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UnitedHealthcare CEO killing unleashed flood of industry frustrations. Could reforms also follow?
By
Caroline Lewis
Published Dec 12, 2024
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By
Caroline Lewis
Published Dec 12, 2024
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The fatal shooting of UnitedHealthcare CEO Brian Thompson uncorked a deep well of pent-up consumer frustration over the country’s health insurance system. Now some New Yorkers say they hope the discussion, notwithstanding how it began, might lead to change.
“It's like an action movie or a spy thriller,” Brooklynite Eli Scherer, 37, said of the fatal shooting, which has become a hot topic for conversation in his social network. Scherer said his “values are not to celebrate someone who’s been killed,” but the incident has sparked “excitement” among his friends that some change might result from the collective outcry.
Other health care consumers are echoing that view in the aftermath of the Dec. 4 shooting in Midtown. Luigi Mangione, 26, faces charges in connection with the killing, and railed against the health care industry and insurers, according to police. But it’s hardly clear what shape any reforms might take.
Some insurance practices, like the rising rate of coverage denials by privatized Medicare plans, have attracted scrutiny from politicians on both sides of the aisle. But the country remains divided on big proposals to overhaul the health system, including a shift toward universal public insurance.
Satisfaction with the overall state of health coverage in the United States is at a 24-year low, according to a Gallup poll released last week. Just 28% of respondents rated it as “excellent” or “good,” even though the majority said they were satisfied with their own insurance plans. Approval for the country’s insurance system overall was similarly low among both Democrats and Republicans.
In a separate Gallup poll released this week, 46% of respondents said they would prefer a government-run insurance system, while 49% said they would prefer to keep a system based on private insurance, with responses largely divided by political party. Among Democrats, approval for a public system was 71%, compared with 21% among Republicans.
Incremental fixes have been proposed to improve coverage, including regulations on the use of artificial intelligence and other technologies to determine whether health coverage is approved, and greater transparency around how frequently insurers require prior approval for medical care and how often they deny coverage.
But even reforms that have been passed in recent years, such as legislation at the state and national levels to prevent people from receiving so-called “surprise” out-of-network bills, often come with caveats. Patients still often struggle to tell whether a medical bill is legitimate, said Elisabeth Benjamin of the Community Service Society of New York, which helps New Yorkers appeal coverage denials through its Community Health Advocates program.
Benjamin added that there should be more programs like hers that can “help patients through the morass,” noting that her organization is usually successful at getting denials reversed.
About 17% of in-network claims made through plans on the federal Affordable Care Act marketplace in 2021 were denied, according to an analysis by the health policy nonprofit KFF. Less than 1% of patients affected filed a formal appeal, but of those who did, 41% were reversed.
Many more patients report taking some kind of action to try to resolve denied claims, even if they don’t file a formal appeal, according to a survey KFF conducted of insured adults last year.
But some say even having to argue with insurance companies is exhausting and makes them more cynical about the health system.
In Scherer’s case, he said he is currently struggling to get his insurance to cover the asthma medication that was recommended for his 18-month-old daughter.
“You just get so frustrated that our system doesn't make it easy to just go get the life-saving things that you need for your family,” he said.
Anthony Almojera, a lieutenant paramedic with FDNY's Emergency Medical Services division, said his job has made him cynical about the health system.
“For 22 years now, I've been going into people's homes who have delayed or denied themselves health care because they don't have adequate insurance,” Almojera said.
He said that big and small issues with insurance can add up, noting that he was recently denied coverage for a blood test. “I don't advocate violence in any way, shape or form,” he said of the CEO shooting. “But I get people’s frustration.”
Almojera said he personally preferred a public insurance option, but he wasn’t optimistic about that. “The hope is that enough people get motivated on both sides of the aisle to say we have to come up with something,” he added.
Marianne Pizzitola, a retired FDNY employee who has organized fellow municipal retirees to resist the city’s effort to switch them from traditional Medicare to a privatized Medicare Advantage plan, says she wants others to follow in her footsteps and use collective action to make demands around health coverage without resorting to violence.
Former Mayor Bill de Blasio first reached a deal with powerful municipal union leaders to make the switch back in 2021, saying it would save the city hundreds of millions of dollars a year that could go toward health care for current union members, without sacrificing retirees’ quality of care.
Mayor Eric Adams has since picked up the mantle and tried to convince retirees that the plan the city developed was not like other Medicare Advantage plans, which have come under fire for requiring doctors to get prior approval for coverage more frequently than traditional Medicare.
“We are confident that it is the right step for retirees, the city, and its taxpayers,” Liz Garcia, a spokesperson for the mayor, said in a statement.
Retirees got a win when a judge moved to block the switch last year — but the city appealed and the changes are still being hashed out in multiple lawsuits.
Still, retirees have continued to resist. Nearly four years after she started to organize people for the cause, Pizzitola said she is “freaking tired of fighting this.” But, she said, “some people listen.”
Tagged
new york
public safety
Health and Science
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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