Healthcare in America is Broken – and So Is Our Response to It

Healthcare in America is broken. While many refer to a “broken healthcare system,” the truth is there’s no universal system in the U.S. Healthcare is a fragmented marketplace: a mix of public and private entities, for-profit and nonprofit insurers, sky-high costs, and often low-quality care.

Millions of Americans remain uninsured, underinsured, or simply unsure of what their coverage includes. Despite spending more on healthcare than any other high-income country, the U.S. has the lowest life expectancy at birth and the highest rate of multiple chronic diseases.

This week, the murder of Brian Thompson, CEO of United Healthcare, forced one of the most disdained practices in healthcare—prior authorization—back into the spotlight.

The outrage surrounding prior authorization isn’t new. What’s different now is how social media has turned it into a full-blown spectacle, giving voice to years of pent-up frustration but also normalizing a dangerous lack of empathy.

In the Beginning

The disdain for prior authorization didn’t start recently—it dates all the back to the 1960s, with the advent of its predecessor, utilization management programs. The creation of Medicare and Medicaid, which provided public insurance to seniors, low-income individuals, and people with disabilities, expanded access to healthcare and raised concerns about rising costs. In those early days, utilization review systems ensured treatments met medical necessity standards. For instance, hospitals had to submit detailed justifications for patient admissions and lengths of stay. These processes introduced the concept of third-party oversight into healthcare.

Expansion into Private Insurance

By the 1970s, private insurers adopted and expanded these strategies through managed care organizations like HMOs and PPOs to control rising healthcare costs. Pre-approvals for expensive treatments became commonplace, shifting decision-making power from providers to insurers. Though initially limited in scope, these measures set a lasting precedent.

In the 1980s, prior authorization intensified, with insurers claiming it reduced waste, even as doctors and patients protested the administrative burdens and delays. The digital age brought electronic systems promising faster approvals, but these systems also expanded the range of services requiring review. By the 2000s, prior authorizations were necessary for everything from imaging studies to specialty medications, fueling frustration over delays and denials. Outrage grew, but it often remained confined to appeals, lawsuits, or letters to the editor.

The Amplifier

Today, social media amplifies anger over prior authorization. Platforms like X (formerly Twitter) and Facebook provide an immediate outlet for people to share their experiences, voice grievances, and rally others. Viral posts, hashtags, and comment threads amplify stories of delays and denials, creating a groundswell of collective outrage—even when denials are based on evidence-based medicine.

However, social media doesn’t just amplify anger; it distorts it. When news broke of Thompson’s murder, online conversations quickly turned toxic. Some posts called his death karma. Memes mocked him. Others openly celebrated the act, blaming him for United Healthcare’s prior authorization policies as though he alone embodied the failures of American healthcare.

Crossing the Line

Frustration with corporate practices has morphed into personal vitriol, with individuals becoming scapegoats for systemic problems.  This shift—from criticizing systems to targeting individuals—is not just unsettling; it’s dangerous. Yes, prior authorization has earned its bad reputation. It’s a bureaucratic nightmare and can delay care.

But celebrating someone’s murder? That’s crossing a line.

Brian Thompson’s murder should be a moment of reckoning—not just about the flaws in prior authorization but about how we channel frustration with a failing system. Social media can amplify the voices of those who’ve been wronged, but it also fosters division, cruelty, and misplaced blame.

The Big Picture

Eliminating prior authorization won’t fix the structural problems of U.S. healthcare. Without such measures, costs would likely skyrocket even further. The real issue lies in a fragmented marketplace that prioritizes profits over patients, fostering inefficiency and inequity.

If we want change, outrage must give way to constructive action. The question is: Will we demand meaningful reform, or remain stuck in a cycle of misplaced, unproductive blame?

Happy reading,

Enjoy the weekend!

Best,
Suzanne
Suzanne Daniels, Ph.D.
AEPC President
P.O. Box 1416
Birmingham, MI 48012
Office: (248) 792-2187
Email: [email protected]