'Boiling cauldron': Experts say CEO shooting exposes deep national rage over denied claims

11 December 2024

Americans' fury at the health insurance industry has continued to build in the wake of UnitedHealthcare CEO Brian Thompson's murder in New York City last week.

NBC News reported Wednesday that many Americans have become increasingly angry over health insurers' denials of claims for doctor-prescribed medication and healthcare procedures. The network cited a 2023 survey by the Kaiser Family Foundation (KFF) in which 60% of respondents said that they had "experience[d] problems" when trying to actually use the insurance they pay for, which includes insurance companies refusing to pay for their care.

UnitedHealth in particular is known for their high rate of denials, with LendingTree's ValuePenguin finding that their denial rate of 32% is double the average claim denial rate for the rest of the industry. The company was sued last year over its claim denials, with plaintiffs arguing that UnitedHealth used an artificial intelligence (AI) called "nH Predict" to automatically deny elderly patients claims, even though the AI had an error rate of 90%.

Andrew Witty, who is the CEO of UnitedHealth Group (UnitedHealthcare's parent company) was seen in a leaked internal video defending the company's claim denials, saying his company played an important role in "guard[ing] against... unnecessary care." And he praised Thompson by saying there were "very few people in the history of the U. S. healthcare industry who had a bigger positive effect on American healthcare than Brian."

Under Thompson's leadership, UnitedHealth was the most profitable health insurance company in the industry. In 2023 alone, the company posted gross revenue of $371.6 billion with an annual profit of $32.4 billion. Stat News estimated that Americans paid roughly $16 billion out of pocket for cancer care last year. This means that UnitedHealth could have single handedly paid for every American's cancer treatment while still pocketing more than $16 billion in profit.

According to Arthur Caplan, who is the head of the New York University Langone Medical Center's medical ethics division, these claim denials also routinely impact children. Caplan told NBC that costly pediatric treatments like gene therapy are "routinely" denied by their parents' insurance companies.

“Our health care is not seen as a right. It’s something you earn,” he said. “This is a boiling cauldron that the shooting exposed.”

Critical care physician Dr. Adam Gaffney told NBC that the insurance industry makes it difficult for both patients and healthcare providers to determine what procedures will be covered and which will be denied. He said the difficulty in navigating the bureaucracy of health insurance claims "creates a degree of anarchy."

“There’s a huge lack of clarity for patients and for doctors about what’s covered, what medicine can be started and what care will be approved and what will be blocked,” Gaffney said. “And there’s also a huge amount of administration burden that falls on medical practices to show that care is needed to get approved.”

Americans' rage at the health insurance industry is also being reflected in the stock prices of the nation's biggest health insurance companies. NBC reported that stock prices for UnitedHealth, Cigna, Centene, Humana and others were down by at least 6% as of Tuesday evening. UnitedHealth alone saw its total value decline by $30 billion since Thompson's shooting.

26 year-old Luigi Mangione was arrested Monday in connection with Thompson's murder. When he was apprehended at a McDonald's restaurant in Altoona, Pennsylvania, police found a 3D-printed "ghost gun" along with a 262-word manifesto, which calls insurance executives "parasites" who "had it coming." He has been charged with five different crimes, including second-degree murder. Shell casings found at the scene of the shooting bore the message "deny," "defend" and "depose," which is a reference to a 2010 book that likened the industry's business practices to "deny, delay and defend."

Click here to read NBC's report in its entirety.

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