UnitedHealthcare CEO fatally shot in midtown Manhattan, law enforcement official says

[jacks]

But I also don't think "Company XYZ has a denial rate of 20%" is necessarily painting a full picture either.

Because of all the reasons you stated insurance companies have legitimate reasons for denials. Given those reasons the rate of denial should be about the same for all insurance companies. It is when a company has a higher than average denial rate, that their practices come into question. Averages HERE. As we can see United Health Care does seem higher than most of its peers.

 

[ThatRobGuy]

Because of all the reasons you stated insurance companies have legitimate reasons for denials. Given those reasons the rate of denial should be about the same for all insurance companies. It is when a company has a higher than average denial rate, that their practices come into question. Averages HERE. As we can see United Health Care does seem higher than most of its peers.

It does, in large part due to a flawed AI model that's been reported on.

To be clear, I'm not trying to absolve UnitedHealth of any wrongdoing here.

 

[comana]

Obviously, you don't have to reveal this information if you don't want to, but what kind of medical practice do you work in?

Keeping in mind, the denial rates cited don't mention whether they were passed on to the patient or not, they're simply "here's the number of claims submitted; here are the number that were rejected".

A personal anecdote I've shared on here before (and don't mind sharing again), is that when my Dad (who passed away a few years back from cancer, that could've been treatable in the early stages, but that was his mistake) was insisting on going to an "alternative practitioner" (it was a guy who was a DC, which is why I have a chip on my shoulder about chiro-quackters), it wasn't the insurance company that screwed him, it was the practice itself.

They take a person who's maybe not thinking clearly (who would when they found out they had cancer), gloss over the forms to get them to sign on the dotted line, and then offer reassuring statements like "I don't think we'll have any problem getting this approved".

They were submitting no less than a dozen things per week (every quack "treatment" in the book), and when the monthly bill came in, it was a
"Yeah, we submitted $3800 worth of stuff to them, they paid for $200 of it, they said the rest wasn't covered, but negotiated the remainder down to $1800....due by the first of next month"

That wasn't the insurance company's fault.

Where I think we'll likely agree, is if these insurance companies want to set the record straight, they just have to make certain pieces of data public. I don't doubt that they're denying some stuff that should be approved, and doing that in the name of profit... I'm not naive. But I also don't think "Company XYZ has a denial rate of 20%" is necessarily painting a full picture either.

I work for a billing company that contracts with providers across multiple specialties.

Most providers are going to have a person who checks for authorization requirements and benefits before scheduling. Just sending out claims to see what gets paid is not so see done. If a provider has a contract with an insurance company, which they need in order to bill to that insurance company, then there are contractual restrictions on what can be billed to the patient when a claim is denied. Some cases you can bill medical necessity denials to the patient and others you cannot. If a provider wants to get paid they will make sure in advance a treatment is covered. Also the no surprises act forces providers to be more transparent about cost estimates and what may not be covered to avoid situations like you describe for your father.

Insurance companies do deny a lot of treatments and surgeries at the pre-authorization stage. That is the easiest way for them to not pay- just tell the provider up front that it won’t be paid.

 

[The IbanezerScrooge]

It does, in large part due to a flawed AI model that's been reported on.

To be clear, I'm not trying to absolve UnitedHealth of any wrongdoing here.

I think the more concerning denials are the ones where care is denied by the provider, not payment after the fact. There are many examples of providers denying care because the insurance company will not accept a preauthorization for the care and will not pay for it. The provider then cancels the appointment stating the insurance company has denied to cover the care. Going self-pay more often than not is not an option, so the care needed is simply not given.

To be sure the insurance companies are just one cog in the tangled mess of the US healthcare machine. The cost of care itself is insanely inflated for simple procedures and medications that should be relatively cheap. There is no legitimate reason why a single dose of Tylenol in a hospital setting should be 50-100x the cost of the OTC for example.

 

[iluvatar5150]

There is no legitimate reason why a single dose of Tylenol in a hospital setting should be 50-100x the cost of the OTC for example.

eh… I have less of an issue with that than I do a lot of things in health care. To make a comparison - the cost of beer and straight liquor in a restaurant is somewhere around 4-6x what it is in a liquor store. That’s just for somebody to hand you a bottle from behind the bar or pour it into a glass. Given all the other overhead with a hospital, marking up tylenol doesn’t seem like that big a deal to me.

 

[durangodawood]

....That’s just for somebody to hand you a bottle from behind the bar or pour it into a glass.....

Its also your rent for the seat you occupy.

 

[The IbanezerScrooge]

eh… I have less of an issue with that than I do a lot of things in health care. To make a comparison - the cost of beer and straight liquor in a restaurant is somewhere around 4-6x what it is in a liquor store. That’s just for somebody to hand you a bottle from behind the bar or pour it into a glass. Given all the other overhead with a hospital, marking up tylenol doesn’t seem like that big a deal to me.

Those are different categories, though. I can freely choose to go to a bar and have the same beer I drink at home with the expectation of a mark-up. It's totally different than being in a setting where professional care-givers are telling you you need this medicine or procedure in order for us to help you feel better. You're trusting those care-givers to actually care and do things that will actually help you, so you do what they say without any thought of what it is costing you. And that was just an example. Almost everything in a hospital setting, including the procedures themselves feels grossly over-priced. Healthcare in this country is simply too expensive.

 

[durangodawood]

Those are different categories, though. I can freely choose to go to a bar and have the same beer I drink at home with the expectation of a mark-up. It's totally different than being in a setting where professional care-givers are telling you you need this medicine or procedure in order for us to help you feel better. You're trusting those care-givers to actually care and do things that will actually help you, so you do what they say without any thought of what it is costing you. And that was just an example. Almost everything in a hospital setting, including the procedures themselves feels grossly over-priced. Healthcare in this country is simply too expensive.

Also, typically you can see the price of a beer at the bar before deciding to get one.

 

[jacks]

Also, typically you can see the price of a beer at the bar before deciding to get one.

And you're not paying for everyone else's beer, who can't afford one.

 

[durangodawood]

And you're not paying for everyone else's beer, who can't afford one.

Even most poor people could afford a normally priced Tylenol. I wouldnt even notice if people like me were asked to subsidize normally priced Tylenol for flat broke people.

 

[iluvatar5150]

And you're not paying for everyone else's beer, who can't afford one.

You’re not paying for their beer, but you kind of are paying for their food to a degree. The markup on booze is so high because it’s usually used to subsidize the low markup on food sales, at least in restaurants.

 

[ThatRobGuy]

Those are different categories, though. I can freely choose to go to a bar and have the same beer I drink at home with the expectation of a mark-up. It's totally different than being in a setting where professional care-givers are telling you you need this medicine or procedure in order for us to help you feel better. You're trusting those care-givers to actually care and do things that will actually help you, so you do what they say without any thought of what it is costing you. And that was just an example. Almost everything in a hospital setting, including the procedures themselves feels grossly over-priced. Healthcare in this country is simply too expensive.

You mentioned the drug markup prices in a hospital setting vs. buying the same thing OTC.

I think that shows some of the "power struggles" that happen back and forth between
"Provider vs. Insurance"
and
"Insurance vs. Pharma"

Another glaring example of a problem that clearly needs to be corrected (and this is actually another thing RFK has talked about in some of his speeches about the Pharma industry -- although others have echoed it).

What he described as "Drug companies sending in sales reps that look like 22-year-old playboy models to shmooze the doctors and be flirty and convince them to push their new product, which indirect promises of getting invited to the corporate retreat next year"

NY Times did a piece about it a few years back detailing how drug companies were regularly hiring young hot drug reps, with little to no sales experience, some of which were former pro sports cheerleaders, a few were literally miss America contestants, and some were former Victoria's secret models.

I suspect that's how we end up with drugs for (let's be honest) some rather frivolous "ailments", that end up getting billed to insurance companies and when they're new and still under patent with no generic available, that can likely drain some funds rather quickly.

 

[ThatRobGuy]

It would appear now that the surviving family is being harassed to some degree as well.

It's been reported by The Hill that they've been targeted with a "Swatting" incident and false bomb threat.

 

[ThatRobGuy]

https://www.cnn.com/2024/12/09/us/unitedhealthcare-ceo-brian-thompson-shooter-monday/index.html

Police question man with gun, suppressor and fake IDs in Pennsylvania in connection with health care CEO killing, sources say​

12:07
Altoona police responded to the call, picked up the man and searched him, the sources said. The man also had some documents investigators want to examine as potentially relating to motive, though further details on them were not clear.

Altoona police are waiting for NYPD detectives, who are en route.

 

[ThatRobGuy]

The man who is being held in Pennsylvania was also in possession of a two-page document railing against the health care industry and suggesting that violence is the answer, a police official who has seen the document told CNN.

 

[Nithavela]

From the comments I've read online, if this shooter had killed the United Healthcare CEO a month earlier and then ran for president, he might have had a solid chance of winning.

 

[iluvatar5150]

https://www.cnn.com/2024/12/09/us/unitedhealthcare-ceo-brian-thompson-shooter-monday/index.html

Police question man with gun, suppressor and fake IDs in Pennsylvania in connection with health care CEO killing, sources say​

12:07
Altoona police responded to the call, picked up the man and searched him, the sources said. The man also had some documents investigators want to examine as potentially relating to motive, though further details on them were not clear.

Altoona police are waiting for NYPD detectives, who are en route.

lol, dude was from the Baltimore suburbs and did an internship at one of the more prominent game studios in the area. I didn't know him, but I know people who did. Slack is *lighting up*....

 

[ThatRobGuy]

lol, dude was from the Baltimore suburbs and did an internship at one of the more prominent game studios in the area. I didn't know him, but I know people who did. Slack is *lighting up*....

Does the name or pics look familiar?

Exclusive | Luigi Mangione, suspect in UnitedHealthcare CEO Brian Thompson killing, was an ivy league grad with a grudge against the healthcare industry

The suspect nabbed in the killing of UnitedHealthcare CEO Brian Thompson is an anti-capitalist Ivy League grad who liked online quotes from “Unabomber’’ Ted Kaczynski — and seethed in a three-page …

nypost.com

Sounds like he was potentially from a pretty "well-to-do" family, went to a prep school, and is ivy league educated. That Gillman Prep high school (which is supposedly top ranked in Maryland, and one of the top in the country) appears to cost more per year for tuition than many colleges charge (about 37k per year)

And a local NBC affiliate said he was born in Maryland and had past addresses in Honolulu and San Fran..

If there's a silver lining in all this...hopefully that Altoona PA McDonald's employee gets to collect on that 50K reward from the FBI, and the 10K reward offered up by NYPD.

 

[iluvatar5150]

Does the name or pics look familiar?

Exclusive | Luigi Mangione, suspect in UnitedHealthcare CEO Brian Thompson killing, was an ivy league grad with a grudge against the healthcare industry

The suspect nabbed in the killing of UnitedHealthcare CEO Brian Thompson is an anti-capitalist Ivy League grad who liked online quotes from “Unabomber’’ Ted Kaczynski — and seethed in a three-page …

nypost.com

View attachment 358386

Sounds like he was potentially from a pretty "well-to-do" family, went to a prep school, and is ivy league educated.

And a local NBC affiliate said he was born in Maryland and had past addresses in Honolulu and San Fran..

That's definitely the guy I looked up on linkedin, but no, I don't believe I ever met him. I'm waiting to hear from some of our mutual connections. lol

 

[durangodawood]

Apparently he was carrying a "handwritten manifesto"?

Must have been planted on him. People dont hand write.