PROVIDENCE – Early on Wednesday morning, Dec. 4, UnitedHealthcare’s CEO Brian Thompson was ruthlessly gunned down in midtown Manhattan, murdered outside the entrance to the Hilton Hotel.

Thompson’s firm, UnitedHealthcare, the mammoth health insurance division of UnitedHealth, was on track to generate roughly $300 billion in revenue in 2024 [emphasis added], according to reporting by the Boston-based publication STAT, which markets itself as the source for in-depth reporting on biopharma and the life sciences.

STAT is owned by John Henry; his wife is in charge of running the publication. Henry also owns The Boston Globe and the Boston Red Sox.

In its own words, STAT is: “A media company focused on finding and telling compelling stories about health, medicine, and scientific discovery.”

The self-promotional prose on its website describes STAT’s mission as follows: “We produce daily news, investigative articles, and narrative projects in addition to multimedia features, podcasts, and opinion pieces. We tell our stories from the places that matter to our readers – research labs, hospitals, executive suites, and political campaigns.”

To set the stage for the Wednesday morning murder, CEO Thompson had been scheduled to speak that morning at UnitedHealthcare’s annual investor conference, sharing financial details of the firm’s future investment plans.

Instead, the corporate dreams of UnitedHealthcare’s future financial health suddenly became the grist for the plot of a grisly Robert Parker murder mystery.

Now STAT can add a new investigative focus: the murder of life sciences CEOs.

What happened? Or, perhaps an equally important question: How did STAT frame the initial narrative of the CEO’s murder?

•    “UnitedHealthcare CEO Brian Thompson became one of the country’s most powerful insurance execs before his tragic killing,” STAT had reported in the immediate aftermath of the murder.

For sure, STAT has been one of the few publications that have detailed the many questionable practices that UnitedHealthcare had deployed to reap its financial profits, often at the expense of patients.

But, compare STAT’s initial framing of the narrative of Thompson’s murder to that of Prospect reporter Moe Tkacik’s take – and her description of the way that UnitedHealthcare makes it profits:

•    “The thing about UHC is not just that it denies medical care, it systematically defrauds seniors into relinquishing the right to Medicare so it can collect $15k/head/yr. denying them care, then appeals to SCOTUS to defend its constitutional ‘right’ to ghost doctors in the process.”

Tkacik’s reporting continued: “A [U.S.] Senate report published in October shows that denial rates at the big three corporate Medicare Advantage insurers for big-ticket expenditures like nursing home care have all risen dramatically over the past five years, as UnitedHealth and its peers outsourced those decisions to algorithms (emphasis added) have an easier time than humans denying vital care to patients in need.”

Tkacik called UnitedHealthcare a pioneer among health insurers for its risk management strategies. “UnitedHealthcare has been a particular trailblazer in the art of managing ‘risk’ by simply denying claims for treatment and procedures it unilaterally deems unnecessary,” she reported.

Tkacik continued: “Even as the company was embroiled in a scandal involving revelations that NaviHealth kicked frail seniors out of rehab facilities after two weeks, the company appealed a decision that affirmed a lower-court determination that it has ‘arbitrarily and capriciously’ denied coverage of a 2014 psychiatric hospital stay to a suicidal middle schooler who had subsequently killer herself.”

As Tkacik further reported, “While the Supreme Court ultimately declined to take the case, the sense of self-righteousness the company maintains around its constitutional right to decline a hospital bed to a suffering patient shows up again and again in the company’s rap sheet.”

The changing narrative    
On Friday, Dec. 6, two days after the targeted murder of UnitedHealthcare CEO Brian Thompson, STAT reporters Bob Herman and Tara Bannow published a story offering a much different narrative – a story that also ran in The Boston Globe.

“The targeted killing of UnitedHealthcare CEO Brian Thompson has become a defining moment in the zeitgeist of American health care,” they wrote in their lede sentence.

Herman and Bannow continued: “The attack was a tragedy that adds to the country’s grim tally of gun deaths. But instead of eliciting sympathy, it opened the floodgates for an outpouring of rage, captured across social media and online forums, over the health care system – one that charges people the highest prices in the world, erects financial and bureaucratic barriers to getting care, and has plunged millions of people into debt.”

The deluge of social media posts, Herman and Bannow wrote, “has forced people across the country to grapple with two heavy subjects at once: the callousness of a slaying, and an undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans.”

The changed narrative captured in the reporting of Herman and Bannow  bears repeating: “An undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans.” [emphasis added]

For consumers and patients, and for doctors and nurses alike, the truth contained in the changed narrative that the “health care industry is making a lot of money by exploiting Americans” is not a big secret.

The problem, it seems, is the way that the practiced distortion of the narrative – by the news media, by legislators, and by the Trump acolytes who claim they want to “make America healthy again” keeps being broadcast and amplified.

The corporate game of “risk”    
Earlier in the same week of Thompson’s murder, The Boston Globe had published a big feature story by Globe reporter Robert Weissman, with the headline: “Snagging ex-Steward hospitals, Brown Health secures a foothold in Massachusetts.”

Somehow, even after months of investigations into the brazen, corrupt corporate practices of the now bankrupt Steward Health Care, when it came to promoting the narrative of engulf and devour,  talking about corporate hospital acquisitions, the question that needs to be asked is this: What, if anything, has The Boston Globe learned? Do not the readers of The Globe deserve better reporting?

The strange choice of language used in the headline, “Snagging ex-Steward hospitals…” [emphasis added], appeared to glorify the acquisition dreams of the CEO of Rhode Island’s largest health care delivery system, as if buying and selling hospitals in Massachusetts resembled playing the board game, “Risk.”

With a successful roll of the dice, you, too, could win control of the territory of Kamchatka [Fall River, Taunton] and gain access to markets with higher-paying health insurance.

Indeed, two of the six bankrupt former Steward properties, the ones purchased for $175 million by Brown University Health [the health delivery system formerly known as Lifespan], one in Taunton and the other in Fall River, were part of a territory acquisition  scheme that was described by a Lifespan strategy official as an opportunity to “grab scale.” [emphasis added]

To “grab scale?” To quote intrepid radio reporter, WPROs Steve Klamkin, “Really?”

The narrative of Weissman’s story offered a glowing portrayal of CEO Dr. John Fernandez, the current CEO of Brown University Health, and his long-standing ties to Boston’s health care hierarchy.

Indeed, the subhead provided even more context for the language of the “risk” narrative: “Rhode Island’s largest health care system took over St. Anne’s Hospital in Fall River and Morton Hospital in Taunton, bringing with it a patient-centered vision.”

But, whose “patient-centered” vision? It begs the question: Why were there no patients – from Rhode Island or from Fall River – who were interviewed for the story?

Missing from the narrative created by Weissman was any mention of the Rhode Island innovation-driven “health equity zones.”

And, why did Weissman fail to ask any questions about the biggest stumbling block Rhode Island faces to the delivery of health care – the dismally low pay for primary care providers?

More problematic was the omission of an interview with R.I. Attorney General Peter Neronha – who has led the successful fight against private equity firms buying and selling of Rhode Island hospitals, Roger Williams Medical Center and Our Lady of Fatima. So it goes.

Also missing from Weissman’s narrative – and from the narrative as told by STAT’s Herman and Barrow – was the dominant role played by UnitedHealthcare’s Optum, the wholly-owned for-profit division of UnitedHealth, in the delivery of behavioral health and mental health services for Medicaid patients receiving care through the Managed Care Organizations in Rhode Island – nearly one-third of all the residents of Rhode Island.

In its coverage of the May 28 health care summit at the State House organized by House Speaker Joseph Shekachi, ConvergenceRI had reported at length, in great detail about the problems with Optum. [See link below to ConvergenceRI story, “Bang the gavel slowly.”]

What it will take to change the narrative?    
This coming week, there will be two big events that go to the heart of the problems of narrative when it comes to health care delivery, both happening on the same day, Wednesday, Dec. 11.

The first will be the annual R.I. Life Index, sponsored by Blue Cross and Blue Shield of Rhode Island and the School of Public Health at Brown University, which gauges in a data-driven survey how Rhode Islanders feel about their own health delivery.

The second will be a discussion of the Rhode Island Foundation’s new five-year strategic plan, revealing the changing priorities for the Foundation, in a conversation moderated by columnist Dan McGowan of The Boston Globe. In recent years, the Rhode Island Foundation has become the veritable fourth branch of government in Rhode Island, attempting to keep the state functioning as the safety net of the social contract has been shredded by disruptions in health care, in affordable housing, and in racial equity.

As much as ConvergenceRI had planned to take a break from publishing, with plans to resume publication in early January, the reality is that one more edition will be published the week of Dec. 16, in order to cover the R.I. Life Index and the new strategic direction of the Rhode Island Foundation. There is a need to “press forward” in the coverage of Rhode Island’s innovation ecosystem, promoting convergence and connectivity.