The idea that it should take the near execution-style death of a US business executive for me to finally focus on the twisted vagaries of the American healthcare industry disturbs me. Shocking though it was, there are takeaways that need to be considered.

Like any investigation, there are several potential starting points from which we could develop an overview here, but to begin with, I’m going with the gut response and ask: Why was the online reaction so visceral?

Prompted by the words written on ammunition found at the shooting scene: ‘deny, depose, defend’, online responders vented wrath that’s been building for years. Together, the three words form a phrase that allegedly describes how insurers dodge claim payouts to produce healthy returns for investors.

In one stark example, a Facebook post by UnitedHealth Group expressing sadness at the loss of UnitedHealthcare CEO Brian Thompson received 62,000 reactions – 57,000 of them laughing emojis. UnitedHealth Group is the parent company of UnitedHealthcare.

Another stated: UnitedHealthcare denied my surgery two days before it was scheduled. I was in the hospital finance office in tears (when I was supposed to be at the hospital doing pre-op stuff),” one user wrote in an X post that received more than 70,000 likes.

A tortuous process

“My mother was flying out to see me. My surgeon spent a day and a half pleading my case to United when she probably should have been taking care of her other patients,” she added, before saying the surgery ended up going ahead but calling the process “torture.”

Insurance companies surely have the right to evaluate claims, but what should scare all of us is that these companies are now employing AI to evaluate, approve or deny claims. AI, of course, is considerably faster, impassionate, and, oh, cheaper.

Federal data shows that health insurance companies denied more than 49 million claims in 2021, but customers appealed less than 0.2 percent of them. Investigative journalists at ProPublica found that Sigma uses an automated system to assess and often deny claims in bulk.

It all boils down to money: for the insurers, it’s money in hand, but for the insured, making a successful claim has become a frustrating and almost forlorn hope.

Vox.com recently reported that health care in the US can be prohibitively expensive, even for people who have insurance. Almost four in 10 Americans say they have skipped necessary medical care over the costs, and millions carry medical debts from past cases.

Prices have continued to spiral upward, driven by the increasing number of baby boomers and the cost of advanced medical procedures.

The crux of the issue centres on a widespread belief that a pill or procedure can be used to solve what really is a lifestyle problem. Many of the big-ticket items insurers are forking out on are for chronic conditions such as heart attack, stroke and obesity-related care.

To their credit, and in a bid to bring down costs, some insurers are becoming directly involved, not only by funding some studies but by offering reduced policy costs if a customer eats more healthfully.

There are indications that some sectors of the community are doing more to take health into their own hands, but warnings that health costs are spiralling out of control have mostly gone ignored for many years.

In one respect, the general public is caught in a cleft stick. Many individuals know they should do more about their general health and rightly expect, if they make a claim, it should be honoured because they paid for the service.

Healthcare cost warning

Almost five years ago, Harvard Magazine warned that healthcare costs were rising dangerously and were unlikely to be addressed sufficiently in upcoming elections. It might be brilliant when all the dots line up, but the magazine noted that America was now running the most costly healthcare system on the planet.

“Nearly half of Americans say they have delayed or skipped medical care because of the cost. People who face higher costs for medical care are diagnosed with cancer at later stages of the disease and take fewer medications. Even the very sick use less care when their out-of-pocket costs rise. Health suffers,” the magazine stated.

As far back as 2014, 21 million people in America were classed as underinsured.

This event was a boil-over but not of the completely unpredictable kind. Something had to give, and a well-healed 26-year-old who has now achieved folk-hero status on social media provided the trigger.

As one commentator put it, “The cheering reaction to this execution amounts to a blinking-and-blaring warning signal for a society that has become too inured to bloodshed.”

The real question now is, who’s listening?