Main Edition
US
FR
December 16, 2024 - 6:00pm
In response to UnitedHealthcare boss Brian Thompson’s slaying at the hands of suspected shooter Luigi Mangione, the CEO of the insurer’s parent company, Andrew Witty, has written an op-ed in The New York Times. In the piece, Witty seemingly acknowledges popular grievances about America’s “patchwork” healthcare system, conceding: “We know the health system does not work as well as it should, and we understand people’s frustrations […] No one would design a system like the one we have. And no one did.” However, for many who read it, in the comments section (which garnered nearly 2,500 responses before the Times website closed it down), on social media, and in the wider political world, Witty’s message was not only deemed insufficient, but offensively tone-deaf and obstinate.
Readers noted that Witty entertained no proposals for policy change nor made any attempt at meeting the criticism that his company’s ruthless pursuit of profit has grossly warped its incentives, perhaps even more so than other insurers. Instead, they charged, his op-ed was an exercise in corporate PR that looked to valorise Thompson as a meritocratic role model while eliding the larger problems his violent death has highlighted. In any event, the reputational damage to the insurance industry has been done and Witty’s invitation “to partner with anyone […] to find ways to deliver high-quality care and lower costs” will inevitably be taken up by elected officials looking to tap into and lead the renewed momentum for enacting reform.
Without condoning the act itself, at least a few members of Congress asserted the connection between Mangione’s vigilantism and what they regard as morally legitimate concerns. Leading the charge are the likes of progressive Senators Elizabeth Warren and Bernie Sanders. In a HuffPost interview, Warren said: “The visceral response from people across this country who feel cheated […] by the vile practices of their insurance companies should be a warning”. Sanders, meanwhile, called the assassination “outrageous” but still expressed his belief that “what the outpouring of anger at the health care industry tells us is that millions of people understand that health care is a human right.” Congressman Ro Khanna likewise lamented the violence while calling for Medicare for All — endorsed by all three Left-wing legislators — as a solution to America’s healthcare woes.
This is in stark contrast to Right-wing media and politicians, who have vociferously opposed any notion of legitimising sympathy for Mangione. This conservative chorus has included Ben Shapiro, Matt Walsh, and Brett Stephens, as well as Fox News’s Laura Ingraham and CNN’s Scott Jennings. Shapiro and Walsh invited considerable backlash from their own audiences, while Ingraham and Jennings baffled some by pivoting in the same breath to praising their preferred vigilante Daniel Penny. In addition, Republican Congresswoman Marjorie Taylor Greene cited her fear that Mangione’s example will create both copycats — already, a Florida woman has been detained for repeating his “delay, deny, depose” slogan — and enthusiasm for a single-payer system, such as Medicare for All.
But any such movement will have to reckon with the fact that the healthcare industry accounts for 18% of US GDP, a sign of high inefficiency among the rich nations, to be sure, but one that indicates just how much of the economy would be affected by any major change. Shifting to a universal healthcare system would require creating new public bureaucracies to replace private ones, potentially costing the federal treasury an astronomical amount (as Warren herself has in the past admitted) while causing disruption to countless Americans’ healthcare plans. It would also threaten the positions not just of the big executives who run the existing system but, in Witty’s telling, the thousands of “nurses, doctors, patient and client advocates, technologists” who work for them.
Evidently, there is no clear fix for Americans. But still, there is no question that the current system is deeply dysfunctional. It should not have taken Brian Thompson’s death to reveal that.
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
Subscribe“Baffled some”. Who did it baffle that defending people directly threatened on a train carriage is not the same as killing a random CEO of a major healthcare provider? Imbeciles. To describe them both as vigilantes is disingenuous – like describing Churchill and Hitler as politicians.
Progressives make unhinged, emotional arguments in the moment to seize the moral highground. Then once the moment ends and public support for their position wanes, they act like it never really happened. The issue is never the issue.
They do this repeatedly with every issue that can be leveraged. All they really want is a greater role in the administration and distribution of public funds.
Could someone with knowledge of the US healthcare insurance market provide an insight into how insurance companies are able to wriggle out of providing for healthcare within the terms of their policies?
Is it a matter of customers not having “read the fine print”, or something else?
There are many, many perfectly legal ways to deny coverage that don’t involve much wriggling.
First, there’s the distinction between in-network and out-of-network. Insurance companies negotiate standard, reduced fees with health care providers. These providers are called in-network. If a policy holder goes to an out-of-network provider (intentionally or accidentally) they will be responsible for the full bill minus what the insurance company typically pays an in-network provider.
Then there’s the question of which procedures, tests and drugs a specific health insurer will pay for and whether the service the insured is requesting is medically necessary. For example, it’s not unusual for an insurance company to deny coverage for the latest tests/procedures on the grounds they’re still experimental or simply don’t have enough evidence to show they confer a substantial benefit on a patient.
Then there’s determining whether a procedure was medically necessary after the fact. For example, some years ago my primary care physician (GP) referred me for a scan of my lower back. I even contacted my insurance company to check the scan was covered by my insurance and I was going to an in-network scanning facility. The scan came back negative and the insurance company promptly denied coverage on the grounds that the test wasn’t medically necessary as shown by the negative scan result–perfect circular reasoning on the part of the insurance company. I challenged the decision and won.
Then there’s the question of formulary. Insurance companies will cover some drugs but not others, usually on the grounds there’s not enough evidence to show some drugs confer a substantial benefit on patients, or perhaps because a cheaper drug in the same class is available (even though not all drugs within the same class work to the same extent on every patient). If you want a drug not covered by your insurer’s formulary, you’re out of luck.
If you suffer from complex medical issues, you will generate an enormous amount of paperwork from physicians, hospitals, the insurance company at a time when you’re least able to deal with all that complexity. Insurers routinely deny a certain percentage of claims and it’s up to you to challenge those denials. Some people even hire services that track medical billing and payments for them, and deal with the insurance company over disagreements.
The Dems promote Medicare for All, while the old joke about the Republicans’ attitude to health care is: don’t get sick, and if you do get sick, die quickly.
I don’t know the answer. Reading Unherd, it appears the UK’s NHS–universal healthcare paid by taxes–doesn’t work either.
Thanks JB, that’s precisely the kind of insight i was looking for.
You’re absolutely right about the UK system too. Its floundering, albeit for different reasons. If Medicare for All is being promoted along the same lines, you really don’t want to go there.
I’m as committed to the principle of “free at the point of use” as anyone; decent healthcare should be a basic element of any advanced society and denial of such regarded with abhorrence. The devil is, of course, in the detail and there’s potentially no limit on what might constitute healthcare, certainly far more than was ever envisaged by the founders of the NHS. It seems we are, as yet, unable to have a sensible conversation in the UK about this. Hopefully what happens in the US in the light of Mangione will provide a few pointers.
No, free at point of use healthcare is NOT part of a decent society. Quite the opposite, both in theory and practice. I am British and the NHS is only viewed with favour by anyone due to its creation having been at the same time as massive improvements in basic public health.
Time to scrap NHS and more forward to private medicine.
“Medicare for all” is not “single payer”. It’s socialized healthcare paid for by taxation. Single Payer would still be private healthcare only without the group/employment based plan Not the same thing remotely. I’m offering no opinion on the arguments for either here. I am just tired of repeatedly hearing this incorrect equivalency.
The problem with selling healthcare is that you always lose as everyone dies in the end.
No happy customers.
The benefit of private healthcare is you can choose the provider with the coverage you want to pay for. You can switch providers.
The benefit of government funded is that it seems like an item society should provide.
In the real world scarcity and economics comes into play.
Who decides what doctors should be paid and what coverage should be supplied and to whom and who pays.
Is it healthcare when you have to wait a half year to see a doctor?
The trick for me is individuals making decisions. They may make poor decisions, but they should get better at it in time. A strong society is made from individuals making good decisions.
Btw, this act was murder and the usual suspects are busy rationalizing it for the comforts of their base.
Single Payer or Medicare for All would be great! It would be like Covid Lockdowns except permanent and with more unelected bureacrats telling everyone what to do and agitating for social justice riots. Sign me up. Socialism 4 All!
Back to the aptly named Mssr. Witty. He notes that United Healthcare employees are the thousands of “nurses, doctors, patient and client advocates, technologists.” It’s telling that he front-loads nurses. One could even have said, in a previous time that he is hiding behind their skirts!