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Just a few years in the past I used to be invited to a lavish dinner with dozens of essentially the most highly effective CEOs in America. I had been requested to average a panel on social media earlier within the night, after which was supplied a seat at a desk, the place I used to be joined by the leaders of tech giants, main retailers, and manufacturing behemoths. Right subsequent to me was the CEO of one among America’s largest well being care corporations—a plump man who, to say it politely, appeared like he’d walked out of central casting for the function of “Health care CEO.” He spent a lot of the night speaking about his current golf and fishing journeys, and ate a steak that appeared prefer it was nonetheless alive. Eventually, after listening to about his single-digit handicap, I couldn’t assist myself, so I leaned in and politely requested, “Do you ever feel bad that your company denies people coverage, and sometimes they die because of it?” Without lacking a beat, he took one other chew of his steak and responded, “Oh, you can’t think of them as people. You just have to think of them as numbers on a spreadsheet.”
I’ve most likely replayed that encounter in my head a couple of hundred occasions since final week, when the nation was gripped by the killing of Brian Thompson, the CEO of UnitedHealthcare. Not as a result of I anticipated one thing like this to occur, however due to the startling public help for the alleged shooter that ensued instantly afterward. It was as if everybody in America knew that almost all of those well being care corporations don’t take a look at Americans as individuals, however fairly as precisely what I used to be advised: numbers on a spreadsheet. “His company put multiple of my family members in debt they will be paying for the rest of their lives & denied care for my uncle which led to his death,” as one lady recalled on Twitter. “Brian Thompson killed people. Full stop.” There had been additionally 1000’s of joke posts (“I’m sorry, prior authorization is required for thoughts and prayers”), whereas others merely captured the sheer nihilism of the American spirit (“I cant even pretend to care, I hope he’s looking up at us”).
It will most likely shock nobody to be taught that, whenever you take a look at their spreadsheets, these medical insurance corporations have been doing fairly effectively. UnitedHealth Group, particularly, reported a whopping $22 billion in earnings in 2023 alone, together with $5.5 billion within the fourth quarter. While on the floor this may suggest one of some situations—maybe that extra Americans have all of a sudden develop into wildly more healthy, or that the well being care insurer has elevated premiums and denied extra claims—there’s really one thing else occurring right here.
Last week (and by probability, the day after Thompson’s killing), Jennifer D. Oliva, a professor of regulation at Indiana University’s Maurer School of Law, printed a paper for the Indiana Law Journal that exposed how synthetic intelligence and algorithms are being weaponized by well being insurers to systematically deny care. The paper factors to a startling report from ProPublica final 12 months, which particulars how Cigna, one among America’s largest insurers, saves itself hundreds of thousands of {dollars} (resulting in billions in revenue) by denying claims with out even taking a look at sufferers’ information. To be exact, Cigna denied greater than 300,000 claims in simply two months in 2022, spending a mean of only one.2 seconds reviewing every case, per ProPublica. As one former Cigna physician advised the nonprofit outlet: “We literally click and submit. It takes all of 10 seconds to do 50 at a time.” (In response to ProPublica’s article, Cigna stated the investigative group’s reporting was “biased and incomplete,” including that its overview system was established to “accelerate payment of claims for certain routine screenings,” permitting the corporate “to automatically approve claims when they are submitted with correct diagnosis codes.”)
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