesn’t make it so.
It’s murder anyway, but I don’t think too many people will shed a tear at his demise
Class is the great bogeyman for America and Americans and they will go to great lengths either to deny it exists in America or that it matters.
Americans may be an “unpredictable mass” at the moment, but only because the penny hasn’t really dropped. But there is only so long that the rich can feed off the poor before the poor wise up or the rich wake up. Which happens first will determine how ugly it gets.
…. intolerant of injustice except when they themselves are being unjust.
I’ve never been ashamed to be an American, but I am today. Murder is never justified. One can argue whether a specific killing is in fact a murder, but murder–the unlawful slaying of another–is never justified. Even grossly immoral people do not deserve to be murdered. The appropriate response to immorality is prosecution if illegal and legislation if it is not. Disregarding the moral dimension, for my own safety I should not want to live in a society that normalizes the murder of people that others dislike or disapprove of. We are not mafiosi or Nazis.
Or, at least, we didn’t used to be.
RIP to all the people UnitedHealthcare has murdered
Lawfully.
Admirable sentiment. Unfortunately where a large number of people, movers and shakers included, fall over each other to justify the actions of a bunch of Nazi loving terrorists in their efforts to annihilate their victims, as in Palestine, the spirit of the Mafiosi or Nazis lurks not far below the surface.
Thank you for being a voice of reason. I’ve never seen reactions like this to a cold blooded murder before.
I think it tells us how seriously angry people are becoming. Things like this are a bit of a societal litmus test.
There’s multiple ways to interpret what you said. Are you defending the gunman or downplaying people celebrating the gunman?
Neither. I’m making the observation. And my point is about how people have reacted. If there is a killing like this and peoples reaction is other than condemnation of the killer and sympathy for the victim, that tells you something important about the mood of America.
Ah…merely an observation. So in your opinion the primary story is the societal impact not the individual facts of the case.
So let me ask strictly from an observational perspective- Do you believe collective justice aka mob terror is a sustainable form of justice?
Imagine the reaction you would have seen if the assassin’s bullet had passed through the middle of Trump’s head, instead of grazing his cheek.
Sad and shocking that this post gets 10 votes.
I just retired last year and now live in Scotland. I trained in London in the NHS but studied and practiced for 40 years in California as a surgeon. Towards the end of my career the behavior of the United Healthcare corporation became so egregious, their reimbursement rates were low, their denials and delays were so high, the difficulty of getting hold of, let alone justice from, one of their employees on the telephone was so protracted, that I finally dropped them entirely. Sure, they were the state’s largest private health insurer (because the patients all went for the cheapest premiums, naturally, given the outrageous cost of private insurance), but I dumped them nevertheless. I lost 30% of my patients, but the others just moved in to fill up and shorten my waiting list. The ladies in my billing and collecting department announced they wanted to have my babies.
My point is that this part of the American healthcare system is private and independent. If the “providers” – the hospitals, doctors, clinics, physios, etc. all did the same the problem would be solved – that’s how capitalism works. But between you and me the great majority of American doctors, hospital administrators, etc., have no balls – there are rules about collusion (rightly) and FOMO renders the individual units of providers spineless.
This has been where we’ve been heading since 2008 when they bailed out the big banks. America had been built on the premise of largely your own self sufficiency bad things could happen and things wouldn’t always be fair but everyone was going to get treated the same more or less. The they bailed out the big corporations they sent the message that some people were more important, while millions were losing their homes they were seeing millions of tax dollars funnelled towards companies that had brought the devastation.
The message then was clear, it was no longer about working hard and dealing with the punches some people were above the consequences of their actions, some people would be saved and that justice wouldn’t be upheld. It sent a message that the system is designed to protect the system and not you.
And that’s the problem there is no avenue for redress of grievances anymore because the rich and powerful have created a playing field where the rich are let go because of their wealth and they connections while the humble average joes are mocked persecuted and driven down. Where is someone to go whose loved one died because UHC denied a valid claim and they couldn’t get the medical they needed, and were entitled to through insurance. What could they do sue UHC so they could spend decades giving every penny they had to lawyers in the hopes that their lawyers could put lawyer the big corp with a hundred billion dollar war chest? Good luck with that.
The problem is if pressure builds with no relief, if those making decisions continue to show a complete lack of regard for who their decisions effect you end up leaving people with nothing to lose and a lot of anger, and only one way to strike back.
If things don’t change, if the response to this is to clamp down more, push for more punishment of the average citizen through gin controls through separating the rich and powerful from others, through “cracking down” this will only become more and more common. However if it can be a time for reflection and reform we may see the arrival of a new golden age. Things were much more grim as far as inequality, powerful corporations and the prospects of the average person in the late 18th century in the US but we reformed we revitalized and we ushered in a new golden age. It can happen again if we want it.
Thank you, Mr. Galt. You have just explained why 70m Americans voted for Trump.
Indeed. Though T will do nothing to change the situation except make it worse. Fat cats are everywhere around him, and of course he’s one himself. Don’t expect slashing of corporate profits or restriction of abusive practices to benefit the little guy.
You are quite mistaken in one significant regard. Trump is most likely the only POTUS who left public office with less money than when he arrived. He already made his fortune and doesn’t need to become a grifter, like his predecessor. Promising to drain the swamp is the opposite of pumping it full of money and perks for all your supporters. The real money is not with big corporations, who provide the products that we all purchase with our own free will. The big money lies with government largesse, given to those who genuflect at the alter of Washington.
My only real point was that people (including me) who feel screwed by the health insurance industry in the US are unlikely to find the T(2) administration does anything to help them. Hopefully I’m wrong, because we could use some help, but I doubt it.
Look at the people Trump surrounds himself with, starting with Elon Musk. He is not only the biggest creature in the swamp, he is an invasive species from South Africa.
Surely the status quo was not the answer.
The CEOs are unwelcome in public. They must retreat to their redoubts.
Makes me laugh, do you actually believe Trump and his billionaire friends actually give a hoot about average Americans? They may try to drain the swamp, but with the purpose of enriching themselves and their crony rich friends in the process. You have no idea what’s coming and in 4 years time the middle class will be so disappointed.
Well said, Dave. Voters’ anger and desire to reject the Democratic Party is understandable, but the notion there’s a positive vision to help regular people coming from the T crew is laughable.
Well, Dave, I really do. You conveniently forgot that Trump was President and the average Americans did pretty well, certainly compared to the last four years. Doesn’t matter, your post was paid for by the DNC.
The game was always rigged of course. A bit less during the postwar period but during the neoliberal period about 50 trillion was transferred from the bottom 90% to the 1% according to the RAND corporation. What 2008 exposed is how rigged the game actually was because the benefactors of the neoliberal nanny state were now on full display. After 2008 we failed to reform and hold those responsible accountable.
“It sent a message that the system is designed to protect the system and not you.”
But this has been the case since Roosevelt, who extended the protection of the state to the wealthy and big business and gave them the access to US tax dollar to which they became addicted and dependant
The killer is a modern day Robinhood.
This event does exemplify the old truth that if the law consistently fails to protect the average citizen, then sooner or later the average citizen will take the law into his own hands. These ‘decriminalization’ laws starting to spring up in liberal areas of the west are the thin end of the wedge in which the politicians’ stupidity now will lead to outright mayhem down the road – and liberal lawmakers will look stupid on camera, scratching their heads and trying to blame ‘extreme right wingers’ or ‘Neo Nazis’ for causing the urban warfare then underway.
Editors, please !!!
“UnitedHealthcare is America’s largest insurer, raking in $372 billion in profits last year”
Revenues were $372bn. Profits were $34bn.
That’s still $100 for every man, woman and child in the US though.
Thanks for this.
It does of course mean that if pay outs increased by a relatively small percentage premiums would have to go up. And it also allows comparison with other systems. If another system was only slightly less efficient it might still be worse. Profit simply being replaced by waste.
There is plenty of profit there to make some fat cats fatter, and the profit margin is high but not astronomical. How does this margin compare with supermarkets, say, or energy companies?
The supermarket industry profit margin is notoriously slim and probably more decentralized than healthcare insurance. OTOH, supermarkets’ profits aren’t based on denying sick insureds the coverage for medically necessary treatment.
I think you are looking at a reformist solution,the whole approach of private insurance solving the problem is nuts
Yea, I stopped reading after seeing that colossal blunder. I’m no fan of big insurance, but it’s better than a State run system. Any author who is critical of a business, and doesn’t understand the difference between revenue and earnings is not reliable on anything else either.
Lies! Lies. All lies!
I am really happy that Americans have the second amendment, even if it inconveniences a few Scrooge CEOs.
This is definitely a darker chapter. I remember putting down a university book with a gloomy set of predictions for neo-liberal policies in 1988, and wondering whether these kinds of retaliation would start, leading to a two-tier world where companies presented only an anonymous face to their users, and any and all ‘service’ was dispensed from behind a grille or bullet-proof glass.
Insurance executives get their revenge daily by boring fellow commuters to death on trains travelling to London from Kent and Surrey each day.
Be afraid, be very afraid. Wednesday Adam’s saying is particularly appropriate to the “elites” vs everybody else in America. We have had it, and if the authors stated facts regarding UH making 34 Billion last year, a 32% claim denial among major insurers, and a 90% error rate among elderly insured are all true, I certainly can see folks thinking this guy deserved it. As well as the rest of these “elites” feasting off the public. The incoming DoGE should make insurance companies a prime target for reform, as well as taking down the deep state. I have a gut feeling there is a great deal of collusion between the Fed’s administrative state and all corporations, not just the insurers. The news anchors remarks that the CEO had a family and the retort that people who died as a result of one of the 32% or 90% denial or error rate is going to be the future of bringing down the greedy, corrupt, and amoral/immoral philosophies that rule the day in corporate America.
My partner and I left the U.S. to live overseas, in part to avoid the outrageously expensive calamity of the current U.S. health system. Per the terms our visas in our host country we buy private health coverage rather than participate in the well-respected public system. Last year we spent just over $3300 dollars for a year’s worth of unlimited medical coverage for us both (two adults, age 61 and 72), no deductibles, co-pays, no restrictions. This year we expect to pay about $3500.
We show or swipe our medical insurance cards at appointments and that’s it. No lingering trail of bills from providers we never met or even knew we hired, no surprise bills to tell us that while a certain hospital was in network and thus covered, a specific operating theater in that hospital was not (yes, that really happened and it would have cost us $14,000 if I hadn’t involved our state’s insurance regulator).
And thanks to good healthcare advice plus the culture of the country that prioritizes healthy eating and increased physical activity, we enjoy our best health in years.
I don’t know the answer to the twisted knot of U.S. health care woes, but surely part of the answer rests in treating health care insurers more like utilities, private companies with a public purpose, and less like cash cows that can pay their executives millions of dollars per month. I think a system that incentivizes health insurance companies to prioritize patient satisfaction also might be part of the answer.
What country do you live in? I’ve worked in the health insurance industry for 15 years in Asia and, even in the lowest-cost countries within the region, there is no way that those premiums even come close to allowing for a sustainable portfolio. Average claims within your age group alone would vastly exceed premium.
Not so sure that is true… Where are the disease exposure and age group stats you are supposed to be referencing ??
I see them every few months when they’re presented by our pricing/actuarial team.
An entitlement mentality is what creates this level of vitriol and the very real violence that it invites. That there are super rich people is not, in itself, a problem unless we make it so. Does it really matter if someone has 5 private jets, or 6 mansions, or a couple islands? Does that in any way deprive someone else of comfort and safety? Of course not, but an entitlement culture that yammers on about equity, and wealth gaps, and race-based resentment creates a very lucrative atmosphere for literally thousands of government supported NGOs, international organizations, local, state and country-wide charities, grants, political causes and excoriations — on and on and on. For all this only two things are necessary: stoked anger and envy, lots of screaming and shouting — and if the death of meritocracy doesn’t do it, actual death, might.
We must not play into this paradigm or we will all live in a perilous world — succeed and die, or fail and subsist.
It might be a problem if those that gained their jets and mansions do so by systemically stealing as much as possible from as many as possible by demanding they pay for an essential service the privileged then withhold.
Medical care is not something that can be treated like any other product or service. Its customers are not, in the deepest sense, free agents in medical transactions and thus their trade is not a truly free market.
And that doesn’t even get into the bankers and VC firms, Hedge funds and the money laundering industry. The banks are free to use depositor money to gamble at the Wall Street casino. they lose OUR money and then we pay it back with OUR taxes, and the elite all get huge bonuses out of the bailouts that we give them.
The Stock market couldn’t be more corrupt. The elites are running their own “Dark Pools”, which are private clearing houses that are run outside of the regulations. They are illegal, but they remain working allowing the big dogs to manipulate the stock market as they see fit, and they always see it fit to rob mom and pops nest egg and fleece the retail markets. I was reading an economist a little while back who was explaining the research project that he had been working on for a couple of years (don’t remember who) and he summed it very well. He said, in essence, that at first he thought that the system had been corrupted, but now he knows that they system has not been corrupted, but that corruption IS the system.
And now, these douche-nozzles are talking about how we need to bring the population down to 600,000,000 worldwide….You don’t think that they are thinking of taking themselves out do you? No, this is down to self-defense.
It also exposes the need for the US Government to do a deep dive into the insurance industry to find out why so many people are being denied coverage. That is surely the priority now.
And whilst unacceptable mistakes and cover ups can occasionally happen in the NHS the funding model avoids the worry, stress, unfairness and downright anger the US insurance model generates. Plus of course the US system costs twice as much and yet read your small-print carefully.
Now what will the Donald do? Remove the Affordable Care Act which at least got more some cover and make it more expensive? That’ll work wonders won’t it.
How long is the NHS going to be able to continue in its present form though?
Depends what we mean by it’s ‘current form’. If the primary ‘form’ issue is ‘free at the point of care’ funded by general taxation I don’t see that changing anytime soon. Private providers already play a significant role in elective treatment and that’ll likely continue and may even expand. The big challenge is the balance between Primary and Acute care and how one rebalances this to the former, esp when Charities, Businesses (Drug companies etc) and Pressure Gps push so hard for the next state of art treatment or product. Probably though the biggest impact on NHS would be reform and better funding for Social care, crucial given an aging population.
As a resident of Australia, the NHS seems to hoover up lots of money, and produce substandard care. I much prefer the Australian system.
You’ve a younger population and you’ve more hospital beds and doctors per 1000 population. Makes a difference. But you do pay more per unit of population too, albeit your average income is higher.
The average Australian can go and see a doctor the same day. I understand the average Briton can’t (or so my friends who still live there tell me).
No you can, but you have to go to A&E to be certain of same day review. And therein lies a massive problem as secondary care struggling because of failure to invest and sustain the needed primary care workforce.
That said in Aus I would suspect the distance in some areas mean the contact on-line? More generally there are some lessons we can take from your system for sure.
Sorry – Obama had some good ideas but they were stripped out of the Act. The shell that remained was unsustainable and I don’t know any private doctors in my part of California who accepted an ACA plan. It was all bureaucracy and no reimbursement.
aaa
An erudite and perspicacious comment.
I offer no opinion on the ethics of Brian Thompson or United HC in general as I have little knowledge of this specific case. However, I have worked in the health insurance industry in Asia for over 15 years and I can confidently state the following:
– Customers expect scrupulous honesty from the insurer but do not hold themselves to the same standard. Non-disclosure is common, as is outright fraud.
– Everyone wants everything paid until they see the premium. The reaction is to then get angry and default to the standard leftist world view or oppressor vs oppressed.
– Health insurance is a low-margin business. The company I work for will see a profit of around 5% for this year; most of our competitors will see a loss.
– Inflation of healthcare costs vastly exceeds general inflation. Where I’m located, the average has been 8% a year, with 2025 projected at +14% by Willis Towers Watson.
– Private hospitals regularly defraud insurers by overcharging and overprescribing.
– All health insurance policies come with a benefit schedule, terms & conditions. Most, while not a scintillating read, are not especially difficult to understand. Most customers do not read them.
– Insurers must apply the T&C strictly to avoid losing money and having to hike premiums for the following year (or discontinue their health business). Claims assessment takes time, and costs which are not deemed necessary and reasonable will not be covered. Claims for standard policy exclusions will not be covered.
– Large insurers are like all large companies – dysfunctional and Kafkaesque by nature.
– The private health insurance model as it stands is not sustainable. Those who want private insurance, more claims paid and faster need to come up with a profitable model for doing so. They won’t.
A good counter argument that I can support through my experience as a private surgeon in California for the last 35 years (see a comment above, now mercifully retired!). Patients – intelligent, college educated, high achieving patients , NEVER looked at the conditions or the coverage limits, pre-existing condition clauses, etc. – they would skim down the list of health insurance companies until they found the lowest number of dollars per month premium and then pick that one. And be horrified when they found out their policy did not cover limousine service to a private clinic and general anesthesia for their hangnail removal. Well, more accurately, they would take the limousine to the private clinic, etc, and be horrified that their insurance policy didn’t cover it, insist that “nobody told them” and demand that the clinics and doctors “eat” the balance …..
The podcaster Tim Pool is not “right wing”.
Wikipedia describes him as “a right-wing political commentator and podcast host”.
Folks. If you don’t like Big Healthcare then you must start by dismantling big gubmint Obamacare and Medicare and Medicaid.
If you don’t like big bank bailouts then you must start by dismantling low-down mortgages for people with bad credit run through Fannie and Freddie.
This is not rocket science.