The brazen assassination of UnitedHealthcare CEO Brian Thompson outside of a hotel in New York City last week was senseless, horrible and completely unwarranted, no matter what justification the killer thought he had. Since the event, there has been an outpouring of anger on social media — directed towards payors in general and UnitedHealthcare in particular. Clearly, many people believe that a big problem in American health care is that payors in America are limiting care in order to maximize their profits.
The problem is not Brian Thompson. The problem is not UnitedHealthcare. The problem is not payors trying to maximize profit. The problem is the American system to fund and reimburse health care is broken.
So how do we fund health care in America? Health care represents about $4.5 trillion worth of spending in America, just under 18 percent of U.S. GDP. A little over $3 trillion of that does not come from patients, the people that use and benefit from the system, at least not directly. So where does this $3 trillion come from? About 60 percent comes from the government via Medicare, Medicaid and other programs and about 40 percent comes from private insurance, most of which is through employer group health plans, which employers pick on behalf of their employees.
There are many participants in the health care system, but simplifying it greatly, we have providers that are responsible for delivering care to patients and payors that are responsible for distributing........