The Public Health of a Nation and a Private Vengeance
The murder of Brian Thompson the CEO of United Healthcare has sent shockwaves throughout the US, if the media are to be believed. There is consternation in some quarters that the motive for the murder may be that he was the CEO of a health insurance company, as evidenced by the message left behind of Delay, Defend, Depose on the shell casings, a reference to the tactics employed by insurance companies to not pay out on medical claims.
The right-wing media are understandably concerned that it is not a one off and that others may take similar action against high-ranking insurance employees. Some have even used the occasion to question, to a degree, the US private health care system, a system the Irish one is a pale copy of but intent on emulating as much as possible.
The company Thompson headed up is worth around US $550 billion, which is no small change. In the first nine months of 2024 it paid out US $9.6 billion to shareholders on total revenues of US $100.8 billion.[1] Despite the company’s name alluding to health care, that is not how it makes its money. Its money is the result of people paying for a private health care plan and then either not claiming or being denied coverage for medical procedures from the routine to vital lifesaving procedures. Health insurance companies are not in the business of curing, they don’t even provide health care, they are merely intermediaries between the surgeon’s scalpel and the patient, capable of inflicting a deeper cut than the sharpest instrument in the hands of the most skilled medical professional with all the finesse of a drunken mugger with a blunt pen knife. It is in the sickness and death business through non-payment.
Every year almost 650,000 people in the US are forced into bankruptcy by medical bills, representing over 60% of all personal bankruptcies. Nearly 80% of those who go bankrupt had medical insurance![2] A recent report found that over 20 million people in the US owe at least US $220 billion in medical debt with the majority of that comprising of debts in excess of US $ 10,000 amongst just 2.9 million people.[3] Some of the debt arises from the so-called deductibles, the point at with insurance kicks in, which has been on the rise for years, with in some cases people having to pay US $3,700 before the insurance company pays a penny.[4] And then 20% of claims are denied, though depending on the company that many range from as low as 2% to 49%.[5]
There is no way of looking at this, other than to conclude that health insurance companies are leeches, sucking the blood of the aged, the infirm and those who fall ill, for whatever reason. In order to force people to pay health insurance the human cost of not doing so must be dramatic, traumatic, life threatening and unbearable. The threat of death or ill health is the whip with which they force people into line.
Thompson’s murder has touched a number of nerves. His company, the media and politicians expressed their sorrow and even rage at the killing. But as the BBC reported unofficial USA had a different reaction.
But online many people, including UnitedHealthcare customers and users of other insurance services, reacted differently.
Those reactions ranged from acerbic jokes (one common quip was "thoughts and prior authorisations", a play on the phrase "thoughts and prayers") to commentary on the number of insurance claims rejected by UnitedHealthcare and other firms.
At the extreme end, critics of the industry pointedly said they had no pity for Thompson. Some even celebrated his death.
The online anger seemed to bridge the political divide.
Animosity was expressed from avowed socialists to right-wing activists suspicious of the so-called “deep state” and corporate power. It also came from ordinary people sharing stories about insurance firms denying their claims for medical treatments.[6]
Facebook is full of memes, celebrating, joking or otherwise supporting the killing. More than a reflection of some well thought out support for the murder, this is people lashing out at a system that condemns them to misery. It is a weapon of mass destruction. Whilst many people with health insurance are frequently denied coverage for medically necessary interventions, there are others who have no health insurance at all. They simply can’t afford it or are not eligible. Another report finds that as “many as 44,789 Americans of working age die each year because they lack health insurance, more than the number who die annually from kidney disease.”[7] That is nearly the same amount as soldiers who died throughout the entire Vietnam war.
So, given the nature of the system and the US $10 million that Thompson, vampire like, earned per year, it is very easy to have no sympathy for him. He was one of those grey men, that moved pieces of paper. He was like Eichmann, the banality of evil. A man who never deliberately shot anyone or even gave an order to kill anyone, but nevertheless was responsible for a system that saw thousands die every year. The insurance companies are not idle bystanders simply taking advantage of a broken system. The system is not broken, it works the way they intend it to work. Every year insurance companies spend millions on lobbying. In 2023, US $ 159 million was spent and in the first three quarters of 2024, US $117 million was spent on lobbying, [8]of which US $10.7 million came from United Healthcare in 2023[9] and a further US $5.8 million reported in the first three quarters of 2024.[10] In the 2019-2020 election cycle, Thompson’s company donated US $ 4,285,464 to the Democrats and the Republicans. [11]
So, neither Thompson nor his fellow CEOs are innocent bystanders just doing a job, or making a buck as they like to say in the US. They are active participants in a system that relies on people falling ill and not being covered by their companies. Death and disease are the lifeblood of the insurance industry, but only when people like Thompson do not pay out. Were they to payout for everyone and everything that US $9.8 billion dividend would be quickly whittled down.
It is easy not to feel any sympathy for Thompson, it is even easier perhaps to feel some sympathy and even empathy with the killer, if indeed his motive was related to a denial of coverage. But knocking off CEOs of insurance companies won’t solve the problem; $9.8 billion dividends can take a hit and pay for increased security. The CEO will be replaced and at 10 million per year, there will be no shortage of candidates. All it does is give some personal satisfaction to the killer and perhaps a sense of schadenfreude to the rest of us, as desperate times produce desperate reactions in many, reactions that in other times we might not have had.
Voting for the Democrats won’t solve it either. The insurance industry remained profitable and continued to not pay out under Obamacare as it did not challenge the private health industry or the insurance industry. Turning your back on such politicians would be a first step and that includes Bernie Sanders who despite all his bluster would also fudge the issue. Desperate times, desperate situations, desperate individual solutions that ultimately do not solve the problem, but give some people a sense that at least one of them got a taste of their own medicine. As The Guardian reported:
Though his survivors include a widow and two sons aged 16 and 19, Thompson’s death elicited a grim schadenfreude from many in the US who had been mistreated by the country’s rapacious health insurance industry. A private funeral for Thompson was planned for Monday.[12]
A private funeral, as there is unlikely to be some mass outpouring of public grief, but rather the unsightly spectacle of public anger was always a possibility at what in the end will be a moment of deep despair and grief for the family, though it should never be forgotten that deep despair and grief was the cut and thrust of how he made his money, his bread and butter. He and his family became rich through the deliberate inflicted anguish and misery on others.
But the only thing that will really give insurance companies a taste of their own medicine is the abolition of private health care and private insurance in all its forms, not just in medicine. And then putting the CEOs on trial for crimes against humanity. Those thousands who die every year without insurance, those who suffer or die due to denial of coverage are not simple administrative situations. They are like the acts of Eichmann, the bureaucratic acts of grey men, who though never pulling a trigger, cause the deaths of millions. Thompson’s epithet on his tombstone should read, Here Lies a Depraved Criminal. Loved by the Shareholders, Not Missed or Mourned by Many Others.
[1] See United Health Group Third Quarter Reports 2024 https://www.unitedhealthgroup.com/content/dam/UHG/PDF/investors/2024/UNH-Q3-2024-Release.pdf
[2] Public Citizen (n/d) Medicare-for-All Prevents Medical Bankruptcies. https://www.citizen.org/article/medicare-for-all-prevents-medical-bankruptcies/
[3] Rakshit, S. et al. (2024) The burden of medical debt in the United States. https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/#Share%20of%20adults%20who%20have%20medical%20debt,%20by%20health%20status%20and%20disability%20status,%202021
[4] CBS News (09/12/2024) Americans are paying more than ever for health insurance. Denials add to their pain. Aimee Pichi. https://www.cbsnews.com/news/health-insurance-costs-inflation-denials-luigi-mangione-united-healthcare/
[5] Ibíd.,
[6] BBC (07/12/2024) Killing of insurance CEO reveals simmering anger at US health system. Mike Wendling & Madeline Halpert. https://www.bbc.com/news/articles/cm2eeeep0npo
[7] PNHP (17/09/2024) Lack of Insurance to Blame for Almost 45,000 Deaths: Study. https://pnhp.org/news/lack-of-insurance-to-blame-for-almost-45000-deaths-study/#:~:text=As%20many%20as%2044%2C789%20Americans,to%20expand%20health%20insurance%20coverage.
[8] See https://www.opensecrets.org/industries/lobbying?cycle=2024&ind=F09
[9] See https://www.opensecrets.org/federal-lobbying/clients/summary?cycle=2023&id=D000000348
[10] See https://www.opensecrets.org/federal-lobbying/clients/summary?cycle=2024&id=D000000348
[11] See https://www.opensecrets.org/industries//indus?ind=H&cycle=2020
[12] The Guardian (10/12/2024) Suspect in UnitedHealthcare CEO shooting charged with murder by New York prosecutors. Edward Helmore. https://www.theguardian.com/us-news/2024/dec/09/brian-thompson-shooting-suspect-mayor