Let Me Tell You Why People Hate Health Insurance Executives
There is no condoning the cold-blooded murder of a UnitedHealth Group executive in predawn Manhattan. Moments after Brian Thompson was shot dead, a torrent of unsympathetic posts flooded social media. I was surprised by both the brazen attack and the unveiled congratulations to a killer. The reasons for the anger, however, I understood very well.
I have my own story. I shared it after the insurer had launched its cruel "Delay Deny Defend" strategy to avoid covering my husband's cancer treatment. Those three words became the title of a 2010 book on the subject, written by Rutgers University law professor Jay Feinman. They may have been the inspiration for the words etched on bullet casings found at the crime scene: "deny," "defend" and "depose."
For years, my husband and I had no serious health issues. We would go to a doctor for annual checkups, and that was it. We were ideal customers for UnitedHealth or any other insurer.
But then my husband was diagnosed with complicated liver cancer. Our plan stipulated that we use doctors in the insurer's network but that if we needed specialized care elsewhere, United Healthcare would cover it. Our network doctor, an expert in liver cancer, told us in no uncertain terms to go to Deaconess Hospital in Boston. Deaconess then offered the cutting-edge treatment my husband needed — and was only a 50-minute drive away.
The doctor obviously anticipated the battle we faced in getting the insurer to cover it. As we walked out of his office, he whispered, "Mortgage the house."
We would have done just that and sued UnitedHealth later had we not fallen victim to the "delay" scheme. The company repeatedly implied that it would seriously consider covering the treatment. To get there, we had to go through an appeal process. That meant speaking to a "handler" who said our case would be reevaluated. About a week later, a one-sentence rejection letter would arrive by snail mail. But it included a number we could call to challenge the verdict. Around we again went.
We could never talk to anyone who made decisions. We couldn't get anyone there to talk to our doctor. At one point, we were told to seek treatment at a now-failing community hospital. The handler told us that the person sending us there was "a nurse" as though that was reassuring.
My husband, an ex-Marine, was a tough customer. He said that dealing with the insurer was worse than dealing with the cancer.
We had fallen into those traps, which Feinman explained, were designed "to wear down claimants" and "flat-out deny" valid claims. Should the policyholder sue, the insurer would unleash a team of lawyers who excelled at swatting away plaintiffs.
Because insurers put the premium payments into investments, delaying payouts also enabled them make more money.
In serious cases, one suspects that delaying tactics are also intended to wait out the life of the patient: The policyholder would die before the insurer had to spend money on medical care. We finally said "the hell with waiting" and went to Deaconess for treatment.
Some months after a grueling round of chemo, my husband died. I'll never know for sure whether the delay hastened that outcome. I do know that the then-CEO of United Healthcare — widely known as William "Dollar Bill" McGuire — later walked off with a $1.1 billion golden parachute after having raked in $500 million.
One last note: Project 2025, the right-wing blueprint for a second Trump term, would, among other things, let Affordable Care Act insurers discriminate against preexisting conditions. It would deregulate Medicare Advantage plans, which are run by private insurers, and herd more Medicare beneficiaries into them.
You've been warned.
Reprinted with permission from Creators.
