Was This Personal or Professional: (UHC CEO murder)

[Private Citizen]

I take Synthroid (name brand). It's cheaper for me to buy it without using my insurance than going through insurance.

We may want to start a new thread, but I don’t see this as a bad thing. It may be the start of a partial answer.

Creating a consumer market where it’s cheaper and more efficient to bypass insurance is part of the eventual solution.

Of course, prices need to be realistic in order to make that work, and they’re largely not in the US. No one needs to convince me that the system is broken, needs serious reform, etc. Insurers are a part of it. But not all of it. And I absolutely believe (and you can strip away my libertarian card) more regulation is needed.

 

[skatfan]

y answer is an unequivocal no, and I don't accept the "systematically causes illnesses and deaths of thousands" as fact.

Where does it stop? What about cigarette company CEOs? Alcohol company CEOs? Fast food company CEOs? Pharma (given the opioid epidemic)? Companies that harm the environment (virtually all)? Can we gun down their CEOs, too? They're all causing deaths of thousands.

I don’t condone the violence at all, but I would say they are morally culpable. I do believe what I’ve said is true, we can differ on that.

My point which you helped with - thanks!- is that we allow companies to cause great harm without any penalties either to the companies or their leadership. It’s shocking how little they are held to account.

 

[once_upon]

@Andora, is name-calling ever appropriate? This is not PI. Plus you said: "I'm sorry, but I can't find it in myself to see this as tragic." Why not? A human person lost his life & his family & friends are deeply affected. If a family member of yours was gunned down because of his/her business practices would that be okay with you?

When I first went to work for the employer that I retired from the ins company (I think Aetna) who handled our insurance claims denied a good many of my legitimate claims. It was so annoying. I had to appeal & then they finally always paid. Depending on the amount some employees wouldn't bother calling, sitting on hold, etc to appeal so Aetna made illegal profit. My company changed to UHC after many complaints & it was so much better that maybe I think they are good just in comparison.

It may also have been the plan from Aneta and UHC your employer purchased. I know you've said that your employer was/still is self funded but they still purchase the insurer plans with specific criteria.

I believe my dad retired from the same company as you. I'm fairly certain it was administered by UHC. His experience was different than yours, he also lived in another state.

My experience comes from years of doing authorization for care. - I dealt with UHC, Aneta, Medica, Cigna, BC/BS etc. Thank Goodness I left that job 15 years ago. It was a nightmare then.

Plans and coverage were different across the board. UHC for company A was not the same as UHC for company B.

BC/BS for company A plans were different than Company B plans.

I dealt with mostly Medicaid or CHIP pools patient coverages. UHC was by far the cheapest and gave some perks like taxi rides to Dr offices but not much coverage for PT, OT and very little is any for Speech therapy. My state offered UHC or BCBS. UHC Medicaid plans were the worst for coverage in Nebraska. UHC would not cover respite care from lowa to Nebraska, even though there were not options available in Iowa. I did deal with other company insurers.

Medicare is a freaking nightmare. All HC companies have to offer the plans - I'm in supplemental plan G. Every company that offers Media-Gap plans, must offer about 6 or 7 plan category. All of which are mandated to offer the exact same plans features. Each company can set premium costs, with different co-pays, different deductible. But the same features.

As far as I know, there are no mandates on coverages for non Medicare plans.

I have no idea what the companies who sell Medicare Advantage plans are mandated to cover. Because I know too many people where plans drop providers and you are searching for new providers who accept the meager reimbursement rates.

 

[Rob]

If anyone says they’re new and it’s not a matter of life and death, I always check the hospital’s website to make sure they’re added and cross check the doctor’s Unique Physician Identifier Number (UPIN) in the state registry to make sure they’re added and have admitting privileges there. I shouldn't have to do this.

I had a long back and forth with UHG about a PT claim they kept denying because the provider was supposedly out of network. My not for profit insurer had a contract with a multidisciplinary practice that said that everyone employed by the practice was in network. When UHG signed an affiliation agreement with my insurer, with specific language saying that all networks would be preserved, they screwed up importing the network and excluded PT, OT, most mental health providers, and a bunch of other things. It took me nearly 3 months to get the claim paid and required me escalating to the not for profit’s head of credentialing. Lay people just get flummoxed by insurance and fooled into over paying every single time.

No, you should not have to do that, but someone who passed out at a friends house and was taken to an emergency room physically cannot do it. It’s crazy.

 

[Buzz]

Shouldn’t this be in PI?

 

[rfisher]

I have no idea what the companies who sell Medicare Advantage plans are mandated to cover. Because I know too many people where plans drop providers and you are searching for new providers who accept the meager reimbursement rates.

My sister's Medicare Advantage plan moved out of state leaving her with no coverage until the open enrollment. My brother's plan would not pay for a dermatologist to remove a skin cancer on his face in the hospital with anesthesia. It was done in the office with a local. It was deep and resulted in a huge scar, swelling to the point he had trouble breathing, (I made him go to the ED when this happened) and a huge scar and infection. It should have been done in the OR. But, he didn't have the money to pay out of pocket and just did it. He didn't even get pain meds. I had some left from a prior surgery and gave them to him. Many hospitals will not take some medicare advantage plans nor will some clinicians due to poor reimbursement rates.

 

[SkateSand]

My husband and I are under a Medigap plan with UHC. My husband had a small claim denied, which he was super irritated about and complained bitterly to his doctor's office that they had told him this would be covered and then it wasn't. The doctor's office ended up waiving the fee since UHC wouldn't budge.

 

[BittyBug]

Shouldn’t this be in PI?

It's a sad comment on the state of the United States if delivering health care for the welfare of citizens is considered a political issue.

 

[sk8pics]

I take Synthroid (name brand). It's cheaper for me to buy it without using my insurance than going through insurance.

Me, too. Abbie subsidizes it so I pay literally half what I would pay if I got it through my Medicare prescription drug plan.

It is not okay to kill another person because you believe they are responsible for decisions or actions that harm others. This is vigilanteism, if in fact this is what happened with this assassination.

 

[once_upon]

Shouldn’t this be in PI?

Perhaps, but the questions posed by this murder was discussing motives to this shooting/act of violence.

Many, many, many of us had a visceral reaction to the "deny" message found at the scene.

In addition some posters, even US citizens who do not or have not needed or been denied care, posted their opinions it is easy to rectify the denial processes. I do think it seems unbelievable to other countries with single payor healthcare, that these issues exist. Or that there are so many moving pieces to the US healthcare system. One where any small piece not functioning can bring a medical bankruptcy, sub level care and/death.

Maybe early on, people expressing their disgust for the system might have said he had it coming. In general the overwhelming statement is no one deserves to be murdered. But the needs to be some sort of punishment for these morally corrupt business practices.

Some of us have had major experiences, either personally or in our professional life, on the practices used to obtain millions of dollars in profit. These are real issues affecting real humans.

As with every single thread on the forum, sometimes it gets personal.

 

[PRlady]

I don’t condone the violence at all, but I would say they are morally culpable. I do believe what I’ve said is true, we can differ on that.

My point which you helped with - thanks!- is that we allow companies to cause great harm without any penalties either to the companies or their leadership. It’s shocking how little they are held to account.

I’m watching 60 Minutes where they just interviewed several whistleblowers at Boeing. Their reports were shocking.

There are products and services where if companies put profits over quality, the result is frustrating but not deadly. Airplanes and healthcare are not in that category. And unlike the rich guy who died in his unsafe submarine, the top guys are usually protected from their own malfeasance.

 

[Private Citizen]

It's a sad comment on the state of the United States if delivering health care for the welfare of citizens is considered a political issue.

To be fair, healthcare is also a political issue in (some) countries with socialized medicine. E.g., how to deliver and pay for healthcare is a political issue in the UK.

The fundamental problems are the same in most of the western world: people living longer, obesity and other lifestyle illness growing, birth rates declining, and more people needing care than care that will be available.

In addition some posters, even US citizens who do not or have not needed or been denied care, posted their opinions it is easy to rectify the denial processes. I do think it seems unbelievable to other countries with single payor healthcare, that these issues exist.

Not sure if this was directed at me, but I've been:
1) denied care in the US
2) denied care by the public system in the UK
3) denied care by private insurance in the UK

A lot of the care the US insurers deny would also be denied by public health systems and even private insurance on top of public health systems.

Even when care is approved, public systems have huge backlogs. Thousands of people in the UK died from treatable cancer during the covid years, and years afterwards as the backlogs continued. These decisions happen all the time in every system.

On balance, I think the US system is better in every way except for cost and risk of bankruptcy, which I admit are two very big drawbacks.

 

[MacMadame]

Where does it stop? What about cigarette company CEOs? Alcohol company CEOs? Fast food company CEOs? Pharma (given the opioid epidemic)? Companies that harm the environment (virtually all)? Can we gun down their CEOs, too? They're all causing deaths of thousands.

They all need to be held accountable.

I take Synthroid (name brand). It's cheaper for me to buy it without using my insurance than going through insurance.

I have a med like that. It's cheaper under GoodRx. But getting Express Scripts to use GoodRx for one med and not for another is not possible as far as I can tell.

When I first went to work for the employer that I retired from the ins company (I think Aetna) who handled our insurance claims denied a good many of my legitimate claims. It was so annoying. I had to appeal & then they finally always paid. Depending on the amount some employees wouldn't bother calling, sitting on hold, etc to appeal so Aetna made illegal profit. My company changed to UHC after many complaints & it was so much better that maybe I think they are good just in comparison.

You may have had a good experience but UHC has a denial rate that is significantly higher than other insurance companies.

We may want to start a new thread, but I don’t see this as a bad thing. It may be the start of a partial answer.

Creating a consumer market where it’s cheaper and more efficient to bypass insurance is part of the eventual solution.

No, the answer is to get for-profit companies out of healthcare. And get universal healthcare so our coverage isn't tied to employment (which is an absolutely bonkers situation).

It is not okay to kill another person because you believe they are responsible for decisions or actions that harm others. This is vigilanteism, if in fact this is what happened with this assassination.

It's absolutely wrong. That said, I am under no obligation to be sad about the death of someone I do not know and whose business decisions I do not respect and actually think are immoral to be considered a good person.

 

[Sparks]

No, the answer is to get for-profit companies out of healthcare. And get universal healthcare so our coverage isn't tied to employment (which is an absolutely bonkers situation).

This.
I've been reading this thread and a lot of what I see are reasons why the US should have Medicare for all - even as a choice. Let's see how for-profit health insurance companies do.

 

[sk9tingfan]

The administrative cost for Medicare is 2% as opposed to 12-18% for commercial insurers. The overhead includes sales and marketing expense as well as redundancy in creating and maintaining provider networks and care management programs, customer services, multiple claims and other supporting quality assurance systems. There are other components not mentioned here.

 

[Prancer]

Obligation to shareholders?

The shareholders could also choose to be good human beings, no?

But again--you demand that we take responsibility for the choices we make; as with us, the CEOs of the world can make other choices, including not working for those shareholders. Just like us, they can find another job.

Blamed for what? Deaths that occurred from denying treatment that the policy doesn't cover? I don't see how they're responsible at all.

You persist in this claim that people are only denied treatment that their policies don't cover.

This study says that hardly anyone appeals a denial, but that a percentage of people who do appeal win on appeal. Apparently there are people who are--like me, in the past--denied service that is covered by their policies.

Where does it stop? What about cigarette company CEOs? Alcohol company CEOs? Fast food company CEOs? Pharma (given the opioid epidemic)? Companies that harm the environment (virtually all)?

Wouldn't it be nice if some entity were concerned enough for the people of the world to demand some accountability for all this?

Can we gun down their CEOs, too?

Yes, because that is the only other option and that is what everyone arguing with you is calling for .

If they only denied what isnt covered, that would be explicable. But denying care that IS covered is the business strategy.

This ^.

It's a sad comment on the state of the United States if delivering health care for the welfare of citizens is considered a political issue.

I don't know how it could be anything else?

A lot of the care the US insurers deny would also be denied by public health systems and even private insurance on top of public health systems.

This is something that a lot of people outside the US don't understand. Denial of care is actually more transparent in the US, not necessarily more common.

 

[allezfred]

US healthcare: A mismatch between spending and results

The assassination of UnitedHealthcare CEO, Brian Thompson, in New York this week has sent shockwaves across the United States.

www.rte.ie

 

[Private Citizen]

The shareholders could also choose to be good human beings, no?

You and others on this thread are probably direct or indirect shareholders of health insurance companies via your 401k, mutual funds, etc. How much of a hit are people willing to take to their retirement funds? Why not start a shareholder campaign that you'll happily accept a 20+% loss on your portfolio to achieve your "good human being" objectives? Or perhaps invest in a fund that guarantees people 20% annual loss but funds these noble objectives? People love to exempt their own direct or indirect behaviors. No market for that? Then I guess people must not hate the system quite as much as they say they do. It seems to me that most are happy to privately profit from it while publicly decrying it.

Changing 17% (forecast to grow to 20%) of the economy is going to have nasty, nasty side effects. The brutal truth will be a large decline in net worth of the middle class coupled with a decline in care standards. It's a poison pill. Even the Dems knew it (or at least Obama did). The billionaires and multi-millionaires will be just fine; the middle class will see a drop in living standards and healthcare standards.

US healthcare: A mismatch between spending and results

The assassination of UnitedHealthcare CEO, Brian Thompson, in New York this week has sent shockwaves across the United States.

www.rte.ie

I agree with parts of this, but not all of it -- especially the parts about entrepreneurship. The article cherry picks Portugal, which has all kinds of other (including tax and residency) incentives for entrepreneurship. Compare the US to the UK, which has totally free healthcare, and you'll get a completely different picture. I'm dubious of the actual relationship between free healthcare and entrepreneurship. It's one of those things that sounds right, but the numbers don't back it up. Low taxes seem to more than offset it.

 

[allezfred]

You and others on this thread are probably direct or indirect shareholders of health insurance companies via your 401k, mutual funds, etc. How much of a hit are people willing to take to their retirement funds? Why not start a shareholder campaign that you'll happily accept a 20+% loss on your portfolio to achieve your "good human being" objectives? Or perhaps invest in a fund that guarantees people 20% annual loss but funds these noble objectives? People love to exempt their own direct or indirect behaviors. No market for that? Then I guess people must not hate the system quite as much as they say they do. It seems to me that most are happy to privately profit from it while publicly decrying it.

Changing 17% (forecast to grow to 20%) of the economy is going to have nasty, nasty side effects. The brutal truth will be a large decline in net worth of the middle class coupled with a decline in care standards. It's a poison pill. Even the Dems knew it (or at least Obama did). The billionaires and multi-millionaires will be just fine; the middle class will see a drop in living standards and healthcare standards.

Feel free to answer or not - do you have investments in private healthcare?

Usually the people defending by all accounts an awful status quo are benefiting in some way.

I agree with parts of this, but not all of it -- especially the parts about entrepreneurship. The article cherry picks Portugal, which has all kinds of other (including tax and residency) incentives for entrepreneurship. Compare the US to the UK, which has totally free healthcare, and you'll get a completely different picture. I'm dubious of the actual relationship between free healthcare and entrepreneurship. It's one of those things that sounds right, but the numbers don't back it up. Low taxes seem to more than offset it.

I think the point stands that if you have a healthcare safety net you are more likely to be able to take risks in your professional life. Which is virtually every other developed country in the world who all seem to be able to do it while spending less and with superior life expectancy.

Even the UK which you constantly deride has average life expectancy that is five years more than the US. Five years….

 

[nlloyd]

Slain UnitedHealthcare CEO Brian Thompson’s tenure was marked by rocketing profits—and accusations of insider trading and coverage denial

Following Thompson’s death, social media erupted with grievances about the health care giant and private insurers in the U.S.

www.yahoo.com

 

[BittyBug]

You and others on this thread are probably direct or indirect shareholders of health insurance companies via your 401k, mutual funds, etc. How much of a hit are people willing to take to their retirement funds? Why not start a shareholder campaign that you'll happily accept a 20+% loss on your portfolio to achieve your "good human being" objectives? Or perhaps invest in a fund that guarantees people 20% annual loss but funds these noble objectives? People love to exempt their own direct or indirect behaviors. No market for that? Then I guess people must not hate the system quite as much as they say they do. It seems to me that most are happy to privately profit from it while publicly decrying it.

I get your point that many people may be passively profiting from industries that they don't support, but there are plenty of mutual fund options that don't include holdings in health insurance companies, and divesting from healthcare does not automatically guarantee a 20%+ loss to one's portfolio.

 

[PRlady]

Israel has got a gazillion big problems and still manages to provide good healthcare through large HMOs. They have a new problem of doctors emigrating but that’s due to politics and war, not the system. The care I receive there when living there was excellent and my employer’s premium was $70 a month.

And this is a country that provides unlimited IVF for free for infertility!

 

[barbk]

You and others on this thread are probably direct or indirect shareholders of health insurance companies via your 401k, mutual funds, etc. How much of a hit are people willing to take to their retirement funds? Why not start a shareholder campaign that you'll happily accept a 20+% loss on your portfolio to achieve your "good human being" objectives? Or perhaps invest in a fund that guarantees people 20% annual loss but funds these noble objectives? People love to exempt their own direct or indirect behaviors. No market for that? Then I guess people must not hate the system quite as much as they say they do. It seems to me that most are happy to privately profit from it while publicly decrying it.

Changing 17% (forecast to grow to 20%) of the economy is going to have nasty, nasty side effects. The brutal truth will be a large decline in net worth of the middle class coupled with a decline in care standards. It's a poison pill. Even the Dems knew it (or at least Obama did). The billionaires and multi-millionaires will be just fine; the middle class will see a drop in living standards and healthcare standards.

I agree with parts of this, but not all of it -- especially the parts about entrepreneurship. The article cherry picks Portugal, which has all kinds of other (including tax and residency) incentives for entrepreneurship. Compare the US to the UK, which has totally free healthcare, and you'll get a completely different picture. I'm dubious of the actual relationship between free healthcare and entrepreneurship. It's one of those things that sounds right, but the numbers don't back it up. Low taxes seem to more than offset it.

"A hit to retirement funds" seems like a crappy reason to avoid fixing a seriously broken US health system. Obamacare got rid of one of the biggest issues (pre-existing conditions) that trapped people in jobs to avoid health care loss. It added other problems.

We need a regulatory framework providing:
1. Clarity of coverage & truthful networks
2. Clarity on costs
3. Ethical claims administration (none of this AI denying some huge percentage of claims, or medical directors spending less than 30 seconds per appeal rubber-stamping what prior reviewers/AI said...and not allowing physicians in unrelated specialties to be the final reviewer for claims for a different specialty. Seriously--what does a dermatologist know about current practices in brain cancer treatment?)
4. Eliminating PBMs. They are the devil incarnate of the health care system.

Traditional Medicare as a model (not as a pricing model) takes care of 1-3. There are issues around the margins (Local Coverage Decisions, meaning that one formulation of a botox-type injection for spasms is approved in certain parts of the country and not in others), but it mostly works. The introduction of Diagnosis Related Codes, which established flat rates for procedures like a knee replacement, eliminated the fifty-plus pages of detail (aspirin, bandage, needle, ....) garbage that hospitals used to generate.

The concept of the Medigap (not Advantage) supplements is pretty fabulous. Every Medigap G supplement must cover the same called-out items.

The pricing for Traditional Medicare is not extendable to the larger population. Primary care physicias are underpaid, surgical specialists are overpaid. But the model itself is pretty clean, except for the mess that is Part D (drug insurance). That one needs a serious re-think, starting with why we're ok with paying 10-100 x more than other developed countries for the same product.

 

[once_upon]

Only 62% of the US population own and 10% of those "investors" own the majority of the stock. Most of us who own the small portion of stock have some entity doing the safe investment, yes we passively likely own stock in healthcare. It is nearly impossible to separate.

One of our non-profits i was a member of tried to do that with environmental things.

So yes walk the talk, but healthcare is so pervasive.

 

[manhn]

It's a sad comment on the state of the United States if delivering health care for the welfare of citizens is considered a political issue.

I will say that almost all violent acts have roots of social injustice or inequality. But the discussion here is beyond that. I mean, it’s like some posters think the shooter is an FSUer.

 

[sk9tingfan]

"A hit to retirement funds" seems like a crappy reason to avoid fixing a seriously broken US health system. Obamacare got rid of one of the biggest issues (pre-existing conditions) that trapped people in jobs to avoid health care loss. It added other problems.

We need a regulatory framework providing:
1. Clarity of coverage & truthful networks
2. Clarity on costs
3. Ethical claims administration (none of this AI denying some huge percentage of claims, or medical directors spending less than 30 seconds per appeal rubber-stamping what prior reviewers/AI said...and not allowing physicians in unrelated specialties to be the final reviewer for claims for a different specialty. Seriously--what does a dermatologist know about current practices in brain cancer treatment?)
4. Eliminating PBMs. They are the devil incarnate of the health care system.

Traditional Medicare as a model (not as a pricing model) takes care of 1-3. There are issues around the margins (Local Coverage Decisions, meaning that one formulation of a botox-type injection for spasms is approved in certain parts of the country and not in others), but it mostly works. The introduction of Diagnosis Related Codes, which established flat rates for procedures like a knee replacement, eliminated the fifty-plus pages of detail (aspirin, bandage, needle, ....) garbage that hospitals used to generate.

The concept of the Medigap (not Advantage) supplements is pretty fabulous. Every Medigap G supplement must cover the same called-out items.

The pricing for Traditional Medicare is not extendable to the larger population. Primary care physicias are underpaid, surgical specialists are overpaid. But the model itself is pretty clean, except for the mess that is Part D (drug insurance). That one needs a serious re-think, starting with why we're ok with paying 10-100 x more than other developed countries for the same product.

During my second stint in Care Management Operations, we used to maintain a list of consulting physicians by specialty so that we could derive a valid determination. One of them was my ENT. He decided to be funny(not) right before I was being put under for an ENT procedure. Walking into the OR, he said to me, "Did you get that determination from me"? I have a long list of "jokes" or payment questions from my doctors, ususally just prior to a procedure I'm undergoing.

 

[BittyBug]

I will say that almost all violent acts have roots of social injustice or inequality.

I agree that it can be a factor, but it's not nearly universal, as our very frequent school shootings show. It's often just a maladjusted teenager.

But the increasing wealth inequality in the U.S. does make me wonder whether we aren't heading towards a broader social uprising There's only so much that the masses can take before they start to revolt.

But the discussion here is beyond that. I mean, it’s like some posters think the shooter is an FSUer.

I'm not following your train of thought here.

 

[genevieve]

I will say that almost all violent acts have roots of social injustice or inequality. But the discussion here is beyond that. I mean, it’s like some posters think the shooter is an FSUer.

I am Spartacus!

 

[PRlady]

What’s happened in Syria and South Korea in the last week demonstrates that everything is calm until it isn’t. The combination of an inflammatory incoming president and seriously pissed-off majority of people is an unstable combination.

It took one gruesome police killing on video to set off BLM protests. It won’t take much to set off the next wave.

 

[Jenny]

But the increasing wealth inequality in the U.S. does make me wonder whether we aren't heading towards a broader social uprising There's only so much that the masses can take before they start to revolt.

Aside from the healthcare industry issues, I've been wondering how many people are annoyed at the amount of attention this is getting and the resources that are being put against it, and thinking it's because the victim was a rich white guy. The stat I found is that this is one of more than 300 murders in NY in 2024 - while in many cases the murderer was likely known, did all of them get this level of attention? Noting also that from the beginning this has been defined as a targeted crime, with no apparent danger to the public, so again, it's a lot of attention and resources for one victim. Who wasn't even a New Yorker.