Forget the bogus 32% stat for a second. The REAL story is that one company can insure you, employ your doctor, manage your prescriptions, process your medical claims, own the technology behind the system, and then make BILLIONS while deciding what care gets paid for.
And UnitedHealth’s reach is absolutely massive. Its Optum business owns physician practices and healthcare services all over the country. OptumRx is one of the largest pharmacy benefit managers in America. Change Healthcare processes an enormous amount of healthcare payment and claims data. UnitedHealthcare is obviously one of the biggest insurers in the country.
Then start looking at where regulators and investigators have stepped in. The DOJ challenged UnitedHealth’s $3.3 billion acquisition of Amedisys over competition concerns. The eventual settlement required UnitedHealth and Amedisys to divest at least 164 home health and hospice locations across 19 states.
The FTC sued OptumRx and two other giant pharmacy benefit managers, alleging their rebate practices helped artificially inflate insulin list prices and shifted costs onto patients. That case involving Optum is still pending.
Then there’s the Change Healthcare cyberattack. Change Healthcare is owned by UnitedHealth, and the 2024 ransomware attack created MASSIVE disruptions across the healthcare system. HHS opened investigations into both Change Healthcare and UnitedHealth over the breach and HIPAA compliance.
And then we get back to care denials. United HealthCare has faced litigation over allegations that its NaviHealth technology was used to cut off rehabilitation coverage for Medicare Advantage patients. A federal judge allowed that lawsuit to move forward, although UnitedHealth strongly disputes the allegations and says AI does not make adverse clinical decisions. So yeah, the viral claim saying UnitedHealth denies 32% of ALL prior authorizations is WRONG.
I’m not going to repeat a bad stat just because it sounds outrageous. But when one corporation can sit inside this many layers of American healthcare…
Insurance.
Doctors.
Prescriptions.
Claims processing.
Healthcare technology.
Home health.
And billions of dollars in profit.
I think asking whether ONE COMPANY should have this much control over healthcare is a pretty damn reasonable conversation to have