The conversation about the assassination of UnitedHealth CEO Brian Thompson has descended into the distraction of the culture war, with claims he was a good man doing his job and a victim of left-wing hatred of free enterprise.

It is in the realm of possibility that the defenders could be right. The real story, however, is the performance of the company that he was a part of and the for-profit health care system in this country. UnitedHealthcare, and the health care services under the Optum brand, is the world’s ninth-largest company by revenue, posting $22 billion profit in the last fiscal year. It went from $41 billion in assets in 2005 to $273 billion in 2023. It has achieved this remarkable growth by acquiring a variety of companies at all levels of the health care system. Currently it has 136 subsidiaries in the U.S. and 27 throughout the world.

The company has been accused of using algorithms to deny treatments and refusing coverage of nursing care to stroke patients. It has been recently been involved in two class actions alleging the use of AI predictive tools to automate claim denials for necessary medical procedures, improperly denying health care coverage for medical services and overriding the medical determinations of their doctors. The Office of the Inspector General released a new report titled “Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions.” The report found that UnitedHealth reaped $3.7 billion in extra federal payments in 2023 for diagnoses from in-home health risk assessments (HRAs) and HRA-linked chart reviews. According to the report, UnitedHealth accepted these payments even though the patients did not receive any additional treatment or medical services following the new diagnoses.

Beyond the corruption at the highest level of this company that has resulted in a probe for insider trading and a lawsuit alleging Medicare fraud, lies the question of the overall performance of the American private health care system.

Along with UnitedHealth, the seven major health care insurers in this country posted profits of more than $70 billion in 2023. Financially, we are burdened by medical expenses comprising 65.5% of the reasons for bankruptcy filings.

Claims that we have the best health care system in the world, unless you are wealthy, are an illusion. What do we get for paying $4,000 more per person than any other high-income nation? We have the lowest life expectancies at birth, the highest infant and maternal death rates, as well as the highest death rates for treatable conditions. Who is responsible for the deaths of those people?  Are their lives any less valuable than the CEO of a major corporation?

Remember Rick Santorum’s and Sarah Palin’s campaign lines about death panels in universal care countries? Or Rep. Spencer Bachus’ speech on the House floor opposing the Affordable Care Act in 2009? (“It is a disaster for patients, because a government-run system will always ration care, reduce quality and raise costs. It will put a federal bureaucrat between you and your doctor.”) The reality is that decisions by insurance companies to deny coverage lead to patient deaths. An insurance adjuster or an algorithm, both incentivized to maximize profits, come between us and our doctor.

The future of our health care is uncertain with a new administration and a Republican majority in both houses. What is certain is that the for-profit health care system is exorbitantly expensive, produces poor results and does not have a plan for the future as our population continues to age. Imagine if that yearly $49 billion profit could be invested in providing health care to underserved rural areas, improving prenatal care and mental health services or addressing the projections that given current conditions we will be short 122,000 physicians, 400,000 home health aides and 29,000 nurse practitioners by 2032. Just imagine.