Summary of "Letters from an American" Podcast Episode: December 5, 2024

Host: Heather Cox Richardson
Produced by: Soundscape Productions, Dedham, MA
Music Composed by: Michael Moss

In the December 5, 2024 episode of "Letters from an American", historian Heather Cox Richardson delves into a tumultuous period marked by corporate malfeasance, political maneuvering, and societal tensions. The episode intricately weaves contemporary events with historical parallels to provide listeners with a comprehensive understanding of the forces shaping today's America.

1. Assassination of UnitedHealth Care CEO Brian Thompson

The episode opens with a shocking event that has reverberated through the nation:

• Incident Overview (00:07 - 02:00):
  On December 5, 2024, Brian Thompson, the CEO of UnitedHealth Care, was assassinated by a gunman as he attended a meeting of investors in New York City. Initial investigations revealed that the bullet casings bore the words "deny," "defend," and "depose"—terms associated with health insurance denials. While authorities consider these clues as potential red herrings, social media users interpret them as symbolic revenge against a system perceived as oppressive.

  "Thompson's murder seems to be a cultural moment in which popular fury over the power big business has over ordinary Americans' lives exploded." (Heather Cox Richardson, 02:50)

• Public Reaction and Social Media Frenzy (02:00 - 03:30):
  The assassination has ignited widespread support for the perpetrator on social platforms, with thousands reacting with laughing emojis to UnitedHealth Group's somber Facebook post about Thompson's death. This reaction underscores a deep-seated resentment toward insurance practices that prioritize profits over people's well-being.

2. Scrutiny of Health Insurance Practices

Richardson provides a critical analysis of the health insurance industry's contentious practices, focusing on UnitedHealth's role:

• ProPublica's Investigations (03:30 - 04:45):
  Over the past two years, ProPublica has extensively reported on how health insurance companies, including UnitedHealth, systematically deny coverage to policyholders. UnitedHealth, part of UnitedHealth Group valued at $560 billion, remains under intense legal and public scrutiny.

• Legal Challenges (04:45 - 06:20):
  Highlighting a significant lawsuit reported by Andrew Stanton of Newsweek, families of two deceased Medicare Advantage patients have sued UnitedHealth. The lawsuit alleges that UnitedHealth employs flawed artificial intelligence algorithms to deny Medicare Advantage claims, with a 90% error rate and an acknowledgment that only 0.2% of policyholders would appeal the denials.

  "The company knowingly uses an algorithm that makes errors 90% of the time because it also knows that only about 0.2% of policyholders will appeal the decision to deny their claims." (Heather Cox Richardson, 05:30)

• Senate Subcommittee Criticism (06:20 - 07:10):
  The Senate Permanent Subcommittee on Investigations criticized UnitedHealth for significantly increasing denial rates for post-acute care between 2019 and 2022, coinciding with the company's shift to AI-driven authorizations.

3. Controversial Policy Changes in Blue Cross Blue Shield

The episode examines another critical development within the health insurance sector:

• Anesthesia Coverage Policy (07:10 - 08:30):
  Blue Cross Blue Shield Insurance attempted to limit anesthesia coverage during surgeries to specific time frames to curb overbilling and reduce premiums. Facing backlash from anesthesiologists and the public, the company retracted this policy, clarifying that their intent was to align anesthesia use with established clinical guidelines rather than deny medically necessary procedures.

  "Their explanation might have calmed the news cycle, but its suggestion that the insurance officials rather than doctors should determine what anesthesia is appropriate for a patient during surgery echoed the argument in the United Healthcare lawsuit." (Heather Cox Richardson, 07:45)

4. Cultural Momentum Against Big Business

Richardson discusses the broader societal implications of these events:

• Public Outrage and Folk Hero Status (08:30 - 09:30):
  The assassination of Thompson has become emblematic of widespread frustration with large corporations wielding excessive power over individual lives. Maureen Tok of the American Prospect notes that with approximately 50 million UnitedHealth customers, there exists a substantial pool of potential support for actions against the CEO.

  "The shooter, whose actual motive remains unknown, is fast becoming a folk hero." (Heather Cox Richardson, 09:15)

• Security Lapses and Societal Trust (09:30 - 10:00):
  Security expert Charlie Carroll criticizes UnitedHealth for not providing Thompson with adequate protection, highlighting a society where distrust in institutions leads individuals to take extreme measures.

  "When people lose trust in the system, you start seeing more kidnappings and assassinations because they feel like they have to take matters into their own hands." (Charlie Carroll, 09:45)

5. Political Maneuvering and Influence of Billionaires

The episode shifts focus to the intersection of politics and corporate influence:

• Elon Musk and Vivek Ramaswamy at Capitol Hill (10:00 - 11:30):
  Billionaires Elon Musk and Vivek Ramaswamy convened with lawmakers to discuss the formation of the Department of Government Efficiency, aimed at cutting the US budget. Representative Ralph Norman emphasized the willingness to reconsider all budgetary aspects, including Social Security, Medicare, and Medicaid.

  "Nothing is sacrosanct and that they're going to put everything on the table, including Social Security, Medicare and Medicaid." (Representative Ralph Norman, 10:30)

• Implications for Medicare (11:30 - 12:45):
  The discussion hints at the potential privatization of Medicare through Medicare Advantage, which UnitedHealth heavily invests in. Richardson criticizes this move, noting that Medicare Advantage is costlier than traditional Medicare, undermining the purported savings.

• Elon Musk's Political Funding (12:45 - 14:30):
  Reports reveal that Elon Musk secretly funded the RBG PAC, a super PAC that controversially aligned Donald Trump with Ruth Bader Ginsburg's stance on abortion shortly before the election. With a total investment of at least $250 million in Trump's campaigns, Musk's influence extends beyond mere donations to strategic political maneuvers.

6. Historical Parallel: The 1872 Assassination of James Fisk Jr.

To contextualize the contemporary events, Richardson draws a parallel with a significant historical incident:

• Edward S. Stokes vs. James Fisk Jr. (14:30 - 17:00):
  In 1872, Edward S. Stokes assassinated railroad baron James Fisk Jr. in a dispute over personal relationships. This act ignited public condemnation of the intertwining between big business and government, mirroring today's tensions between corporations like UnitedHealth and their influence over societal structures.

  "Together they redefined late 19th century industrialists with one painting Fisk as a representative businessman who, with just an hour's effort, could gather into his clutches a score of millions of other people's property, impoverish a thousand wealthy men, or derange the values and the traffic of a vast empire." (Heather Cox Richardson, 16:15)

• Public Rebellion and Media Coverage (16:15 - 17:00):
  The media frenzy surrounding Fisk's murder and the subsequent portrayal of him as a symbol of corporate excess resonate with today's narrative of public rebellion against perceived corporate tyranny.

Conclusion: Reflections on Power and Public Sentiment

Heather Cox Richardson concludes by reflecting on the cyclical nature of public sentiment toward corporate power. The assassination of Brian Thompson serves as a stark reminder of the lengths to which disenfranchised individuals may go when institutional trust erodes. By drawing historical parallels, Richardson underscores the persistent theme of conflict between burgeoning corporate influence and popular resistance in shaping America's socio-political landscape.

Notable Quotes:

1. "The company knowingly uses an algorithm that makes errors 90% of the time because it also knows that only about 0.2% of policyholders will appeal the decision to deny their claims."
   — Heather Cox Richardson (05:30)

2. "Nothing is sacrosanct and that they're going to put everything on the table, including Social Security, Medicare and Medicaid."
   — Representative Ralph Norman (10:30)

3. "When people lose trust in the system, you start seeing more kidnappings and assassinations because they feel like they have to take matters into their own hands."
   — Charlie Carroll (09:45)

4. "Together they redefined late 19th century industrialists with one painting Fisk as a representative businessman who, with just an hour's effort, could gather into his clutches a score of millions of other people's property, impoverish a thousand wealthy men, or derange the values and the traffic of a vast empire."
   — Heather Cox Richardson (16:15)

This episode of "Letters from an American" provides a compelling narrative that interlaces current events with historical context, offering listeners a profound understanding of the intricate dynamics between corporate power, political influence, and public sentiment in shaping the American socio-political landscape.