By now everyone has heard about the killing of United Healthcare CEO Brian Thompson by an as-yet unknown assassin. The articles about this and the hunt for the shooter are all over the news sites, so I won't link them, because it is not really what this post is about.
My first thought on reading about it was, that's too bad, and sympathy for his family and a prayer for his soul. Then I looked at some of the comments on social media, and was shocked. People are really, really angry with the for-profit insurance/healthcare industry. Not really shocked about that, it has been simmering for a long time, just surprised that people didn't even take a breath before jumping into the anger.
In no way would I ever condone the murder in cold blood of anyone. But what I do hope is that the incident makes everyone stop and think about our healthcare system. It is said that corporations are beefing up security for their executives in response to this incident. But there is a different kind of anger here. People are ordinary, simmering along, angry at greedy corporations. But there is boiling over, white hot anger at systems which deny healthcare, or make it unavailable because of financial issues to people. (Maybe they should have thought about that more carefully before voting?)
My hope for something of a silver lining to this tragedy is that it makes the new administration coming in think harder about messing with Medicare, Medicaid, and trying to further privatize them. and still attempting to destroy the ACA, where millions of people get their healthcare coverage, even if it is at times too expensive and inadequate. Really, the best that I can hope for is that all the anger keeps them from making things worse. And going forward, makes people more receptive in the next election to public options, and reforms of the system to make our healthcare system equal to that of most industrialized nations.
There's no silver lining. Only completely impotent people resort to lashing out by murdering CEOs, and these companies are rich enough to put all their top people in bunkers to keep the icky sick people with no money away from them.
ReplyDeleteAs far as I can see get all the touted drawbacks of "socialized medicine" (long wait times for GP visits, doctor scarcity, rigid treatment protocols, denial of experimental care) and none of the cost savings and freedom from worrying how we're going to afford it all.
Our Medicare advantage plan is being cancelled after this year. Not making enough $$ for the U-M health system that bought up most of the hospital networks in lower Michigan, including ours. I'm getting new glasses and getting the crowns I need this year.
If the replacement plan jacks up our premiums, we're back on straight Medicare, and that's basically no meds, no dental, no vision, and no specialists unless you've got a lot of $$. I have zero $$ and zero energy to fight any of this. It is completely clear that my country sees me as a "useless expense." I'd just as soon hang my DNR around my neck, let nature take its course.
Clarification: Cancelling our plan for 2026; good through 2025.
Delete“Only completely impotent people” is exactly what we are. When it comes to voting as a means of structuring society to benefit the ordinary person, I feel completely impotent, gelded, if you will. When the laws, government and news media are completely enclosed by a powerful, moneyed elite, things like this assassination may start occurring and it’s natural and to be expected. Like terrorism, it’s the only agency remaining for the powerless. Shooting politicians makes no sense at all. If you don’t like what Charlie McCarthy is saying, you shoot Edgar Bergen. Yes, they can stay in bunkers but bunkers are no fun at all. Isn’t it better to steal a billion less and spend your time on a 300 foot yacht instead of having an 800 foot one you can’t use because they’ll get you?
DeleteReading Dougla Rushkoff's book, "Survival of the Richest."
DeleteThe big worry of the One Percent is not living in the bunker but on how to prevent their security details from turning on them. Electric collars were discussed. Rushkoff suggested that they create a system of interdependence and skills sharing so people saw that their survival depended on working together. The One Percenters laughed and rolled their eyes.
The one percenters are the most delicate hothouse plants there are. The people who have the best chance of surviving would be Amazon natives with little contact with civilization, in my opinion. I know the Waltons have a large underground facility. But yes, you’re only rich if you have a government that says you are. Once your Praetorian Guard turns on you, you’re toast. The rich surviving a global extinction event was a theme of the movie “Don’t Look Up” with an oh so satisfying ending.
DeleteAll I remember was that it partly was set in East Lansing, Mich., where I lived and worked for many years, and it looked nothing like E Lansing.
DeleteFrom a comment I read on one blog: "If the ultra rich have any brains at all, they'll take this as a serious wake up call...we're seeing a rage not very dissimilar to that just prior to the French Revolution..."
ReplyDeleteI don't think we're there yet, but we could be adjacent.
Seems to be worse since Obama care. It was v affordable while we were on it, but premiums kept rising. And employers now keep employees under 35 hours per week so they don't have to provide it a plan. Which means employees have less $$ to spend on a plan. The marketplace is not really getting people enough good deals, and there are more people in the donut hole. Healthcare systems are also jacking up big city campuses and leaving hospital deserts in rural areas like mine. To what extent insult-legislation (ex, you have to work to get Medicaid when 90+ percent of Medicaid recipients already work) makes a diff in people's tempers, I don't know.
DeleteTrump has the outline of a bee-yoo-tee-full new plan, tho.
Yes, his "concept of a plan".
DeleteI don't know what the status of the subsidies are now, but for awhile even if you didn't have employer sponsored insurance you could get reasonably priced plans with a subsidy if you were under a certain income, which most hourly workers were. But then the insurance companies started bailing out of different states, and sometimes there was only one left (I think there wa required to be at least one insurance provider in a state). But so much for choice.
If you didn't qualify for a subsidy, you may have been stuck with a high deductible plan.
The COVID pandemic should convince that taking care of poor people is, at very least, a line of defense for the well off. Get poor people vaxxed, provide testing, ensure hospitalization for economically vulnerable populations, and you decrease overall infections. I presume that the lower death rates in other industrialized countries can, in part, be explained by more generous access to health care.
DeleteBut that's not gonna be a lesson-learned with RFK in charge.
Concept of a plan: Save your Pets Plus coupons so you can get the Ivermectin cheap and hurry on down to the vitamin store for your unregulated quinine supplements!
People in other advanced industrialized countries don’t go bankrupt due to catastrophic medical events. That’s apparently as American as apple pie.
DeleteI don't think this guy deserved to be killed.
ReplyDeleteFWIW: the first news article I saw about the assassination noted that one of the Blue Cross companies (Anthem) was about to implement a policy that would put a limit on the anesthesia(!) it would pay for - if it deemed a surgical procedure would take too long, it would only pay for a certain number of hours/minutes of anesthesia. This would have taken effect in three states, I believe it was NY, CN and MO.
Then, the second article I read noted that Anthem has now announced it is not going to implement the limited-anesthesia plan. The cause-and-effect leading to that decision seemed pretty clear.
FWIW - my experience with health insurers hasn't been that bad. In my family's experience, we're more at risk from doctors screwing up than insurers seeking to screw us. To be sure, we're mostly healthy. The biggest health events we've faced so far are the births of our children. I think we're lucky our kids were born in the '90s; from what I'm hearing, the insurance benefits aren't as good anymore for childbirth. I worked for a woman about 15 years ago who gave birth; she told me that our corporate health policy (and this was when I was working for one of the world's largest consumer tech companies) paid 80% of hospital bills, with we the consumers being on the hook for the other 20%. 20% of a hospital childbirth bill was a fortune back then; presumably it is considerably more now.
One of my kids was in an auto accident a few years back. The other party claimed to be injured, and the lawyers got involved. Our insurer (Allstate) managed to eventually reach a settlement with the other guy that didn't cost me anything out of pocket; so on the whole I was satisfied.
Jim I didn't think the guy deserved to be killed either.
DeleteI read the thing about Anthem limiting coverage for anesthesia if they thought it took too long. I had a surgery last year that was supposed to take 45 minutes. Due to unforseen circumstances, it took three hours. There was no problem with coverage; I am Medicare with a supplemental. I didn't find out that it had taken three hours until my husband told me the next day. I wasn't tracking well enough to account for the missing hours.
It seems ridiculous for them to try to micromanage something that is out of anyone's control.
We were leery of Medicare Advantage plans because formerly our hospital and none of the local doctors accepted it. Then they did for awhile, and now I heard that they're not any more.
DeleteUHC denies 32% of claims. It is a leader. No matter how beloved he was by his fellow executives, he was part of it. They spend millions to lobby/bribe our legislators to go lightly with them and to suppress any single payer initiatives. My medical coverage is good. I also realize that I’m very lucky.
DeleteAccording to the NY Times he had a compensation of 10 million dollars and I worked for the company for 20 years. Even if he made that compensation for all 20 years that is only 200 million. He was nowhere near to being a billionaire. I suspect there are billionaire investors in his company who set the goals, etc.
ReplyDeleteFrom a modest background, Mr. Thompson had achieved executive status but remained open and approachable. When asked to develop a long-term plan for the company, he solicited input from top executives and then synthesized their views. “That speaks to how inherently sharp he was and how well he knew the business,” “He actually was the smartest guy in the room, without being annoying,” “He would make fun of himself a lot,”
Sounds to me like a company man who could easily be replaced.
He sounds like a decent person.
DeleteCompare his business leadership style to Donald Trump's.
Re: billionaire investors: if I'm not mistaken, United Healthcare Group is not a freestanding company; it is a subsidiary of UMR. So, like the rest of us, he had bosses to report to. At the level he had risen to, the level of stress he had to absorb daily probably would break most of us.
DeleteNone of the gainsays Stanley's metric of 32% of claims being denied. Whatever the morality of the business practices and policies behind that metric (and I don't know enough about that business to judge), if he was president, then he "owned" those practices and policies, and he surely had the authority to change them.
"Only $200 million ... solicited input ... sounds like a decent guy."
DeleteHe denied care to and likely hastened the deaths of thousands of people by supporting, if not actually inventing, rejection guidelines.
But he didn't pull a trigger doing it, so, hey, pay him millions and let him join the country club.
His group is being sued for insider trading, dumping stocks. You can bet he wasn’t happy making a lousy $10M per year and was jockeying for a higher position. You don’t get there by being Mr. Nice Guy. But, of course, you have to look and sound like Mr. Nice Guy.
DeleteThe inscriptions on the cartridges indicate revenge for denial of payment. That could be a red herring, though. Insider trading shenanigans could have cost someone their savings. Wives have had their husbands whacked but they are usually intercepted by cops posing as hit men. Also, maybe he was turning state’s evidence and his fellow conspirators wanted to shut him up.
DeleteFundamentally, there should be no profit involved in medical insurance. What money that goes in should be in a pool that is used only to support medical care for the holders and whatever administration costs are necessary.
ReplyDeleteThe more profit making entities you have, the higher the cost: for-profit hospitals + for-profit insurance companies + for-profit drug companies + for-profit pharmacies. It all adds up when that many people need to take a piece out of you.
DeleteThe profit motive gives the participants an incentive to drive down costs. It's not intuitive, but conceivably costs can be lower with for-profit companies jockeying for profit margin than for not-for-profit entities (like the federal government) that don't have as strong an incentive to contain costs.
DeleteIf you want to hear people grouse about the reality of cost containment, spend some time with doctors, especially primary-care physicians and especially the young ones. They are not making as much money as they think they should. The debt that many of them are saddled with coming out of their medical school training would probably drive most of us to despair. Few of them belong to small, independent practices anymore; they're salaried with large healthcare delivery orgs.
I listened to a long radio documentary about the health care crisis years ago before Obama care was passed. Among its conclusions were that insurance companies were not the biggest culprits in jacking up cost, but hospital systems with "prestige centers." You get a new diagnostic tool or an infusion center or a bunch of cancer centers and you have to charge everybody really high prices to pay for them.
ReplyDeleteInsurance companies came in for criticism for denying procedures, kicking people off for pre-existing conditions, or having very limited formularies.
That's a good reminder that there is more than one factor driving up healthcare costs. I don't know if "prestige centers" would be part of administrative costs?
DeleteOn the subject of Anthem's attempt to rein in anesthesiologists charges, there was this article on the Vox site:
ReplyDeletehttps://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance
The article maintains Anthem's cost control measure was meant to cost the anesthesiologists, not to be born by the patient. For some reason this argument reminded me of the tariff wars, and who would ultimately pay for them. I think there is zero chance that the patient wouldn't be at the bottom of the proverbial hill down which stuff rolls.
A bit of perspective, I looked up the average salary of an anesthesiologist, it was $472,000 a year. To be sure, that is a nice income, but it isn't millions. And doesn't seem that unreasonable considering the level of responsibility for someone's life when they are undergoing surgery. That's definitely a job where they can't phone it in or work from home.
Which isn't to say that someone doesn't need to throw a flag if it appears that someone is padding their bills.
I had a bone marrow biopsy many years ago. It cost $900 for a 15-minute procedure done in the clinic with topical anesthesetic that the pathologist applied as he drilled. Discomfort was minimal, and I thought that price was excessive.
DeleteA random search for BMB prices around the country showed they varied wildly. One factor in the price diff was that big cancer research hospitals offered the procedure with anesthesia. Guessing that their patients were more likely to be kids (you could not do a BMB on a squirmy kid without knocking them out) or people who feared pain or had had pain in the past.
Another factor was whether you had the procedure done in the office or a hospital.
But some places that were only using topical anesthesia in clinics were charging the same big bucks.
I would not want to deny people a BMB without anesthesia. But a national healthcare system could standardize prices for BMBs with and without anesthesia.
My husband has had four prostate biopsies because of high PSA numbers. Thankfully they have turned out benign. All they ever gave him was local (I guess guys are supposed to be tough, or something?). Two of them weren't too bad, one was pretty painful, and the last one was torture level awful. I think patients ought to have the option of something stronger than local. The last biopsy was 6 years ago. Lately he had an MRI. I guess they do those now as a screening to see if a biopsy is needed, which is good. It used to be that it wss just about an act of Congress to get an MRI, but the cost has come down a lot, and people are spared some painful tests.
DeleteEarlier this year our 12 year old granddaughter had to have a small procedure. In addition to some drugs they gave her one of those virtual 3D headsets,and she swam with the dolphins while it was going on. She was pretty impressed.I imagine that cuts down on the anxiety a lot.
Yes, pain levels vary with personal tolerance, skill of the pathologist, and how sick the patient is.
DeleteI have had a million soft tissue biopsies in the last 10 years, all pretty pain free, though they put me under for the one where they ran a tube down my throat to snip out polyps.
I kinda roll my eyes at the breast biopsy place, a special area in the cancer center all done up in pink with special pink gowns and piped in space music with pictures of pink flowers in a meadow, tra lah. Huge waste if you ask me. I suggested to the nurse that they provide a face cradle for old ladies like me with neck problem who can't lie on their stomachs. I took my own to the last one.
The thyroid and skin biopsies were just in a regular procedure room. But the pathologist and nurses were just as nice, and I was out of there quicker.
Glad your granddaughter had a good experience and is ok!
DeleteOur hospital's radiology dept. finally got rid of the cheesy decor in their mammogram room. You know, the Victorian pictures in gilt frames, and a couple of framed "inspirational" quotes. And the chirpy upbeat Hearts of Space music. I'm sure that they were just trying to dial down anxiety about being there. It didn't work.
DeleteNow they just have a couple of nature scenes, and no music. That's fine.
At the time that Obama was putting together Obamacare, my foot doctor said the problem was essentially that providers are greedy, so someone had to monitor them, e.g. the insurance companies, but they are also greedy, and then there is the high cost of malpractice insurance for doctors. He would cut the for-profit insurance companies out of the picture and have nonprofit insurance companies oversee the providers. The malpractice suits are more difficult. You just can't put a cap on awards, because some malpractice does deserve high awards. You also have to find a way to remove poor professionals from the system. Easier said than done.
ReplyDeleteIncreasingly in the last decade hospital systems have been buying out group practices, so that essentially hospital system costs are now born by the group practice charges.
Everyone is building new facilities with their profits which raises future costs.
So at least three entities which tend toward greed are supposed to keep an eye on one another. What could possibly go wrong!
DeleteWonder what happened to Unagidon, i.e. Patrick Shannon, who used to hang out with us? I think his last update was
ReplyDeletehttps://newgathering.blogspot.com/2019/06/unagidon-on-
insurance.html
He was in bad shape then. Hope he wasn't another casualty of the pandemic.
Yes, I have wondered about him too. I hope he is okay, he was going through a very rough time the last time we heard from him.
DeleteThanks for reminding us of him, Jack. Poor guy was really hammered by circumstance more than anybody should be. We're all at an age where people will start dropping off here without warning and never be heard from again.
DeleteYes, a very intelligent writer. Probably too good a person to fit well in the insurance business of which he had been a part. So sad to see someone caught in the works of that pitiless machine called the United States economic system. I’d be happy to pay more taxes to make life better for my fellow citizens.
ReplyDeleteHe always struck me as a good guy. He really took risks here in Illinois to try to make Obamacare work.
Delete