We're at mercy of the health insurance industry

COMMENTARY

So, a person of interest has been taken into custody for the slaying of United Health CEO Brian Thompson. Much speculation has been cast as the hunt was on for the gunman. Was it random? Not likely. Was this a pointed attack targeting the health care industry? Possibly.

Was this a direct attack on a story that could be far worse than a father of two being snubbed from existence? That story being a long played out tale of uncovered medical debt or the refusal of treatment by an insurance company.

Cold blooded murder is just that, cold. One might say there is no way to excuse it or condone it.

But if you're in the throes of losing a loved one while an insurance company seems to be holding the key to their health, all the while refusing to unlock the one piece that unfortunately drives Americans' decisions - finances - then I say maybe you could understand a temporary loss of sanity. I should say, I/we don't know that this is the case here. But I also know that for many years we've tried to conquer health care; after all, it is a human right. But there is too much money to be made from it and as a country with a for-profit mentality, health insurance companies are all in on the money train.

Health insurance companies have earned a reputation for prioritizing profits over people, leaving countless clients feeling abandoned during their most vulnerable moments. They often employ tactics designed to deny or delay care, such as rejecting claims on technicalities, imposing endless prior authorizations, or offering networks so narrow that finding an in-network provider feels impossible. These companies present themselves as protectors of health, yet their practices regularly create financial and emotional turmoil for policyholders.

Premiums and deductibles continue to skyrocket, while coverage shrinks, forcing individuals and families to shoulder exorbitant out-of-pocket costs. Even those who dutifully pay for top-tier plans can face unexpected denials or partial payments for life-saving treatments, leaving them drowning in medical debt. The fine print of insurance policies often hides limitations, leaving clients unaware of what's truly covered until it's too late.

Moreover, the lack of transparency and opaque billing practices add layers of stress for clients who are already struggling with health challenges. Instead of easing the burden, insurance companies frequently exacerbate it, putting corporate interests ahead of their duty to ensure accessible, affordable care. In the end, their focus on the bottom line leaves countless clients betrayed, battling not only their illnesses but also a system stacked against them.

With that as the backdrop and possible story we possibly have the motivating factors of what might have happened, as awful as it seems.

None of this condones the action of the gunman, none of it.

But it speaks to a higher power ... emotion. Because let's face it, the non-emotional way is difficult. Someone might suggest that you gather all documentation of denied claims or poor practices.

File a formal complaint with your state's insurance regulator.

Consider escalating the issue with legal counsel or advocacy groups.

Publicly share your experience to hold them accountable and encourage systemic change for others and maybe 5-10 years later you may feel vindicated, or you may feel further depleted than when it originally started. I want you to think about the last time you heard about a health insurance company losing their battle in court... Nothing will really spring to mind. Health insurance companies know this. Health insurance companies literally bank on it.

At the end of the day, we are all at the mercy of health insurance.

We all have those ridiculous stories about fighting with insurance companies. I'm dealing with one right now, it's not a break-the-bank thing, more a principal thing order by my doctor that should just be covered... but it's not. I'm not sure when we're going to start putting pressure on the those that can regulate it, but if we leave it up to them (lawmakers), it won't happen.

Health insurance reform needs to happen. We need to ensure affordability, simplify billing, expand coverage, promote preventive care, regulate costs, and prioritize patient- centered services. Or we need a bottomless pit of money to sue the insurance industry for practicing medicine without a license.

Peter "Fish" Case is a man with an opinion. He offers up a weekly podcast discussion that can be heard at www. theearspoon.com. He also serves on the Brattleboro Select Board. Questions, compliments and complaints can be sent to him at [email protected].

The opinions expressed by columnists do not necessarily reflect the views of Vermont News & Media.