Insurance CEO’s murder reveals simmering anger at US health system

The “brutal and targeted” murder of a health insurance executive outside a New York hotel this week shocked America. The reaction to the crime also highlighted simmering anger against the trillion-dollar industry.

“Prior permission” doesn’t seem like a phrase that will generate much passion.

But on a hot day last July, more than 100 people gathered outside UnitedHealthcare’s Minnesota headquarters to protest the insurance company’s policies and denials of patients’ claims.

“Prior authorization” allows companies to review suggested treatments before agreeing to pay for them.

Eleven people were arrested for blocking roads during the protests.

Police records indicate they came from across the country, including Maine, New York, Texas and West Virginia, to the rally organized by the People’s Action Institute.

Eunai Montes-Irueste, media strategy director for the Chicago-based advocacy group, said the protesters had personal experience with denied claims and other problems with the health care system.

“They are denied care, then they have to go through an appeals process which is incredibly difficult to win,” he told the BBC.

The latent anger felt by many Americans at the health care system — a dizzying array of for-profit and nonprofit companies, insurance giants and providers for government programs — burst into the open after the apparently targeted assassination of health insurance executive Brian Thompson. Wednesday in New York City.

Thompson was the CEO of UnitedHealthcare, the insurance arm of healthcare provider UnitedHealth Group.

Police are still searching for the suspected killer, whose motivation is unknown, but authorities have revealed messages written on shell casings found at the scene.

The words “deny”, “defend” and “defend” were found on the casings, which investigators believe may refer to tactics used by insurance companies to deny coverage and increase profits .

Scrolling through Thompson’s LinkedIn history shows that many people were angry over the rejected claims.

One woman responded to a post in which the executive touted his company’s work on making drugs more affordable.

“I have Stage 4 Metastatic Lung Cancer,” he wrote. “We just left (UnitedHealthcare) because of all the rejections for my medications. Every month there is a different reason for rejection.”

Thompson’s wife told American broadcaster NBC that she had received threatening messages before.

“There were some threats,” said Paulette Thompson. “Basically, I don’t know, lack of (medical) coverage? I don’t know the details.”

“All I know is that he said there were some people who were threatening him.”

One security expert says frustration over high costs in various industries inevitably results in threats against corporate leaders.

Philip Klein, who runs Texas-based Klein Investigations, which protected Thompson when she gave speeches in the early 2000s, says he’s surprised the executive didn’t have security for his trip to New York City.

“There is a lot of anger in the United States right now,” Mr. Klein said.

“Companies need to wake up and realize that their executives can be victimized anywhere. I would not allow any of my clients to go to New York City right now.”

Mr Klein says he has been inundated with calls since Thompson’s murder. Top American companies typically spend millions of dollars on personal security for high-level executives.

In the wake of the firing, many politicians and industry executives expressed grief and sympathy.

Michael Tuffin, president of insurance industry organization AHP, said he was “shocked and horrified by the death of my friend Brian Thompson”.

“He was a devoted father, a good friend to many, and a refreshingly candid colleague and leader.”

In a statement, UnitedHealth Group said it had received numerous messages of support from “patients, consumers, health care professionals, unions, government officials and other caregivers.”

But many people online, including UnitedHealthcare customers and users of other insurance services, reacted differently.

Those reactions ranged from sharp jokes (a common quip is “consideration and prior authorization”, a play on the phrase “thoughts and prayers”) to commentary on the number of insurance claims rejected by UnitedHealthcare and other firms.

On the receiving end, industry critics clearly stated that they had no pity for Thompson. Some people even celebrated his death.

Online anger appeared to bridge the political divide.

Hostility was expressed from avowed socialists to right-wing activists skeptical of the so-called “deep state” and corporate power. It also came from ordinary people sharing stories about insurance companies denying their claims for medical treatment.

Mr. Montes-Irueste of People’s Action said he was shocked by news of the killing.

He said his group campaigned in a “non-violent, democratic” manner – but said he understood the bitterness online.

“We have a fragmented and broken healthcare system, which is why there are very strong feelings being expressed right now by people who are experiencing that broken system in different ways,” he said.

The post highlights the deep frustration felt by many Americans toward health insurers and the system in general.

“The system is incredibly complex,” said Sarah Collins, senior scholar at The Commonwealth Fund, a healthcare research foundation.

“Just navigating and understanding how you’re covered can be challenging for people,” he said. “And everything may seem fine until you get sick and you need your plan.”

Recent Commonwealth Fund research found that 45% of insured working-age adults were charged for something they thought should have been free or covered by insurance, and were more likely to report suspected billing errors. Less than half of them had challenged him. And 17% of respondents said their insurer denied coverage for care recommended by their doctor.

The American healthcare system is not only complex but also expensive, and enormous costs can often fall directly on individuals.

Ms. Collins says prices are negotiated between providers and insurers, meaning what patients or insurance companies are charged often bears little resemblance to the actual cost of providing medical services.

“Across all types of insurance, even (government-funded) Medicaid and Medicare, we find high rates of people saying their health care costs are unaffordable,” he said.

“People accumulate medical debt because they can’t pay their bills. This is unique to the United States. We truly have a medical debt crisis.”

A survey conducted by researchers at the health policy foundation KFF found that nearly two-thirds of Americans said insurance companies deserve “a lot” of the blame for high health care costs.

Christine Ebner, a senior economist at the nonprofit think tank RAND Corporation, said insurers in recent years have increasingly been issuing denials for treatment coverage and using prior authorizations to deny coverage.

He said the premium is about $25,000 (£19,600) per family.

“In addition, people face out-of-pocket expenses, which can easily run into the thousands of dollars,” he said.

UnitedHealthcare and other insurance providers have faced lawsuits, media scrutiny, and government investigations over their practices.

Last year, UnitedHealthcare settled a lawsuit brought by a chronically ill college student, whose story was covered by the news site ProPublica, who says she was abused when her doctor refused prescribed medications. He was burdened with medical bills of $800,000.

The company is currently fighting a class-action lawsuit The claim is that it uses artificial intelligence to finish the treatment quickly.

The BBC has contacted UnitedHealth Group for comment.

With reporting from Tom Bateman