The tragic murder of UnitedHealthcare CEO Brian Thompson on Dec. 4, 2024, shocked the nation and ignited a complex discourse on the state of the American health care system. While violence is unequivocally condemnable, this incident has unveiled the profound frustration many Americans harbor toward health insurance companies.

The circumstances surrounding Thompson’s death serve as a stark indicator of the urgent need to scrutinize health insurance practices and pursue comprehensive health care reform. Thompson was fatally shot outside the New York Hilton Midtown in what authorities describe as a “brazen, targeted attack.” The suspect left behind bullet casings inscribed with the words “deny,” “defend” and “depose” – terms that resonate deeply with the grievances many hold against health insurers’ practices of denying claims and creating bureaucratic obstacles to care.

This tragic event has prompted a wave of public discourse, with individuals sharing personal stories of denied coverage and the resulting hardships. For instance, Tim Anderson told the Associated Press how his wife, suffering from ALS (Lou Gehrig’s disease), was denied essential medical equipment, forcing the family to rely on donations, to provide even the most basic equipment. Such narratives underscore the systemic issues within the health care industry, where profit motives often appear to overshadow patient care.

Last week, Anthem was going to limit the amount it paid anesthesiologists to provide necessary care during surgery. These past years have seen Anthem threaten to not cover Maine patients at Maine Medical Center. The day after Mr. Thompson’s murder, Anthem wisely rescinded the policy on limiting anesthesia time. Several physicians have commented to me – perhaps cynically – that this decision was more to protect the well-being of the insurance executives than the patients.

Unsurprisingly, the public’s reaction to Thompson’s death has been cruel and polarized. Online postings on social media demonstrate profound rage at insurance companies as well as cruel remarks about the deceased, who reportedly earned over $10 million per year. While many condemn the act of violence, others have expressed schadenfreude, highlighting their own negative experiences with insurance companies. This dichotomy reflects a deep-seated anger toward a system perceived as prioritizing profits over people.

Health insurance companies have long been criticized for practices that delay or deny necessary care. A 2020 study estimated that automated processing of claims saves U.S. insurers over $11 billion annually, yet challenging a denial can be an arduous process for patients or their families. A Kaiser Family Foundation survey found that approximately 6 in 10 insured adults experience problems when using their insurance, including denied claims and network inadequacies. It is these systemic issues that contribute to the widespread dissatisfaction and mistrust. The use of algorithms to deny care, particularly to vulnerable populations like seniors, exacerbates the problem, leaving many without access to necessary treatments.

This murder serves as a grim reminder of the human cost associated with systemic failures in health care. This incident should not be viewed in isolation but rather as a catalyst for a thorough investigation into the practices of health insurance companies. Comprehensive health care reform is imperative. Policymakers must address the root causes of public frustration by ensuring transparency, accountability, affordability and, most importantly, patient-centered care within the insurance industry. This includes reevaluating practices that lead to unnecessary denials and delays in care, and implementing safeguards to protect patients’ rights. Moreover, there is a need for a cultural shift within the industry to prioritize patients’ well-being over profits. This involves not only policy changes but also fostering an ethical commitment to serve patients effectively and compassionately.

The murder of Brian Thompson is a reprehensible act and it has clearly illuminated the deep-seated issues within the American health care system. This tragedy should serve as a wake-up call, prompting a comprehensive examination of health insurance practices and spurring meaningful health care reform. Only through such efforts can we hope to rebuild trust and ensure that the health care system serves the best interests of all Americans.

With a new incoming administration, and Robert F. Kennedy Jr. as chief of the Department of Health and Human Services, the opportunity for appropriate changes and disruption can be identified and implemented so our health care system can be more affordable and offer the highest quality of patient care for us all. An obvious starting point for the new administration is to include a public option in the health insurance exchanges. This would allow the existence of both commercial insurers such as Anthem, UnitedHealthcare, etc. to continue to do business but also allow us the personal choice, liberty and freedom to choose a plan with identical coverage but at a substantially lower cost than commercial plans.

Unlike commercial insurers, a public option would not have to divert money to shareholders nor would obscene executive salaries be permitted as this would be a nonprofit system, similar to Medicare, but funded by the insured patients. Change is urgently needed as the status quo is simply lethal to everyone, as we witnessed this past week.