The US health insurance industry is broken. Don’t let it break us
WHEN news broke that UnitedHealth Group executive Brian Thompson had been fatally shot on a street in Midtown Manhattan, the public responded with the kind of vitriol usually reserved for our most polarizing politicians.
I found myself wincing at the tone of the messages rolling in on my various group threads and social media sites — including from people whose opinions I usually deeply respect. My compass on these things is always how I’d want my daughter to hear me react in such a moment. Would I want her to think it’s okay to dance on the grave of someone whose sons are now fatherless?
I unequivocally do not. Nor would I want her to get the idea that this craven act was justified.
And yet, we can’t ignore the ferocity of the response — or the fact that no one’s gut told them to check it. It lays bare a ground truth: If there’s anything our fractured country seems to agree on, it’s that the healthcare system is tragically broken, and the companies profiting from it are morally bankrupt. And it shows that most of us have felt harmed by a system that puts profits before patients.
Thompson became a proxy for the healthcare industry writ large (It does not help that the company he led has repeatedly been shown to be one of the worst offenders when denying claims.)
Nearly everyone has a story of their insurance company denying basic care. Raise your hand if you’ve ever been brought to tears while on a call with your insurance company. Keep it up if your stomach has ever dropped on opening the mailbox to find a bill from your insurer; if you’ve walked up to the pharmacy counter wondering if you can afford your prescription; if you’ve gone into debt because of medical costs; if you’ve watched a family member suffer because they’ve been denied treatment.
I suspect a lot of hands are up.
Those indignities hit us at our most vulnerable moments: when we are grappling with a life-changing diagnosis, when our children are struggling with depression, or when we need a medication that we’ve always relied on — one that has made it possible to be a functional member of society. Those moments stick with you for life.
My compass still points me to civility because I fundamentally don’t believe in celebrating personal tragedy. And I certainly don’t believe in condoning violence. I don’t like the idea of living in a world where a killer (whose motives, by the way, still are unknown) is elevated to the level of folk hero.
Yet I desperately want this rage to be channeled into something productive.
My worry is that it will not and, by design, cannot under the US’ current healthcare infrastructure. That instead of prompting healthcare companies to introspection about their most egregious, profit-driven behaviors, they will simply go quiet and hope we move on.
We’re hearing about how companies had beefed up security even before this event. They have since removed executives’ photos from their websites and canceled in-person investor events. Those are rational changes to protect their employees. We have yet to hear whether they will make any changes to protect their customers’ access to care.
Instead of sparking an honest reckoning about the structural fixes needed to arrive at a more functional and humane system, we are being primed for an administration whose approach to healthcare will make it so much worse. President-elect Donald Trump’s administration seems keen to find cuts in ways that will directly harm Americans’ access to care, whether by making insurance less affordable or through deep cuts to Medicaid. People won’t have insurance companies to be mad at because millions more won’t have insurance at all.
I also worry that the rage is causing more people to gravitate toward ideas that ultimately are dangerous. There seems to be a growing attitude that real change can only come by burning it all down. Or that we need to be open to extreme approaches to fixing our system — even if they involve sacrificing bedrock tenets of public health. One needs only look at the positive caveats many suddenly seem to be finding in the incoming administration’s picks to lead the nation’s top public health agencies as a guide.
I hope my cynicism is off base. But I fear there are dark days ahead for so many of us. And especially for the two kids who just lost their dad.
BLOOMBERG OPINION
