Was This Personal or Professional: (UHC CEO murder)

Wow! There is really a lot of gallows humor on social media right now.
It's like Facebook ,Youtube, and Reddit are having a National day of Schadenfreude.
 
Folks, this was a Law & Order episode at least a decade ago (minus the message on the bullet casings).

I'm not excusing this assassination, but a point made on SM is that through denial of claims, health insurers regularly kill people. Meanwhile, this guy was raking in tens of millions of dollars at the expense of people's wellbeing. It's easy to understand the motive and in some ways it's almost the perfect crime because the pool of suspects - disgruntled insureds - is so vast.
 
My guess is as bad as this company was, the murder had nothing to do with that.

The killer wants everyone to think it’s because of the company’s business decisions as that would be a huge needle and haystack investigation.

My money is on this guy being involved with the shadiest of shady including organized crime.

Those are the types of people that usually make it to the CEO seat of large corporations unfortunately.
 
skategal said:
My money is on this guy being involved with the shadiest of shady including organized crime.

Those are the types of people that usually make it to the CEO seat of large corporations unfortunately.
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This is the main thing I have thought as well. Is organized crime making a comeback in the NYC area?
 
My money is on an ex-employee. The shooter had to have known that even though the meeting was at the Hilton, he wasn’t staying there.
 
Private Citizen said:
What a shocking and sick defense of presumed vigilante justice.
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I did not and do not defend the murder. I do want the CEOs of companies that literally have the power of life and death over their customers to think long and hard about what happens when they put profits over people. No one should live in fear - that includes their customers.

Private Citizen said:
I don’t care what the guy did; there is no “defense” for what happened to him.
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The killer has the right to a defense at trial.
 
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I have had UHC for many years both before & after retirement. My company was self-insured & UHC managed the claims. Companies who are self-insured dictate approvals of claims. I have never been denied coverage although one hospital stay a rep from the company came to my room to see why I had been there so long which was offensive. I have never had any medical debt even though I'm coming up on at least 20 surgeries in my life, most of them major. My co-pays have ranged from $20.00 to $250.00 & that's for hospital stays. I've always been afraid they will eventually say "we've spent to much on you" but they never do. The recent denial of coverage for proton therapy was the result of the way the doctor worded the request. Once that was cleared up they immediately approved it. My 33 treatment will cost them over $1,000,000. My co-pay: $.00 So I think I have really good coverage.

eta: I realize that I have no knowledge of how other UHC patients have coverage when they aren't getting it from a self-insured company. So others may have an entirely different experience than I have had. But there's no excuse for murder because you don't like the way they run their company. There's no "he got what he had coming".
 
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skategal said:
My guess is as bad as this company was, the murder had nothing to do with that.

The killer wants everyone to think it’s because of the company’s business decisions as that would be a huge needle and haystack investigation.

My money is on this guy being involved with the shadiest of shady including organized crime.

Those are the types of people that usually make it to the CEO seat of large corporations unfortunately.
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I always say/think to wait until they complete their investigation and go from there but that’s just me of course.
 
taf2002 said:
I have had UHC for many years both before & after retirement. My company was self-insured & UHC managed the claims. Companies who are self-insured dictate approvals of claims. I have never been denied coverage although one hospital stay a rep from the company came to my room to see why I had been there so long which was offensive. I have never had any medical debt even though I'm coming up on at least 20 surgeries in my life, most of them major. My co-pays have ranged from $20.00 to $250.00 & that's for hospital stays. I've always been afraid they will eventually say "we've spent to much on you" but they never do. The recent denial of coverage for proton therapy was the result of the way the doctor worded the request. Once that was cleared up they immediately approved it. My 33 treatment will cost them over $1,000,000. My co-pay: $.00 So I think I have really good coverage.

eta: I realize that I have no knowledge of how other UHC patients have coverage when they aren't getting it from a self-insured company. So others may have an entirely different experience than I have had. But there's no excuse for murder because you don't like the way they run their company. There's no "he got what he had coming".
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When you are in a self-insured plan, you're not really being insured by UHC, so...that has nothing to do with how UHC handles claims for policies where they are actually the insurer. I'm glad your company has such great coverage. Not many do.

There ought to be prison consequences for executives of insurance companies mishandling claims at a tremendous rate. Lives depend on fair and honest claims administration. In the current situation, the execs get away with murder, and if there is a penalty, the shareholders, not the execs, pay the price. I'd rather have seen Brian Thompson jailed than killed, but I do get the social media anger against an insurance company that fails to live up to its promises.

I'm sorry that his kids are being exposed to the vitriol on social media. They probably thought their dad was a good guy rather than the guy who made bank while allowing hundreds of thousands of folks to be hurt by unfair claim denials.
 
Private Citizen said:
What a shocking and sick defense of presumed vigilante justice.

Replace healthcare exec with abortion doctor and see how it sounds. By all means let’s change business models of things we don’t like by making their CEOs fear for their lives :rolleyes:
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SCOTUS has indeed changed the business model and made hundreds of healthcare providers - hospitals, clinics, physicians fear for their safety and experience loss of their lives. For providing care, not restricting care. That's the business model the legislators and courts have adopted.
 
barbk said:
When you are in a self-insured plan, you're not really being insured by UHC, so...that has nothing to do with how UHC handles claims for policies where they are actually the insurer. I'm glad your company has such great coverage. Not many do.

There ought to be prison consequences for executives of insurance companies mishandling claims at a tremendous rate. Lives depend on fair and honest claims administration. In the current situation, the execs get away with murder, and if there is a penalty, the shareholders, not the execs, pay the price. I'd rather have seen Brian Thompson jailed than killed, but I do get the social media anger against an insurance company that fails to live up to its promises.

I'm sorry that his kids are being exposed to the vitriol on social media. They probably thought their dad was a good guy rather than the guy who made bank while allowing hundreds of thousands of folks to be hurt by unfair claim denials.
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Employer self insured plans are administrated by a company like UHC or BCBS or Atena or....whomever. the self insured plans are only as good as the pool of money available to disburse.

One of my employers was self insured - the selling point was it was cheaper. Until one employee required a bone marrow transplant to treat leukemia. The self insured plans went poof! And the employer transfered to another healthcare plan. Long before any ACA protections - he was unable to get any healthcare insurance coverage.

Whoever is insuring is banking on taking in more than paying out. That's the business model. Period more in than out. How to best manage that? Deny, deny, deny, deny. And reward, reward, reward those who can deny.

I don't understand the execs should be rewards and shareholders be penalized. The executives should be held responsible, the Board of directors should be held responsible, the shareholders should know the number of lives impacted by denial process.

He didn't deserve death or murder. He should have absolutely served consequences for his lack of compassion.

His kids should not be held accountable - unless they were participating in the actions of their father's vision
 
once_upon said:
Employer self insured plans are administrated by a company like UHC or BCBS or Atena or....whomever. the self insured plans are only as good as the pool of money available to disburse.

One of my employers was self insured - the selling point was it was cheaper. Until one employee required a bone marrow transplant to treat leukemia. The self insured plans went poof! And the employer transfered to another healthcare plan. Long before any ACA protections - he was unable to get any healthcare insurance coverage.

Whoever is insuring is banking on taking in more than paying out. That's the business model. Period more in than out. How to best manage that? Deny, deny, deny, deny. And reward, reward, reward those who can deny.

I don't understand the execs should be rewards and shareholders be penalized. The executives should be held responsible, the Board of directors should be held responsible, the shareholders should know the number of lives impacted by denial process.

He didn't deserve death or murder. He should have absolutely served consequences for his lack of compassion.

His kids should not be held accountable - unless they were participating in the actions of their father's vision
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Being self-insured does not mean the insurance company who is administering the account has the leeway to write a blank check on the behalf of the client. There is always medical necessity/policy that governs claim assessments/payment and that is based on that of the insurance company. There are mitigating circumstances for which specific procedures may come up for review by the two parties and may be paid on an extracontractual basis.
 
Actually, the motive for the crime may be very important, depending upon state law. For example, in California, certain motives for murder, such as financial gain, are special circumstances that may result in death penalty eligibility.
 
sk9tingfan said:
Being self-insured does not mean the insurance company who is administering the account has the leeway to write a blank check on the behalf of the client. There is always medical necessity/policy that governs claim assessments/payment and that is based on that of the insurance company. There are mitigating circumstances for which specific procedures may come up for review by the two parties and may be paid on an extracontractual basis.
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I don't think I said it was. I just said the money pool is more limited.
 
sk9tingfan said:
Not sure what you mean by "the money pool is more limited". Maybe I'm being obtuse.
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I read it to mean that in a self-insured environment, the premium and risk pool is more limited, but in any event, most self-insured plans have stop loss coverage to avoid being bankrupted by large claims. It's the small self-insured risk groups that you typically see among religious groups that have limited means to pay.
 
Most insurers have monies in a fund based upon the amount paid in. The use those monies to grow in amount. The plans bank on receiving more dollars in premiums and their investments vs pay out to you.

Let's look at life insurance - you pay a premium of maybe $200.00.

The insurer is banking on you not dying for 50 or 60 years. They are taking the money you put into the fund and investing it to grow their profits. In general, it works out well for the insurance company. But if many more people die than reasonably expected - the investment can not/does not grow enough to cover the expenses/payout.

The same is true for healthcare insurers. They are banking on the ability to grow the pot of money through investments. When the number of claims exceed what they can payout, the insurer denies coverage

ETA - yes @BittyBug explained, but it is applicable to both small and large pools. If not managed by what is covered or payouts, the company goes under
 
BittyBug said:
I read it to mean that in a self-insured environment, the premium and risk pool is more limited, but in any event, most self-insured plans have stop loss coverage to avoid being bankrupted by large claims. It's the small self-insured risk groups that you typically see among religious groups that have limited means to pay.
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Here's some of the difference between self vs. fully insured accounts:

Insurers make money on self insured accounts based on per member per month(pmpm's) fees that may or may not based on:

  • Membership management
  • Claims processing
  • Network rental and discounts tied to specific networks
  • Care and case management
  • Specialty networks including but not limited to organ transplants, ESRD, vision, etc.
  • Drug coverage including PBM fees
  • Other services/other lines of business including life insurance, disability insurance, subrogation, etc.

Net of the administrative expense tied to the above, the remainder for the insurance company(TPA) is pure profit.

Also, in some cases, self-insured accounts may not be subject to state-mandated benefits.

The problem is how well the TPA controls claims and care management still is an incentive for the TPA, because there's an incentive for the client to jump ship to another TPA.

Both individual and overall account level (aggregate)reinsurance (stoploss)coverage for self-insured accounts are very expensive, although usually necessary.

For fully insured accounts, the insurer must construct prospective premium that not only covers all costs but earns a profit. And that includes state-mandated benefits and reinsurance. Hence the need to deny claims/benefits.
 
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CantALoop said:
Possible. UHC ex-employees are sharing horror stories on social media of talking to suffering patients and their families and being unable to help. The fish rots from the head down, and UHC employees bore witness to UHC's policies and the people screwed over by the insurance that was supposed to help them.
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Everywhere I haved looked today the posts are about this underlying fury with UHC and not about the murdered man. I hope they catch the shooter and I hope UHC and their shoddy practices face deeper scrutiny.
 
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