YouTube Transcript:
When The Mask Slips - A Clearly BROKEN System

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