A version of this piece originally appeared in the TooMuchTV newsletter.
I recently wrote a piece arguing that the best thing CNN could do for its slumping ratings is to lean heavy into populism. Whether you're politically on the left or right, nearly everyone hates "the man." And there are certainly plenty of examples of the rich and powerful doing things which need to be highlighted.
After I posted the piece, I heard from a producer at CNN who had a lot of thoughts they wanted to share off the record. But one thing I can share that permeated the conversation was the question of what populist cable news programming would look like. What's an example of what I thought would work?
I was reminded of this today as I was watching coverage the cable television news coverage of the shooting of UnitedHealthcare insurance unit CEO Brian Thompson. One thing that struck me was the media's unwillingness to address this event's elephant in the room.
I don't an executive should be murdered for what he or she does at work. I am certainly not going to celebrate someone being killed. That being said, I have heard a number of vague contextual comments from cable TV news contributors for the shooter's motive that have been along the lines of "well, health insurance can be a contentious subject."
But in the this case, if the murder did take place because of unhappiness with some aspect of health insurance, it seems disingenuous not to at least touch on the fact that Thompson was a controversial CEO even in a controversial industry.
UnitedHealthcare has the largest number of claim denials in the industry - 32%, which is more than four times higher than the industry's lowest claim-denying company. It has been using an AI-based program to examine claims, which outside critics claim can have an error rate close to 90% in some categories. Even worse, when patients do file an appeal and ask for an explanation (and most patients don't bother), they're told the AI decision-making software is "proprietary," so the company can't offer an explanation of the decision-making process.
And while I have no doubt that on a personal level Thompson was a wonderful husband and father, on a business level he was the Scrooge McDuck of healthcare company executives.
Thompson was one of several United Health executives under investigation for selling off company stock before an anti-trust lawsuit filed against the company was made public. According to reporting by Crains New York, Thompson exercised options and sold shares on February 16th, netting him $15.1 million. The news of the lawsuit broke 10 days later, and the company's stock dropped 15%. Thompson's decision to sell was especially noteworthy because it was the first time he had sold some of his company stock since he rose to the CEO of the insurance division in 2021.
Thompson's star at UnitedHealthcare rose in part because he aggressively pushed the company's Medicare Advantage Plan. That government-funded plan was in theory set up to provide expanded care to seniors at a lower cost. But Thompson was one of the industry executives who realized the best way to make money selling and managing a Medicare Advantage Plan was to make it was difficult as possible for seniors to fully utilize their health care coverage. The less money UnitedHealthcare spent on care, the more money that was left over for the bottom line.
According to a lawsuit filed last year in Minnesota, UnitedHealthcare was accused of using its nH Predict software to routinely deny care patients were otherwise qualified to receive:
According to the lawsuit, the estimates are often draconian. For instance, on a Medicare Advantage Plan, patients who stay in a hospital for three days are typically entitled to up to 100 days of covered care in a nursing home. But with nH Predict, patients rarely stay in nursing homes for more than 14 days before receiving payment denials from UnitedHealth.
When patients or their doctors have requested to see nH Predict's reports, UnitedHealth has denied their requests, telling them the information is proprietary, according to the lawsuit. And, when prescribing physicians disagree with UnitedHealth's determination of how much post-acute care their patients need, their judgments are overridden.
And even when patients appealed the denial and won, case managers were instructed by higher-ups to immediately deny the claim again, leaving patient with only 3-4 days of care before benefits ended again. One training document provided examples of how to push back when patients, families and doctors disagreed with denials:
- If a nursing home balked at discharging a patient with a feeding tube, case managers should point out that the tube needed to provide "26 percent of daily calorie requirements" to be considered as a skilled service under Medicare coverage rules.
- If a nurse took a broader tack, and argued a patient was unsafe to leave, case managers were instructed to counter, in part, that the algorithm's projections about a patient's care needs, and readiness for discharge, are based on a "severity-adjusted" comparison to similar patients around the country. "Why would this patient be any different?" the document asks.
So is any of this is "newsworthy" in the context of his murder? I would argue that it is. Not in an effort to blame the victim. But to explain the anger surrounding the company's business. And it also helps explain today's negative social media reaction to his death.
Is this a topic you focus on the day of his murder? No. But it's a reasonable jumping off point for future coverage, including expanding it beyond just one company.
There are a thousand similar stories to tell. And it can be done in a way that isn't partisan at all. "CNN is on your side" certainly has a ring to it.
