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AMERICANS HATE THEIR PRIVATE HEALTH INSURANCE  
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Branko Marcetic
December 7, 2024
Jacobin
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_ The response to UnitedHealthcare CEO’s murder surely disproves
the claim that Americans love the private health insurance system.
It’s a political force waiting to be harnessed — but few in DC
seem interested. _

UnitedHealthcare has been accused of using AI to deny patients
coverage. , Stephen Maturen / Getty Images

 

Americans are not happy with the US health care system. For the first
time in two decades, a majority of Americans rate
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US health care as substandard, including a new high calling it
“poor.” Nearly three-quarters say it’s failing
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needs, and about half
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find it difficult to afford their medical bills. A majority
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have had some kind of problem — denied claims, for instance, or
issues with provider networks or pre-authorization — with their
insurance, and even bigger majorities
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feel insurers aren’t transparent about what they cover, or think
insurance bills or the various payments they have to make to insurers
are not easy to understand.

But forget the polls. If you want to get a sense of just how deep and
widespread Americans’ rage at this often absurd and unfair system
is, just look at the public reaction to the shocking news of the
assassination of Brian Thompson, the CEO of UnitedHealthcare (UHC),
one of the country’s most cruel
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and rapacious
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health insurance companies. Whatever his killer’s motive, across the
internet — on social media, YouTube, news comments sections, and
more — the response has been the same: Americans are either
gleefully mocking his death, saying they understand why it happened
even if they don’t condone it, or sharing their own appalling
personal experiences with health insurers.

The fact that this is the US public response, en masse, to the murder
of a human being speaks volumes about Americans’ widespread disgust
with a profit-driven health care system that leaves so many destitute
or simply dead.

“I Hate Insurance Companies”

A Facebook post
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by the company expressing sadness and shock at Thompson’s killing
has, as of the time of writing, nearly eighty thousand _laughing emoji
_reactions. Twitter/X exploded with jokes
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murder.

“A good lesson here is that you should live your life in such a way
that when you die, nobody pulls out a spreadsheet to mathematically
explain why they’re happy you’re dead,” wrote
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Kristin Chirico in a tweet that so far has 54,000 likes.

“Chipotle raised its prices again and someone just asked who the CEO
is LMFAOOOO,” another user tweeted
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315,000 likes so far.

Many of these are being collected and cross-posted on Instagram. Angry
commentary is also happening at X’s rival, Bluesky. “The reward
out for the person who shot United Healthcare’s CEO isn’t even
enough to cover 1/9 of the bill we got for 28 days of radiation,”
cartoonist Marie Enger wrote
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the platform, receiving thousands of likes.

TikTokers are writing and performing songs
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Thompson’s murder, with lyrics like “the people got a prize in a
blood celebration” and “you should never have to face the things
your customers all face,” directed at CEOs. _Delay, Deny, Defend:
Why Insurance Companies Don’t Pay Claims and What You Can Do About
It_ — a fourteen-year-old book criticizing health insurance
companies’ practices whose title closely matches the words written
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on the casings of the bullets Thompson’s killer fired at him — has
suddenly rocketed to number three on Amazon’s best-selling books in
the business and money category.

On Reddit, a thread
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about the murder on the r/medicine subreddit — a forum that
describes itself as “a virtual lounge for physicians and other
medical professionals” — had to be closed by moderators because
users responded with a spree of jokes. The top comment is from a nurse
who wrote out a parody of a UHC denial-of-care letter, in this case
addressed to Thompson regarding his emergency treatment after being
shot. UHC couldn’t cover his emergency services, explains the
comment, because he hadn’t proved “medical necessity,” he
hadn’t gotten “prior authorization,” the ER he went to was out
of network, and he hadn’t explored other, lower-cost options.

“We understand that you were actively ‘bleeding out,’ but this
does not exempt you from exploring lower-cost care pathways,” says
the comment.

It was a similar scene over at r/nursing, another forum run and
populated by medical professionals, specifically nurses. That
subreddit is now filled
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with “Code Blue Threads” — meaning threads that moderators had
to restrict comments on — making
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snarky
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responses
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to Thompson’s murder and to health insurance executives fretting
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for their security or backtracking
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some truly heinous policy changes in response. A moderator had to post
a reminder
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that content advocating for violence was not allowed and would be
removed. (“I don’t envy your position in the slightest. It’s
like having to be the one to stop the people from playing soccer with
Mussolini’s head,” replied one user.)

One of that subreddit’s threads about the murder made it over
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to r/SubredditDrama, a forum covering what are considered particularly
entertaining internal controversies in the site’s various
subreddits. A user posted “some highlights” of the snarky comments
in the thread, like a discussion about good tuna salad recipes, or one
charging that a “bullet in chest . . . sounds like a pre-existing
condition” and that Thompson should “try physical therapy”
instead. The poster notes that a comment chiding people that
“celebrating a murder and calling for more is gross” was downvoted
way into the negatives — meaning disapproval by users en masse.

Similar or even more scathing comments were rife throughout the
r/nursing subreddit: “I hope they bill his family for the ambulance
ride in this trying time
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“No sympathy here, and his millions of dollars are now worthless to
him
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“Sounds like this is related to the pre-existing condition of being
an amoral asshole
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“The absolute savagery in these comments really shows you how
absolutely sick we all are of our patients and families being fucked
by insurance companies,” wrote
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another user. The r/jokes subreddit is packed
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with
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jokes
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about the murder, which are currently some of the most upvoted threads
on the page (meaning they’ve gotten the most approval from users of
the forum).

Meanwhile, several users took the occasion to relate their own horror
stories of working with insurers, including UHC.

“I work at a gastroenterology center in billing, and I have actually
had to argue with UHC because they didn’t want to deem a procedure
for a man who had been shot in the stomach as ‘emergent,’” wrote
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one account whose comment was met with numerous replies from users
sharing their own stories. “I hate insurance companies. Insurance is
a literal scam.”

Another user recounted
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how he suspected that UHC had made a deal with his former employer,
AT&T, to exclude his jaw surgery from coverage, because his surgeon
had had at least thirteen patients with the company that year and seen
similar denials. Despite being told he “would lose the ability to
chew by [his] forties,” he couldn’t get the surgery, and now, at
forty-two, he can only eat certain foods while in extreme pain and is
worried about the possible side effects of retrying the procedure at
an older age. “So, I won’t outright say how I feel but you might
guess it,” he concluded.

This was not unique to Reddit. You could find the same sentiment on
YouTube, in the comments sections of videos about the murder from CNN
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(“oh my god that’s so horrible!! is the floor that he fell on
okay???”), _Inside Edition_
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empathy is out of network”), and the _Today Show_
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many lives and families. Condolences: denied”; “If you have any
information on the shooter, keep it to yourself”), for instance.
When _CBS Mornings_ posted a video
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outpouring of popular anger, YouTube commenters heaped scorn on the
anchors.

“How can she say with a straight face, ‘we’re a country of law &
order’? Since when have any of these corrupt, greedy corporations
been held accountable?” was the most-liked comment.

“You should have called this video ‘Out of touch, rich [news]
anchors shocked by common people’s anger over watching their
families die due to denied claims,’” went the second-most liked.

You’re seeing the same kind of thing in the comments sections of
right-leaning news outlets. One of the _Wall Street Journal_’s
stories
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on the matter has more than two thousand comments, far more than most
of its other stories. “After just watching _Pain Hustlers_ on
Netflix, I can understand how this incident could happen. . . .
Don’t condone it, but understand,” wrote one reader. “Oh well.
What’s for lunch?” wrote another.

This was repeated in stories about the killing on Fox News
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(“I’ve been a surgeon for almost a decade and I see patients
suffer daily because insurance companies put profits over healthCARE
every time — something that I find morally abhorrent”), the _Daily
Mail_
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(“I work in healthcare and UHC is one of the worst insurances we
work with. They deny EVERYTHING initially and it is outrageous the
hoops we have to jump through to provide patients with this
insurance.”), and even the _New York Post_
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(“United Health Care mailed me some messages too: Denied, Declined,
Deductible, Out of Network, Pre-Approval Needed, Co-payment, Your
Monthly Premium has increased. That translates to a lot of ammo.”)
— despite the paper taking a disapproving editorial stance
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toward the less-than-sympathetic responses to the crime.

Good Morals and Good Politics

What is particularly stunning about all this is that one of the core
arguments used against putting in place a single-payer health care
system like Medicare for All in the United States — by politicians,
political commentators, corporate flacks — is that people simply
love their private health insurance too much. These comments show this
is blatantly untrue.

In fact, they show that public hatred of the predatory US private
insurance system runs through not just patients but health care
professionals ranging from nurses to surgeons and even workers
responsible for billing at health care providers. And more
importantly, that hatred isn’t limited to the left side of the
political spectrum.

Yet when Bernie Sanders ran for president in 2020 calling for Medicare
for All, Americans’ supposed love for their insurance was constantly
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thrown
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at him as an argument against his proposal.

“I’m not going to support any plan that rips away quality health
care from individuals,” then Montana governor Steve Bullock said in
a debate, describing something that already happens under private
insurance.

“The real obstacle to Sanders’s plan is the public’s
expectations,” went
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one _Atlantic_ op-ed. “As much as Americans hate insurance companies
in general, they want the right to have a love-hate relationship with
their own insurer.”

Sanders’s lonely stance, promising that he would almost entirely
abolish private insurance, was framed by pundits as so politically
risky that multiple of his Democratic rivals ran away from it. That
included the next-most progressive candidate in the race, Elizabeth
Warren
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The other candidate
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who did so was Vice President Kamala Harris. This was one of the
supposedly unpopular left-wing stances from her 2019 campaign that we
were told
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Harris had to overcome to beat Donald Trump for president this year,
as she came
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under
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right-wing [[link removed]] attack
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for the position and, true to form, wilted under the pressure, selling
her flip-flopping as an act of sensible, moderate political maturity.

The deluge of public wrath toward insurers in the wake of this
startling crime — let alone the possible
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health care–related motive of the killer — casts serious doubt on
this piece of conventional political wisdom. In fact, it calls into
question the political establishment’s entire thinking on health
care.

For Republicans, that means making no changes to health care
whatsoever, other than making it easier
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for companies like UHC to deny claims and screw over patients, making
it harder for people to sue insurance
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companies, and making Americans more reliant on them by crippling
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public health care programs with spending cuts
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For Democrats, that means leaving the status quo in place and modestly
expanding Medicare while making only vague promises to “strengthen
the Affordable Care Act” (ACA) — even though the intolerable
status quo that internet users are eviscerating right now is a direct
result of nearly fifteen years under the ACA.

If you’re a Democratic official, you must surely be kicking yourself
for the direction the party has taken on this issue. First, there was
Joe Biden’s decision to abandon
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the public health insurance option pledge he made on the campaign
trail upon winning — and that was before he signed legislation that
led to more than 25 million people
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being thrown off their Medicaid insurance since last year, including
millions who were still eligible but lost it for procedural,
bureaucratic reasons.

Second, there was the decision of Harris and her team to offer no
substantive health care reform to anyone under sixty-five (that is,
anyone who isn’t eligible for Medicare). One of the indelible
moments on the road to Harris’s election failure came in an October
Univision town hall
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when a sixty-two-year-old disabled woman who had become homeless due
to a series of ailments asked the vice president how she would “make
America great again” by helping disabled people like her get health
insurance once more. Harris, who had no policy to offer, replied with
a lengthy word salad before simply suggesting that she’d ensure the
homeless woman’s medical debt wouldn’t count against her credit
score.

Anger at the privatized US health care system is not just a matter of
moral urgency (for the ordinary people who suffer constantly under
that system as well as the executives who get death threats from
them). It’s clearly a potent political force waiting to be
harnessed. No one in Washington seems to have much interest in doing
so right now. If and when they do, it could cause a political
earthquake.

* health insurance
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* Medicare for All
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