The health care murder

The ghoulish reaction to a CEO's cold-blooded killing highlights just how broken our health care system is.

Consolidation Nation: A sign in a Seattle medical center, after its purchase by UnitedHealth Group’s Optum unit, early this year.

“Is anyone happy with our health care system?” I asked in October. This week, we got another brutal answer.

I’m talking not only about the apparent assassination of a major health care CEO, but also about the response to his death: the jokes and costume contests and overwhelming glee at his fate, all wrapped in widespread—and bipartisan—fury about his business and the expensive, fundamentally broken state of American health care.

The motives of the alleged killer are still unknown. But the public reaction to his murderous actions: Ooof.

However ghoulish the rhetoric, it can’t be dismissed as just people behaving badly on the Internet. This isn’t only a crime story, or a New York City story, or a digital-moral-decay story. So in the hours after the shooting, I raised my hand to cover this story at NPR, because health care is one of the most important—and most broken—businesses in the country.

And the victim ran one of the biggest pieces of it. Until his death, United Healthcare CEO Brian Thompson led the largest health insurer in the United States. He was one of the top executives at parent company UnitedHealth Group, a quiet colossus that controls almost every part of how Americans get health care. It oversees for-profit insurance, surgical centers, pharmacy benefits, and the software (hi, Change Healthcare!) that connects everything. It also employs more than 90,000 U.S. doctors—or 10 percent of all U.S. physicians.

All of this is pretty profitable for UnitedHealth! It earned $23 billion last year, and is the fourth-largest company in the United States.

But is that healthy for the rest of us? As I told Steve Inskeep on Up First on Thursday:

“Health care executives receive a ton of threats, and part of that is the general anger and frustration so many feel over health care in the United States. The country has the most expensive health care in the world—and some of the worst outcomes.”

Now the ongoing reaction to Thompson’s cold-blooded killing highlights just how powerless—and furious—we the people feel about this status quo.

Listen to me discuss this story on NPR’s Up First and All Things Considered.

Lady Bits

• Letter of Recommendation Operation Mincemeat, coming soon to Broadway. I saw this in London last week and was so entertained, and even moved. (I didn’t expect a slapstick, fringe-originating musical about a Dad-history subject to make me cry, and yet!)

• ...And Anti-Recommendation: The Hills of California, closing soon on Broadway. Sara Holdren, incisive per usual, pares down why it’s a business failure as much as a boring story. (Stop me if this sounds familiar: Investors like to shower money on established white men who are seen as sure bets, because they’re already successful. But having too much power and money—and ability to ignore editors—doesn’t always make for the most thoughtful art!) I’ll just add that (spoiler!) using rape as your plot device is never as surprising as the writer thinks. Making your female protagonist a survivor of sexual assault is the distaff version of killing off your hero’s wife, so he has some revenge to seek; questions of taste aside, it’s tediously predictable.

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