The sudden and tragic death of Brian Thompson, the CEO of United Healthcare, has rocked the healthcare industry to its core. The gunman inscribed “deny, delay, depose” on the bullets that he used to send out a clear message.
United Healthcare, one of the largest insurance providers in the United States, controls a vast and integrated system that includes brokers, hospitals, physicians, and pharmacies.
However, as we reflect on Mr. Thompson’s passing, one uncomfortable truth remains: The tactics of “deny, delay, depose” have become the backbone of an insurance industry that increasingly prioritizes profits over people’s health.
The saddest part? These tactics don’t just affect the executives at the top.
They harm millions of patients, physicians, and healthcare providers every single day.
And now, with Thompson’s death bringing these issues back into the spotlight, it’s time to take a hard look at the system that has failed so many.
The Bullets That Took a Life: “Deny, Delay, Depose”
In the wake of Thompson’s passing, disturbing details have resurfaced about how insurance companies have long operated under a playbook that encourages cost-cutting strategies at the expense of patient care. The words “deny, delay, depose” are not just empty slogans. They are the actions: cold, clinical realities that shape the decisions made by healthcare insurance companies every day.
“Deny” – They deny coverage for procedures, medications, and care doctors know they are necessary for their patient’s well-being.
“Delay”—They delay treatment approval, leading to prolonged suffering, worsening health, and unnecessary complications.
“Depose” – They depose physicians, dragging them into lengthy and frustrating battles with insurance companies, forcing them to spend more time on paperwork than on actual patient care.
These tactics are not isolated incidents; they are systematic and widespread. And they are killing people, literally and figuratively.
How Did We Get Here?
We’ve all seen it: insurance companies wielding power over life-and-death decisions. Patients endure long waits for the care they need, while healthcare providers are caught in the middle, constantly fighting for approval to administer basic care.
How did we arrive at this point?
How did we get to a place where people are paying more and more for their healthcare each year but still can’t access the treatment they need?
It’s not just a financial issue—it’s a human one.
Patients are losing their health, their time, and, in some cases, their lives due to an industry more concerned with its bottom line than with the well-being of those it’s supposed to serve.
The Consequences of “Deny, Delay, Depose”
Let’s break it down.
Deny: The Battle for Access to Care
Insurance companies routinely reject treatments, medications, and procedures that physicians know will benefit their patients. This denial of care is not limited to life-threatening situations—it happens every day for routine medical procedures, diagnostic tests, and treatments that would improve patients’ quality of life.
Just recently, Anthem Blue Cross Blue Shield attempted to deny anesthesia claims based on surgery time limits. The outcry from the public was so intense that the company eventually reversed its decision. But how many patients had to endure unnecessary pain while this policy was in effect?
These decisions are made by administrators in distant offices who do not understand the patient’s circumstances.
They have no medical training.
Their decisions do not affect them.
What’s worse, these actions create a convoluted environment where doctors spend more time justifying their medical decisions than providing care.
Delay: Worsening Health While Waiting for Approval
Patients don’t just face denial; they face long delays—sometimes months—before they can access critical treatments.
These delays can worsen conditions, sometimes leading to permanent damage.
A patient suffering from rheumatoid arthritis, for example, may need a medication adjustment to prevent the progression of their disease.
But with insurance companies demanding multiple approvals and waiting periods, those patients could face months of pain, joint destruction, and debilitating inflammation—all because of an arbitrary delay in treatment approval.
Imagine the frustration of having to wait for weeks or months for a simple test or procedure when your health is deteriorating and when you suffer in pain.
The mental and physical toll this takes on patients is immeasurable.
Depose: The Time Wasted on Paperwork
As a physician, one of the most frustrating aspects of the modern healthcare system is the constant struggle with insurance companies.
Physicians are forced to spend 10-18 hours per week—depending on their specialty—on paperwork, justifying medical decisions, and battling with insurance companies to get approval for procedures, tests, and treatments.
This time could be spent directly caring for patients.
Instead, it’s siphoned off to navigate the bureaucratic red tape created by insurance companies. So much time is spent on administrative work that doctors are stretched thin, and patients suffer as a result.
The Hidden Costs of a Broken System
- Patients suffer prolonged pain and worsening health due to delayed treatments.
- Physicians are stuck in endless battles with insurance companies, spending more time on paperwork than providing care.
- The system continues to demand more money from patients through rising premiums, higher deductibles, and more out-of-pocket expenses without delivering the care they deserve.
This system is unsustainable. But the good news is, we don’t have to accept it.
A New Path: Direct Specialty Care at Rheumatologist OnCall
The reason I chose to take a different path in my practice, Rheumatologist OnCall, is simple:
We can do better.
We don’t have to accept a system that puts profits above patient care.
I believe the future of healthcare lies in direct specialty care, where patients and doctors work together directly, cutting out the insurance middleman and putting the power back where it belongs: with the patient.
How Direct Care Works: A Transparent, Patient-Centered Approach
Direct specialty care is all about empowering patients to take control of their healthcare.
At Rheumatologist OnCall, I provide a direct contract between myself and my patients. This model allows us to work together without interference from insurance companies, creating a more personalized, transparent, and affordable healthcare experience.
Here’s how it works:
- No Referrals: Patients can book appointments directly with me without needing a referral from another physician or approval from their insurance company.
- Timely Care: No waiting months to see a specialist. With direct care, patients can get appointments faster, and treatments are administered promptly.
- Transparent and Affordable Pricing: No surprise bills or hidden charges. You know upfront what each service will cost.
- Maximizing Benefits: While the direct care model bypasses many insurance obstacles, I still work with patients’ insurance plans to ensure they can maximize the benefits they’ve paid for, when needed.
In essence, I put my patients in control of their healthcare journey.
They can choose when and how to use their insurance—and more importantly, they can get the care they need when they need it.
Why Aren’t We Demanding Better?
We all need to ask: Why are we tolerating this broken system?
- Why are insurance companies allowed to make life-altering decisions without considering the patient’s best interests?
- Why are patients subjected to delays and denials when they’ve already paid into the system?
- Why are we continuing to accept a system that causes unnecessary pain, suffering, and escalating costs for both patients and healthcare providers?
These are hard questions, but they are necessary ones. And the answer is simple: We need change.
It’s Time for a Revolution in Healthcare
If you’re frustrated by seeing your patients struggle with the same issues—denials, delays, and unnecessary paperwork—it’s time we push for a better way.
A healthcare system where patients are in control of their care.
A medical system that values people over profits.
Here’s what we need to ask ourselves:
- What would happen if patients could choose their own medical options without insurance interference?
- What if insurance companies could no longer dictate who gets access to care, when, and how?
- How many more lives must be lost before we demand a system that actually works for people?
We have the power to change the system, but we must demand accountability from the insurance companies and put patients back at the healthcare center.
A Call to Action
Let’s make healthcare work for us, not against us. If you’re tired of seeing your patients suffer because of insurance delays, denials, and bureaucracy, let’s take action. Let’s work together to build a healthcare system that truly serves the people.
We deserve better. Our patients deserve better.
Together, we can create an environment where patients come first, and healthcare becomes MEDICAL CARE. Where we are truly about healing, not profit margins.
Share your thoughts, your experiences, and your ideas below. Let’s continue this conversation and demand change.
