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Cake day: June 26th, 2023

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  • I have been following the news about Brian Thompson’s assassination in New York, and I am astounded by the flood of sympathy the media has poured out for him. Why? This man spent his entire career working tirelessly to deny healthcare to millions of Americans, all in the name of lining his own pockets and enriching shareholders. Yet the media praises him for his “kindness” and “generosity.” Let me be clear: pushing your company’s claim denial rate to nearly double that of your most cold-hearted competitors, bankrupting families through deceptive fine print and delay tactics, is not kindness, and it is not generosity. No, setting up boiler-room style offices with denial scoreboards is one of the most inhuman things I can imagine.

    I spent nearly a decade writing software to help hospital systems fight insurance claim denials, and I can tell you, these insurers are getting better at it every year. They deny even the most justified claims, banking on the fact that most people won’t have the energy, resources, or will to fight back. And for the majority, they’re right. We had a team of a dozen nurses and PAs working alongside twice as many analysts. These were people who knew the system inside and out. We knew the deadlines, the bureaucratic jargon, the documentation required, and we tracked every claim meticulously. But even armed with all that knowledge and experience, we couldn’t win them all. On a good month, we might win two-thirds of the denials. That was considered a success.

    What’s even worse is that for every claim we fought, there were countless others that never even made it that far, we only got denials on services that actually happened. A patient’s doctor tells them they need surgery, but an insurer like UnitedHealth says no and that’s it. The patient gives up and it is difficult to imagine they get better.

    If you’ve ever had a serious medical condition—and I pray you haven’t—you know how much it drains you, how it strips you of your will to do anything. When every moment is agony, you don’t have the strength to sit on hold for hours, fill out endless forms, or chase down a bureaucratic system designed to wear you down. All you want is to sleep, because that’s the only place that pain can’t find you. How many people have simply lacked the strength to fight back, and ultimately succumbed to their conditions? How many families have been driven into poverty, their lives torn apart by a single emergency, all because of these executives’ policies?

    We all know someone who has been through a health insurance nightmare and we also know that while political changes could probably help this problem the reality now is that these people are making a choice to run their companies this way, knowing full well the impact of their greed and indifference.

    Where are your tears, your headlines, for the thousands of people and families whose lives have been destroyed and whose loved ones have died because of these same executives?