(Brad Ryan’s post from ABC NEWS AUS on 7 December 2024.)
Killing of the healthcare CEO in New York
highlights anger and danger for US health insurers: As he walked a footpath in
central Manhattan just before the sun rose over New York, Brian Thompson
suddenly fell victim to a deadly ambush.
The father-of-two had travelled from Minnesota to
attend a conference for UnitedHealthcare — a huge health insurance company
where he was the CEO. Its parent company, UnitedHealth Group, is America's
fourth largest money-maker, after Walmart, Amazon and Apple. It was set to
present investors with a revenue forecast for the coming year of $US450 billion
(A$705 billion).
CCTV shows Thompson, 50, approaching the doorway of the conference venue, the Midtown Hilton hotel, at 6:45am. Suddenly, a man wearing a black hoodie appears in the corner of the frame. He raises a gun, which appears to be fitted with a hitman-style silencer, aims at Thompson and fires two rounds.
Ignoring a bystander as she runs away, the gunman
approaches Thompson, who is lying on the footpath. He shoots him again. Then,
he dashes across the street. Investigators said the suspect ran through an
alley, got on an e-bike, and cycled into Central Park.
On Friday, local time, police said they believe he
caught a cab to a bus station, where he likely boarded a bus and left New York
City. But, according to local news reports, he left behind a message. Investigators
found three words written on bullet casings found at the murder scene. "Deny."
"Defend." "Depose."
Three Words
The three words appear to be a reference to a
phrase commonly used in conversations about America's health insurers.
"Delay, deny, defend" is a three-word
summary of the tactics insurers are said to use to avoid paying out clients.
Delay dealing with a claim, deny payment, and defend the decision in court.
Unlike Australia, whose citizens are covered by
Medicare, the US does not have universal public health insurance. Most
Americans are reliant on their employers for insurance. Individual private
insurance is costly.
But without the help of an insurer — or even with
cover — a serious injury or illness can send a patient and their family broke.
A fifth of insured adults aged 18-64 incurred unaffordable out-of-pocket costs
for healthcare in 2020, according to the non-profit Commonwealth Fund.
Healthcare bills are now the number one cause of
personal bankruptcy in the US. The Consumer Financial Protection Bureau says
about 100 million Americans owe medical debt of more than $US220 billion ($345
billion).
Flags were flown at half-mast outside the company's
Minnesota office. But in some corners of the internet, Thompson's death was
ghoulishly celebrated in gleeful posts that have both attracted outrage and
been sent viral. And social media was flooded with stories of healthcare claims
denied by insurers.
Columbia University professor Anthony Zenkus, in an
X post that's been liked more than 100,000 times, wrote: "Today, we mourn
the death of United Healthcare CEO Brian Thompson, gunned down … wait, I'm
sorry — today we mourn the deaths of the 68,000 Americans who needlessly die
each year so that insurance company execs like Brian Thompson can become
multimillionaires."
Michael Tuffin, the president of insurance industry
group AHIP, said he condemned "any suggestion that threats against our
colleagues – or anyone else in our country – are ever acceptable".
"The people in our industry are mission-driven
professionals working to make coverage and care as affordable as possible and
to help people navigate the complex medical system," he wrote on LinkedIn.
While police say the motive for the killing remains
unclear, it also sparked a bigger conversation — about how anger at the system
had reached a point where someone might think there's justification for murder.
A maligned industry
The phrase "delay, deny, defend" gained
prominence in 2010 as part of a book title – Delay Deny Defend: Why Insurance
Companies Don't Pay Claims and What You Can Do About It. In the book, law
professor Jay Feinman argued America's top insurers began employing these
tactics in the 1990s.
Many of them worked with the same consulting firm,
McKinsey & Company, to develop new strategies for handling claims. Computer
systems were designed to generate lowball offers for clients, who were given
"take it or litigate" ultimatums. "The claims department became
a profit centre rather than a place that kept the company's promise,"
Feinman wrote.
Years later, after Hurricane Katrina devastated
parts of south-eastern America in 2005, the state of Louisiana took on McKinsey
and the insurers it worked with. As summarised in a later appeals court
decision, the state argued McKinsey:
"…engineered a strategy that undervalued
insurance claims, allowing insurance companies and their shareholders to reap
the profits. Initially, McKinsey advised insurers to stop 'premium leakage' by
undervaluing claims using the tactics of 'deny, delay, and defend;' as a
result, many insurers began hiring McKinsey…"
The state was ultimately unsuccessful, and the case
was dismissed. But there's evidence such practices persist, including in health
insurance. More recently, the use of AI-driven algorithms has compounded the
controversy.
Last year, the families of two UnitedHealth clients
sued the company, claiming it used an AI model with a 90 per cent error rate to
override doctors' decisions to provide care to patients. At the same time, an
investigative piece in online medical publication STAT News outlined how
UnitedHealth staff were pressured to follow an AI algorithm's calculations on
when to cut off rehabilitation care for elderly patients.
Staff reportedly faced discipline or termination if
they didn't cut off the care, even if ongoing care was actually covered. UnitedHealth
has argued it employs AI for guidance, rather than ultimate decision-making. AI
and machine-learning are used "as inputs in the decision-making process
[combined] with inputs from patients, providers, experts and partners".
McKinsey has a policy not to publicly discuss work
it does for clients, and did not respond to the ABC's request for comment.
Shockwaves through sector
The killing has now prompted a reassessment of the
security risks facing senior figures across the US health insurance sector. Thompson's
loved ones said they were "shattered" by the "senseless"
killing.
Brian Thompson was about to attend an investor
meeting when he was shot. "Brian
was an incredibly loving, generous, talented man who truly lived life to the
fullest and touched so many lives," the family said in a statement.
His employer said it was "saddened and
shocked" by his death. "Brian was a highly respected colleague and
friend to all who worked with him," UnitedHealth Group said. "We are
working closely with the New York Police Department and ask for your patience
and understanding during this difficult time."
UnitedHealthcare has taken down the online
biographies of its leadership team, while other companies, including major
insurer CVS Health, have removed photos of their executives from their
websites.
Minnesota-based healthcare firm Medica temporarily
closed its office buildings in multiple states, "out of an abundance of
caution" for its employees. The UnitedHealth Group has also stepped up
security for its staff. Police in New York say Thompson was not being
accompanied by bodyguards when he was shot.
He killed a CEO. A CCTV trail unravels his last steps
After the shooting of UnitedHealthcare CEO Brian
Thompson, questions swirl over how the killer could disappear in the city of
surveillance. "We have increased security at our campuses in Minnesota, in
addition to sites in Washington DC and New York City areas," CEO Andrew
Witty said in an email sent to staff and obtained by CNN.
Before his death, Thompson had a relatively low public profile. But some of America's biggest companies spend millions of dollars per year protecting their senior executives, particularly those who are the public faces of their organisations and are more likely to become the subject of threats.
Social media giant Meta, for example, reportedly spent $US24 million ($37 million) last year on security for CEO Mark Zuckerberg and the company's former chief operating officer.The company said the Facebook founder was "synonymous with Meta and, as a result, negative sentiment regarding our company is directly associated with, and often transferred to, Mr Zuckerberg".
Still on the run
Three days after the killing, the suspect remains
on the run from authorities. Police in New York are still scouring surveillance
footage from across the city, and the CCTV images of a "person of
interest" are being frequently flashed over US news networks.
Local media outlets are also quoting unidentified
law enforcement officials as saying the suspect is believed to have used a fake
ID to book into an Upper West Side hostel, after arriving in New York last
month on a bus that originated in Atlanta.
They're also reporting that possible DNA evidence
is now being tested in the hope it could provide a major breakthrough in the
case. "We are on the right track," the city's mayor, Eric Adams,
said. "We're going to bring this person to justice."
(Blogger's Notes: I can understand the anguish and frustration of US citizens as a collective response towards their nasty health insurers. I also had American health insurance for nearly four years at a great expense while I was semi-permanently residing in NYC. Even as a not-so-healthy old man, I didn't have to claim for anything as I tried to avoid the stupid doctors first three years there.
Only in last and my fourth year there, I had to see a dentist as my four molars were rotting. So I went and had the extractions, and a dental bridge put in at the left side first and arranged an appointment to do the same thing on the right side a week later. But unfortunately, my insurer denied to pre-approve that second dental bridge and I ended up eating only with my left side for the rest of my life. Just for lousy three grands, which was well less than tens of thousands of US$ premiums for four years there, they fucking ruined my life, bastards.
I was a born-communist but I ain't a Socialist. And as a long-term Sydney resident I've truly benefitted from the Universal Heatlh Insurance run by the Australian government and, thus I strongly believe that letting profit-seeking private businesses run the health insurance, like in the US, is a gross violation of universal human-rights and spitting at our human-dignity.)
