The assassination of Brian Thompson, CEO of UnitedHealthcare, in New York this week has left the nation in shock.This tragic event has sparked widespread outrage among Americans regarding their nation’s healthcare system.Washington Correspondent Sean Whelan explores the various challenges facing the US healthcare sector.
Every time I feel the need to see a doctor, I’m struck by a daydream – a picturesque marina lined with beautiful yachts under a clear blue sky. Perhaps it’s a placebo effect, as I often hesitate to contact my “provider,” distracted by thoughts of their luxurious yacht.
The healthcare professionals I have encountered in the last three years either criticize the system or agree with my assessment. It may be their tactic to handle a disgruntled customer, or perhaps it’s their genuine opinion.
The sentiment among the American populace is largely characterized by fear and disdain towards the healthcare system. They resent the greedy nature of the all-consuming health industry and its exorbitant costs while fearing the loss of their employer-sponsored health insurance.
Without insurance, individuals are left vulnerable: they either must find the necessary funds themselves or face suffering and death. It is not uncommon for people to spend more on their monthly health insurance than their mortgage.
Many individuals believe it is a broken system and wish to see changes, viewing themselves or their loved ones as its victims.
But does their hatred extend to the point of committing murder to express their frustrations?
This question arises in the aftermath of Brian Thompson’s assassination, CEO of America’s largest health insurer, who was shot outside a midtown Manhattan hotel before addressing an investor conference, a crucial event for a company valued at $560 billion and employing 140,000 people.
Brian Thompson was the CEO of UnitedHealthcare.
Despite this, and the ongoing threats against the company and its executives from individuals who feel victimized, activist groups seeking healthcare reform, and others calling for broader changes, he lacked a security detail during this incident, though it has been reported that he had one previously.
His executive compensation was $10 million annually, primarily through bonuses and stock options, with a base salary of $1 million. While this is a substantial amount, it’s not exceptional for major US corporations, especially one that reported $16 billion in profit last year (notably, Elon Musk is engaged in a court battle to retain a $50 billion compensation package from Tesla, a company that has reported losses).
The market for executive protection is vast, employing numerous former military and law enforcement personnel. The oil and gas industry is a significant consumer, along with other sectors that attract controversy, such as health insurance.
In Ireland, there’s a long-standing tradition to avoid speaking ill of the deceased. However, this cultural restraint does not apply on social media, which has witnessed a wave of animosity directed at the medical insurance sector in light of Mr. Thompson’s murder.
Some of the most extreme critiques have accused Mr. Thompson and UnitedHealthcare of committing mass murder by denying coverage or claims. A refusal for coverage can have devastating effects on individuals. There are claims that United is developing an AI system designed to process claims more swiftly than human workers, but which allegedly results in a significantly higher denial rate.
These allegations have now become part of a police investigation focused on determining the motive behind the murder of a business leader who was respected within his industry. This incident has also spotlighted a longstanding and seemingly insurmountable issue in America – the exorbitantly high costs associated with medical care.
Even with health insurance, the financial burden of illness can be overwhelming for many Americans – a reality that affects 37% of the population, who reportedly cannot raise $400 in cash for emergency expenses, according to the Federal Reserve.
A survey by Bankrate indicates that 63% of Americans would face financial ruin due to a $1,000 emergency expense, which could stem from any number of situations, from car repairs to medical bills. This is because insurance often doesn’t cover everything – there are deductibles, co-pays, and exclusions.
Defenders of the industry argue that individuals have the freedom to choose their doctors and “providers.” While technically true, patients still have to find an “in-network” provider to maximize their coverage, presenting a daunting challenge that can take hours of phone calls, online searches, and follow-ups just to minimize their bills.
Furthermore, there are numerous services that are simply not covered. You may assume that having health insurance protects you, but when difficulties arise, you might find yourself uncovered for the exact service you require, or receive an unexpected bill in the recovery room due to the complexities of the insurance system, or simply because the insurer denied coverage.
The shooting of Mr. Thompson led to a surge of posts on social media from individuals who had experienced coverage denials from UnitedHealthcare and other insurance companies. They shared accounts of medical bankruptcy, unnecessary fatalities, and significant emotional and physical distress.
UnitedHealthcare is one of the largest health insurers in the US.
And there is a palpable undercurrent of hatred. “My thoughts and prayers are out of network,” “My empathy hasn’t met its deductible,” “prior authorization is needed for thoughts and prayers” are just a few of the more printable remarks. More than a few individuals even expressed sympathy for the shooter. However, this situation goes beyond mere online hostility.
The New York Times mentioned a TikTok user who lamented, “I pay $1,300 a month for health insurance with an $8,000 deductible. ($23,000 yearly). When I finally reached that deductible, they denied my claims. He was earning a million dollars a month.”
The publication also quoted author Joyce Carol Oates, who noted that the negative outpouring “is better described as cries from the heart of a deeply wounded and betrayed country; hundreds of thousands of Americans shamelessly exploited by healthcare insurers reacting to a single act of violence against one of their multimillionaire executives.”
Clearly, the assassination, regardless of any direct connection to Mr. Thompson’s role in the healthcare sector, touches a chord in America – a reflection of the staggering costs associated with medical care in the country.
This financial strain is why so many individuals avoid seeking medical attention, enduring chronic illnesses, and limiting their life experiences.
This healthcare system is detrimental not only to individuals but also to the economy. Some business-minded individuals assert that the fear of losing employer-provided insurance discourages people from becoming entrepreneurs, thereby hindering economic growth.
For employees, job loss can be devastating, as it often means losing health insurance for themselves and their families. Factory closures, sunset industries, and job insecurity are further complicated by the dread of illness or accidents, or even mundane health issues.
This situation complicates and stresses the social transition from one job to another (with stress frequently leading to chronic health conditions needing treatment). During times of significant technological change, the added difficulties stemming from the dysfunctional American healthcare system exacerbate the pressures felt by many.
A manager from a European company recounted two years ago during a post-Covid tour of some of his offices. One location was in Portugal, the other in North Carolina. Both offices performed the same duties for the company, working on the same project in different time zones.
Noticeably, however, he recognized a stark contrast among the staff: those in Portugal, benefiting from a single-payer medical system and a social safety net, were happier, more relaxed, collaborative, and produced better results (even working shorter hours).
Read more: Man who killed CEO may have left state, New York police say. Trump has nominated Robert F. Kennedy Jr. for the role of US health secretary.
The US employees he described were perceived as needy, competitive, and fearful of losing their jobs and benefits, unwilling to let others on the team get ahead at their own expense. This environment consumed considerable time and emotional energy, leading to reduced productivity despite a culture of long hours. Moreover, they demanded higher wages than their European counterparts.
To entertain the manager, the Portuguese team treated him to a courtyard gathering where neighbors (aided by a corporate engagement program) provided grilled food, wine, and music.
Conversely, in the US, he was limited to vending machine fare, and corporate entertainment involved trips to shooting ranges to fire AR-15 rifles. He firmly believed that healthcare and social security were significant factors influencing the stark differences in workplace culture. (The major downside in Portugal was the housing shortage, causing rents to soar).
But if the system is so flawed, why not change it? There have been initiatives – the Affordable Care Act, commonly known as Obamacare – has greatly improved insurance coverage for many individuals. Republican politicians pressured Donald Trump to moderate his stance against Obamacare in the last election cycle, aware that it was an unpopular viewpoint among voters.
Yet, it remains an extraordinarily expensive system. The primary obstacle to reform lies in the immense financial interests at hand, incentivizing those within the system to resist changes that could disrupt the status quo.
The volume of pharmaceutical advertising in the US is noteworthy, especially on cable news networks like CNN, MSNBC, and Fox News. Every commercial break is often packed with advertisements promoting prescription medications, ranging from Ozempic to drugs for erectile dysfunction and HIV, in seasonal cycles. Personally, I find the daily barrage of advertisements for Plaque Psoriasis medications on breakfast TV to be exhausting.
This level of advertising is prohibited in Europe, making it an alarming sight. Furthermore, it significantly inflates the prices of medications, resulting in consumers paying the highest costs globally here since the advertising expenses are passed on to the end users.
Again, the affordability of these medications hinges on the health insurance coverage one possesses (or lacks).
For years, the OECD (Organisation for Economic Co-operation and Development) has spotlighted the exorbitant costs of the American healthcare system. In its latest “Health at a Glance” report (a recommended read), this group of wealthy nations once more reveals that the US spends 16.6% of its GDP on healthcare, far surpassing the 9.2% average among OECD countries (Observatory of Economic Complexity).
In monetary terms, calibrating for purchasing power parity, the US invests $12,555 per capita in healthcare, while the OECD average stands at $4,986. In Ireland, the figure is $6,047.
Despite this lavish expenditure, the outcomes in health do not reflect superior results. Indeed, on one of the most vital indicators of health – life expectancy – the US lags behind with an average life expectancy of 76.4 years, in contrast to the OECD average of 80.3 years, and Ireland’s average of 82.4 years.
When it comes to preventable illnesses, the US also underperforms, reporting 238 cases per 100,000 individuals, compared to an average of 158 cases (and 109 in Ireland, based on pre-Covid data).
The US President-elect moderated his message about dismantling Obamacare during the most recent election cycle.
Pharmaceutical expenses in the US average $1,432 per capita, compared to the average of $614 across 33 OECD countries (Ireland is at $625 and the UK at $466).
The American healthcare system is incredibly expensive, labor-intensive, and bureaucratic – and, surprisingly, it does not deliver particularly favorable outcomes for consumers.
While some individuals in the US can access top-tier medical care globally, receiving operations and medications unavailable elsewhere, this certainly isn’t the experience of the majority.
The overall health statistics reveal the dissonance between spending and results, leaving many Americans anxious, distressed, insecure, sometimes unwell, and, alarmingly, occasionally violent.
There are countless admirable qualities about America, but its healthcare system is not among them.
