PROFITS OVER PEOPLE A POSSIBLE MOTIVE IN UNITED HC SLAYING

Story is emerging that could shake the country

I had that old, journalistic tingle yesterday when I learned about the shooting of the United Healthcare executive in New York City. The chilling murder of Brian Thompson in front of a decent hotel by a hoody-wearing assailant may be a turning point for Americans, many of whom have some of the worst medical care in the developed world. This is made more infuriating because some of the best medical care in the world is just out of reach, locked away by the insurance industry which gate-keeps by denying coverage and care. I learned yesterday that United Healthcare is infamous for denying claims and is the most hated insurance company in the system.

Reading the comments section of the Daily Mail, a British paper with a huge American following, its clear people are sick of runaway CEO salaries at companies that aren’t fit for purpose - especially if the purpose is supplying health insurance to the customers paying for it. A CEO’s ten million dollar salary and a reported tens of billions in profits could push someone with a personal medical tragedy over the edge. Here is a sample of some of the comments.

One of my readers sent me this article yesterday about how UHC actually assesses claims.

United Healthcare, the largest health insurance company in the US, is allegedly using a deeply flawed AI algorithm to override doctors' judgments and wrongfully deny critical health coverage to elderly patients. This has resulted in patients being kicked out of rehabilitation programs and care facilities far too early, forcing them to drain their life savings to obtain needed care that should be covered under their government-funded Medicare Advantage Plan.

A lawsuit by patients and their families against United Healthcare lays out how its AI model, seemingly designed to deny coverage is so hard to beat. Those who fight back and win coverage for their claim, face more denials.

Even for the patients who appeal their AI-backed denials and succeed at getting them overturned, the win is short-lived—UnitedHealth will send new denials soon after, sometimes within days.

A former unnamed case manager told Stat that a supervisor directed her to immediately restart a case review process for any patient who won an appeal. "And 99.9 percent of the time, we're going to turn right back around and issue another [denial]," the former case manager said. "Well, you won, but OK, what'd that get you? Three or four days? You’re going to get another [denial] on your next review, because they want you out."

The plaintiffs leading the proposed class-action suit include the family of Gene Lokken, who died on July 17 of this year. On May 5 2022, the 91-year-old fell at home, fracturing his leg and ankle. After around six days in the hospital, he was moved to hospice care, where he spent a month recovering from his injuries. After that, doctors said he became well enough to start physical therapy. But UnitedHealth only paid for 19 days of therapy, dumbfounding his doctors and therapists, who described his muscle functions as "paralyzed and weak." The family appealed the denial, but their appeal was rejected. The rejection letter UnitedHealth sent the family said additional physical therapy was unneeded because there were no acute medical issues, and he was self-feeding and required minimal help for hygiene and grooming.

The theory that this was a revenge killing gained more traction this morning. Police found three words inscribed into rounds found at the scene.

According to police sources, the three words “deny,” “depose,” and “defend” were carved into the live rounds and shell casings found outside the Hilton Hotel on Sixth Avenue in Midtown Manhattan, New York City, where Thompson, 50, was gunned down Wednesday morning.

Police sources confirmed the chilling message to ABC News and theNew York Post, adding that three live nine-millimeter rounds and three discharged nine-millimeter shell casings were recovered from the scene.

Several of the bullets were each inscribed with one of the three words, they added.

A book for sale on Amazon holds a further clue:

Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It Hardcover – March 18 2010

by Jay M. Feinman (Author)

This is from the Amazon blurb:

Over the last two decades, insurance has become less of a safety net and more of a spider's web: sticky and complicated, designed to ensnare as much as to aid. Insurance companies now often try to delay payment of justified claims, deny payment altogether, and defend these actions by forcing claimants to enter litigation.

Jay M. Feinman, a legal scholar and insurance expert, explains how these trends developed, how the government ought to fix the system, and what the rest of us can do to protect ourselves. He shows that the denial of valid claims is not occasional or accidental or the fault of a few bad employees. It's the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm.

Citing dozens of stories of victims who were unfairly denied payment, Feinman explains how people can be more cautious when shopping for policies and what to do when pursuing a disputed claim. He also lays out a plan for the legal reforms needed to prevent future abuses. This exposé will help drive the discussion of this increasingly hot-button issue.

You’ll note the shooter changed the word “deny” to “depose” — the legal word for the taking of evidence, under oath at the beginning of a proceeding. Is the shooter connected to a United Healthcare, denial of claim lawsuit?

Obviously I don’t condone violence and never have. But this story may end up highlighting the scandal and failures of healthcare for profit. Those of us in Canada are depressed over the state of our own system — but these stories out of America suggest things can always be worse.

Meanwhile, United Healthcare execs, including Thompson have been under investigation by DOJ for insider trading and stock selling that made them even richer. Obscenely so. And if you understand that the money they are taking out of the company for themselves was made in part by denying legitimate claims….. one could argue it was only a matter of time. Thompson’s widow said this yesterday.

“Yes, there had been some threats basically, I don’t know, a lack of coverage? I don’t know details,” she told NBC News. “I just know that he said there were some people that had been threatening him.”

Maybe RFK junior should turn his focus to making America’s health care great again.

Stay critical.

#truthovertribe