UnitedHealthcare is facing a flood of scrutiny—and it deserves it. The Department of Justice is investigating the company for alleged Medicare Advantage fraud. Patients are seeing record levels of claims denials, even for essential care. Shareholders are suing. And secret payments to nursing homes to discourage hospital transfers have raised serious ethical red flags.
This isn’t just a bad press cycle. It’s a reckoning—and long overdue.
Insurers like UnitedHealthcare have grown far too powerful, effectively holding the healthcare system hostage. They determine which treatments are approved, what providers get paid and how much, and how long patients wait—all while operating with little transparency and even less accountability. These actions are not harmless inefficiencies; they cause real suffering and disillusionment among both patients and providers.
But the truth is finally coming to light.
UnitedHealthcare sets the tone for the entire health insurance industry. What it does, from how it processes claims to how it’s using vertical integration to essentially print money, others follow. For years, they have managed to maneuver largely unchecked, despite some legal skirmishes along the way. But now it seems cracks are beginning to show, and the whole system is feeling the tremor. It’s both a crisis and an opportunity.
Hospitals and health systems are the ones who must absorb the financial and emotional fallout of insurance-driven dysfunction. As the public grows more aware of the harmful actions insurance giants are taking, there is an opportunity to reassert providers, the real face of the healthcare system, as the true champions of care.
The message should be clear: hospitals and health systems are not the problem. They are forced by behemoth organizations, like UnitedHealthcare, to operate within the dysfunction if they have any hope of being paid for the work they do.
The public is watching. They are frustrated, confused, and hungry for someone they can trust in a system that increasingly feels rigged. Systems have the chance to rise to that challenge—to lead with compassion, transparency, and integrity.
UnitedHealthcare’s unraveling isn’t just a headline—it’s a turning point. The insurance façade is cracking. Now is the time for those who truly care for patients to take center stage. Health systems should continue being vocal when outstanding AR days are egregiously excessive, or when delays and denials routinely interfere with patient care.
And patients deserve better. No one in the middle of a healthcare crisis has the time or energy to fight with an insurance company—and that’s what insurers count on. Yet data consistently shows most appeals are decided in the patient’s favor. Giants like UnitedHealthcare use their size and scale to intimidate providers and members into compliance when that power dynamic should be flipped.
Maybe, just maybe, we’re at least on the way to gaining more balance.
