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Here is a hard truth for those of us who are care providers: Americans are unsatisfied with the country's healthcare system. It is not just about cost or lack of access. Gallup recently found only 44% of Americansopens in a new tab or window think the quality of the care they get in this country is excellent or even good.
Here is another hard truth: every one of us who is involved in the healthcare ecosystem bears some responsibility for this prevailing feeling -- and we must each do our part to solve it. From the doctor who doesn't even glance up from charts to look a patient in the eye to the pharmacy benefit managers (PBMs) who manipulate prescription drug prices, it is time to recognize these hard truths and take decisive action toward reform.
Unfortunately, Sir Andrew Witty, British business executive and CEO of UnitedHealth Group, appears to think insurers bear no blame for Americans' discontent. In recent comments to investorsopens in a new tab or window in the wake of the killing of UnitedHealthcare CEO Brian Thompson, Witty essentially absolved UnitedHealthcare of any insurer's role in the dissatisfaction plaguing the U.S. healthcare system. While acknowledging healthcare costs are significantly higher than in other countries, Witty seemed to lay the blame squarely on the cost of careopens in a new tab or window-- prescription drugs, hospital procedures, and physician services -- without acknowledging UnitedHealthcare's role in this broken system. (Interestingly, Witty was previously CEO of pharma giant GSK.)
Make no mistake: insurers are certainly one reason Americans are angry.
Profits Over People
Witty talked about the growing costs of healthcare while on the earnings call -- an earnings call that made plain how much Witty and his company are raking in. Specifically, as Axios spelled out, UnitedHealth Group posted revenue of $400.3 billionopens in a new tab or window for 2024, up 7.8% from 2023.
Earnings were down, but that appears mostly due to the cyberattack against UnitedHealth's Change Healthcare in the first half of last year, wreaking havoc for hospitals, doctors' offices, and patients. Even so, as Healthcare Dive reportedopens in a new tab or window, excluding the cyberattack costs and other factors that UnitedHealth believes were not representative of its overall business performance in the year, the company reported an adjusted profit of $25.7 billion, which was an all-time record. Additionally, by the fourth quarter, revenue had increased 6.8% year-over-year to $100.8 billion and net earnings were up 1.6% from a year earlier to $5.5 billion.
As Axios wrote, the company's "profits are still large enough, though, to rank among America's 25 most profitable companies."
The massive scale of UnitedHealth Group's revenue is due to its ability to operate as a massively consolidated, vertically integrated organization that touches nearly every corner of the healthcare value chain. From employing the largest group of cliniciansopens in a new tab or window (Optum) in the country to owning one of the largest PBMsopens in a new tab or window (OptumRx), UnitedHealthcare plays a pivotal role in determining costs and shaping patient experiences -- and outcomes.
Failing to Hear Americans' Frustrations
In the immediate aftermath of Thompson's murder, Witty failed to connect with Americans who, while condemning the murder, understood how frustrating it isopens in a new tab or window to deal with health insurance companies. Back in December, Witty also seemingly played the blame gameopens in a new tab or window in an internal video message for employees.
Witty's more recent statement that "healthcare costs more in the U.S. because the price of a single procedure, visit, or prescription is higher here than it is in other countries" is accurate -- but it is also incomplete. Time and time again, he fails to publicly address the frustration patients feel when their care is delayed or denied due to prior authorizations, restrictive networks, or unreasonable claims denials -- all hallmark behaviors of the health insurance industry.
We should also consider UnitedHealth Group's role in perpetuating the myth that PBMs help alleviate drug costs for patients. A Federal Trade Commission (FTC) reportopens in a new tab or window issued mid-January examined the practices of the country's three largest PBMs: CVS Health's Caremark Rx, Express Scripts, and UnitedHealth Group's OptumRx. According to the report, these organizations marked up the prices of many specialty generic drugs by hundreds or thousands of percent, helping to generate more than $7.3 billion in revenue for the PBMs and their affiliated specialty pharmacies between 2017 and 2022.
$7.3 billion. That's more than the GDP of some small countries.
What's more, these companies have a corner on the market. In 2023, the firms examined by the FTC received 68% of all dispensing revenue generated by specialty drugs in the U.S.
The January report was the FTC's second on PBMs. The first studyopens in a new tab or window, released mid-2024, found that, instead of helping keep healthcare costs down, PBMs steer patients toward more expensive drugs and, incredibly, even overcharge for cancer treatments.
And, yet, Witty shows no remorse and no willingness to drive change.
Time for Insurers to Take Ownership
UnitedHealth Group cannot ignore these issues. Shifting blame to providers, hospitals, and pharmaceutical companies is disingenuous, particularly given that the company itself employs many of those providers and controls major portions of the drug supply chain.
If members of the healthcare ecosystem want to change Americans' attitudes, we need all stakeholders to take responsibility for their role in our systemic healthcare challenges -- not just point fingers elsewhere.
It is time for a real conversation about improving affordability, access, and patient satisfaction without the hollow rhetoric. Let's keep pushing for a better, more equitable healthcare system. Patients and clinicians deserve better than what we have right now.
"
UnitedHealth CEO Andrew Witty Is Wrong. Just Plain Wrong.
— Everyone in healthcare bears some blame for our broken system
by N. Adam Brown, MD, MBA, Contributing Writer, MedPage TodayFebruary 2, 2025Here is a hard truth for those of us who are care providers: Americans are unsatisfied with the country's healthcare system. It is not just about cost or lack of access. Gallup recently found only 44% of Americansopens in a new tab or window think the quality of the care they get in this country is excellent or even good.
Here is another hard truth: every one of us who is involved in the healthcare ecosystem bears some responsibility for this prevailing feeling -- and we must each do our part to solve it. From the doctor who doesn't even glance up from charts to look a patient in the eye to the pharmacy benefit managers (PBMs) who manipulate prescription drug prices, it is time to recognize these hard truths and take decisive action toward reform.
Unfortunately, Sir Andrew Witty, British business executive and CEO of UnitedHealth Group, appears to think insurers bear no blame for Americans' discontent. In recent comments to investorsopens in a new tab or window in the wake of the killing of UnitedHealthcare CEO Brian Thompson, Witty essentially absolved UnitedHealthcare of any insurer's role in the dissatisfaction plaguing the U.S. healthcare system. While acknowledging healthcare costs are significantly higher than in other countries, Witty seemed to lay the blame squarely on the cost of careopens in a new tab or window-- prescription drugs, hospital procedures, and physician services -- without acknowledging UnitedHealthcare's role in this broken system. (Interestingly, Witty was previously CEO of pharma giant GSK.)
Make no mistake: insurers are certainly one reason Americans are angry.
Profits Over People
Witty talked about the growing costs of healthcare while on the earnings call -- an earnings call that made plain how much Witty and his company are raking in. Specifically, as Axios spelled out, UnitedHealth Group posted revenue of $400.3 billionopens in a new tab or window for 2024, up 7.8% from 2023.
Earnings were down, but that appears mostly due to the cyberattack against UnitedHealth's Change Healthcare in the first half of last year, wreaking havoc for hospitals, doctors' offices, and patients. Even so, as Healthcare Dive reportedopens in a new tab or window, excluding the cyberattack costs and other factors that UnitedHealth believes were not representative of its overall business performance in the year, the company reported an adjusted profit of $25.7 billion, which was an all-time record. Additionally, by the fourth quarter, revenue had increased 6.8% year-over-year to $100.8 billion and net earnings were up 1.6% from a year earlier to $5.5 billion.
As Axios wrote, the company's "profits are still large enough, though, to rank among America's 25 most profitable companies."
The massive scale of UnitedHealth Group's revenue is due to its ability to operate as a massively consolidated, vertically integrated organization that touches nearly every corner of the healthcare value chain. From employing the largest group of cliniciansopens in a new tab or window (Optum) in the country to owning one of the largest PBMsopens in a new tab or window (OptumRx), UnitedHealthcare plays a pivotal role in determining costs and shaping patient experiences -- and outcomes.
Failing to Hear Americans' Frustrations
In the immediate aftermath of Thompson's murder, Witty failed to connect with Americans who, while condemning the murder, understood how frustrating it isopens in a new tab or window to deal with health insurance companies. Back in December, Witty also seemingly played the blame gameopens in a new tab or window in an internal video message for employees.
Witty's more recent statement that "healthcare costs more in the U.S. because the price of a single procedure, visit, or prescription is higher here than it is in other countries" is accurate -- but it is also incomplete. Time and time again, he fails to publicly address the frustration patients feel when their care is delayed or denied due to prior authorizations, restrictive networks, or unreasonable claims denials -- all hallmark behaviors of the health insurance industry.
We should also consider UnitedHealth Group's role in perpetuating the myth that PBMs help alleviate drug costs for patients. A Federal Trade Commission (FTC) reportopens in a new tab or window issued mid-January examined the practices of the country's three largest PBMs: CVS Health's Caremark Rx, Express Scripts, and UnitedHealth Group's OptumRx. According to the report, these organizations marked up the prices of many specialty generic drugs by hundreds or thousands of percent, helping to generate more than $7.3 billion in revenue for the PBMs and their affiliated specialty pharmacies between 2017 and 2022.
$7.3 billion. That's more than the GDP of some small countries.
What's more, these companies have a corner on the market. In 2023, the firms examined by the FTC received 68% of all dispensing revenue generated by specialty drugs in the U.S.
The January report was the FTC's second on PBMs. The first studyopens in a new tab or window, released mid-2024, found that, instead of helping keep healthcare costs down, PBMs steer patients toward more expensive drugs and, incredibly, even overcharge for cancer treatments.
And, yet, Witty shows no remorse and no willingness to drive change.
Time for Insurers to Take Ownership
UnitedHealth Group cannot ignore these issues. Shifting blame to providers, hospitals, and pharmaceutical companies is disingenuous, particularly given that the company itself employs many of those providers and controls major portions of the drug supply chain.
If members of the healthcare ecosystem want to change Americans' attitudes, we need all stakeholders to take responsibility for their role in our systemic healthcare challenges -- not just point fingers elsewhere.
It is time for a real conversation about improving affordability, access, and patient satisfaction without the hollow rhetoric. Let's keep pushing for a better, more equitable healthcare system. Patients and clinicians deserve better than what we have right now.
"
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