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December 11, 2024
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David Burda
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From Benefit to Business: Did Medicare Privatization Lead to Murder?

The brazen assassination of healthcare insurance executive Brian Thompson, CEO of UnitedHealthcare, has everyone commenting on the deeper meaning of the public’s lack of empathy for his murder. Since I’m part of everyone, here’s my 2 cents: It’s the government’s fault.

It’s the government’s fault because it privatized Medicare with the passage of the Balanced Budget Act of 1997 when Bill Clinton was president. The BBA created Medicare Part C, which became the Medicare Advantage (MA) program. Medicare Advantage plans, which are run by commercial insurance companies like United under contract with the government, have a two-part business model: exaggerate how sick their members are to inflate payment rates from the government, and minimize how sick their members are to deny benefits, claims and coverage.

It’s not the MA plans’ fault. Businessmen and businesswomen like Thompson run commercial insurance companies. Businesspeople are going to business. It’s what they do. It’s what big companies hire them to do. They’re going to do everything they can to increase revenues and decrease expenses to drive higher and higher profits for their companies’ owners, shareholders and investors.

The government privatizes government programs and services like Medicare because someone in the government — usually many someones with ties to the private sector that would benefit — thinks the private sector can do the job better, faster and more efficiently than the government. Maybe that’s true, but privatization comes with big risks for taxpayers who rely on those programs and services. Unless the government keeps a close eye on private companies that take over government programs and services, the private companies and their businesspeople are going to do their thing to maximize profits. Those things usually don’t benefit taxpayers, customers or consumers.

Hey, we’ll give you a free health club membership! But sorry, we won’t cover your life-saving medication.

The crazy thing is everyone knows that. But the government prodded by special interests keeps doing it anyway. You can expect more of that under the upcoming Trump administration.

That’s a long walk around the block to argue that the government is responsible for Thompson’s death, assuming his killer was making a statement about United’s claims-paying business practices. The feds’ failure to protect consumers from the dangers of Medicare privatization is to blame.

Privatization is deadly without adequate consumer protections.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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