First, let me state this for the record so no one can try to manipulate my words. The murder of UnitedHealthcare CEO Brian Thompson is nothing short of an act of murder. I condemn the act and hope the perpetrator is apprehended and prosecuted to the fullest extent of the law, left to the justice meted out by a jury of his peers.
I also extend my sincere condolences to Mr. Thompson’s family and close friends.
That said, it would be wise to examine the possible motives that spurred the shooter to engage in murder, in the taking of another human being’s life.
The security camera footage of the shooting is chilling, even in a world where violence is over-glorified in the entertainment industries. The shooter, calculated and cold in his simplicity, stalked Thompson and very simply pulled the trigger…three times.
Investigators have discovered that etched onto the bullet casings found at the murder scene were the words “deny,” “defend,” and “depose.” These words are eerily similar to the title of the book, Delay, Deny, Defend, which discusses why “insurance companies don’t pay claims and what you can do about it.”
The book is a critical examination of the insurance industry in the United States, delving into how insurance companies often operate through strategies encapsulated by its title:
Insurers often use delaying tactics to slow the claims process, hoping claimants will give up or settle for less. When that doesn’t work, they often reject claims (even valid ones) by finding any reason not to pay out. And if those two tactics don’t work, many, if not most, insurers will proceed to litigation, aggressively defending and leveraging their resources to outlast or outspend the policyholder.
The book’s author uses numerous examples and case studies to illustrate these practices, highlighting how they affect individuals and the broader economy and society. He argues that these strategies prioritize profit over policyholder welfare, often at the expense of those who have paid for coverage expecting protection in times of need. The book also explores regulatory failures and suggests reforms to make the insurance industry more equitable and consumer-friendly.
So, it is reasonable to speculate that the shooter was adversely affected by the health insurance industry and decided, like the character Howard Beale in the movie Network, that he was mad as hell and wasn’t going to take it anymore.
Of course, that wouldn’t rationalize an act of murder, and it certainly doesn’t excuse it. But who hasn’t had a run-in with a health insurance company and ended up enraged and disgusted? At every turn, there seems to be a loophole or fine-print caveat that excludes what an insured patient needs or saddles him or her with co-pays that are just about as expensive as paying out-of-pocket.
Then there is the unholy alliance between the health insurance industry and BigPharma.
Insurance companies influence drug costs through their formulary, a list of insurance-covered medications. BigPharma often colludes with insurers to ensure their drugs are included in these formularies through financial incentives or exclusive deals, which usually aren’t in the best interest of patients or based on the drug's effectiveness.
Further, there have been legal actions regarding price-fixing and collusion in drug pricing, where insurance companies and pharmaceutical companies agree on pricing strategies that limit competition and keep prices artificially high.
For example. The average price for a 30-day supply (60 tablets) of the anticoagulant medication Eliquis is approximately $185 in Canada. In the United States, where we are told we have a superior healthcare system, the list price for a 30-day supply is approximately $594. That’s a $409 difference.
The average price in Mexico is approximately $85. This translates to slightly more than $1 per pill. In the United States, the land where the US federal government tried to mandate health insurance for all each tablet of Eliquis costs approximately $9.90.
That’s just one medication. Now use that as a loose base-line in contemplating how the costs of other medicines and medical procedures are affected by this unholy alliance.
Consider this. One report of cost inflation after an Emergency Room visit detailed a case where a $629 bill was issued, with $7 attributed to a Band-Aid and the rest to the facility fee for emergency services. In another example, the cost of a Band-Aid was part of a $478 bill for a minor injury treatment. The retail price of a Band-Aid is anywhere from $0.05 to $0.50.
Then there are plain old visits to a doctor. The average non-insurance out-of-pocket cost for a visit to the doctor in 2024 is anywhere from $150 to $300 for a basic visit. In 2000, that same visit cost $61. In 1980, it cost $14. These costs are based on data from the Agency for Healthcare Research & Quality.
But what about major life-threatening illnesses and how health insurance companies issue payments to cover those?
Let’s use the scariest example for most people: cancer. And please remember this is a generalization, so numbers are to be understood as approximate references. Different kinds of cancer treatments cost more and some less.
The average cost for cancer treatment in 2024 is around $150,000 per patient annually. This figure encompasses treatments like chemotherapy, radiation, surgery, and medications.
Typically, insurance might cover around 70% to 90% of the total cost of cancer treatment, assuming the patient is within network and all treatments are covered under the policy. But most—if not all—patients should expect to pay anywhere from $5,000 to $30,000 out-of-pocket annually for cancer treatment, including the deductible, co-pays, coinsurance, and any non-covered treatments or expenses.
Now, consider this. According to a study by Synchrony released in 2022, the average insured American adult with employer-sponsored health insurance could spend more than $320,000 over their adult lifetime on healthcare costs. This includes both premiums and out-of-pocket expenses. Given that approximately 92% of the US population had health insurance coverage for all or part of 2023, the math bears out that over the lifetimes of those American adults, the health insurance industry—and through them, BigPharma—extracts over $98.035 trillion from the insured.
And if they only pay 90% of the patients' costs, they make $9.803 trillion over the course of an American Generation. If they only pay out 70% of the expenses incurred, they make $68.624 trillion. So, you can see the incentive for health insurance companies to “delay, deny, and defend.”
Again, I am not defending the person who took Brian Thompson’s life. I will restate this with all seriousness and sincerity. I hope he or she is apprehended, prosecuted to the fullest extent of the law, and adjudicated by a jury of his or her peers.
But, and this should be taken existentially, if the shooter lost a child, a spouse, or a parent—hell, even a close friend—because a health insurance company delayed the claims process in hopes the claimant would settle for less or rejected the claim—or any of the necessary medication or medical procedures needed for survival—because of a loophole, or ended up litigating a claim to outlast or outspend the policyholder so they wouldn’t have to pay out on the claim, well, I can see clearly how that person’s hopelessness, frustration, and anxiety would have motivated him or her to do something, especially when we are talking about lifetime profits in the $9.803 trillion to $68.624 trillion range.
This is the hope of what Robert F. Kennedy Jr. in the Trump 2.0 administration represents. Is it too much for one person to tackle in one four-year stint? Honestly, yes. The Deep State bureaucratic behemoth that is the healthcare industry—to include Big Pharma—here in the United States will take generations to tame and reform, but damn it, it’s a start.
If Kennedy, Elon Musk, and Vivek Ramaswamy can work together to set in place the basis for the continued refinement and reform of the healthcare industrial complex so that it serves the American people rather than creating billionaires and placing every other country’s people before ours, we will be re-charted in the right direction.
Just my two cents, but the first things that should happen are to:
Mandate over-state-line portability for all insurance policies
Restrict BigPharma from the duplicitous pricing of medications between nations
Eliminate “enrollment periods
And last but certainly not least, unpackage health insurance plans to make them ala carte so that only age- and gender-appropriate treatments are covered in anyone’s plan.
Oh, and get the federal government—and state governments, for that matter—out of bed with health insurance companies and BigPharma. The federal government has proven itself an abstract failure in all things private sector related, especially in aspects of healthcare. The sooner we get that gaggle of self-enriching assholes out of the healthcare process, the better.
Then, when we come back, our segment on America’s Third Watch, broadcast nationally from our flagship station WGUL AM930 & FM93.7 in Tampa, Florida.
Share this post