The murder of CEO Brian Thompson exposed simmering anger at the US healthcare system

The “blatant and intentional” murder of health insurance executive Brian Thompson, CEO of UnitedHealthcare, outside a New York hotel this week shocked the United States. The reaction to the crime also revealed seething rage against the trillion-dollar industry.

“Prior authorization” does not seem like a phrase that would generate much passion.

But on a hot day last July, more than 100 people gathered outside UnitedHealthcare headquarters in Minnesota to protest the insurance company’s policies and the denial of patient claims.

“Prior authorization” allows companies to review proposed treatments before agreeing to pay for them.

Eleven people were arrested for blocking roads during the protest.

Police records show they came from across the country, including Maine, New York, Texas and West Virginia, to the rally organized by the People’s Action Institute.

Unai Montes-Irueste, director of communications strategy for the Chicago-based advocacy group, said the protesters have personal experience with denied claims and other problems with the health care system. Strong.

“They are denied care, then they have to go through an appeal process that is extremely difficult to win,” he told the BBC.

The underlying anger of many Americans at the health care system — a dizzying array of providers, to for-profit and nonprofit companies, insurance giants and government programs — outbreak follows the apparent premeditated killing of Thompson in New York City on Wednesday.

Thompson is CEO of UnitedHealthcare, the insurance unit of medical services provider UnitedHealth Group. The company is the largest insurance company in the US.

Police are still searching for the murder suspect, the motive is unknown, but authorities have revealed messages written on bullet casings found at the scene.

The words “deny,” “defend” and “depose” were discovered on the cover, which investigators believe could refer to tactics critics say insurers use. used to avoid payments and increase profits.

A quick look at Thompson’s LinkedIn history shows many people angry about the rejected claims.

One woman responded to a post in which the CEO bragged about his company’s efforts to make drugs more affordable.

“I have stage 4 metastatic lung cancer,” she wrote. “We just left [UnitedHealthcare] for all my drug refusals. Every month there is a different reason for refusal.”

Thompson’s wife told American television station NBC that he had previously received many threatening messages.

“There have been some threats,” Paulette Thompson said. “Basically I don’t know, lack [medical] insurance? I don’t know the details.”

“I just know that he said some people threatened him.”

Frustration over high costs in many industries is bound to lead to threats against corporate leaders, one security expert says.

Philip Klein, who runs the Texas-based Klein Investigations Agency, which defended Thompson when he gave speeches in the early 2000s, said he was surprised the executive did not ensure security for your trip to New York City.

“There is a lot of anger in the United States right now,” Mr. Klein said.

“Companies need to wake up and realize that their executives can be hunted anywhere.”

Mr. Klein said he has received many calls since Thompson was killed. Top American companies often spend millions of dollars on the personal security of senior executives.

After the shooting, several politicians and industry officials expressed shock and sympathy.

Michael Tuffin, chairman of insurance industry organization Ahip, said he was “heartbroken and appalled by the passing of his friend Brian Thompson”.

“He was a devoted father, a good friend to many and an outspoken colleague and leader.”

In a statement, UnitedHealth Group said it received numerous messages of support from “patients, consumers, health care professionals, associations, government officials and other interested parties.”

But online, many people, including UnitedHealthcare customers and users of other insurance services, reacted differently.

Those reactions range from harsh jokes (a popular quip is “thoughts and permissions”, a play on the phrase “thoughts and prayers”) to comments about the number of insurance claims denied by UnitedHealthcare and other companies.

In the end, industry critics were outspoken in saying they had no pity for Thompson. Some even celebrated his death.

Online anger appears to have narrowed the political divide.

Hostility ranges from avowed socialists to right-wing activists suspicious of the so-called “deep state” and corporate power. It also comes from ordinary people sharing stories of insurance companies denying their requests for medical treatment.

Mr. Montes-Irueste of the People’s Action Organization said he was shocked by the news of the murder.

He said his group had campaigned in a “non-violent, democratic” way – but he added that he understood the bitterness online.

“We have a fragmented and broken health care system, which is why people who are experiencing that broken system are expressing very strong emotions right now,” he said.

Mr Tuffin, who heads the health insurance trade association, condemned any threats against his colleagues, describing them as “professionals whose mission is to work to provide insurance and care at the most affordable price possible.”

The posts underscore the deep frustration many Americans feel toward health insurance companies and the system in general.

“The system is incredibly complex,” said Sara Collins, a senior scholar at the Commonwealth Fund, a health care research organization.

“Just navigating and understanding how you’re covered can be a challenge for people,” she said. “And everything seems fine until you get sick and need your plan.”

Recent research by the Commonwealth Fund found that 45% of insured working-age adults were charged for things they thought should have been free or covered by their insurance, and less than half of The person reporting suspected billing errors challenged them. And 17% of respondents said their insurer denied coverage for care recommended by their doctor.

The US healthcare system is not only complex but also expensive, and the huge costs can often fall directly on the individual.

Ms. Collins said prices are negotiated between providers and insurers, meaning what is charged to patients or insurers is often not the same as the actual cost of providing medical services. .

“We see a high percentage of people saying their health care costs are unaffordable, across all types of insurance, even Medicaid and Medicare,” she said. aid).

“People accumulate medical debt because they can’t pay their bills. This only happens in the United States. We really have a medical debt crisis.”

A survey by researchers at the health policy organization KFF found that about two-thirds of Americans say insurance companies deserve “a lot” of responsibility for high health care costs. Most insured adults, 81%, still rate their health insurance coverage as “excellent” or “good.”

Christine Eibner, a senior economist at the nonprofit consulting organization RAND Corporation, said that in recent years, insurers have increasingly issued denials for treatment coverage and taken advantage of the Prior authorization to decline coverage.

She said the premium is about $25,000 (£19,600) per family.

“On top of that, people face out-of-pocket costs, which can run into thousands of dollars,” she said.

UnitedHealthcare and other insurance providers have faced lawsuits, media inquiries and government investigations into their practices.

Last year, UnitedHealthcare settled a lawsuit brought by a college student with a chronic illness. His story was reported by the news site ProPublica, which said he was saddled with $800,000 in medical bills when medication prescribed by his doctor was rejected.

The company is currently fighting a related class action lawsuit claims they use artificial intelligence to end treatment early.

The BBC has contacted UnitedHealth Group for comment.

With reporting by Tom Bateman