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Outside In | US insurer murder a warning as Hongkongers worry about medical bills

City’s situation is not as extreme but the private sector is out of reach for too many and wait times in the public sector can be painfully long

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Police place bullet casing markers outside a Hilton hotel in midtown Manhattan where UnitedHealthcare CEO Brian Thompson was fatally shot on December 4. Photo: Getty Images/TNS

Forever etched on my memory is the story of my ex-wife’s uncle. He had a heart complaint, and all efforts to get life insurance failed, year after year. Eventually, he hit upon on a neat idea: he went into his local betting shop on January 1, and asked for betting odds on him surviving until the following January 1.

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The bookie knew him well, and knew of his heart problem, and so he offered poor odds, but at long last this uncle had what he needed: insurance cover for his wife and family against the possibility of his dying from a heart attack in the coming 12 months. Every January 1 for several years after, he repeated his bet, and was happy every time he lost. The loss was no different from the insurance premium he would otherwise have had to pay to an insurer.

The story was for me a potent one because it stripped the professional gloss away from the insurance industry: actuaries are no different from bookies in betting shops, and insurance policies nothing more than gambling.

I have thought often of that old story since I watched the shocking video of the cold-blooded murder of Brian Thompson, CEO of America’s biggest health insurer UnitedHealthcare.

The tragedy perhaps says most about the ugly and shameful gun culture that blights the United States: there are few places in the world where a bookie – no matter how money-grabbing – would find an argument over an unsettled debt ending with a bullet in the back.

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The murder also shines a light on another ugly and shameful aspect of US culture: despite being by far the world’s wealthiest economy, and spending more on healthcare per capita than any other developed country, the healthcare provided to Americans is by most measures the worst among the world’s rich economies. And as the murder showed, many in the US blame this failure on the country’s health insurers.
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