\n<\/p>\n
A few years ago I was invited to a lavish dinner with dozens of the most powerful CEOs in America. I had been asked to moderate a panel on social media earlier in the evening, and then was offered a seat at a table, where I was joined by the leaders of tech giants, major retailers, and manufacturing behemoths. Right next to me was the CEO of one of America\u2019s largest health care companies\u2014a plump man who, to say it politely, looked like he\u2019d walked out of central casting for the role of \u201cHealth care CEO.\u201d He spent most of the evening talking about his recent golf and fishing trips, and ate a steak that looked like it was still alive. Eventually, after hearing about his single-digit handicap, I couldn\u2019t help myself, so I leaned in and politely asked, \u201cDo you ever feel bad that your company denies people coverage, and sometimes they die because of it?\u201d Without missing a beat, he took another bite of his steak and responded, \u201cOh, you can\u2019t think of them as people. You just have to think of them as numbers on a spreadsheet.\u201d<\/p>\n
I\u2019ve probably replayed that encounter in my head a few hundred times since last week, when the nation was gripped by the killing of Brian Thompson, the CEO of UnitedHealthcare. Not because I expected something like this to happen, but because of the startling public support for the alleged shooter that ensued immediately afterward. It was as if everyone in America knew that most of these health care companies don\u2019t look at Americans as people, but rather as exactly what I was told: numbers on a spreadsheet. \u201cHis company put multiple of my family members in debt they will be paying for the rest of their lives & denied care for my uncle which led to his death,\u201d as one woman<\/a> recalled on Twitter. \u201cBrian Thompson killed people. Full stop.\u201d There were also thousands of joke posts<\/a> (\u201cI\u2019m sorry, prior authorization is required for thoughts and prayers\u201d), while others simply captured the sheer nihilism of the American spirit (\u201cI cant even pretend to care, I hope he\u2019s looking up at us\u201d).<\/p>\n It will probably surprise no one to learn that, when you look at their spreadsheets, these health insurance companies have been doing quite well. UnitedHealth Group, in particular, reported<\/a> a whopping $22 billion in profits in 2023 alone, including $5.5 billion in the fourth quarter. While on the surface this might imply one of a few scenarios\u2014perhaps that more Americans have suddenly become wildly healthier, or that the health care insurer has increased premiums and denied more claims\u2014there\u2019s actually something else going on here.<\/p>\n Last week (and by chance, the day after Thompson\u2019s killing), Jennifer D. Oliva,<\/strong> a professor of law at Indiana University\u2019s Maurer School of Law, published a paper for the Indiana Law Journal<\/em><\/a> that revealed how artificial intelligence and algorithms are being weaponized by health insurers to systematically deny care. The paper points to a startling report from ProPublica last year<\/a>, which details how Cigna, one of America\u2019s largest insurers, saves itself millions of dollars (leading to billions in profit) by denying claims without even looking at patients\u2019 files. To be precise, Cigna denied more than 300,000 claims in just two months in 2022, spending an average of only 1.2 seconds reviewing each case, per ProPublica. As one former Cigna doctor told the nonprofit outlet: \u201cWe literally click and submit. It takes all of 10 seconds to do 50 at a time.\u201d (In response to ProPublica\u2019s article, Cigna said the investigative organization\u2019s reporting was \u201cbiased and incomplete,\u201d adding that its review system was established to \u201caccelerate payment of claims for certain routine screenings,\u201d allowing the company \u201cto automatically approve claims when they are submitted with correct diagnosis codes.\u201d)<\/p>\n<\/div>\n