Americans Hate Their Private Health Insurance
Americans are not happy with the US health care system. For the first time in two decades, a majority of Americans rate US health care as substandard, including a new high calling it “poor.” Nearly three-quarters say it’s failing to meet their needs, and about half find it difficult to afford their medical bills. A majority have had some kind of problem — denied claims, for instance, or issues with provider networks or pre-authorization — with their insurance, and even bigger majorities feel insurers aren’t transparent about what they cover, or think insurance bills or the various payments they have to make to insurers are not easy to understand.
But forget the polls. If you want to get a sense of just how deep and widespread Americans’ rage at this often absurd and unfair system is, just look at the public reaction to the shocking news of the assassination of Brian Thompson, the CEO of UnitedHealthcare (UHC), one of the country’s most cruel and rapacious health insurance companies. Whatever his killer’s motive, across the internet — on social media, YouTube, news comments sections, and more — the response has been the same: Americans are either gleefully mocking his death, saying they understand why it happened even if they don’t condone it, or sharing their own appalling personal experiences with health insurers.
The fact that this is the US public response, en masse, to the murder of a human being speaks volumes about Americans’ widespread disgust with a profit-driven health care system that leaves so many destitute or simply dead.
“I Hate Insurance Companies”
A Facebook post by the company expressing sadness and shock at Thompson’s killing has, as of the time of writing, nearly eighty thousand laughing emoji reactions. Twitter/X exploded with jokes about his murder.
“A good lesson here is that you should live your life in such a way that when you die, nobody pulls out a spreadsheet to mathematically explain why they’re happy you’re dead,” wrote comedian Kristin Chirico in a tweet that so far has 54,000 likes.
“Chipotle raised its prices again and someone just asked who the CEO is LMFAOOOO,” another user tweeted, garnering 315,000 likes so far.
Many of these are being collected and cross-posted on Instagram. Angry commentary is also happening at X’s rival, Bluesky. “The reward out for the person who shot United Healthcare’s CEO isn’t even enough to cover 1/9 of the bill we got for 28 days of radiation,” cartoonist Marie Enger wrote on the platform, receiving thousands of likes.
TikTokers are writing and performing songs celebrating Thompson’s murder, with lyrics like “the people got a prize in a blood celebration” and “you should never have to face the things your customers all face,” directed at CEOs. Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It — a fourteen-year-old book criticizing health insurance companies’ practices whose title closely matches the words written on the casings of the bullets Thompson’s killer fired at him — has suddenly rocketed to number three on Amazon’s best-selling books in the business and money category.
On Reddit, a thread about the murder on the r/medicine subreddit — a forum that describes itself as “a virtual lounge for physicians and other medical professionals” — had to be closed by moderators because users responded with a spree of jokes. The top comment is from a nurse who wrote out a parody of a UHC denial-of-care letter, in this case addressed to Thompson regarding his emergency treatment after being shot. UHC couldn’t cover his emergency services, explains the comment, because he hadn’t proved “medical necessity,” he hadn’t gotten “prior authorization,” the ER he went to was out of network, and he hadn’t explored other, lower-cost options.
“We understand that you were actively ‘bleeding out,’ but this does not exempt you from exploring lower-cost care pathways,” says the comment.
It was a similar scene over at r/nursing, another forum run and populated by medical professionals, specifically nurses. That subreddit is now filled with “Code Blue Threads” — meaning threads that moderators had to restrict comments on — making snarky responses to Thompson’s murder and to health insurance executives fretting for their security or backtracking on some truly heinous policy changes in response. A moderator had to post a reminder that content advocating for violence was not allowed and would be removed. (“I don’t envy your position in the slightest. It’s like having to be the one to stop the people from playing soccer with Mussolini’s head,” replied one user.)
One of that subreddit’s threads about the murder made it over to r/SubredditDrama, a forum covering what are considered particularly entertaining internal controversies in the site’s various subreddits. A user posted “some highlights” of the snarky comments in the thread, like a discussion about good tuna salad recipes, or one charging that a “bullet in chest . . . sounds like a pre-existing condition” and that Thompson should “try physical therapy” instead. The poster notes that a comment chiding people that “celebrating a murder and calling for more is gross” was downvoted way into the negatives — meaning disapproval by users en masse.
Similar or even more scathing comments were rife throughout the r/nursing subreddit: “I hope they bill his family for the ambulance ride in this trying time”; “No sympathy here, and his millions of dollars are now worthless to him”; “Sounds like this is related to the pre-existing condition of being an amoral asshole.” “The absolute savagery in these comments really shows you how absolutely sick we all are of our patients and families being fucked by insurance companies,” wrote another user. The r/jokes subreddit is packed with jokes about the murder, which are currently some of the most upvoted threads on the page (meaning they’ve gotten the most approval from users of the forum).
Meanwhile, several users took the occasion to relate their own horror stories of working with insurers, including UHC.
“I work at a gastroenterology center in billing, and I have actually had to argue with UHC because they didn’t want to deem a procedure for a man who had been shot in the stomach as ‘emergent,’” wrote one account whose comment was met with numerous replies from users sharing their own stories. “I hate insurance companies. Insurance is a literal scam.”
Another user recounted how he suspected that UHC had made a deal with his former employer, AT&T, to exclude his jaw surgery from coverage, because his surgeon had had at least thirteen patients with the company that year and seen similar denials. Despite being told he “would lose the ability to chew by [his] forties,” he couldn’t get the surgery, and now, at forty-two, he can only eat certain foods while in extreme pain and is worried about the possible side effects of retrying the procedure at an older age. “So, I won’t outright say how I feel but you might guess it,” he concluded.
This was not unique to Reddit. You could find the same sentiment on YouTube, in the comments sections of videos about the murder from CNN (“oh my god that’s so horrible!! is the floor that he fell on okay???”), Inside Edition (“I’m sorry but empathy is out of network”), and the Today Show (“UHC has destroyed many lives and families. Condolences: denied”; “If you have any information on the shooter, keep it to yourself”), for instance. When CBS Mornings posted a video yesterday covering this outpouring of popular anger, YouTube commenters heaped scorn on the anchors.
“How can she say with a straight face, ‘we’re a country of law & order’? Since when have any of these corrupt, greedy corporations been held accountable?” was the most-liked comment.
“You should have called this video ‘Out of touch, rich [news] anchors shocked by common people’s anger over watching their families die due to denied claims,’” went the second-most liked.
You’re seeing the same kind of thing in the comments sections of right-leaning news outlets. One of the Wall Street Journal’s stories on the matter has more than two thousand comments, far more than most of its other stories. “After just watching Pain Hustlers on Netflix, I can understand how this incident could happen. . . . Don’t condone it, but understand,” wrote one reader. “Oh well. What’s for lunch?” wrote another.
This was repeated in stories about the killing on Fox News (“I’ve been a surgeon for almost a decade and I see patients suffer daily because insurance companies put profits over healthCARE every time — something that I find morally abhorrent”), the Daily Mail (“I work in healthcare and UHC is one of the worst insurances we work with. They deny EVERYTHING initially and it is outrageous the hoops we have to jump through to provide patients with this insurance.”), and even the New York Post (“United Health Care mailed me some messages too: Denied, Declined, Deductible, Out of Network, Pre-Approval Needed, Co-payment, Your Monthly Premium has increased. That translates to a lot of ammo.”) — despite the paper taking a disapproving editorial stance toward the less-than-sympathetic responses to the crime.
Good Morals and Good Politics
What is particularly stunning about all this is that one of the core arguments used against putting in place a single-payer health care system like Medicare for All in the United States — by politicians, political commentators, corporate flacks — is that people simply love their private health insurance too much. These comments show this is blatantly untrue.
In fact, they show that public hatred of the predatory US private insurance system runs through not just patients but health care professionals ranging from nurses to surgeons and even workers responsible for billing at health care providers. And more importantly, that hatred isn’t limited to the left side of the political spectrum.
Yet when Bernie Sanders ran for president in 2020 calling for Medicare for All, Americans’ supposed love for their insurance was constantly thrown at him as an argument against his proposal.
“I’m not going to support any plan that rips away quality health care from individuals,” then Montana governor Steve Bullock said in a debate, describing something that already happens under private insurance.
“The real obstacle to Sanders’s plan is the public’s expectations,” went one Atlantic op-ed. “As much as Americans hate insurance companies in general, they want the right to have a love-hate relationship with their own insurer.”
Sanders’s lonely stance, promising that he would almost entirely abolish private insurance, was framed by pundits as so politically risky that multiple of his Democratic rivals ran away from it. That included the next-most progressive candidate in the race, Elizabeth Warren.
The other candidate who did so was Vice President Kamala Harris. This was one of the supposedly unpopular left-wing stances from her 2019 campaign that we were told Harris had to overcome to beat Donald Trump for president this year, as she came under right-wing attack for the position and, true to form, wilted under the pressure, selling her flip-flopping as an act of sensible, moderate political maturity.
The deluge of public wrath toward insurers in the wake of this startling crime — let alone the possible health care–related motive of the killer — casts serious doubt on this piece of conventional political wisdom. In fact, it calls into question the political establishment’s entire thinking on health care.
For Republicans, that means making no changes to health care whatsoever, other than making it easier for companies like UHC to deny claims and screw over patients, making it harder for people to sue insurance companies, and making Americans more reliant on them by crippling public health care programs with spending cuts. For Democrats, that means leaving the status quo in place and modestly expanding Medicare while making only vague promises to “strengthen the Affordable Care Act” (ACA) — even though the intolerable status quo that internet users are eviscerating right now is a direct result of nearly fifteen years under the ACA.
If you’re a Democratic official, you must surely be kicking yourself for the direction the party has taken on this issue. First, there was Joe Biden’s decision to abandon the public health insurance option pledge he made on the campaign trail upon winning — and that was before he signed legislation that led to more than 25 million people being thrown off their Medicaid insurance since last year, including millions who were still eligible but lost it for procedural, bureaucratic reasons.
Second, there was the decision of Harris and her team to offer no substantive health care reform to anyone under sixty-five (that is, anyone who isn’t eligible for Medicare). One of the indelible moments on the road to Harris’s election failure came in an October Univision town hall, when a sixty-two-year-old disabled woman who had become homeless due to a series of ailments asked the vice president how she would “make America great again” by helping disabled people like her get health insurance once more. Harris, who had no policy to offer, replied with a lengthy word salad before simply suggesting that she’d ensure the homeless woman’s medical debt wouldn’t count against her credit score.
Anger at the privatized US health care system is not just a matter of moral urgency (for the ordinary people who suffer constantly under that system as well as the executives who get death threats from them). It’s clearly a potent political force waiting to be harnessed. No one in Washington seems to have much interest in doing so right now. If and when they do, it could cause a political earthquake.