

Private insurers profit by denying claims.

By Sam Pizzigati
Associate Fellow
Institute for Policy Studies
Over 8,000 Americansย dieย every day, many of them unnecessarily.
Why? Because the United States still doesnโt have a national health care system that guarantees everyone adequate medical attention.
One particular Americanโs death has driven that point home. On December 4, a gunman murdered Brian Thompson, UnitedHealthcareโs 50-year-old CEO. The bullet casings from the shooting read โdeny,โ โdefend,โ and โdepose.โ
Those three words neatly sum up the gameplan Americaโs giant insurers so relentlessly follow: deny the claim, defend the lawsuit, depose the patient.
Last year, United pulled down $281 billion in revenue,ย boostingย annual profits 33 percent over 2021. Thompson himself pocketed $10.2 million in personal compensation. And Andrew Witty, CEO of the overall UnitedHealth operation,ย collectedย $23.5 million, making him the nationโs highest-paid health insurance CEO.
All private insurers profit by denying help to sick people who need it. But UnitedHealthโs operations have become especially rewarding thanks to the shadowy world of โMedicare Advantage,โ the program that gives Americaโs senior citizens the option to contract out their Medicare to private health-service providers.
These private providers collect fixed fees from the federal government for each of the senior citizens they enroll. They profit when the cost of providing care to those seniors amounts to less than what the government pays them in fees. And that gives private providers an ongoing incentive to limit the care their patients receive.
No Medicare Advantage provider, theย American Prospectโs Maureen Tkacik points out, has done more than UnitedHealthcare when it comes to โsimply denying claims for treatments and procedures it unilaterally deems unnecessary.โ Industry-wide, Medicare Advantage providers deny 16 percent of patient claims. UnitedHealthcareย denied 32 percent last year.
The publicโs frustration with health insurance companies erupted bitterly after Thompsonโs murder. UnitedHealthโs official Facebook report on Thompsonโs death quicklyย drewย 35,000 responses using the โHahaโ emote.
โThoughts and deductibles to the family,โย readย one reaction. โUnfortunately my condolences are out-of-network.โ
โCompassion withheld,โย readย another, โuntil documentation can be produced that determines the bullet holes were not a preexisting condition.โ
Some of the fiercest reactions to Thompsonโs death came from within the medical community.
โThis is someone who has participated in social murder on a mass scale,โ a medical student wrote in one typical post.
โMy patients died,โ a nurseย spat outย in another, โwhile those bโ-s enjoyed 26 million dollars.โ
โIf thereโs anything our fractured country seems to agree on,โ mused Bloombergโs Lisa Jarvis, โitโs that the health care system is tragically broken, and the companies profiting from it are morally bankrupt.โ
โTo most Americans,โย agreedย theย New Yorkerโs Jia Tolentino, โa company like UnitedHealth represents less the provision of medical care than an active obstacle to receiving it.โ
Among wealthier countries, Americans โdieย the youngest and experience the most avoidable deathsโ despite spending almost twice as much on health care as others, a recent Commonwealth Fund Study found. And 25 percent of Americans, Gallup pollingย adds, have people in their family who have had to delay medical treatment for a serious illness because they couldnโt afford it.
Thompsonโs murder wonโt change those stats. The system that enriched him lives on โ and the incoming Trump administration figures to make that system even worse. The corporate-friendly Heritage Foundation, in its controversialย Project 2025ย blueprint for the second Trump term, is proposing that Medicare Advantageย becomeย the โdefault optionโ for all new Medicare enrollees.
That would โessentially privatize Medicareโ and significantly raise the programโs cost,ย warnsย analyst Heather Cox Richardson.
With Thompsonโs death, Americaโs health care powers feel and fear the American publicโs anger now more than ever. The rest of us need to channel that anger toward ending this system thatโs failed Americaโs health.
We need to remake health care into a vital public service โ not a tool for profit.
Originally published by OtherWords, 12.11.2024, under the terms of a Creative Commons Attribution-No Derivative 3.0 license.


