At first, and for a good long while, I was firmly in the camp of "Brian Thompson is a murderer, the law that declared his actions legal voided the right to reasonably expect that a vigilante wouldn't take him out to avenge his tens of thousands of victims, assuming his killer wasn't one of them". After all, UnitedHealthCare does deny a shocking 32% of all claims. That appeared to me like fraud and indirect murder.
But I happened to dig just a little bit deeper, and here is what I found. In 2024 UHC had a Medical Care Ratio of roughly 85%. This means that, of all the premium money they collect, 85% of it gets paid out in the form of medical care, meaning only 15% is available for administrative costs and profit. With 85% of revenue covering just 68% of claims, then at a hypothetical 100% (e.g. no company employee gets paid and they're all literally working for free out of the goodness of their hearts) that'd still leave UHC with a roughly 20% claim denial rate.
So what's the real problem with UHC? It's cheap healthcare, catering to a low-income base who can't afford better than its premiums (or who enrolled in UHC as a benefit of low-skilled, low-paid jobs in industries like retail or fast food whose employers won't pay for better) but customers expect that their medical bills will be taken care of the same way BCBS or whatnot would. But UHC can't afford to pay out the same as BCBS, because it has a dearth of richer clients paying into the system. They're enrolled in better insurance, which exists on a separate, segregated plane from UHC.
So what could UHC have done differently? Nothing, really. Had they paid out more claims, they would've run out of money. Had they charged higher premiums, fewer people could've afforded to be enrolled with UHC. Popular rage should be redirected toward the root causes of expensive medicine, and not toward a framework that rose to such prominence as a mere reaction to such. This is my understanding, anyway.
