The killing of CEO Brian Thompson is fueling anger at America’s health care system

The “brutal and targeted” killing of health insurance executive Brian Thompson, the CEO of UnitedHealthcare, outside a New York hotel this week shocked America. The response to the crime has also exposed the simmering anger in the multi-billion dollar industry.

“Pre-approved” doesn’t seem like a phrase that would express much love.

But on a hot day this past July, more than 100 people gathered outside the Minnesota headquarters of UnitedHealthcare to protest the insurance company’s policies and denials of patient claims.

“Pre-authorization” allows companies to review suggested treatments before agreeing to pay for them.

11 people were arrested for blocking the road during the protest.

Police records show they came from across the country, including Maine, New York, Texas and West Virginia, according to a report compiled by the People’s Action Institute.

Unai Montes-Irueste, director of media strategy for the Chicago-based advocacy group, said those protesting have personal experience with denied claims and other problems with the health care system.

“They are denied care, and then they have to go through an appeals process which is very difficult to win,” he told the BBC.

The latent anger felt by many Americans at the health care system — a myriad of providers, for-profit and nonprofit companies, insurance giants, and government programs — came to the fore in the wake of Thompson’s targeted killing in New York City. on Wednesday.

Thompson was the CEO of UnitedHealthcare, the insurance division of health services provider UnitedHealth Group. This company is the largest insurer in the US.

The police are still looking for the suspect who is suspected of being the killer, it is not known why it happened, but the authorities revealed the messages written on the shells found at the scene of the incident.

The words “deny”, “defend” and “depose” were found in the boxes, which investigators believe could indicate tactics that insurance companies use to avoid payments and maximize profits.

A scroll through Thompson’s LinkedIn history revealed that many were angry about the denied claims.

Another woman responded to the job by an executive who made her brag about her firm’s work in making drugs cheaper.

“I have stage 4 metastatic lung cancer,” he wrote. “We just left [UnitedHealthcare] because of all the denials of my medication. Every month there is a different reason for denial.”

Thompson’s wife told American broadcaster NBC that she had received threatening messages before.

“There have been threats,” said Paulette Thompson. “Actually, I don’t know, lack [medical] spread? I don’t know the details.”

“I just know that he said that someone was threatening him.”

A security expert says frustration with high costs across many industries is resulting in threats against corporate leaders.

Philip Klein, head of Texas-based Klein Investigations, which defended Thompson when he gave a speech in the early 2000s, says it is surprising that the official did not have security on his trip to New York City.

“There is a lot of anger in the United States of America right now,” said Mr. Klein.

“Companies must wake up and realize that their managers can be hunted anywhere.”

Mr Klein says he has been inundated with calls since Thompson was killed. Top US firms typically spend millions of dollars on personal security for top executives.

After the shooting, a number of politicians and industry officials expressed their shock and sympathy.

Michael Tuffin, president of insurance group Ahip, said he was “saddened and shocked at the loss of my friend Brian Thompson”.

“He was a devoted father, a great friend to many and a refreshing colleague and leader.”

In a statement, UnitedHealth Group said it had received many messages of support from “patients, consumers, healthcare professionals, organizations, government officials and other concerned individuals”.

But online, many people, including UnitedHealthcare customers and users of other insurance services, reacted differently.

Those reactions ranged from acerbic jokes (one common one was “thoughts and pre-authorization”, a play on the phrase “thoughts and prayers”) to comments on the number of insurance claims denied by UnitedHealthcare and other industries.

Ultimately, the industry’s critics made it clear that they had no sympathy for Thompson. Some even celebrated his death.

Online anger seems to bridge political divides.

Hatred was expressed from well-known socialists to right-wing extremists who blamed the so-called “deep state” and corporate power. It has also surfaced in ordinary people sharing stories about insurance firms denying their medical claims.

Mr. Montes-Irueste of People’s Action said he was shocked by the news of the killings.

He said his party campaigned in a “non-violent, democratic way” – but added he understood the bitterness online.

“We have a very strong and broken health care system, and that’s why there are very strong feelings expressed by people who are dealing with this broken system in different ways,” he said.

Mr Tuffin, head of the health insurance traders’ association, condemned any threats made by his colleagues, describing them as “objective-driven professionals working to make protection and care as accessible as possible”.

The post underscored the deep frustration many Americans feel with health insurers and the system as a whole.

“This system is incredibly complex,” said Sara Collins, a senior scientist at The Commonwealth Fund, a health research foundation.

“Just navigating and understanding how to protect yourself can be a challenge for people,” she said. “And everything can seem fine until you get sick and need your plan.”

A recent Commonwealth Fund study found that 45% of insured working-age adults were charged something they thought should be free or covered by insurance, and less than half of those reported suspected billing errors that challenged them. And 17% of respondents said their insurance denied care recommended by their doctor.

Not only is the US health care system complex, it is expensive, and large costs often fall directly on individuals.

Rates are negotiated between providers and insurers, Ms. Collins says, meaning what patients or insurance companies are charged often does not match the actual cost of providing medical services.

“We’re getting high rates of people saying their health care costs aren’t covered by all kinds of insurance, even (government-sponsored) Medicaid and Medicare,” she said.

“People are accumulating medical debt because they can’t pay their bills. This is unique in the United States. We really have a medical debt problem.”

A survey by researchers at the health policy center KFF found that nearly two-thirds of Americans say insurance companies deserve “blame” for high health care costs. The majority of insured adults, 81%, still rated their health insurance as “very good” or “good”.

Christine Eibner, a senior economist at the nonprofit think tank RAND Corporation, said that in recent years insurers have been rolling out denials of medical coverage and using prior authorizations to deny coverage.

He said the premiums were about $25,000 (£19,600) per family.

“On top of that, people face out-of-pocket costs, which can easily be in the thousands of dollars,” she said.

UnitedHealthcare and other insurers have faced lawsuits, media investigations and government investigations into their practices.

Last year, UnitedHealthcare settled a lawsuit filed by a terminally ill college student whose story was exposed by the news site ProPublica, alleging that he was saddled with $800,000 in medical bills when his prescriptions were denied.

The company is currently fighting a class action lawsuit it says it uses artificial intelligence to end treatment early.

The BBC has contacted UnitedHealth Group for comment.

With reporting by Tom Bateman