0:04 I want to start the video by
0:06 acknowledging something which is that
0:07 health care is an impossibly complicated
0:09 subject. Countries all around the world
0:11 choose different systems. People all
0:13 around the world have different
0:14 opinions, but the underlying foundation
0:16 across all of it is that when someone is
0:18 sick without the ability to fix that
0:20 problem for themselves, they want help
0:22 with it. I can't sit here and tell you
0:24 what the system should be. I'm not even
0:26 remotely qualified to do that. Very few
0:28 people conceivably are. But what I can
0:29 do is tell you when something is broken.
0:32 To give a sort of extreme example here,
0:34 I can't build a car, but I can tell you
0:36 if the car won't start or if the brake
0:38 pedal stops working. I wouldn't
0:39 necessarily be able to tell you why that
0:41 happens. But when something as obvious
0:42 as the brake pedal completely fails, the
0:45 issue stops requiring complex knowledge.
0:48 Basically, anyone who gets in the car
0:49 from that point forward can tell you
0:51 this is broken. And you don't really get
0:54 to argue with them. It's an imperfect
0:56 comparison. If the car was healthcare
0:58 and the brake pedal was wrongfully
1:00 denied claims, as soon as you said,
1:02 "This is broken," someone would slither
1:04 out of the woodwork to complain about
1:06 how the car is actually super wellmade
1:08 and probably you did something to the
1:10 pedal. So, the fact that it's broken
1:11 doesn't make the car bad, it makes you
1:13 bad because that car over there has even
1:15 worse problems. Would you rather be
1:16 driving that car, you socialist? The
1:19 entire discussion is painfully derailed
1:22 by politics. Which car or system is
1:25 superior? what should or shouldn't be
1:27 changed about it with millions upon
1:29 millions of people arguing that don't
1:31 even have the faintest idea what they're
1:33 talking about. But looking past the
1:34 surface level bickering once in a while
1:36 if you're paying attention that is
1:38 something will happen which is just so
1:40 egregiously obvious it shatters the
1:42 house of mirrors and lets everyone see
1:44 what's actually there which in this case
1:47 is a broken piece of the system that
1:49 needs to change. Here we go. This is a
1:52 man named Luigi Manion. Most people have
1:55 probably heard the name before, who's
1:56 currently on trial for the murder of
1:58 Brian Thompson, CEO at the time, of a
2:01 company called United Healthcare.
2:03 Actually, it's a little bit of a
2:04 technical spiderweb here. United
2:06 Healthcare is one of perhaps hundreds of
2:08 subsidiary companies incorporated across
2:10 the United States, but the ultimate
2:12 parent organization at the top of this
2:14 corporate tree is called United Health
2:16 Group. Well, United Health Group, aside
2:19 from being a $350 billion industry
2:21 behemoth, is also a substantial
2:22 political donor. Over the past few years
2:24 alone, they've donated tens of millions
2:26 of dollars to various different lobbying
2:28 groups. And something else that becomes
2:29 clear rather quickly is that they do
2:31 this across the entire political
2:32 spectrum of the United States. This is
2:34 what's called buying influence. And if
2:37 we're talking about a broken system,
2:38 companies paying tens of millions of
2:40 dollars, mostly to exgovernment workers
2:42 at these firms, who then go on to lobby
2:44 current politicians as an effort to
2:46 impact future policy. At a certain
2:49 point, that company is no longer just a
2:51 participant in the broken system.
2:53 They're an architect of it. Regardless,
2:56 United Health Group is no stranger to
2:58 controversy. Back in November of 2023,
3:01 the company was sued in a Minnesota
3:02 class action lawsuit for allegedly and
3:05 willfully using a highly flawed
3:07 algorithm called NH Predict in order to
3:10 quote prematurely and in bad faith
3:13 discontinue payment for health care
3:15 services for elderly individuals with
3:17 serious diseases and injuries. End
3:19 quote. Further down on page 11 of that
3:22 lawsuit, we can also read this quote.
3:24 The NH predict AI model attempts to
3:26 predict the amount of post-accute care a
3:28 patient should require, pinpointing the
3:31 precise moment when defendants will cut
3:32 off payment for a patient's treatment.
3:34 The NH predict AI model compares a
3:36 patients diagnosis, age, living
3:39 situation, and physical function to
3:41 similar patients in a database of 6
3:42 million patients it compiled over the
3:44 years of working with providers to
3:46 predict a patients medical needs,
3:48 estimated length of stay, and target
3:50 discharge date. End quote. That's
3:52 already bad, if true. It's an AI model
3:55 effectively deciding you should be done
3:56 healing, therefore you are done and you
3:59 get no more care. But something else I
4:01 want to make note of is that this is far
4:03 from the only healthcare company where
4:04 it's allegedly happening. In July of
4:06 2023, a healthcare company named Sigma
4:09 was sued for using algorithms to
4:11 unlawfully deny patient claims. And in
4:13 December also of 2023, a healthcare
4:15 company called Humana was also sued for
4:18 allegedly using AI programs to
4:20 prematurely cut funding for
4:21 rehabilitative care. Still focusing
4:24 individually on United Healthcare,
4:26 according to a stat investigation of the
4:28 company in November of 2023, quote,
4:30 "Three former case managers said the
4:32 individual stories behind the
4:34 algorithmic denials were haunting. An
4:36 older woman found in the laundry room by
4:38 her grandson after a stroke, her right
4:40 side paralyzed, was allotted 20 days of
4:42 rehab by the algorithm when the average
4:44 for severely impaired stroke patients is
4:47 almost double that." End quote. That's
4:49 just one example, but for the sake of
4:51 time, I'll focus on two additional
4:52 segments from the investigation. First
4:54 is this quote, the stringent performance
4:57 goal was part of a broader effort to
4:59 reduce expensive nursing home care for
5:01 frail patients with privatized Medicare
5:04 plans. The internal documents show the
5:06 strategy was conceived and executed by
5:08 former top Medicare officials whose
5:11 policies became a blueprint for United
5:13 Health to reap hundreds of millions of
5:15 dollars annually by shredding the
5:17 government's safety net with payment
5:19 denials backed by an algorithm. End
5:22 quote. Lastly, and I appreciate everyone
5:24 bearing with me on this. I know some of
5:26 it's dry and boring. Lastly is this
5:28 quote from healthcare market analyst
5:30 Spencer Pearlman, which I believe
5:32 perfectly sums up kind of the whole
5:33 problem. Quote, "You can maximize your
5:36 profitability if you're able to get
5:38 people out of expensive care settings as
5:40 quickly as you possibly can." End quote.
5:43 And that is the critical issue here. Say
5:46 what you want about the system as a
5:47 whole. Argue whatever you feel like in
5:49 terms of other countries or structures
5:51 or politics, but the stone cold fact
5:53 here is that United Healthcare was
5:55 already neck deep in over their
5:57 alleged use of algorithmic systems to
6:00 wrongfully deny patient care. That's
6:02 what matters. Well, flash forward to
6:04 December of 2024 and we have a very
6:06 specific timeline of connected events.
6:09 Here goes. On December 3rd, again, 2024,
6:12 United Healthcare issued a financial
6:13 guidance statement citing net earnings
6:15 targets of roughly $28 per share and
6:18 adjusted earnings targets of roughly $30
6:20 per share. December 3rd, 2024. However,
6:24 on December 4th of 2024, CEO Brian
6:27 Thompson was murdered in New York City
6:29 at the annual investor conference. This
6:31 is where things get technical. On
6:33 January 16th, 2025, this time about a
6:35 month and a half later, United
6:37 Healthcare releases a statement
6:38 reaffirming their previous net earnings
6:40 estimate of $28 and adjusted net
6:42 earnings of roughly $30, which is even
6:44 further reinforced during the company's
6:46 investor call transcript recorded by Mly
6:49 Fool where we can see quote from chief
6:51 financial officer John Rex. Next
6:53 question. Given all that, are we
6:55 confident in the adequacy of our pricing
6:57 for 2025? The answer is yes, and here's
7:00 why. to start for 25. The outlook we
7:03 shared in December incorporates a view
7:05 of care activity commensurate with what
7:07 we saw in 24. Even the care activity we
7:10 experienced as we exited the year. End
7:12 quote. Now, there's a fair bit of
7:14 corporate double speak happening here
7:16 all over the place. But from what I see,
7:18 he's basically pontificating about how
7:19 the end of the year saw increased care
7:22 activity, which means we had to pay a
7:24 lot more money than we expected to help
7:26 people. And that's where things get
7:27 dicey. He gives all sorts of complicated
7:29 reasons about why that might be the
7:31 case. But something we have to consider
7:33 is that the murder of CEO Brian Thompson
7:36 was ideologically motivated. Luigi
7:38 Manion, it would seem, had a deeprooted
7:41 disdain for the healthcare industry at
7:43 large, specifically United Healthcare.
7:45 And one of the most obvious connections
7:47 was inscribed directly on his
7:48 ammunition. Deny, defend, depose. three
7:52 famous words now carved on casings which
7:54 refers to the tactical process by which
7:56 insurance companies avoid paying claims.
7:59 Remember, United Healthcare is already
8:01 neck deep in credible allegations and
8:04 ongoing lawsuits that they used AI
8:06 programs to wrongfully deny patient
8:08 claims and restrict important care for
8:11 the sake of profit. Make sense?
8:14 Hopefully, yes, it makes sense because
8:15 there's more. But before I get to that
8:17 part, I want to ask kind of a question.
8:19 Should it matter for the company's
8:21 financial bottom line if an executive is
8:24 killed? Not to be callous here, but
8:26 should it realistically matter if a
8:28 company is merely conducting a
8:29 legitimate business that one of their
8:31 top level executives was suddenly taken
8:33 out of the equation? To a degree, yes,
8:35 obviously. Although some companies are
8:38 only successful because of their founder
8:40 or CEO or a top level executive. But
8:43 many other companies, it's a revolving
8:44 door. I mean, they're like Lego blocks.
8:46 You can put them in and take them out.
8:47 It's largely based on nepotism as well.
8:49 None of them are even qualified and
8:51 they're overpaid, highly
8:52 overcompensated. But regardless, that's
8:54 a whole separate thing. It shouldn't
8:56 really matter or impact their immediate
8:58 financial status or shall we say
9:00 short-term earnings, right? Ideally, no.
9:04 Sticking to our previous metaphor of the
9:05 car, if the CEO of I don't want to get a
9:08 cease and desist from a car company by
9:09 saying a specific name, the CEO of car
9:12 company X or Y or Z was suddenly
9:15 incapacitated, it wouldn't really impact
9:17 the short-term runway of cars being
9:19 manufactured and shipped. Unless, and
9:22 here's where things get sticky, unless
9:24 he was killed by someone who was
9:26 disgruntled over the fact that the brake
9:28 pedals didn't work. Well, if the
9:31 allegation and apparent motive for the
9:33 crime was that the brake pedals didn't
9:35 work while the company simultaneously
9:37 faced other lawsuits and credible
9:39 investigations over deliberately making
9:41 a bunch of the brake pedals not work
9:43 because it's way cheaper, then you
9:45 suddenly do have a problem. If you keep
9:48 doing it, which is the only way you
9:50 manage to have profit margins that high
9:52 in the first place, you run the risk of
9:54 people getting even angrier with you or
9:56 attracting the attention of regulators,
9:58 which would be much worse. But if you
10:00 stop, you have to actually pay the money
10:03 you owe or should be paying in the first
10:05 place. Enter this. This is a press
10:08 release from United Healthcare, April
10:10 17th of 2025, which says, quote, revised
10:14 2025 earnings outlook to 24 to $25 per
10:17 share with adjusted earnings of 26 to
10:20 26.50. End quote. Suddenly, things start
10:23 making a little bit more sense, don't
10:25 they? Obviously, yes, they do. But
10:27 here's the part where it goes totally
10:29 off the rails. On May 7th of 2025, in
10:32 the Southern District of New York, yet
10:34 another lawsuit gets filed. this time a
10:36 class action investor lawsuit which
10:39 specifically takes aim at the financial
10:41 statements that I previously mentioned
10:43 right altogether claiming that United
10:45 Healthcare knowingly misrepresented
10:47 their financial status thereby harming
10:49 investors. But I want to read from pages
10:51 9 and 10 right now because the language
10:54 here is where it just all falls apart.
10:57 Quote, "The statement in paragraph 33
10:59 was materially false and misleading at
11:01 the time it was made because it omitted
11:02 that the company was no longer willing,
11:04 as a result of heightened scrutiny
11:06 against the company, as well as open
11:08 hostility against the company from large
11:09 swats of the general public to use the
11:12 aggressive anti-consumer tactics that it
11:14 would need to achieve $28 in earnings
11:17 per share or 29.50 to 20. It's supposed
11:20 to say 30, but that's a typo. There's
11:22 actually a bunch of typos in this case,
11:23 which is just super unprofessional from
11:25 the Rosen Law Firm. But anyway, typo 20
11:28 supposed to say $30 in adjusted net
11:31 earnings per share. As such, the company
11:33 was deliberately reckless in doubling
11:36 down on its previously issued guidance.
11:38 End quote. So, that's a little bit on
11:40 the nose, don't you think? The investors
11:42 are suing the company because they were
11:44 no longer willing, their words not mine,
11:47 to use aggressive anti-consumer tactics.
11:50 But wait, there's more. Now, from page
11:53 10, quote, "The statements referenced in
11:56 paragraph 31, 33, and 35 above were
11:59 materially false and/or misleading
12:01 because they misrepresented and failed
12:03 to disclose the following adverse facts
12:05 pertaining to the company's business,
12:07 operational, and financial results which
12:08 were known to defendants or recklessly
12:10 disregarded by them. Specifically,
12:13 defendants made false and/or misleading
12:15 statements and or failed to disclose
12:16 that one, United Health had for years
12:20 engaged in a corporate strategy of
12:22 denying health coverage in order to
12:24 boost its profits and ultimately its
12:26 share price. Two, this anti-consumer and
12:29 at times unlawful strategy resulted in
12:31 regulatory scrutiny as well as public
12:34 angst against United Health, which
12:36 ultimately resulted in the murder of
12:37 Brian Thompson. Three animous towards
12:40 United Health was such that subsequent
12:42 to the murder of Mr. Thompson, many
12:43 Americans openly celebrated his demise,
12:46 expressed admiration for his accused
12:48 killer, and or otherwise demanded that
12:50 United Health change its strategy even
12:53 if they condemned Mr. Thompson's
12:54 killing. Four, the foregoing regulatory
12:57 and public outrage caused United Health
12:59 to change its corporate practices. Five.
13:02 Notwithstanding the foregoing, United
13:04 Health recklessly stuck with the
13:06 guidance it issued the day before
13:07 Thompson's murder, which was unrealistic
13:09 considering the company's changing
13:11 corporate strategies. And six, as a
13:14 result, the defendant's public
13:15 statements were materially false and/or
13:18 misleading at all relevant times. End
13:21 quote. That was incredibly long, I know,
13:23 but what the actual This lawsuit
13:26 would not exist, period, if the company
13:29 had just kept on doing what they were
13:31 before. In 2023, when the class action
13:33 lawsuit in Minnesota became public, the
13:36 investors didn't care. But now, after
13:38 the CEO is murdered and the public turns
13:40 against them completely, suddenly we
13:42 have a new lawsuit against United
13:44 Health, specifically because they were
13:46 quote no longer willing to continue
13:49 using allegedly illegal, aggressive, and
13:52 anti-consumer practices, which resulted
13:54 in their earnings being substantially
13:56 decreased. This is a complete mask off
13:58 type situation in my view. Nothing
14:00 legitimate is happening to this company
14:02 on a regulatory level. The class action
14:04 against them for wrongfully denying care
14:06 through a manipulated and predatory AI
14:09 algorithm probably won't go anywhere. I
14:11 think five out of the nine claims so far
14:13 have already been dismissed. But now
14:15 after that company was so evil that they
14:18 inspired vigilante justice against their
14:20 own executives now because they stopped
14:24 doing the predatory allegedly illegal
14:26 things that made people hate them. Now,
14:29 the people with the money are suing them
14:31 because they're not making enough money.
14:33 It is a sickly dystopian wake-up call as
14:36 to this true state of corporate
14:37 healthcare. Let's do a timeline recap.
14:39 Okay. In 2023, United Healthcare along
14:42 with multiple others in the industry get
14:44 sued for allegedly denying claims with
14:46 AI algorithms that they shouldn't be
14:48 denying. At the end of 2024, they
14:50 release an earnings estimate. Nothing
14:52 out of the ordinary there. But one day
14:54 later, their CEO is supposedly murdered
14:56 by someone with an ideological vendetta
14:58 against healthcare companies who are
15:00 abusing the American people and most
15:02 importantly wrongfully denying claims
15:05 multiple times in the aftermath of that
15:07 crime. They reassert that that same
15:09 financial guidance from before until
15:11 suddenly substantially downgrading it in
15:14 2025. But directly after the downgrade,
15:17 investors open a lawsuit because the
15:19 company is quote unwilling to continue
15:23 using the illegal anti-consumer and
15:25 aggressive monetization tactics. Once in
15:28 a while, if you're paying attention,
15:30 something will happen that shatters the
15:32 house of mirrors, exposing a piece of
15:33 the system for what it truly is. It
15:35 could be subtle, like a few words in a
15:37 lawsuit, or it could be bigger, like
15:39 premeditated crimes with national
15:41 headlines. And I believe that this is
15:43 one of those moments. The structure of
15:45 United Health Care in the United States
15:47 is fundamentally at odds with the actual
15:50 best outcome for its patients. Publicly
15:52 traded health care companies are the
15:54 direct embodiment of conflict of
15:56 interest because the way that they earn
15:58 more money is to care for people less.
16:01 Obviously, the entire thing is just a
16:03 quagmire of complexity because maybe the
16:05 average cost of health care wouldn't be
16:06 so damn high if people weren't so
16:08 unhealthy to begin with in this country.
16:10 If the food was better, the culture
16:12 improved, tobacco, alcohol, drugs,
16:14 crime, etc., or any number of other
16:16 seemingly unrelated factors that are
16:18 actually deeply related, which would
16:20 make it so that customers didn't require
16:22 more money from health insurance than
16:24 they pay into it, which is before we
16:26 even begin unpacking the maze of
16:28 political arguments and different health
16:30 care systems entirely. But the point I'm
16:32 trying to make, okay, if you distill it
16:34 down to the main point, is that even
16:36 when you can't necessarily say this is
16:38 how you fix the brakes in the car,
16:41 sometimes it's just so painfully obvious
16:43 that the brakes are in fact broken,
16:45 people start disassembling things
16:47 themselves. Of course, that's an
16:49 extremely dangerous thing to have
16:50 happening, and I would never, will
16:52 never, and explicitly have not ever
16:54 supported or condoned it. But at the end
16:56 of the day, if someone asked me whether
16:58 or not I'm surprised, I don't think I'd
17:01 say yes. Echoing the sentiment at the
17:03 start of the video, I can't sit here and
17:05 tell you what the system should be. I'm
17:07 not even remotely qualified to do that.
17:09 Very few people are. But what I can do
17:11 is tell you when something is broken,
17:13 and the health care system in the United
17:15 States is broken. For the sake
17:17 of being much more specific here,
17:19 because I know people will want that, we
17:21 cannot allow a profit-driven algorithm,
17:24 which is quite literally programmed to
17:26 deny as much care as possible to
17:29 patients, to make bottom line decisions
17:31 about who is and is not medically cared
17:34 for. That is an unacceptable system,
17:37 regardless of individual politics.
17:39 That's it. If you want to support the
17:40 channel, check out the links down below.
17:41 a special VPN deal, locals and Patreon,
17:44 merchandise, social media, our own
17:46 website with stories and articles posted
17:48 there, etc., etc. But I'll cut it there
17:50 and stop rambling. As always, thank you
17:51 all for watching. Question everything
17:54 and have a nice night.
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