To Iowans like Brian Thompson, reputation matters; UnitedHealth must improve its | Opinion
Now is the time for UnitedHealth to embrace greater accountability by supporting the expansion of consumer remedies.
- Ben Hassebrock is a shareholder with Ver Ploeg & Marino, a Miami-based law firm representing policyholders with insurance coverage and bad faith disputes.
- He lives in Philadelphia and is currently licensed to practice law in Pennsylvania, Florida, and Missouri.
I shared a personal and professional connection with UnitedHealthcare CEO Brian Thompson. We grew up in the same rural Iowa community, graduating from South Hamilton High School six years apart. Our careers carried us to opposite ends of the same spectrum. While Thompson climbed through UnitedHealth’s corporate ranks, I built a law practice helping insurance consumers fight claim denials against industry giants like UnitedHealth.
Thompson’s shocking and tragic assassination should have been universally condemned, but it wasn’t. Reactions of laughter and indifference spread across social media, revealing widespread frustration directed at UnitedHealthcare and the entire U.S. health insurance industry. Days later, Brian’s boss — UnitedHealth Group’s CEO, Sir Andrew Witty — issued a remarkably tone-deaf response. Sir Witty accepted no responsibility for UnitedHealth’s terrible reputation, though it is a direct consequence of bad behavior that occurred on his watch.
Recent history provides many examples. In 2019, the year he became CEO, a Miami federal judge called UnitedHealth "immoral and barbaric" for denying proton beam therapy to treat Richard Cole's prostate cancer. Within the past year, a series of reports from ProPublica detailed UnitedHeath’s concerted efforts to deny coverage for college student Christopher McNaughton's expensive ulcerative colitis treatment, Sharelle Menard’s autistic son’s behavioral therapy, and 15-year-old Emily Dwyer's anorexia treatment. And in October, a Senate committee concluded that UnitedHealth used prior authorization denials to deny Medicare Advantage patients access to post-acute care facilities.
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The American consumer is not stupid. They have seen UnitedHealth elevating profits over care too many times. Why should they believe UnitedHealth will work to improve their health care experience?
I was not surprised to learn that Thompson raised concerns about UnitedHealth’s lack of consumer confidence and wanted to improve it. Reputation and trust are prized in Iowa’s rural communities, where families are well known to each other across generations and small town pride is worn on every sleeve. Now UnitedHealth has an opportunity to bring about Thompson's vision for positive change if it focuses on his heartland values, starting with accountability.
Health insurers are often insulated from liability by a federal law known as ERISA. If you get health insurance through your employer, like over 60% of Americans under age 65, then ERISA likely restricts your right to be fairly compensated for your insurer’s wrongful coverage denial. There are no jury trials. You cannot get pain and suffering damages. The insurer could be required to pay your attorneys’ fees, but such awards are discretionary and too infrequent, making it difficult to find representation.
Courts know that ERISA is unfair to consumers, but they are powerless to help. Thirty-five years ago, Florence Corcoran's doctor recommended hospitalization in the late stage of pregnancy because her fetus was at risk. UnitedHealth denied coverage, and Mrs. Corcoran’s fetus died two weeks later. The Corcorans tried to bring an action against UnitedHealth for the wrongful death of their child and they lost. The court explained that ERISA provided the Corcorans with no remedy for UnitedHealth’s mistake, urging Congress to change the law.
Congress tried, in 1999, and Sen. Ted Kennedy’s words from that debate still ring true: "If a doctor fails to treat a patient with cancer correctly and if the patient dies, you can sue the doctor for malpractice. But if a managed care company decides to pinch pennies and overrule the doctor's recommendations on treating the patient and the patient dies, the insurance company is immune from responsibility. No other industry in America enjoys this immunity from the consequences of its actions." Sen. Chuck Grassley, the long-serving Iowa Republican, was not persuaded, and the measure failed. Members of Congress had no personal stake in the outcome, of course, because their government health insurance was exempt from ERISA.
Now is the time for UnitedHealth to embrace greater accountability by supporting the expansion of consumer remedies. Demonstrate a commitment to fair claims handling practices that consumers can respect. Send the message that UnitedHealth will not deny claims unless it is proud to stand up and defend that decision in a courtroom. Compete and win in the free market by developing the most effective claims organization, outmatching competitors held back by poor judgment and substantial verdicts.
Sir Witty’s essay celebrated Brian Thompson for always considering how he could best serve his hometown of Jewell, Iowa. If Sir Witty doubts that Jewell residents want and deserve greater accountability from their health insurers, then I suggest he pay a visit. I’ll be happy to meet him there and we can find out together.
Ben Hassebrock is a shareholder with Ver Ploeg & Marino, a Miami-based law firm representing policyholders with insurance coverage and bad faith disputes. He lives in Philadelphia and is currently licensed to practice law in Pennsylvania, Florida, and Missouri. His undergraduate degree is from the University of Iowa.