After a healthcare CEO is whacked, a horrific medical policy is reversed

Social change works in mysterious ways

If you’ve followed the targeted killing of UnitedHealthcare CEO Brian Thompson in Manhattan, you have probably heard that Anthem Blue Cross Blue Shield planned to cut off payment for anesthesia during medical procedures if they went past a time limit.

It’s one of those stories that sound like an internet hoax. Except it wasn’t. On Nov. 1 Anthem announced a new policy covering 8 million people in New York, Connecticut, and Missouri. Anthem said it would pay for anesthesia up to a standard time limit according to each procedure, but not beyond that. It is the type of cruelty most people can’t imagine, but which is the bread-and-butter of C suite executives. The policy drew little attention until Thompson was knocked off.

The American Society of Anesthesiologists said the policy was worse than it seemed. Accusing Anthem of a “cynical money grab,” the ASA said if a procedure exceeded an “arbitrary time limit,” “Anthem will deny payment for the anesthesiologist’s care.” In other words, anesthesiologists would be paid nothing if a procedure took too long.

It would be like placing a ticking time bomb in operating rooms. Surgeons would race to finish as a timer clicked down. It would mean more botched procedures, infections, internal bleeding, suffering and unnecessary deaths. It evoked horrifying scenes out of an alien abduction film: People suddenly waking up as probes were being shoved in their orifices or seeing their innards splayed out on the operating table.

If a surgery ran even a minute or two over, the patient could be stuck with an anesthesia bill that ran into the tens of thousands of dollars. All to satisfy the greed of insurance executives and shareholders.

A funny thing happened, however. When news spread of the killing of Thompson, the internet erupted in celebration and Anthem shit its corporate pants. The next day it reversed the policy. It whinged that “significant widespread misinformation about an update to our anesthesia policy” was the reason for the reversal. If you believe that, I got some real estate on Mars to sell you.

Consider this. The media have settled on “brazen” to describe the killing of Thompson. But you know what isn’t brazen? It’s decisions by corporate executives to kill us for profit. In 2023, Anthem CEO Gail Boudreaux raked in $21.9 million. Five other Anthem executives were paid from $6.5 million to $12.4 million.

According to The Lever, anesthesiologists raised concerns with Anthem on Nov. 15 about the time limit. It affected commercial insurance plans initially. After the call, the ASA alleged that “the health insurer announced it would be extending parts of these coverage limits to its Medicaid services in these states as well.”

That is brazen. After being confronted with the dangers of a greed-driven arbitrary policy, Anthem doubled down and expanded it.

Or take Thompson. He nabbed $10.2 million in pay last year as UnitedHealth Group, the parent of UnitedHealthcare, faced a Department of Justice antitrust investigation, six class-action lawsuits, and accusations that it bilked the government out of as much as $3.7 billion in fraudulent Medicare payments. Thompson was also confronting charges of hiding the DoJ investigation from investors and insider trading in cashing out $15 million in stock earlier this year.

Sounds brazen. Instead of learning of this history of corruption, we were told by USA Today that Thompson was “a father, Midwesterner, and well-liked executive.” An even more skilled polisher of turds is The New York Times. It claimed Thompson was the rare executive who wanted to address unhappiness among UnitedHealthcare’s 49 million members — that is nearly one-in-six Americans — by changing “the state of healthcare coverage in the country and the culture of the company.”

As CEO of UnitedHealthcare, the insurance arm of UnitedHealth, Thompson did change the state of healthcare coverage. Two weeks before he ate lead, Pro Publica reported that UnitedHealth was using an “illegal algorithm” to police “mental health care with arbitrary thresholds and cost-driven targets.” UnitedHealth was punishing patients by cutting off coverage if they received treatment weekly for eight months. One patient advocate said he felt like “a cog in the wheel of insurance greed.” Many of these patients were receiving treatment once or twice a week because they were considered high risk.

A year earlier, STAT reported that UnitedHealth was “illegally using an algorithm to deny rehabilitation care to seriously ill patients.” A class-action lawsuit filled on behalf of dead patients claimed UnitedHealth used an AI algorithm to “prematurely” kick the elderly out of nursing homes.

When it comes to both algorithms, UnitedHealth overrode treatment recommended by clinicians. In one case, UnitedHealth forced a 91-year-old patient with a fractured leg and ankle to go home after 19 days of therapy despite doctors attesting his muscles were “paralyzed and weak.” The patient died the following year. In the case of nursing-home patients, over 90 percent of the cases that went to appeal were overturned. That means less than 10 percent of denials passed muster.

Under Thompson, UnitedHealthcare led all insurers in denying claims, some 32 percent of them. That is nearly five times the rate that Kaiser Permanente denied, only 7 percent.

Thompson was a murderer. He and other healthcare executives know exactly what they are doing. They kill people for cash. That’s the utter barbarity of for-profit healthcare.

His killing raises a red flag no one in journalism wants to touch. It looks like Anthem reversed its anesthesia policy as a consequence. There is no other credible reason it would have done so within 24 hours.

Go ahead and criticize the killing of Thompson. But it may wind up being harm reduction. If Anthem had gotten its way, putting time limits on anesthesia would have spread to other insurers. Capitalism is a race to the bottom.

To be fair, random murders of the ruling class is not a political strategy. But it’s all you need to know about America that this killing may have been more effective in making healthcare policy better that the system of politics, elections, and protests.