Was This Personal or Professional: (UHC CEO murder)

[Private Citizen]

It's because we preach empathy for the downtrodden and otherwise oppressed.

And what about two children who will grow up without their father? I don't think a trust fund is going to make up for that loss or the trauma that comes with it.

At least with politicians (like Nancy Pelosi, Gabby Gifford, Ronald Reagan, etc), you can vote them out if you don't like the way they do their job. You can't do that with CEOs.

Yes, you can. You can not buy their products or services. With insurance, it's a bit harder, but there are options. Lobby your employer to switch providers. In a couple, choose the other's insurance. Or quit employer provided service entirely and buy it on the exchange. "Oh, but it's more expensive!" you'll say. Well, you get what you pay for. It's not United Healthcare's job to make it easy or cheap for you to switch from their plan to someone else's. Don't choose to do business with cut-rate shady companies whose reputations are well known and then act like it's your divine right to gun down the CEO.

I'd argue politicians are worse because there's no escaping the impact they have on your life (you can't switch products or services).

I'd further argue denial of claims has some social benefit. Americans are addicted to expensive and wasteful healthcare treatments that they don't need. Insurance companies are doing social good by denying these treatments and opening up more healthcare resources to those who need it. It helps with equality of healthcare outcomes and social justice and all of that .

 

[Rob]

“Oh, but it's more expensive!" you'll say. Well, you get what you pay for.

“You get why you pay for” is the central theme of so much disagreement. Many people believe that when it comes to buying cell phones and cars, but they do not when it comes to health care. Many people think they should have a right to healthcare without great expense, but that just isn’t the system we have in the US. Others think they shouldn’t be forced into paying monthly premiums at all if they can’t afford them. And still others generally believe that you get what you pay for until they get a really huge medical bill. Health care is a profit center in this country.

As an ERISA lawyer, I have seen a number of insurers deny claims without detailing the specific reasons (especially disability insurers). Many insurers like to send an initial form letter saying your policy does not cover this claim, but that is not sufficient. They are supposed to cite plan/policy provisions. I know how to write an appeal so I know how to deal with these things, but I find it sad that the general public needs to get a lawyer in order to get the attention of the insurer. There are pro bono resources in most states, but it becomes pay the doctor or pay the lawyer. That said, most insurers do have a reason behind the failure to pay- either there is a deductible, or there is an exclusion, or you went out of network, or you chose a provider that charges more than UCR, or you didn’t get pre authorization or your pre authorization did not cover the whole procedure. Few people have a degree in this stuff, but if you choose a lower monthly premium, and something happens, you will pay more out of pocket. It’s insurance, it’s a gamble. I budget more for health care a year than I do for housing, vacations, etc.

Back to the murder, the timeline now shows the killer was walking up and down 54th street for at least an hour before the killing. Now that they have the backpack, there should be some DNA, but is he in any database?

 

[rfisher]

Insurance, like Medicaid, operates on the principle that you deny automatically and a sufficient percentage of people will leave it there because they don't know what to do next. This saves a lot of money. Also, there is an unwritten rule, that if the person/patient is really sick and you wait long enough, they may die before you have to pay (or enroll in the case of Medicaid) saving even more money. @Rob is so correct that most people have no idea how to navigate the labirinth of insurance, be it private or public. Plus, a lot of insurance denials are now being done by AI. NPR did a program on this yesterday and AI will deny up to 90% of claims. Then you have to work through the system to get to actual people. The bottom line is insurance is practicing medicine without a medical degree. This has been the situation for many years, but AI has made it much more efficient for the industry.

 

[Rob]

Insurance, like Medicaid, operates on the principle that you deny automatically and a sufficient percentage of people will leave it there because they don't know what to do next. This saves a lot of money. Also, there is an unwritten rule, that if the person/patient is really sick and you wait long enough, they may die before you have to pay (or enroll in the case of Medicaid) saving even more money. @Rob is so correct that most people have no idea how to navigate the labirinth of insurance, be it private or public. Plus, a lot of insurance denials are now being done by AI. NPR did a program on this yesterday and AI will deny up to 90% of claims. Then you have to work through the system to get to actual people. The bottom line is insurance is practicing medicine without a medical degree. This has been the situation for many years, but AI has made it much more efficient for the industry.

And disability insurers - LTD is the worst for automatic denials.

 

[Jenny]

Back to the murder, the timeline now shows the killer was walking up and down 54th street for at least an hour before the killing. Now that they have the backpack, there should be some DNA, but is he in any database?

Doesn't make much sense to me that he'd ditch the backpack there. Having spent 10 days in the city, he'd know what we can see on lots of the footage - it was garbage day in Midtown and the UWS, so all he had to do was shove it into a plastic bag and put it among one of the many mounds on the sidewalk, and by the time they found any footage it would be on a truck or in a landfill.

So, either it's a decoy - apparently it was sent straight to a lab without anyone touching it so no word yet on what was in it - or the shooter is very confident that even if they can lift DNA or fingerprints, they still won't find him because he's not in any of the usual databases. He might not even be American.

Another thing I'm wondering about, might be nothing, but the words on the bullets were deny and depose, and in some reports, a third bullet had defend on it. But the actual phrase is delay, deny, defend. Not depose. Which means "remove from office suddenly and forcefully," as well to testify in a legal sense. Interesting choice.

And yes, a CEO can be voted out, so to speak. CEOs are hired by and report to boards, who can be pressured by shareholders and investors either through their votes or their dollars, and others, to replace the CEO.

 

[BittyBug]

The bottom line is insurance is practicing medicine without a medical degree.

Exactly this.

 

[sk9tingfan]

And disability insurers - LTD is the worst for automatic denials.

i nearly worked for UNUM. The vibes I got from them in the mid-nineties was totally creepy and I pulled out of the interview process. You can tell a lot about the various health insurers and health care companies when you interview with them.

 

[taf2002]

Health insurers remove executive bios, images from websites

Gee why would they do that? Aren't they proud of all they've accomplished and done for the healthcare of their subscribers?

I'm not sure if this is sarcastic but I read today that CEOs in general have a large expense fund in order to protect them. There's a lot of crazies out there & some people blame the wrong people for their lot in life.

 

[sk9tingfan]

Interesting article about the internet sleuths who generally help law enforcement with internet expertise are refusing to get involved because of the rapacious tendencies of health care insurers.

Why top internet sleuths say they won't help find the UnitedHealthcare CEO killer

TikTok users who would normally leap at the chance to identify an alleged criminal are standing down during the manhunt for the killer of UnitedHealthcare CEO Brian Thompson.

www.nbcnews.com

 

[Barbara Manatee]

Yes, you can. You can not buy their products or services. With insurance, it's a bit harder, but there are options. Lobby your employer to switch providers. In a couple, choose the other's insurance. Or quit employer provided service entirely and buy it on the exchange. "Oh, but it's more expensive!" you'll say. Well, you get what you pay for.

Sure, everyone has the money or influence or knowledge to do that. Just like women living in states with abortion bans can all just travel one or two states away if they should need healthcare, nothing but a minor inconvenience, right?

I'd further argue denial of claims has some social benefit. Americans are addicted to expensive and wasteful healthcare treatments that they don't need. Insurance companies are doing social good by denying these treatments and opening up more healthcare resources to those who need it.

You said no one should be assassinated on the street because of business decisions (I agree!). But it's okay, even good, if people suffer and die at home because of them?

 

[Private Citizen]

Interesting article about the internet sleuths who generally help law enforcement with internet expertise are refusing to get involved because of the rapacious tendencies of health care insurers.

What a sad descent into tribalism. Things like this make me wonder if the US is already in a civil war.

 

[barbk]

Yes, you can. You can not buy their products or services. With insurance, it's a bit harder, but there are options. Lobby your employer to switch providers. In a couple, choose the other's insurance. Or quit employer provided service entirely and buy it on the exchange. "Oh, but it's more expensive!" you'll say. Well, you get what you pay for. It's not United Healthcare's job to make it easy or cheap for you to switch from their plan to someone else's. Don't choose to do business with cut-rate shady companies whose reputations are well known and then act like it's your divine right to gun down the CEO.

There is a chasm between understanding (and experiencing) the frustrations of the millions of folks who've been bad done by insurers and believing in a "divine right to gun down the CEO." I don't see anyone here advocating that.

So, let's talk about lobbying employers. Are you shocked to learn that C-Suite folks often get certain personal benefits from choosing one company over another? Look at all the companies with truly crappy 401K investment choices with high fees. That's changing, because the law changed, but it was (and likely still is) a reality. Magically, the C-Suite folks often got benefits, and the brokers who sell the company the plan make bank.

I had the miserable experience of serving on a company's team for determining our 3-year health insurance buy. This was before Obamacare, FWIW. The company had about 1000 employees, with about 700 in one state and the rest spread around 8 different states and the DC/Maryland/Virginia area, considered partially experience rated. We used a broker to identify options. I'm pretty competent at analysis, but it was like comparing apples to tea kettles to lawnmowers. Basically, other than premium costs and deductibles for in vs out-of-network costs, the rest was like trying to grab handfuls of grape jelly, since the insurers are free to change participating providers, formularies, pre-authorization requirements, and virtually every other aspect. Meanwhile, the CEO and Sr. VPs had a special healthcare benefit that provided for coverage of many items not covered by anyone else's regular plan.

And then--bonus!--the Blue Cross (Anthem) plan we chose turned out to have secret deals that meant that a pregnancy/childbirth experience where they were supposed to cover 90% of the costs (all in-network) actually had them covering substantially less than that because the charges/coverage printed on the EOB didn't match what they paid the providers. I learned about that when I had trouble reconciling a bill and got a printout from the OBG's business manager showing the truthful transactions.

In the end, they paid. Bigly. Because I was one of the lead plaintiffs in a class action lawsuit that cost them millions. I didn't get millions, FWIW...the lawyers were the ones who made bank. But this is the kind of crap insurers pull day in and day out. The rage against insurers is real, and justified, though murder is not. Jail time, on the other hand....

 

[rfisher]

It would be nice if denial of "unneeded expensive and wasteful treatments" (no idea what those might be) meant resources went to those people who really needed care. Having worked in healthcare for many years I can catagorically say it flat out doesn't work that way. Denial means one thing: increased profits for the insurance executives and stockholders.

 

[sk9tingfan]

Thank G-d I got out of the care management/insurance business in the early 2000's just before Insurance companies were going for profit. I ran two National care management units where denials happened, but they were generally on the inpatient side(length of stay)and more rarely for outpatient institutional services. Fortunately we did not have to deny specific procedures or drugs at that point in time, but there was the emergence of companies that specialized in procedural and other types of review. Some were snapped up by larger health care companies such as Centene or Optum or insurers like UHC or capabilities developed inhouse.

We were never that aggressive.

 

[Rob]

Doesn't make much sense to me that he'd ditch the backpack there. Having spent 10 days in the city, he'd know what we can see on lots of the footage - it was garbage day in Midtown and the UWS, so all he had to do was shove it into a plastic bag and put it among one of the many mounds on the sidewalk, and by the time they found any footage it would be on a truck or in a landfill.

So, either it's a decoy - apparently it was sent straight to a lab without anyone touching it so no word yet on what was in it - or the shooter is very confident that even if they can lift DNA or fingerprints, they still won't find him because he's not in any of the usual databases. He might not even be American.

I read that there are far fewer cameras in the park than there are on the streets. Lots of conflicting reports on what they have, but there was a report that NYPD managed to get his coffee cup from a trash can. There is all kinds of dumping surveillance, logging, sifting, transfers before incineration in the city too so they might still have found it.

 

[Cachoo]

What a sad descent into tribalism. Things like this make me wonder if the US is already in a civil war.

I don’t see it that way. I do wonder how close we are to another “Gilded Age.” There was a lot of political violence that had underlying economic motives at that time. The old haves vs. the have nots. I think we are in a better place now but there do seem to be similarities. The one thing I noticed about this murder is how the reaction seems to cut across political lines. There are plenty of MAGA who have their own insurance horror stories.

 

[sk9tingfan]

It would be nice if denial of "unneeded expensive and wasteful treatments" (no idea what those might be) meant resources went to those people who really needed care. Having worked in healthcare for many years I can catagorically say it flat out doesn't work that way. Denial means one thing: increased profits for the insurance executives and stockholders.

I can comment on a specific set of diagnostic procedures that applied personally to me as an example of a wasteful/potential dangerous care. My medical condition required that I undergo full chest and trunk CAT scans with contrast media every six months(the radiological services staff all knew me). At about the two year mark, I rebeled and started to refuse them and had one of my other physicians have a discussion with my oncologist(that was about 2009). That subjected me to excessive radiation. I know that this is anecdotal, but I'm sure that the standard of care no longer involves the use of this prior practice as an sppropriate standard of care.

My oncologist did not request another one until last Spring and we saw some relatively minor pulmonary issues, so I was glad of that.

I have checked out of PT services in advance of the full set of services after proactively discussing it with my therapist because I felt that I was no longer deriving a benefit. I've also proactively discharged my home care nurse proactively, again after which I could ot discern a value add.

 

[Cachoo]

That is a conundrum: When does care become wasteful? Fifteen years ago there was an excellent article in “The New Yorker” that is still relevant now called “The Cost Conundrum.” The author wanted to know why care was costlier in McAllen, Texas than at the Mayo Clinic. In McAllen if you were on Medicare and had a problem you would receive a whole battery of tests, many unnecessary. Those docs weren’t streamlining anything. A group of local doctors owned testing equipment and made sure the equipment was always in use. Do we think that has stopped?

 

[rfisher]

That is a conundrum: When does care become wasteful? Fifteen years ago there was an excellent article in “The New Yorker” that is still relevant now called “The Cost Conundrum.” The author wanted to know why care was costlier in McAllen, Texas than at the Mayo Clinic. In McAllen if you were on Medicare and had a problem you would receive a whole battery of tests, many unnecessary. Those docs weren’t streamlining anything. A group of local doctors owned testing equipment and made sure the equipment was always in use. Do we think that has stopped?

Medicare fraud by clinicians is an entirely different matter. DRGs have made a huge difference in orders for Medicare. Any procedure has to be justified.

 

[MacMadame]

And what about two children who will grow up without their father? I don't think a trust fund is going to make up for that loss or the trauma that comes with it.

I expressed empathy for the people mourning this dude. (I may have deleted that during editing though.)

Yes, you can. You can not buy their products or services. With insurance, it's a bit harder, but there are options.

The best I can say about this is that it's hopelessly naive. With all the consolidation of corporations, there are very few choices. Plus, tey pretty much all operate like this in healthcare (and a few other industries at all).

I'd further argue denial of claims has some social benefit.

Of course, you would. Bottom line: insurance companies are not doctors and shouldn't be deciding on the standard of care. If you think we get too many tests, the people to change that are the organizations that make treatment recommendations.

Americans are addicted to expensive and wasteful healthcare treatments that they don't need. Insurance companies are doing social good by denying these treatments and opening up more healthcare resources to those who need it. It helps with equality of healthcare outcomes and social justice and all of that .

That only works if they deny in a responsible and reasonable manner. They do not.

Step therapy, in particular, is immoral IMO. I know people who were denied a certain therapy until they tried other less effective ones and by the time they had proven to the insurance company that those other ones were inappropriate, their disease had progressed to the point that the effective therapy was no longer an option.

And yes, a CEO can be voted out, so to speak. CEOs are hired by and report to boards, who can be pressured by shareholders and investors either through their votes or their dollars, and others, to replace the CEO.

That's fine if you are a shareholder or investor, but what about the rest of us?

In the end, they paid. Bigly. Because I was one of the lead plaintiffs in a class action lawsuit that cost them millions. I didn't get millions, FWIW...the lawyers were the ones who made bank. But this is the kind of crap insurers pull day in and day out. The rage against insurers is real, and justified, though murder is not. Jail time, on the other hand....

Good for you! And thank you!

I don’t see it that way. I do wonder how close we are to another “Gilded Age.” There was a lot of political violence that had underlying economic motives at that time. The old haves vs. the have nots. I think we are in a better place now but there do seem to be similarities.

This is something. Heather Cox Richardson brought up in a recent essay. She agrees with you, FWIW.

 

[Rob]

Reuters is reporting NYPD has identified the killer, but that isn’t exactly what Eric Adams’ quote says. nY Post is reporting that the jacket he wore was in the backpack.

 

[CantALoop]

I'd further argue denial of claims has some social benefit. Americans are addicted to expensive and wasteful healthcare treatments that they don't need. Insurance companies are doing social good by denying these treatments and opening up more healthcare resources to those who need it. It helps with equality of healthcare outcomes and social justice and all of that .

Do you think the money from denied claims is going to those who actually need it? Where are your statistics to back that up?

 

[Rob]

There is also waste in the policies of the insurance companies. When I hurt my knee, I had an X-ray that didn’t reveal much more than bone edema (from 3 weeks of swelling). The ortho drained the fluid and gave me a cortisone shot with a referral to PT and a referral to an MRI to keep in my back pocket. He said not to bother getting the MRI until after I’d tried 3 of weeks of PT with time for the shot to work because even though he was pretty sure it was a torn meniscus, insurance won’t pay for the MRI until you’ve tried to let it settle down on its own (which I had already done for 3 weeks before even consulting the ortho). No relief and I couldn’t even do a lot of the PT exercises. So I got the MRI, which revealed the torn meniscus, back to the ortho. Then scheduled surgery, weeks more PT, etc. So insurance paid for a shot I didn’t need, a second visit I didn’t need, 3 weeks original PT I didn’t need, and then paid for things I did need in the first place. Never mind several weeks waste of my time. It’s a broken system.

 

[sk9tingfan]

That is a conundrum: When does care become wasteful? Fifteen years ago there was an excellent article in “The New Yorker” that is still relevant now called “The Cost Conundrum.” The author wanted to know why care was costlier in McAllen, Texas than at the Mayo Clinic. In McAllen if you were on Medicare and had a problem you would receive a whole battery of tests, many unnecessary. Those docs weren’t streamlining anything. A group of local doctors owned testing equipment and made sure the equipment was always in use. Do we think that has stopped?

Circa 1978, my Operations Management professor gave us a case study in which a group of doctors were assessing an investment in what was termed "a multi-phasic" screening service center. Services included lab and radiology and had a 15% rate of return. I shocked my classmates by saying that they would be delighted who protested that their doctors would want to do their own tests. I replied that if doctors had someone else to do their "scut work" and that by doing so, they could run several more patients through their practices a day, they would love it. When my professor asked why? I replied, "Doctors are like taxi cab drivers; they rely on turnover". Remember that this is more than 45 years ago, but was a hint of what was to come regarding the whole underlying approach to medical and investment strategies.

At the time, few companies on either the payer nor provider side were for profit. No HMO's existed apart from HIP and Kaiser Permanente. Few companies owned multiple doctors' practices nor large physician groups existed. Multiple hospial systems did not generally exist other than NYC's Health and Hospital Corporation. When rationing of services were mentioned, everyone was shocked. When cost controls were imposed during the early 1970's on the health care industry, the results were varied.

It was during the late 1970's when development of average cost pricing reimbursement algorithms were being developed(as previosly mentioned) and included DRG's and per diems. These then went onto development of per member per month amounts and case rates as a means of controlling costs, followed by episode development. The more draconian measures of care denial started later as a way of getting at the components of care as cost drivers.

I would recomend the book, "Who Shall Live" by the Nobel prize winning economist, Kenneth Arrow which was amended several times(I should re-read it), which discusses the evolution of the health care industry in the US. Another source is David Mechanic who as early as 2006 wrote about why Health Care Reform was not working. Again, I should read some of his additional books because since my retirement, I was so burned out, I could not fathom following up with developments.

 

[Prancer]

And what about two children who will grow up without their father?

It is very sad for them.

As it is for all the children who are growing up without parents who were denied medical treatment that could have made a difference or with parents who had to declare bankruptcy because of medical bills.

Empathy, like preaching, is selective.

Yes, you can. You can not buy their products or services. With insurance, it's a bit harder,

A bit. Or should I say, a bit?

Lobby your employer to switch providers.

And suck it up until they do. If they do.

In a couple, choose the other's insurance.

Um, don't know about all insurance, but insurance plans I am familiar with want your SO to use their own medical insurance if such is available.

I'd further argue denial of claims has some social benefit. Americans are addicted to expensive and wasteful healthcare treatments that they don't need. Insurance companies are doing social good by denying these treatments and opening up more healthcare resources to those who need it. It helps with equality of healthcare outcomes and social justice and all of that .

How do you arrive at that conclusion? I haven't had a denial of claim of any kind in years. Why? Because I have good insurance. Why do I have good insurance? Because I can afford good insurance. How does my good insurance help anyone else get better treatment? It's the people who have poor insurance--who are usually poor already, at least relatively speaking--who get denials of claims. How does this balance out socially?

We had insurance once that denied all claims as a matter of routine. I made them pay every single claim, but it took a whole lot of time and effort on my part and it was exhausting as hell. What kind of social justice was achieved there?

 

[once_upon]

Insurance, like Medicaid, operates on the principle that you deny automatically and a sufficient percentage of people will leave it there because they don't know what to do next. This saves a lot of money. Also, there is an unwritten rule, that if the person/patient is really sick and you wait long enough, they may die before you have to pay (or enroll in the case of Medicaid) saving even more money. @Rob is so correct that most people have no idea how to navigate the labirinth of insurance, be it private or public. Plus, a lot of insurance denials are now being done by AI. NPR did a program on this yesterday and AI will deny up to 90% of claims. Then you have to work through the system to get to actual people. The bottom line is insurance is practicing medicine without a medical degree. This has been the situation for many years, but AI has made it much more efficient for the industry.

And the pre auth nurses or billing department are not notified of denials until someone who gets a denial and fights it.

I would get immediate denial of care and file maybe 5 or 6 times before I could get it approved. But you had to know the word of the quarter. And PT/OT needed the therapist's progress records.

AI or adult doctors had no idea what speech therapy does, especially in children. Swallowing and feeding issues to them doesn't mean speech. PT and OT had to be certified providers - not just the therapy provider

Same with anesthesiologist. The practice might be a preferred provider, but not individual physicians or CRNA.

Or your doctor might refer you to a specialist during a hospitalization. Even though the hospital might be approved provider, the consulting Dr is not.


Same holds true for radiologist. The hospital radiology department may be a preferred provider, but the radiologist isn't.

Insurers make the rules so complicated and easier to deny

 

[Private Citizen]

People on this thread seem to have unrealistic expectations about insurance companies. They're for-profit businesses, not charities. I'm also not sure it's fair to blame companies for not regulating themselves. This isn't PI, but both parties have controlled three branches of government in the recent past, so shouldn't they have done something about this? Improper denial of claims seems like great bipartisan legislation.

As it is for all the children who are growing up without parents who were denied medical treatment that could have made a difference or with parents who had to declare bankruptcy because of medical bills.

It's not the insurance company's job nor their responsibility to provide treatment that isn't covered. I don't equate the deaths that resulted from denied coverage* to cold-blooded murder.

*Exception: if an insurance company knowingly denied treatment covered under a plan. In which case they should be sued, and the penalty should be such that it far exceeds the cost of the denied treatment to produce a deterrent effect.

How do you arrive at that conclusion? I haven't had a denial of claim of any kind in years. Why? Because I have good insurance.

Maybe also because you read your policy and understand what you're buying and not buying?

I have no disagreement that the system is overly complex, piecemeal, poorly regulated, and hard to understand.... to which I say, blame Washington. Don't shoot CEOs (or anyone else).

I'm still disappointed that people who have the skills and abilities to help identify a murderer are choosing not to do so. Maybe I'm more idealistic than I gave myself credit for, but I think I'd help track down any murderer if I had the skills to do so.

 

[rfisher]

Speaking of anesthesiology, apparently that's the denial du jour from the insurance use of AIs. I really don't want an AI to say whether or not I can have anesthesiology for a procedure or what kind.

 

[once_upon]

Sorry - up thread PC said to lobby your employer to change healthcare insurers shows a lot of ignorance on how selection of plans happen. Plans, providers (hospitals, clinics, pharmacies, physicians and so much more) takes months sometimes a year or more to write.

Look at the Medicare coverage of certain drugs. The law might have been passed in 2023. But those prices don't go into effect until 2025 or 2026.

My experience from a far, your company offers their new plan starting Jan but the negotiations likely started in Feb 1. Doctors sign their payment agreements in October, so the insurance company can develop the preferred providers list

All the other BS on denials doing a public service shows someone who doesn't need care. Or someone who gets basic healthcare in another country. Also "from the market" was not an option just a few years ago. If you have insurance no matter how crappy through other means (ie employer) you may be required to use that option

There is a sh!load more I could say. But it's wasting ergs.

 

[Prancer]

People on this thread seem to have unrealistic expectations about insurance companies. They're for-profit businesses, not charities. I'm also not sure it's fair to blame companies for not regulating themselves.

Why not? One can earn a profit and be a decent human being. It does, however, usually mean not making as much profit.

This isn't PI, but both parties have controlled three branches of government in the recent past, so shouldn't they have done something about this? Improper denial of claims seems like great bipartisan legislation.

It is! Which is why you are seeing this seething reaction to the murder of this CEO. Neither party is interested in pursuing this, however. Hmm, why could that be? A cynic would say that it's because a lot of those profits that insurance companies rake in go to lobbying.

It's not the insurance company's job nor their responsibility to provide treatment that isn't covered. I don't equate the deaths that resulted from denied coverage* to cold-blooded murder.

*Exception: if an insurance company knowingly denied treatment covered under a plan. In which case they should be sued, and the penalty should be such that it far exceeds the cost of the denied treatment to produce a deterrent effect.

They HAVE been sued by the people who can afford the time, effort and expense of suing. Has it had a deterrent effect? I would say no. It's part of the cost of doing business.

Maybe also because you read your policy and understand what you're buying and not buying?

Good lord, no. I'd rather stick needles in my eye than read an insurance policy. Insurance comes through the job; like most people, I take what I get. The only time I have ever really looked into coverage has been when I've been denied a claim. And if I am denied a claim, I WILL look into it and argue it.

But a) I can, if I have to, wade through an insurance policy and make sense of it; b) I have the flexibility in my schedule that allows me to be on the phone for hours disputing the denials; c) I know how to make an argument; d) I am willing to go at it hammer and tongs for a lot longer than most people (as everyone here knows).

I have no disagreement that the system is overly complex, piecemeal, poorly regulated, and hard to understand.... to which I say, blame Washington. Don't shoot CEOs (or anyone else).

I agree that no one should be shot. But I don't agree that CEOs should not be blamed. Like the rest of us, they have made choices. Why are we responsible for choices (such as they are) but somehow they aren't?

I'm still disappointed that people who have the skills and abilities to help identify a murderer are choosing not to do so.

I don't know that it's fair to blame people for not regulating themselves and ignoring their own sense of what justice means for them personally. They're human beings, not AI.