UnitedHealth Group is America’s largest private health insurer and also the largest employer of physicians. The umbrella company, which has nearly $400 billion in annual revenue, helps run hospitals, has rapidly acquired outpatient surgery centers, employs middlemen that handle pharmaceutical prescriptions and payment processes, and is expanding into home health services.
Thompson, a 50-year-old insurance executive from Maple Grove, Minnesota, was the CEO of UnitedHealthcare, UnitedHealth’s insurance subsidiary that covers more than 50 million Americans and generated $281 billion in 2023, accounting for about 75% of the parent company’s revenue.
That vast revenue stream helped UnitedHealth Group rank as the fourth-largest U.S. company by revenue in 2024, just behind Apple and ahead of tech giants Alphabet and Microsoft. That outsized revenue stream has drawn much attention of late:
- AI algorithms – In November 2023, STAT News reported that UnitedHealthcare used AI tools developed by subsidiary NaviHealth to deny care for seniors enrolled in the company’s Medicare Advantage plan. STAT found troubling instances, like when an older woman who had a stroke was only covered for half the nursing days typically required for recovery.
- Private data loss – In February 2024, a UnitedHealth subsidiary, Change Healthcare, suffered a cyberattack that led to months of unprecedented outages and widespread disruption across the U.S. healthcare sector. But it wasn’t until January 2025, however, that UnitedHealth confirmed that the Change Healthcare data breach affected 190 million Americans. The data included names, addresses, dates of birth, phone numbers and email addresses, plus government identity documents, including Social Security numbers, driver’s license numbers, and passport numbers. If all this wasn’t bad enough, UnitedHealthcare deliberately hid the breach from online searches by including a “noindex” code in its Change Healthcare data breach notice, which tells the search engines to ignore the web page. This data theft and subsequent subterfuge will have significant and long-lasting effects on nearly two-thirds of Americans.
In its data breach notice, Change Healthcare said that the cybercriminals stole names and addresses, dates of birth, phone numbers, email addresses, and government identity documents, which included Social Security numbers, driver’s license numbers, and passport numbers. The stolen health data also includes diagnoses, medications, test results, imaging, and care and treatment plans, as well as health insurance information. Change said the data also includes financial and banking information found in patient claims.— TechCrunch
24-Jan-25
- Insider trading – In May 2024, the City of Hollywood Firefighters’ Pension Fund filed a lawsuit alleging that UnitedHealth executive Brian Thompson, CEO Andrew Witty, and board chairman Stephen Hemsley sold millions of dollars worth of shares based on non-public information, damaging the financial position of the pension fund. In July, the California Public Employees Retirement System, CalPERS, joined the case as the lead plaintiff.
- Pharmacy Benefit Manager (PBM) – In July 2024, a New York Times exposé blamed UnitedHealth Group’s pharmacy benefit manager OptumRx — one of three powerful healthcare middlemen — for profiting by inflating drug costs. In October 2024, the Times reported PBMs were running independent pharmacies out of business. On Dec. 17, 2024, The New York Times reported that the PBMs took secret payments to allow the free flow of opioids:
“For years, the benefit managers, or P.B.M.s, took payments from opioid manufacturers, including Purdue Pharma, in return for not restricting the flow of pills. As tens of thousands of Americans overdosed and died from prescription painkillers, the middlemen collected billions of dollars in payments.”
— The New York Times
17-Dec-24
- “Unfair” treatment – In September 2024, UnitedHealth sued the Centers for Medicare & Medicaid Services (CMS), alleging the agency downgraded its star ratings “based upon a single phone call that lasted less than 10 minutes.’ UnitedHealthcare claims the call was never connected to its call center. In documents filed on October 15, UnitedHealthcare alleged the agency ignored its claims that it received “disparate” treatment from Elevance Health (Anthem Blue Cross/Blue Shield). In January 2024, Elevance sued the agency over its star ratings for that year. One issue in the case was the inclusion of a “secret shopper” phone call Elevance said did not connect. On Jan. 24, 2025, CMS dropped its appeal against UnitedHealthcare, likely due to the new Trump administration. Now you’re aware of whose side the new administration is on.
- Claim denial – In October 2024, a Senate committee investigating Medicare Advantage plans released a report detailing the denial of nursing care to patients who had suffered falls and strokes. The committee found that three major companies — UnitedHealthcare, Humana, and Aetna — were purposefully denying claims for this expensive treatment in order to increase profits. The committee found that requests for these nursing stays were turned down three times more frequently by UnitedHealthcare than requests for other treatments. (Humana fared even worse, with a 16-fold increase in denying.) The report found that UnitedHealthcare’s denial rate for post-acute care — health care needed to transition people out of hospitals and back into their homes — for people with Medicare Advantage plans rose to 23% in 2022 from 9% in 2019.
- Windfall profits – According to financial records examined by The Lever, America’s largest health insurers have raked in more than $371 billion in profits since the Affordable Care Act (ACA) was passed in 2010. Over 40% of that net income went to UnitedHealth Group, whose annual profits have reportedly increased by almost 400% as the corporation now rejects almost one out of every three policyholder medical claims. Insurers have profited from these increases, while the average American family’s premiums have increased to around $26,000 a year. The largest health insurance companies in the nation, including UnitedHealth Group, Cigna, Kaiser Permanente, Elevance Health, the parent company of Anthem Blue Cross/Blue Shield, and CVS Health, which purchased Aetna in 2018, have received over $9 trillion in revenue since ACA was passed.
Social Media Uprising
In these turbulent waters entered one of the most sensational murders of an industry executive since Cash App founder Bob Lee was stabbed to death in Downtown San Francisco on April 4, 2023. For days, the world was captivated by a mysterious, masked gunman who eliminated a member of the UnitedHealth corporate team and escaped with almost hitman precision.
The most notable clue emerged a day later when reports surfaced that bullet casings found at the site of the killing had the words “deny,” “delay,” and “depose” written on them. Those words were linked to a 2010 book by Jay Feinman entitled, “Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It.”
The verdict on social media was swift and overwhelmingly brutal. A UnitedHealth Facebook post honoring Thompson received 75,000 “haha” emoji reactions. UnitedHealth quickly restricted who could leave a comment on its Facebook and X posts. A comment posted underneath a CNN video of the shooting read, “Thoughts and deductibles to the family.” Another added acerbically, “Unfortunately my condolences are out-of-network.”
A UnitedHealth Group Facebook post that paid tribute to Brian Thompson drew 71,800 “haha” emoji reactions when this screenshot was taken. Fully 93% of the emoji reactions took issue with UnitedHealth honoring Thompson.
I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick. I just can’t feel sympathy for him because of all of those patients and their families.”
— TikTok User
Dec. 5, 2024
On TikTok, one user wrote, “I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick. I just can’t feel sympathy for him because of all of those patients and their families.”
Today I’m thinking about the time United Healthcare suddenly decided to stop paying for my chemotherapy and didn’t bother telling me, so the nurses had to tell me when I checked in at the cancer center for my next treatment.
Totally unrelated to any current news, of course.
— Kendall Brown (@kendallybrown) December 4, 2024
Alex Goldenberg, who tracks online threats at the Network Contagion Research Institute, told The New York Times that the glorification of the murder of Brian Thompson and the “lionization of the shooter” left experts aghast. “But what’s disturbing about this is it’s mainstream,” Goldenberg noted.
Mr. Goldenberg, welcome to the Casual Living Ubertrend — the evaporation of decorum. This Ubertrend, which has led to a less formal and more in-your-face society, shielded by the anonymity of big cities and the internet, is partly responsible for the outpouring of social media rage that followed Thompson’s murder.
The other reason behind this torrent of negative sentiment is the collapse of business ethics, which is another Casual Living-fueled phenomenon. While anger and frustration over the state of healthcare in America are primarily to blame for the dark commentary, the manner in which it’s being presented is caused by the erosion of moral values.
UnitedHealthcare actively delayed, denied and defended its insurance practices, and the public is sending a clear message of revulsion.
Sad State of Affairs
While many bemoan the “lionization of the shooter,” it’s quite evident that the U.S. healthcare industry has a target on its back, and Luigi Mangione is widely considered the antihero. The industry only has itself to blame for this scenario, as the previously outlined exposé of UnitedHealth vividly illustrates.
Insured members often find themselves battling with health insurance companies over reimbursement for medical treatment and are often denied.
No one knows how often private insurers like UnitedHealthcare deny claims. However, people who were covered under the Affordable Care Act had 17% of their care denied in 2021, according to KFF, formerly known as the Kaiser Family Foundation. Other surveys have found that denials are more prevalent among the privately insured than those with Medicare coverage.
A comment posted on TikTok illustrates the predicament patients can find themselves in:
“I pay $1,300 a month for health insurance with an $8,000 deductible ($23,000 yearly). When I finally reached that deductible, they denied my claims. He [Brian Thompson] was making a million dollars a month.”
Author Joyce Carol Oates offered this social media commentary:
“[The outpouring of negativity] is better described as cries from the heart of a deeply wounded & betrayed country; hundreds of thousands of Americans shamelessly exploited by health-care insurers reacting to a single act of violence against just one of their multimillionaire executives.”
— Joyce Carol Oates
Dec. 5, 2024
An unidentified UnitedHealthcare employee noted that workers at the company had been aware for years that members were unhappy. Ironically, Thompson was among the few executives who wanted to do something about it. In speeches to employees, Thompson spoke about the need to change the state of U.S. healthcare coverage and the culture of the company, topics other executives avoided, the employee told The New York Times.
The other executives did not avoid the ruthless fleecing of their members in pursuit of the almighty dollar, eagerly hoping to boost UnitedHealth’s $16 billion in operating profits. Shockingly, in a video recorded the day after Thompson’s death and leaked to journalist Ken Klippenstein, UnitedHealth Group’s CEO had this to say:
“We make sure that care is safe, appropriate, and is delivered when people need it and we guard against the pressures that exist for unsafe or unnecessary care to be delivered in a way that makes the whole system too complex and ultimately unsustainable.”
— Andrew Witty, UnitedHealth CEO
Dec. 5, 2024
One UnitedHealthcare patient, a college student whose medical bills were running nearly $2 million a year to treat a severe case of ulcerative colitis, was the subject of a 2023 ProPublica report. United disregarded an internal report that determined that costly therapy was needed. The patient, Christopher McNaughton, ultimately filed a lawsuit against United and settled for an undisclosed amount.
UnitedHealthcare is not the only company that practices “delay and deny.” Cigna owns a division called EviCore that is used by major U.S. health insurers to review medical treatment requests. According to an investigation by ProPublica and Capitol Forum, EviCore developed an algorithm backed by AI, which some insiders call “the dial,” that can be adjusted to increase denial rates, a practice that prioritizes profit over patient care.
In Arkansas, which requires the release of denial rates, EviCore has denied prior authorization requests about 20% of the time since 2021. The comparable figure for federal Medicare Advantage plans was almost 7% in 2022. The ProPublica report highlights a specific case where a patient’s cardiac exam request was denied by EviCore, ultimately leading to his death. ValuePenguin reports that UnitedHealthcare denies a staggering 32% of claims, based on data it collects.
[I condemn companies that] continue to abuse our country for immense profit because the American public has allowed them to get away with it.”
— Luigi Mangione
As Mangione wrote in his minifesto: “[I condemn companies that] continue to abuse our country for immense profit because the American public has allowed them to get away with it.” He also noted that UnitedHealthcare’s market capitalization has grown, but American life expectancy has not.
Business As Usual
UnitedHealth is merely a proxy for an American business establishment gone awry due to a short-term-focused Wall Street feeding frenzy that celebrates market exploitation. There was no more glaring example of corporate leaders’ mistaken beliefs than what happened during the COVID-19 pandemic.
The Small Business Association’s $349 billion PPP program was designed to help small businesses retain employees and prevent mass layoffs due to the coronavirus pandemic. Originally aimed at companies with less than 500 employees, the $2 trillion CARES Act allowed large restaurant and hotel chains to participate regardless of how many people they employed due to relentless lobbying by the National Restaurant Association.
Illustrating the startling jump in unprincipled behavior, the L.A. Lakers, Ruth’s Chris steakhouse chain and Shake Shack applied for PPP loans. Ruth’s Chris, which earned a $42 million profit on revenues of $468 million in 2019, tapped the PPP program for a $20 million loan.
Shake Shack was even more morally bankrupt. It earned an operating profit of $128 million on revenues of $595 million in 2019. More than 200 public companies disclosed obtaining a total of $775 million in paycheck-protection loans.
One could argue that the virulence of the pandemic in those early months of 2020 contributed to a major reality distortion field. The erosion of business values, however, began accelerating much earlier. In the 1990s, shenanigans at Enron, WorldCom and Tyco turned Kenneth Lay, Bernard Ebbers and Dennis Kozlowski into household names.
Since those quaint days of television shows like Seinfeld and Friends, incidences of ethical missteps have exploded and now include a long list of Silicon Valley stalwarts who were once regarded as the standard bearers of an enlightened business age. The list of profiteering exploiters is long. Here are just a few, starting with America’s most hated company, Comcast:
- Comcast – The Federal Communications Commission (FCC) fined Comcast $2.3 million for charging customers for equipment and services they hadn’t requested or authorized. In many cases, customers had explicitly rejected these offers when speaking with Comcast representatives. Washington State Attorney General Bob Ferguson filed a $100 million lawsuit against Comcast, alleging the company violated the state’s Consumer Protection Act (CPA). The company was accused of duping 500,000 consumers into paying $73 million for a “protection plan” that did not cover the majority of wiring work done in homes. Though Comcast acknowledged its bills could have been more transparent and its customer service better, it denied any wrongdoing or even “problematic policy.” In a press release, Ferguson noted, “This case is a classic example of a big corporation deceiving its customers for financial gain.”
- Cox Communications – Cox Communications was sued by the Arizona Attorney General for deceiving customers who purchased television services with promises of “price lock guarantees” and fixed-pricing deals. The company allegedly failed to fully explain additional fees, such as the Broadcast Surcharge Fee and Regional Sports Surcharge, which allowed them to raise bills of price-locked customers.
- Big Pharma – In 2019, Gallup found that the pharmaceutical industry ranked below all other public and private sectors in favorability among Americans. This was partly due to Mylan, which raised the price of its EpiPen emergency allergic reaction treatment by more than 500% in 2016. However, some are becoming increasingly aware that the U.S. pharmaceutical industry charges Americans more for the same drugs than even Canadians. In 2022, U.S. prices for brand-name drugs were 4.2 times higher than in 33 other countries, according to a RAND report. They will soon become incensed when they discover that a Wegovy prescription, which costs about $1,349 per month in the U.S., costs just $140 in Germany and $92 in the U.K. The unprincipled behavior of American pharmaceutical companies has clearly even rubbed off on Denmark’s Novo Nordisk. Worse, that $1,000-per-month Ozempic costs just $4.73 to make, according to researchers from Yale University and King’s College Hospital in London. Greedflation indeed.
- Bilking Medicare – A year’s long analysis by The Wall Street Journal of billions of records of Medicare services obtained through a data-use agreement with the federal government showed that private insurers took extra payments after diagnosing patients with conditions that no doctor ever treated, recruited patients who use few services and, at times, obstructed access to care for the sickest patients. The most outrageous example of misconduct cited included diagnosing more than 66,000 Medicare Advantage patients with diabetic cataracts even though they had already had surgeries that cured the condition, making it anatomically impossible for them to still have the disease.
- Major airlines – Airlines were tied with health insurance companies at the bottom of a 2018 American Customer Satisfaction Index study. Yet, major U.S. airlines are a perfect case study of stock buyback excess. The big four U.S. air carriers, American, Delta, Southwest and United, have spent $39 billion on repurchasing their own shares from 2012 through 2019 rather than making investments to help employees and passengers. Then they got a CARES bailout of $58 billion, paid for with American tax dollars to prop up their sagging businesses.
- Overpaid CEOs – There was a time in America when most large corporations were headed up by someone with a truly impressive title, “President.” In 1955, only two Fortune 200 companies boasted a “chief executive officer.” By the late 1970s, almost all were led by chief executive officers. In a parallel trend, CEOs have increased their own pay to extortionate amounts. In 1965, CEOs were paid about 21 times what the average worker earned. By 2023, this ratio had grown to approximately 268-to-1 for S&P 500 companies. Some CEOs, however, make far more. NU Skin Enterprises Inc.’s CEO, Ryan Napierski, made a staggering 10,377 times its median employee’s pay for the fiscal year ending in 2023, according to the AFL-CIO. And the abuse is not limited to for-profit companies. The Economic Research Institute compiled a list of the top 10 highest-paid CEOs at nonprofits and found that at some major organizations, particularly in healthcare, compensation for top executives eclipsed $10 million. All these abuses occur with the tacit approval of boards and stockholders or stakeholders.
- Stock buybacks – In the 10-year period between 2008 and 2017, S&P companies sank $2.4 trillion of their cash into buying back their own stock. In the seven years since, these S&P companies have already bought back $4 trillion, which has made corporations the single largest source of demand for American stocks. The quickened pace of buybacks illustrates the impact of the 2017 Tax Cuts and Jobs Act on stock manipulation. Apple has seen it fit to spend more than $800 billion on stock buybacks since 2012, the year after former CEO Steve Jobs died, while charging customers $1,000 for a monitor stand. Stock buybacks do not directly benefit customers because they primarily serve to increase the value of a company’s shares for existing shareholders and do not impact the price or quality of products or services that customers receive. Critics argue that the money used for buybacks could be better invested in company growth, employee benefits, or research and development, which would ultimately benefit customers more than simply raising the stock price. Harvard Business Review even argues that stock buybacks are “dangerous for the economy.”
- Apple – In June 2024, Apple advertised a Higher Education promotion that, according to MacRumors, contained the following text, “Buy Mac for university or college with education savings. Plus get a gift card for up to $200.*” That wording was deceptive because, as the asterisk suggested, the company’s Higher Education Terms and Conditions contained a hidden surprise: “The Promotion Product is redeemable for future purchase(s) only and is not a ‘gift.’” When a sales promotion includes a gift card, it’s customary that buyers see a bonus gift card as an additional way to offset the cost of the item purchased, particularly since it’s not a cash discount. This deceptive marketing tactic is another glaring example of how business ethics have eroded, even at a $3 trillion company that, theoretically, at least, should not have to stoop this low. One customer, however, Dr. Mara Einstein, did not fall for the scam.
This Apple ad deceptively implied that a bonus gift card was included to help offset the cost of an Apple device as part of the promotion. Reading the fine print, buyers realized they paid for the gift card themselves.
- Boeing – In October 2018, Lion Air Flight 610, a Boeing 737 Max 8, plunged into the Java Sea off the coast of Indonesia minutes after takeoff from Jakarta, killing all 189 people on board. Less than five months later, Ethiopian Airlines Flight 302, crashed after takeoff from Addis Ababa, Ethiopia, killing 157 passengers and crew members. Both accidents were blamed on Boeing and the FAA agreeing not to inform pilots about the Maneuvering Characteristics Augmentation System (MCAS) in manuals, even though pilots were expected to be the primary backstop in the event the system went haywire. This “put profit before safety” behavior was designed to save the 5,000 pre-orders the company had received for the 737 Max in September 2018. Instead, the company was forced to pay victim families $500 million for the “deadliest corporate crime in U.S. history.” Boeing has lost a cumulative $32 billion since the second crash in 2019 resulted in a 20-month grounding of its best-selling jet.
- Capital One – Despite advertising claiming that Capital One offered high-yield savings that would earn much more interest than traditional bank accounts, a lawsuit filed against the bank claims depositors lost more than $2 billion. For years, Capital One held interests artificially low in their “high-yield product” to 0.3%, even as the Federal Reserve raised rates above 5%.
- Grubhub – Grubhub, another new-age startup, has also fallen into the ethical abyss. Grubhub will pay $25 million to settle a lawsuit filed by the Federal Trade Commission and Illinois Attorney General Kwame Raoul. The company was accused of illegal practices, such as tricking customers about delivery fees, misleading drivers about how much they could earn, and featuring restaurants on their site without permission.
- Honey – PayPal, the very company that spawned the “PayPal mafia,” which includes the likes of Elon Musk, David Sacks and Peter Thiel, acquired Honey in 2020, a browser extension that promises to save users money by scouring the internet for the best digital coupons and promo codes from more than 30,000 online shopping sites. However, according to YouTuber MegaLag and a class action suit filed by YouTuber Devin Stone (LegalEagle), the extension often prioritizes coupon codes from partner stores, even though better offers exist. MegLag alleges that the extension swapped out creator affiliate links with links of its own — regardless of whether the extension successfully found a viable coupon/promo code or not. This siphoning of affiliate commissions likely cost content creators millions of dollars.
- MGM Resorts – Resort fees are the bane of consumers everywhere. Yet Las Vegas resorts are notorious for charging exorbitant resort fees that are rarely fully disclosed when making reservations. MGM Resort has just raised its daily resort fees at all its properties, which include MGM, Mandalay Bay, Bellagio, Aria, etc., to $55 per day. It also raised its parking fees, which used to be free, to $20 on weekdays and $25 per day on weekends. Democratic Congresswoman Eddie Bernice Johnson of Texas and Republican Jeff Fortenberry of Nebraska introduced the Hotel Advertising Transparency Act of 2019 in an effort to ban “the most-hated fee in travel.”
- Quicken – Intuit, the parent company of QuickBooks and TurboTax, has been accused of intentionally obscuring the availability of free tax filing options. Despite an agreement with the IRS to provide free filing services to millions of Americans, internal documents and testimonies from former employees suggest that Intuit actively steered customers towards paid products instead, according to a pair of ProPublica reports, tellingly entitled “TurboTax and H&R Block Saw Free Tax Filing as a Threat — and Gutted It” and “Inside TurboTax’s 20-Year Fight to Stop Americans From Filing Their Taxes for Free.” Unsurprisingly, these tactics were designed to protect company profits by minimizing the number of users who would take advantage of the free services available under the Free File program.
- RealPages – In an article appropriately entitled, “Shiny New Technology, Same Old Funny Business,” The New York Times columnist Binyamin Appelbaum reports that the Justice Department filed a lawsuit on Aug. 23, 2024 alleging that Richardson, Tex.-based “ RealPage is orchestrating what amounts to a nationwide apartment cartelby persuading major landlords to use its software to set prices for millions of apartments across the country.” RealPage boasts that its software helps boost rents by 3-7%, highlighting the growing use of algorithms, some AI-based, to fix prices. Rental companies coordinate instead of competing, using the same price-setting formulas, which ultimately increases the price of housing, the most expensive aspect of life.
A paranoid person might say that the killing and cruel actions of oligarchs and company chieftains are related. However, if corporate executives don’t change their ways, the target on their back will only grow larger. Given that the Western world will now be guided by a leader who made 30,573 false or misleading claims in a little over four years, any hope for a reversal of fortune looks dim indeed.
