A warning shot to the rapacious health insurance industry

It is difficult for me to find a single tear to shed over the assassination of Brian Thompson, CEO of UnitedHealthcare. Someone finally found a way to strike a blow that has made the health insurance industry and the American public sit up and take notice. I do find it significant that the assassination was carried out as the annual open enrollment period for Medicare beneficiaries like myself drew to a close on Dec. 7. Full disclosure: I am not related to Mr. Thompson and I am insured by UnitedHealthcare. I also used to teach college students medical billing and insurance.

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What I have to say about Medicare is complex and confusing, and it is kept that way by enormous and enormously powerful corporations like Aetna, Humana and UnitedHealthcare because it serves their singular purpose: making money, lots of money.

Let’s consider the choices I just made for myself for 2025. I support the idea of a universal-coverage, single-payer system like traditional Medicare – the way Medicare started out in 1965 – so that was my choice for Medicare A and B (hospital care and physician care). To that I added a Medicare D policy for prescription drug coverage and a Medicare supplemental plan to pick up the 20% of costs in Medicare B that are my responsibility.

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Those last two policies are sold only by commercial insurers. In my case, I chose UnitedHealthcare, the company favored by AARP. (In fact, I notice that at my doctor’s office, all the staff refer to those policies as AARP policies, but they are in fact UnitedHealthcare’s policies.) So I pay three premiums – one to Medicare for parts A and B (out of my Social Security check) and two to UnitedHealthcare for Part D and the supplemental policy. When you’re over 65, this is standard because you can’t afford to go without insurance when you know your health will decline as the years advance. You insure for future needs, not current realities.

So, what’s the alternative? During the open enrollment period, all the corporations break out their smoke and mirror shows. What they are pushing is Medicare Advantage plans, not policies like those I chose for myself. With these policies, also known as Medicare C, they are happy to entice beneficiaries with relatively inexpensive “expanded benefits”: routine dental, vision and hearing coverage, gym memberships and expense allowances for over-the-counter medications.

They simplify the many financial transactions into one. You could think of traditional Medicare vs. Medicare Advantage as an equation: Traditional Medicare A and B + D + supplemental = Medicare C. It does sound like a good deal. But what Medicare Advantage enrollees find out is that in exchange for giving one of these corporations all their Medicare dollars they may have a protracted fight on their hands if their health care suddenly gets too expensive.

If the company decides it doesn’t want to cover something, it doesn’t cause them any distress to go through a lengthy legal contest, whereas for the Medicare beneficiary, a delay in coverage can cause real hardship or ruin. The pressure is on the beneficiary to give up the fight and let the insurer off the hook. Many do. A few have won their cases and the company had to pay in the end – again, no great hardship to make the occasional big payout for these obscenely wealthy corporations.

Every fall, every Medicare beneficiary has this decision: Give a commercial health insurance mega-corporation all my Medicare dollars or just some of my Medicare dollars. It is impossible to give them no money. Doing without prescription drugs and supplemental coverage is a risk seniors cannot afford to take.

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And let’s take another look at Medicare D premiums. When I first signed up in 2015, my premium for Part D was in the $45-$50 a month range. In 2025, I will be paying UnitedHealthcare $112 a month for Part D alone. I will still have copayments when I pick up my prescriptions.

So as the Biden administration sought to cap seniors’ out-of-pocket prescription drug costs at $2,000 a year, UnitedHealthcare decided to raise Part D premiums sharply. I could switch to another plan except, guess what? They’re all doing the same thing. (These corporations talk to each other!) I should also mention that during the COVID pandemic, all these corporations made record profits and celebrated by raising everyone’s premiums as though nothing had changed.

So pardon me if I find some relief in someone finally striking a blow at one of these rapacious corporations that take so much from those who can least afford it when they simply do not need it. I feel like at last someone sees me.

So many of us struggle financially while these corporations just take and take and take and take. They’ve got all of us exactly where they want us. They’re big and rich and powerful enough that they have bought all our elected officials by financing their campaigns regardless of party affiliation.

We now know how thoroughly they have bought our Supreme Court justices as news of the ethics violations have emerged. And if anyone voted for Donald Trump thinking he will fix it, I can assure you it’s going to get much, much worse because the last time he was elected he cut taxes for the wealthy and he’ll do it again. What’s to stop him?

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