The Ultimate Blowback

The murder of Brian Thompson, CEO of United Health Corp., on December 4^th, in one of the most heavily surveilled areas of NYC, represented the ultimate blowback of the public's growing ire of the insurance industry, not just healthcare.

Most CEOs and executives in the insurance industry have a more than generous pay package. Thompson's was no exception earning a reported 2023 annual salary of $10 million. This pay package contrasts sharply with the millions of enrolled customers who struggle to pay ever-increasing insurance premiums and sky-high deductibles with a high-risk of denial when they need insurance the most.

It has become publicly transparent through their blatant decision-making that an insurance company's objective and business model are to increase the value of their company (profits) for the shareholders, not to protect their customers.

This is why insurance companies utilize the methods as articulated in the 2010 book entitled "Delay, Deny, Defend" by Jay Feinman, a professor at Rutgers University on the healthcare insurance industry tactics; and, not coincidentally engraved on the bullet casings of the aforementioned murder.

Healthcare Costs Kill Americans' Budget

The 20 December 2024 Wall Street Journal article entitled "Nation's Healthcare Tab is Surging Amid Rising Wages, Hospital Fees" provided a litany of disturbing pricing trends in the healthcare industry.

Paraphrasing these facts from the article specific to the healthcare industry are as follows:

• Healthcare Cost Increases: The nation's healthcare spending increased 7.5% year on year in 2023. This exceeded the 4.6% increase in 2022 according to the Centers for Medicare and Medicaid.
• Drug Expenses: Spending on drugs increased including medications for obesity and diabetes [To be discussed further].
• Pricy Premiums: Americans spent on average $4,000 annually in 2023 for health insurance, up 20% from 5 years earlier and nearly double from a decade ago, according to the US Labor Department.
• Overall Medical Care Costs: For the past several decades medical care costs have risen 40% faster than inflation, according to the US Labor Department. Reasons: high labor costs in this sector, more expensive drugs & treatments and greater demand for medical services as population ages.
• Higher Deductibles: The average deductible for a worker insuring himself is $1,787, up 47% from a decade earlier according to KFF, a healthcare non-profit. The deductible for a worker and his family averages $3,000-$4,000.
• Extra Outpatient Charges: Hospitals are routinely tacking on "facility fees" to medical bills for outpatient procedures. For this reason, patients are paying hundreds of dollars for standard care.
• Co-Pay Unchanged: Interestingly, co-pay fees have remained relatively steady, averaging $26 during this period.

Most infuriating is that healthcare and other insurance companies "game" the system by aggressively moving the goalposts by reinterpreting and/or editing the policies' language to their advantage to reduce or deny payouts.

Finally, insurance companies' increasing use (and abuse) of Artificial Intelligence (AI) to determine payout eligibility conveniently serves as an internal cover for questionable corporate tactics while legally protecting decision making executives and Board members. It's the next level con artist, a virtual ghost in the shell, by reducing risk and shifting legal liability to a virtual entity.

The Silent Partner

A seldom mentioned accelerant to premium increases has been the current administration's permissive policy of allowing millions of illegal migrants to enter the country. These illegal migrants have siphoned billions of taxpayer monies for essential services: free food, lodging, health care, and transportation which is greatly exacerbating the federal deficit.

In other words, from an economic perspective, one could say that the government is indirectly complicit in the additional healthcare costs above & beyond normal macro-economic fundamentals.

Finally, tangential to healthcare insurance shenanigans is the incessant use of "climate change" by other insurance companies as justification to drop or deny payments such as flood insurance which render properties unsalable even if no event has occurred which reduces the owner's net worth considerably with a stroke of a pen.

The link to the following chart entitled America's Largest Healthcare Insurers by State in 2023 by their share of total enrollments provided by the American Medical Association and presented by Visual Capital, indicates the nationwide dominance of various healthcare providers by state.

Aging Demographic Dangers

As mentioned earlier, the irreversible trend of an aging American demographic and its associated medical conditions result in greater lifelong healthcare costs.

The link to the following chart entitled Where Obesity is Most Prevalent in the US in 2023 by state/territory provided by the CDC and Behavioral Risk Factor Surveillance System. It's medically proven that obesity triggers a host of future health issues requiring pharmaceutical intervention.

The link to the following chart entitled Diabetes Cases Are Climbing provided by the International Diabetes Foundation, indicates the disturbing surge in diabetes in adults, closely linked to obesity, consumption of ultra-processed foods and a sedentary lifestyle, is a worldwide trend. It estimates the number of adults with diabetes in 2021 and its projections to 2045; or 23 years, or within a generation.

It is highly likely that these estimates are under-reported as many people don't realize they are diabetic. Furthermore, globally hundreds of millions more are pre-diabetic perhaps at the cusp of becoming diabetic.

China: The Key to America's Health

The link to the ollowing chart entitled Cars, Meds, Oil and Tech: America's Main Imports provided by the US Census Bureau and Bureau of Economic Analysis, dramatically highlight America's dependence on imported pharmaceuticals most of which is manufactured in China.

Pharmaceuticals are far cheaper to manufacture overseas and then exported to the US. To put it bluntly, for decades our nation's health is in the hands of China. Nonetheless, I believe that these imports will not only continue unimpeded with zero additional tariffs or import duties, under the Trump administration.

It is unlikely that the Trump administration will put itself in a position to create a barrier for the importation of essential pharmaceuticals to Americans, including their constituency, and already exploding health care costs.

Additionally, China is suffering an economic malaise and are trying to flood many foreign markets across all sectors, to generate cash flow and keep their factories open and producing.

Nonetheless, many of Trump's enemies are savvy enough to create the illusion of American government import interference with clever media banter thus artificially increasing pharmaceutical costs and provide the illusion of a pharmaceutical drug shortage.

"Combat Pay" & Copycats

As the aforementioned rising healthcare costs, they provide a twisted "inspiration" for those bent on vengeance because of an actual or perceived grievance against an insurance company.

The premeditated killing of Mr. Thompson puts executives and their families across many unpopular insurance sectors on edge. This goes beyond the defacing of national, regional and local offices and cream pies on the designer suits of their respective executives.

According to many media reports, there has been a reassessment of corporate executive protective services from physical attacks including the removal of photos of executives from their websites.

Although these firms can easily afford greater security for their key executives, some may not think spending more money will offer more protection especially since attacks committed are unstable and unpredictable lone wolves. In fact, corporate security services may view the Thompson killing as an one-off affair.

In all likelihood, most security changes will be superficial. Nonetheless, they will be thoroughly and cleverly documented to provide the illusion that the updated security procedures are robust. This would give them greater legal protection by being supposedly pro-active if such violence occurs against their personnel.

This elevated security alert is applicable to all sectors in the insurance industry notably healthcare, auto and home insurance that are justifiably on edge. Even when the enrollee is willing or can afford a particular insurance, often insurance companies will drop that insurance altogether notably flood and wildfire insurance.

Conclusion & Takeaways

Insurance companies will continue to establish revenue and profit objectives and then calculate how to "back in" and cap their expenses. Although there are businesses and require a profit to survive, the morality of the public good has been erased by insatiable greed.

Any security reassessments and upgrades are merely temporary and cosmetic, a beau geste to executives and shareholders and avoid liability.

A deceased CEO, executive or even manager is merely a sacrificial lamb in a ruthless industry of fat profits, fat cats and high customer body count. There are no shortages of executive minions willing to risk life & limb for a supreme pay package.

From the political perspective, although President-elect Trump will play hardball with the Chinese government on tariffs in general, I believe that any present-day import duties and/or tariffs on pharmaceuticals will remain unchanged.

Nonetheless, as articulated earlier, anti-Trump forces may create a disinformation campaign so that American insurance companies and pharmaceuticals can continue to unjustifiably raise prices.

It's uncertain whether the Trump administration can make inroads into eliminating, or at least curbing, these embedded, systematic and egregious abuses. Lobbyists are the most powerful political parasites in a democracy and may be more difficult to root out than an intestinal worm.

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The Cerulean Council is a NYC-based think-tank that provides prescient, beyond-the-horizon, contrarian perspectives and risk assessments on geopolitical dynamics and global urban security.