The arrest of a suspect in the assassination of UnitedHealthcare CEO Brian Thompson on a street in midtown Manhattan leaves some questions unanswered. But the gleeful reaction to the executive’s slaying leaves nothing subject to interpretation. Many Americans feel that they have been treated so shabbily by the health insurance industry that they despise it and want their leaders to die—and they’ve been willing to say so loudly and publicly.

            I’m 61. I can’t recall the demise of any public figure being greeted with as much glee and dark humor, including the killing of Osama bin Laden. Which makes psychological sense. If someone is trying to kill you, you hate them.

            Health insurance companies are trying to kill us.

While Americans were shocked and some even traumatized by the 9/11 attacks, most individuals didn’t feel personally threatened, much less harmed, by Al Qaeda. On the other hand an insurer like United, which is reported to deny a whopping 32% of in-network claims, wields the power to overrule doctor’s orders, harass sick people at their most vulnerable and, given the sky-high health costs in this country, put medical treatment—the ultimate non-discretionary expense—out of reach. Rare is the health insurance customer who can’t tell a horror story of being unfairly turned down for reimbursement for a doctor’s visit or procedure, usually after being given the runaround over pre-authorizations, procedural codes, doctors erroneously listed as in network, and other Soviet-style nonsense.

Sometimes health insurers decide that people—people like you—shouldn’t receive life-saving care. Patients die every year due to the health insurance industry’s sinister profit model, which heavily relies upon quotas for automatic and in many cases automated denials.

            Even when health insurance works as advertised, it feels like a scam. You pay a monthly premium yet, even when you have a legitimate claim, you probably won’t be able to collect a reimbursement due to high deductibles that can exceed $10,000 a year. Insurers’ online directories of in-network health providers are years out of date; most of the doctors listed no longer accept the company’s insurance (or never did), have moved their practices, or are retired or deceased. “In a 2023 analysis, researchers surveyed nearly 450,000 physicians in the Medicare provider database that appeared in online physician directories for UnitedHealth, Elevance, Cigna, Aetna, and Humana,” Jacobin reported. “They found that only 19 percent had consistent addresses and specialty information across all the directories in which they were found.” (Failing to keep these lists up-to-date is illegal under the 2022 No Surprises Act (NSA), but the federal law is not enforced.)

There ought to be more difference between the experience of being uninsured and paying for insurance.

Health insurance companies create misery that feels intensely personal. The fact that a procedure or medication ordered by your physician, whom you know and has examined you personally, can be overruled by an anonymous individual who has never laid eyes upon you in a completely opaque process can be maddening. Insurers want to make more money and are willing for you and your loved ones to suffer great pain, and perhaps even death, in order to maximize revenues.

“Our role is a critical role, and we make sure that care is safe, appropriate, and is delivered when people need it,” UnitedHealth Group CEO Andrew Witty reassured employees in an internal video following Thompson’s killing. “We guard against the pressures that exist for unsafe care or for unnecessary care to be delivered in a way which makes the whole system too complex and ultimately unsustainable.” He hasn’t learned a thing.

This, of course, is bullshit. Companies like UnitedHealthcare are leeches, a net negative to the patient experience. No one believes they are “guarding” us against any danger whatsoever. They aren’t fighting “complexity;” they are the complexity. They add an additional, unnecessary layer of bureaucracy between sick people and healthcare providers, with only one goal: profits.

The obvious solution is to abolish the medical insurance industry and join the 69% of the world’s population that has some form of universal healthcare. For the foreseeable future, however, massive donations by the health insurance lobby both to Democrats and Republicans make it highly unlikely that something like Medicare For All, popular among  voters of both parties, will be enacted anytime soon. 

Still, the staggering hatred by health insurance consumers for the current system creates a political opportunity for the politician or party willing to push through three simple reforms to protect health insurance consumers from the industry’s most predatory practices.

First, if a physician is listed as a member of a health insurance company’s network, an insured patient’s experience should be frictionless. In network, no claim for a visit, test, procedure or medication should ever be denied. Pre-authorizations should never be required.

Second, if an insurer believes that one of its network member physicians is overprescribing or otherwise abusing the system, the dispute should be resolved between the insurance company and the doctor. An insurer can sue a rogue doctor, kick them out of their network, whatever, but leave sick patients out of it.

Third, failure to update lists of in-network physicians should inconvenience the insurance company that fails to fulfill its responsibilities and comply with federal law, not those of us who are seeking medical care. We deserve truth in advertising. If an insurer lists a doctor as being in-network on their website or elsewhere, patients should be reimbursed for visiting that doctor under the doctrine.

As President-elect Trump formulates his policies for his second term, I hope that his powerful instinct when it comes to gauging public opinion has taken note of our hatred of the for-profit health insurance industry. Pushing through these three reforms would enjoy bipartisan support and begin to fulfill his pledge to fix the badly-broken American healthcare system.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, co-hosts the left-vs-right DMZ America podcast with fellow cartoonist Scott Stantis and The TMI Show with political analyst Manila Chan. His latest book, brand-new right now, is the graphic novel 2024: Revisited.)