Assassination

We don't yet know the motive for the murder of United Healthcare CEO Brian Thompson, but while we're waiting to find out, it's a good time to talk about the company. It's conceivable that this was an entirely personal matter, having nothing to do with Thompson's job -- maybe Thompson was boinking the guy's wife. But that seems highly unlikely, all the more so because the hit happened in Manhattan, a thousand miles away from his home in Minnesota.

 

On the other hand, if the motive were political, we'd expect to have seen some sort of public manifesto or claim of rationale, and so far that hasn't happened. What I can well believe, however, is that the motive was more about a personal grievance against the company. An earlier ProPublica investigation found that United HealthCare flags expensive accounts for added scrutiny and in at least one case, had improperly denied paying for a treatment apparently because of the expense. This is anecdotal, and the company disputes that the denial was improper. But lack of transparency by insurers, and lack of enforcement action by government, leaves us in the dark about the extent of the problem.

A more recent investigation by ProPublica finds that United systematically denies payment for behavioral health services. The company uses algorithms to arbitrarily limit the number of therapy sessions it will pay for, without regard for patient’s needs. It’s practices have been found illegal in three states, but there is no relevant national regulatory authority for plans that people buy in the marketplace, or plans funded by Medicaid. As many people with behavioral health needs are Medicaid beneficiaries, this means that some of the most vulnerable people are routinely denied needed services. New York’s Attorney General won a $14.3 million judgment against United for illegally denying mental health services, but this had no effect in other states.

 

According to an analysis in The Economist, 45% of medical spending in the U.S. goes to just nine firms: insurers, drug distributors and pharmacy benefit managers.  UnitedHealth had revenues of $324 billion in 2022, second only to Walmart, and it is now America’s 12th most valuable company. United is the health insurance provider for 50 million people. So Thompson was making millions, much of it off of the government,  juicing  profits by denying desperately needed services to the most desperate people. I'm not saying that the proper response was to assassinate him, but I think that's the likely motive. Maybe some other people ought to be looking over their shoulders right now.