Column: UnitedHealthcare’s chief executive was shot dead. Why did thousands react with glee?

The apparent assassination of UnitedHealthcare Chief Executive Brian Thompson on a Midtown Manhattan sidewalk Wednesday has unleashed an extraordinary outpouring of emotion. But it’s not all horror or sadness over a 50-year-old father of two being shot dead in public by a man in a mask.

Thompson’s death has inspired a torrent of fury about the way his insurance company and others treat — or mistreat — people in their moments of greatest need. Some of the reactions, particularly on social media, have been downright gleeful about the killing.

What a stunning illustration of the hatred so many Americans feel toward for-profit health insurance companies, which too often make money for stockholders by withholding care from sick people.

UnitedHealthcare is a particularly awful exemplar. It is infamous for high denial rates and low reimbursement levels.

According to an investigation by the medical news site Stat and a federal lawsuit recently filed in Minnesota, UnitedHealthcare has been using a deeply flawed artificial intelligence algorithm to wrongfully deny healthcare to elderly and disabled patients. Stat reported that the company “pressured its medical staff to cut off payments for seriously ill patients … denying rehabilitation care for older and disabled Americans as profits soared.”

ProPublica reported last month that the company was using algorithms to identify people it deemed guilty of “therapy overuse” and deny mental health treatment. Both California and Massachusetts determined that the company was breaking the federal law that requires insurers to cover mental health issues the same way they cover physical ailments. UnitedHealthcare denied claims for more than 34,000 therapy sessions from 2013 to 2020 in New York alone, saving the company about $8 million.

Adding to this unsavory picture, four of its top executives, including Thompson, have been under scrutiny for $101.5 million in stock trades they made after the company was informed that it was the target of a federal antitrust investigation but before the news became public and the stock price dropped.

Perhaps all this helps explain why, as of Friday morning, more than 85,000 people had reacted to UnitedHealthcare’s solemn Facebook statement about Thompson’s death with a laugh emoji.

People on other social media platforms also piled on.

“All human life is sacred, so it’s not proper to laugh when serious harm befalls someone,” wrote one Bluesky user. “The moral thing to do is instead charge them hundreds of thousands of dollars.”

“UnitedHealth CEO meets the same fate as many of his clients,” posted another Bluesky user above photos of the shooter pointing his gun at Thompson’s back before he reportedly rode off on an e-bike.

Stories of terrible interactions with the largest health insurer in the country also poured forth.

Elizabeth Austin, a single mother who lives in Bucks County, Pa., told me she had a miserable experience with UnitedHealthcare after her young daughter, Carolyn, was diagnosed with leukemia during the COVID-19 pandemic. Her chemotherapy caused nausea, so Carolyn’s doctor ordered a nighttime feeding tube to supplement what little she was able to eat while awake. She said United Healthcare wouldn’t pay for the feeding tube unless Carolyn ate no solid food at all.

“I was like, ‘She’s 9! She wants to eat food!’” Austin told me. Unmoved, the insurer forced Austin to pay $900 a month out of pocket for the device.

Later, when Carolyn developed a sensitivity to a sedative used during her monthly lumbar punctures, her doctors switched to another medicine, and the company again denied payment, Austin said. She paid for that herself too.

Austin said she eventually developed a stress-related heart condition that required ablation surgery. She and her daughter are healthy now, but the scars remain. She said she was saddened but not shocked to learn about Thompson’s death.

“These things are happening because people are really struggling,” she told me. “I don’t think the CEO was responsible for my daughter’s caregiving issues, but it’s smart to ask, ‘Why did this happen?’ Could it be a systemic issue?’ People are buckling under the pressure.”

At this point, the motive for Thompson’s killing is a matter of speculation. But ammunition recovered from the scene was inscribed with words often used to describe insurance companies’ anti-patient strategies, including “deny” and “defend,” the Associated Press and others reported.

In the 2010 book “Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It,” Jay M. Feinman, a Rutgers law professor, traces the evolution of insurance companies from generally helpful organizations where adjusters — that is, human beings — were responsible for reimbursements into the antagonistic, algorithm-driven behemoths they are today.

In the 1990s, he writes, insurance companies such as Allstate turned to the consulting firm McKinsey & Co. to develop new strategies.

“McKinsey,” Feinman writes, “saw claims as a ‘zero-sum game,’ with the policyholder and the company competing for the same dollars. No longer would each claim be treated on its merits.” Computers would determine reimbursements, and settlements would be offered on a “take-it-or-litigate basis.” Feinman writes that McKinsey urged Allstate to move “from ‘Good Hands’ to ‘Boxing Gloves.’”

Earlier this year, the insurance giant Anthem Blue Cross Blue Shield announced that it would start limiting reimbursements for anesthesia based on its own time limits for surgeries. The idea, Anthem said, was to prevent overbilling. Doctors, predictably, were outraged.

“This is just the latest in a long line of appalling behavior by commercial health insurers looking to drive their profits up at the expense of patients and physicians providing essential care,” Donald Arnold, the president of the American Society of Anesthesiologists, told NPR.

On Thursday, after the outpouring of rage against health insurers sparked by Thompson’s killing, Anthem reversed course, blaming “significant widespread misinformation” about its proposed policy for the about-face.

No wonder there is so little empathy for Brian Thompson, who was by many accounts a lovely human being. In death, he has become an unwitting symbol of the terrible things health insurance companies do to people for money.

Bluesky: @rabcarian.bsky.social. Threads: @rabcarian