How Much Do Americans Really Hate Private Health Insurers?
On Monday, December 9, authorities apprehended 26-year old Luigi Mangione for the murder of United Healthcare (UHC) CEO Brian Thompson.[1] Since the murder on December 4, one of the biggest stories has been the widespread sentiment, both whispered and broadcasted, that Thompson’s murder was justified to some extent because of the excessive financial and medical burden his company’s policies impose of many of their insured members. UHC, which is the largest medical insurance company in the country,[2] had net earnings in 2023 of $22B,[3] representing a lot of money paid by members that did not get paid out in benefits.
On one side, Thompson earned $10M a year running UHC.[4] On the other, more than 100 million Americans have some level of medical debt,[5] and 700,000 go bankrupt each year from it. It is not surprising, then, that Mangione has become something of a celebrity, with many blatantly not condemning his actions. In a weird twist on the story, social media has also been abuzz about how attractive Mangione is, often referring to him as the “hot shooter.” While some scold that this trivializes the situation (it does) and disrespects Thompson’s family (it does), people are quite willing to sympathize with Mangione and blow off steam at the same time. There is clearly a lot of anger behind the mocking that seems prudish to dismiss, though late night shows notably hardly joined in on the fracas last Monday night.[6]
Because we are a society enamored with spectacle, Mangione’s trial will keep attention on the case, but the boiling rage that private insurers may be fearing this month will likely die down to a simmer, and things will continue as they are, though there is a chance that Congress nixes the Affordable Care Act, ending the current coverage for millions of Americans. This begs the question of why people don’t channel their outrage into political action. I am genuinely curious about voters who have taken satisfaction in the last two weeks in Thompson’s murder but who voted for politicians that want to maintain something resembling the status quo. What is their ideal system? A free market where private insurers are kind, considerate, and ethical? The incoming Trump administration will apparently focus on increasing choice (?) and transparency (this would be good!) and taking on big pharma,[7] though Project 2025 notably would stop the federal government from negotiating the price of prescription drugs.[8]
This all begs another question that we are more equipped to tackle here at Market Research Sucks. How do Americans really feel about private health insurance? All of the noise around Thompson’s murder suggests a majority of Americans are fed up and ready for change. But do recent polls really bear that out?
Here's a quick review of opinion polling on health care.
· A Gallup poll conducted in November 2024 found that only 28% think the quality of health care coverage in the US is excellent or good,[9] and there is little difference by political party affiliation. However, 65% think their own health care coverage is excellent or good.[10]
· 70% think the US health care system has major problems (54%) or is in a state of crisis (16%), with these numbers being consistent over the last thirty years.[11]
· A 2020 Kaiser Family Foundation (KFF) study found that 52% of Americans favor Medicare for All, 66% a public option.[12] A 2023 survey by the Partnership for America’s Health Care Future found that 49% support Medicare for All but only 48% a public option.[13] A 2024 survey by Pew Research found support for a Medicare for All type plan at 33%,[14] while in a 2024 Gallup survey, 46% said they would prefer a government-run health care system. This is up from 34% in 2010.[15]
Perhaps this will be a watershed moment, but I doubt it. Look at the numbers. Americans agree that there is a problem that needs fixing but not that a government-run system would be better. Public opinion is just not there yet, and if increased transparency can do anything to bring costs down, interest in a public option may go in the other direction for a while.
I would think we would need polling for Medicare for All to be more like 60-65% to get serious consideration. While the 2020 KFF study found strong interest in a public option, the 2023 Partnership for America’s Health Care Future contradicts this, though the Partnership does have strong ties to the status quo. As Slow Boring’s Matt Yglesias says, it may be more fruitful in the near term to focus on incremental improvements to what exists, like expanding Medicare to some extent or expanding Medicaid coverage.[16] These things will not happen in the next four years but would be good goals for a future Democratic administration.
It seems, at this point, that a shock to the system would need to occur for opinions to change enough for Medicare for All to be viable. Thompson’s murder is almost certainly not providing that event, though it’s worth watching polls in 2025 for upticks in interest in government-run options. COVID 19 also did not really change the trajectory of public opinion on these matters, at least not enough to have changed the political calculus yet.
In conclusion, while the events of early December gave people an occasion to vent their frustrations with private health insurers, they do not point to the coming of a major change in health care policy in this country. The keg is simply not full enough of powder, and the spectacle aspect of the whole situation dampens the wick. If you see data that suggests otherwise, I’d love to know.
Thank you for reading.
-CW
[1] https://www.cnn.com/2024/12/11/us/luigi-mangione-unitedhealthcare-arrest-explained/index.html
[2] https://apnews.com/article/unitedhealthcare-ceo-shooting-suspect-c68d0328f278d85fcf201ae89f634098
[3] https://www.managedhealthcareexecutive.com/view/unitedhealth-group-s-revenue-grew-almost-15-in-2023
[4] https://www.yahoo.com/news/uhc-ceo-brian-thompson-net-135558746.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAFETc2hMEQlEHmZY_2ifRwAHITHvFTWAFZL4eCpwX7hvGNPfoZNQfEr3ZWlAQwOrAz-oiq4YeqOpgra1gAhRKjtqgE2RR4WYs-sgcC2ZV5ZCh3iRSTgFArvdIEKNK33jL9BWs0Z9vW2iJEf0JMLXCdz7JkJUwbDVU9Mn-O54_83A
[5] https://www.texastribune.org/2022/06/16/americans-medical-debt/
[6] https://latenighter.com/news/late-night-shows-largely-resist-naming-alleged-ceo-assassin/
[7] https://www.pwc.com/us/en/industries/health-industries/library/election-2024-trump-health-agenda.html
[8] https://www.project2025.org/policy/
[9] https://news.gallup.com/poll/654044/view-healthcare-quality-declines-year-low.aspx#:~:text=Most%20Americans%20Say%20Healthcare%20System,think%20it%20has%20no%20problems.
[10] Ibid.
[11] Ibid.
[12] https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/
[13] https://americashealthcarefuture.org/resources/voter-vitals-december-2023-edition-national-tracking-poll/
[14] https://www.pewresearch.org/politics/2024/06/24/americans-views-of-governments-role-persistent-divisions-and-areas-of-agreement/
[15] https://news.gallup.com/poll/654101/health-coverage-government-responsibility.aspx
