Testimony of a former UnitedHealthcare employee who says she worked under CEO Brian Thompson

[pknopp]

You had your shot with obamacare. It was and is a disaster, so the public isn't going to trust the next scheme.

It's amazing how people like yourself will fight against good health care for the country all over your politics.

It's really sad.

 

[initforme]

You had your shot with obamacare. It was and is a disaster, so the public isn't going to trust the next scheme.

The public sentiment has always been our healthcare system is broken yet neither side has ever elected someone who is capable of fixing it. Or they just don't want to. Perhaps a blend of both.

 

[Seymour Flops]

It's amazing how people like yourself will fight against good health care for the country all over your politics.

It's really sad.

Move to Canada, 'cause we ain't changing our mind after your disaster with Obamacare.

 

[initforme]

Move to Canada, 'cause we ain't changing our mind after your disaster with Obamacare.

If our leaders are so smart why is it so hard to fix the system? It can't be that complicated. There was very little mention of it during the last campaign. Sad.

 

[Seymour Flops]

If our leaders are so smart why is it so hard to fix the system? It can't be that complicated. There was very little mention of it during the last campaign. Sad.

Our leaders aren't so smart.

The majority of political figures in the U.S. are politicized, agendized, bought out, and controlled by corporate interests.

Why did we think it was a good idea to give them control over our personal healthcare? Why would anyont think that the solution is to give them total control?

The stupidity of the American voter?

 

[cnm]

I didn't say that you did. I said that democrats do, not meaning all of you.

Then the term is 'some democrats'.

 

[cnm]

That's what insurance companies do, they charge as much as they can for coverage, then deny the things you've paid for, making you waste your time, money (attorney, time away from work) and effort fighting them for what you're entitled to under the terms of your policy, at least on the day you entered into the contract.

Insurance companies are allowed to lawfully breach the contracts that they have with their victims customers by listing a bunch of exceptions in the small print. If you don't understand what you're reading because it's too similar to legalease then that's your our fault. ​

​

You’re absolutely correct that such situations can feel deeply unfair, especially when insurance is a necessity rather than a luxury. The imbalance of power in the relationship between insurers and policyholders often leaves consumers with limited recourse, which can feel like a "take it or leave it" situation. Let’s explore why this happens, why it’s problematic, and what might be done about it:​

​

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1. The Reality of Adhesion Contracts​

• Insurance policies are contracts of adhesion, meaning they are non-negotiable agreements drafted solely by the insurer. Consumers must either accept the terms as-is or forgo coverage entirely.
• While adhesion contracts are not inherently unfair, they often leave little room for individuals to challenge or influence the terms, particularly when those terms allow mid-year changes that negatively impact consumers.

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2. Lack of True Consumer Choice​

• Limited Options: Many people have no real choice when it comes to health insurance, especially in regions with few insurers offering coverage. Employer-sponsored plans often leave employees with only one or two options, if any.
• Essential Need: Health insurance is not optional for most people. The ACA’s individual mandate may no longer penalize uninsured individuals federally, but the cost of healthcare without insurance is prohibitive for most Americans, making insurance a de facto requirement.

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3. Regulatory and Legal Challenges​

• Regulatory Loopholes: While regulators require insurers to provide notice of changes and maintain certain minimum standards, there is often no explicit prohibition against mid-year changes to formularies or other covered benefits.
• Judicial Deference to Insurers: Courts often defer to the terms of the insurance contract unless they violate specific laws or public policy, making it difficult for individuals to challenge these practices as breaches of contract.

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4. Ethical Concerns​

• Bad Faith Practices: While insurers may lawfully change their coverage terms, such practices can still feel like a breach of trust. Advertising coverage for a medication and then removing it after consumers are locked into a plan borders on bad faith, even if it doesn’t meet the strict legal definition.
• Power Imbalance: Insurers know that most consumers lack the resources or knowledge to challenge these practices effectively, leaving them vulnerable to disadvantageous changes.

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5. Is It Truly "Take It or Leave It"?​

• From a practical perspective, yes, it is. When insurance is an essential service, and all providers operate similarly, there is no real choice. This lack of alternatives undermines the basic premise of a fair market, where competition and consumer choice should incentivize better practices.
• Critics argue that this monopolistic or oligopolistic behavior warrants stricter regulation to protect consumers.

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6. Possible Solutions​

To address this imbalance, several reforms could be considered:​

​

• Stronger Consumer Protections:
  
  • Require insurers to lock in their formularies for the full plan year or provide ongoing coverage for medications prescribed before the formulary change.
  • Implement broader bad faith laws to penalize insurers for practices that harm consumers unfairly.
• Increased Competition:
  
  • Expand public health insurance options or introduce a public option to compete with private insurers.
  • Enforce antitrust laws to prevent regional monopolies in the insurance market.
• Transparency Requirements:
  
  • Mandate clear disclosures about the potential for mid-year changes and their implications before consumers commit to a plan.
• Advocacy and Legislation:
  
  • Encourage lawmakers to enact protections like those in California, where insurers must provide notice and continuity of coverage for enrollees impacted by formulary changes.

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Conclusion​

The situation you’ve described highlights a systemic issue where legal and regulatory frameworks fail to fully protect consumers from practices that, while lawful, feel unjust. Advocacy for stronger consumer protections and systemic reform is critical to addressing these inequities. In the meantime, consumers must navigate a challenging and often frustrating system that prioritizes insurer flexibility over individual needs.​

Only in America.

 

[cnm]

The stupidity of the American voter?

Who refuse to look at the way other developed nations do health.

 

[otto105]

You had your shot with obamacare. It was and is a disaster, so the public isn't going to trust the next scheme.

Hilarious

Idiot

 

[pknopp]

Hilarious

Idiot

Sadly there is some truth in what he says. I never supported Obamacare but the lies behind it most certainly made people less trustworthy.

 

[Greenbeard]

You had your shot with obamacare. It was and is a disaster, so the public isn't going to trust the next scheme.

 

[otto105]

Sadly there is some truth in what he says. I never supported Obamacare but the lies behind it most certainly made people less trustworthy.

What lies?

The action took underinsured and uninsured from 45 million to around 12-15.

It requires coverage of preexisting conditions.

It established a floor to overage over polices being sold without.

It slowed the closing of rural hospitals.

It slowed the rate of increase in HC insurance rates that we incurred for decades before it’s becoming law.

So, what lies

 

[pknopp]

What lies?

What did you spend your $2500 savings on?

How much time did you take to read through it online before it was passed like Obama promised would happen?

The action took underinsured and uninsured from 45 million to around 12-15.

Many who still can't use it because of deductibles and co-pays.

It established a floor to overage over polices being sold without.

It slowed the closing of rural hospitals.

It slowed the rate of increase in HC insurance rates that we incurred for decades before it’s becoming law.

Costs have raised constantly. It was inevitable.

 

[Crepitus]

Are you all really still trying to justify this murder? Really???

It justifies itself.

 

[Greenbeard]

Costs have raised constantly. It was inevitable.

Relative to the rest of the economy, they have not. The ACA era is the only sustained period of zero excess health care cost growth on record.

 

[pknopp]

Relative to the rest of the economy, they have not. The ACA era is the only sustained period of zero excess health care cost growth on record.

Not true. But lets add in other factors. Huge government subsidies (which aren't bad in themselves) funded by debt.

 

[Crepitus]

Krista Monroe spills the beans on business practices of UnitedHealthcare



As you can see, it's not good.

Not a surprise. As the parent of a handicapped adult I have been fighting with KanKare over meds and prior authorizations and such for years for my son. Fortunately I am on first name basis with the local pharmacist as well as being financially situated to pay for things they deny. Everyone cannot say that, of course.

Guess who runs KanKare for the state of Kansas?

UHC.

 

[Crepitus]

Not true. But lets add in other factors. Huge government subsidies (which aren't bad in themselves) funded by debt.

Single payer is the solution.

 

[pknopp]

Single payer is the solution.

I don't disagree.

 

[Greenbeard]

Not true.

100% true. Excess cost growth in health care since the passage of the ACA in 2010 has been zero (the data there goes through 2021, but the story continued through 2022; official health spending data for 2023 will probably be out next week). That's never happened over any period this long.

But lets add in other factors. Huge government subsidies (which aren't bad in themselves) funded by debt.

ACA subsidies have always cost less than expected, to the tune of hundreds of billions of dollars cumulatively at this point. A few years ago, Biden and the Dems actually reformed the ACA subsidies to be more generous and available to more people and they're still costing ~9% less right now than spending on the ACA’s original skimpier, less-widely-available premium subsidies was projected to be this year when the CBO released (well-publicized at the time) updated cost estimates ten years ago. The impacts of bending the cost curve have been substantial.

The ACA was originally designed to be deficit-reducing and in practice its spending has been much lower than expected and its savings much higher, so it isn't "funded by debt."

In fact, the ACA era has seen enormous improvements in the long-term budget/debt picture in that trillions of dollars in future federal health care spending (i.e., Medicare, Medicaid, premium subsidies) obligations have melted away as health care cost growth stalled out. You can see the progression in the parade of CBO Long-Term Budget forecasts over the past decade and a half. Trillions of dollars in health care costs, entire points-worth of GDP, vanishing as the health care cost curve bent for the first time. A BFD!