Editorial | Suspect in CEO killings doesn’t end debate over health care insurance industry

The detention Monday of a suspect in the murder of United Health Care CEO Brian Thompson while an apparent resolution of a crime mystery that captivated the media and online world over the past week, won’t resolve the discord over how insurers deal with their clients.

The suspect, 26-year-old Luigi Mangione, originally from Towson, Md., had not as of this writing been formally charged with killing Thompson, but according to news reports is a tech whiz with ties to San Francisco and Stanford and a grudge against the medical community over treatment issues. He looks just like the photos released of the killer’s face.

But after the targeted assassination of Thompson and the shooter’s escape from Manhattan, the online world, ever toxic and filled with conspiracy theories, seemed to collectively express a degree of admiration for the killer, while condemning the health-care insurance industry for using its power of denying treatment to maximize profits.

On online forums and social media many people were celebrating the suspect as a quasi-folk hero who struck a blow against the reviled for-profit system. Many were rooting for the killer to evade capture and defended his actions. In some cases, this support crossed over into calls to stymie the police manhunt that Monday apparently was resolved.

The debate over health-care insurance (and insurance in general) might also have resonated with Americans over the age of 65 who entered into, or already reside in, the Medicare system.

Many people (especially in a county like ours where the population is increasingly older) were inundated by offers in both snail mail and email to either join or switch to a new Medicare Advantage program.

The open enrolllment period for such a decision ended Dec. 7, so presumably most of the over-65 crowd have made their decision, however reluctantly.

Medicare Advantage keeps costs relatively low and can include plenty of goodies that you won’t get from traditional Medicare, including dental and vision coverage, prescription drugs, all with low or zero premiums.

But as financial writer and consultant Brett Arends wrote this week in a MarketWatch column, these benefits are not offered out of the goodness of the corporate insurance industry’s heart, but because these giant health-care companies have successfully lobbied government leaders for a sweetheart deal that means taxpayers pay them 22% more per beneficiary would be paid out to insure individuals directly through traditional Medicare. The extra costs come to some $83 billion a year – or about 10% of the entire Medicare budget.

But the downside for an individual with Medicare Advantage is you are dependent for your health-insurance coverage on an organization that has huge and powerful economic incentives not to pay.

Arends writes, “Theoretically, it’s in the interest of your Medicare Advantage insurer to refuse to pay for anything. They pay because they have to – either because the law and the government will force them to, or because if they don’t pay they will end up losing so many customers that they will go out of business. The less they pay out in benefits, the more they keep in profits. In other words, if you sign up for Medicare Advantage, you will effectively be playing poker with your health insurer.”

Meanwhile, there is an alternative. When the nonprofit health-care think tank the Commonwealth Fund sat down and conducted surveys and focus groups last year with insurance brokers who sold Medicare Advantage plans, they found that “most brokers and agents said they personally would choose traditional Medicare with Medigap (supplemental insurance), believing that combination offers better coverage and choices than Medicare Advantage, particularly as people age.”

The Sentinel Editorial Board is accepting applications from Santa Cruz County residents who are interested in joining the board. Please send applications, along with a brief statement of qualifications including past community service, to Opinion Editor Don Miller at [email protected]

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