Our pre-op diagnosis was acute appendicitis, but the patient actually had a ruptured Iliac artery aneurysm. Instead of an hour’s procedure, I was in the OR most of Saturday morning and afternoon repairing the aneurysm. The memory of that Saturday ordeal came flooding back to me on hearing that an insurance company planned to henceforth limit how much anesthesia time they would pay for — as if any physician wants to spend any more OR time than is absolutely necessary.

In other words Anthem would determine how much time patients could remain under anesthesia. “What a mad idea!” flashed through my brain. “What Martians make such decisions?” kept going round and round in my head.

Health care in the United States seems to dizzily skip from one lily pad to the next, uncertain about what it is about, while insurance executives invent new ways of sucking the marrow of the last drop of profit. The public at large is left aghast and discombobulated, unsure of what to do. And whoever else is powerful seems incapable of righting this ship.

The murder of Brian Thompson, CEO of UnitedHealthcare, in New York City reminded me of the absurdity of our health care system. It seems better geared to cause more pain than to actually offer balm. But killing one executive will not change the current health care paradigm and, no one is advocating the wholesale murder of health care insurance executives. However the evidence on the social media demonstrates the raw, deep anger at these companies whose profit is based on giving less, denying more and more benefits and care, often causing harm to their clients, that’s opposite to the health care profession’s credo — “do no harm.”

Unlike any manufacturer, UnitedHealthcare has no products to show. Despite that, its finances are mind blowing. With a 32% denial of service rate — highest in the industry in America — the company is worth $560 billion. Its 2023 revenues were $281 billion. With astronomical denials under Thompson, United Healthcare’s profits rose from $12 billion to $16 billion in 2023. For that Thompson was paid $10 million in 2023 as compensation. It’s a common occurrence; other health care companies’ CEOs rake in astronomical incomes.

I have previously written about Dr. William McGuire, the United Healthcare CEO who received the biggest golden parachute — $1.6 billion — on retirement. I have always looked back at Dr. McGuire, a former physician, spending 15 years cutting back on what his former physician colleagues and patients received. In our Kafkaesque economic-scape, health care insurance companies see American patients as a cash cow that will never stop producing. Indeed, to look at the financial returns of other health care insurance companies, the cow’s milk continues to flow. The question is: if today United Healthcare’s denial rate is 32%, will it keep climbing? What will be the optimum denial rate — 50%?

Insurance company executives, and other health care bean counters are the lords of the new empire: The Empire of Malady and Service Denial. We have a cadre of men and women — the majority never went to a medical school; have no idea what happens in ERs or in ORs; have never sweated over a procedure going bad — deciding life-saving physicians’ monetary worth.

The amounts of money they pay themselves obscenely increase the yawning American income gap to a point where many physicians are tempted to quit “serving the machine,” while patients’ lives, upended by denials, are driven to suffer indescribable pain.

Speaking as a physician who has saved more lives than I can count, I resent that people in offices somewhere view my work as so unworthy as to pay me peanuts while they reward themselves the whole farm. It is an emotion felt by the majority of American citizens and American physicians who treat them, who are getting progressively tired and fed up. We need them whole, more than we need the bean counters.

Many Americans do not admire health care insurance executives who replaced physicians from their duty of health care. When citizens resort to cold blood solutions, leaving behind bullet shell casings with: deny; delay; depose inscribed on them, it’s a warning that the time has come for wise, more practical solutions.

Maybe it is time for a new political party — one given to solving the American health care conundrum. If a party dedicated to abolishing abortion could succeed in doing so, “Americans for a sane health care” might succeed in changing how we are treated by those who promise to be the new guardians of our health.

Pius Kamau, M.D., a retired general surgeon, is president of the Aurora-based Africa America Higher Education Partnerships; co-founder of the Africa Enterprise Group and an activist for minority students’ STEM education.