My sympathy is not in-network

To the general public,

We are offering a reward for information on the suspect. The reward is very large—it is almost enough to cover your family’s deductible.

In fact, if you catch the perpetrator yourself, the copay on your next annual physical will be waived. Note: If you already pay us a monthly premium that covers your annual physical, congratulations: you don’t need to claim this reward.

We recognize that, while all our current resources have been redirected at this case, there are many other cases that need to be investigated—and often go ignored. We ask you to remember that this particular case is worth much more to our shareholders.

When considering and discussing the world’s largest private companies and the suffering they impart, please remember that your enemy is not the CEOs. Your enemy is the AI program that decides whose coverage gets denied, which was simply created and deployed by the CEOs.

Now is not the time to be flippant about death. Please. That’s what the last 100 years were for.

This moment is different. It is tenuous. It has thinned the veil between the projected reality of stability in our system and the house of cards built by an abject disregard for humanity that lies underneath. Do your part—help us strengthen that veil.

You can be a hero. Help us find who did this and hold them to account, and we will include an Amazon gift card with your next hospital bill.

Thank you for your cooperation and understanding at this time.

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To whom it may concern,

My sympathy is not in-network.

By that I mean: if you’ve filed a claim for my sympathy, that claim will be denied. Press four to consult a preferred list of sympathy providers.

Thank you for your cooperation and understanding at this time.

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How to deny people healthcare with #empthy

An excerpt from my satirical essay collection This Won’t Help, a New Yorker best book of 2023:

Here at Althinea Health Partners (a subsidiary of Amrexa), we have one crucial mission: We’re out to prove that you can deny people health care with empathy, kindness, and support. As one of our representatives, we believe that when dealing with patients, either online or in person, your number one duty is to let them know that even though their lifesaving procedure may not be covered, they are still #Valid.

Here’s a useful set of phrases you can start putting into practice today.

• We stan an appendicitis queen! Unfortunately, your #GirlBoss abdomen is not covered by your insurance. But we believe in you, you bad bitch!!

• You are seen. You are heard. And most importantly, you are no longer allowed to stay at our facilities because we don’t take Medicaid—or any other kind of insurance. Slay!

• No cap, you’re basically our BFF. But even our BFF has to pay in full for SSRIs. Need to use a credit card? That’s gucci with us!

• Wow, a soft tissue infection, asthma, and a concussion? You’re a true triple threat! Get out of our hospital and go make your mark on the world, king!

• Oof. We heard about your heart palpitations. And just so you know, our hearts are palpitating for you. You’re a perfect ten in our book. But you’re not on our books. Please leave.

• Zomg, your arm sling is on fleek! We need it back, though, because your coverage got denied. Don’t worry—we won’t give it to someone else! We’ll throw it in the biomedical wastebasket instead. Go find a ripped T-shirt or something, those work great.

• No matter how bad your cough is, you are worthy. Worthy of respect, not health care. There’s a bus to another hospital in two hours.

• LYLASWHHBP!!! (Love You Like a Sister Who Has High Blood Pressure!!!) Srsly tho, we’re gonna need you to GTFO.

Please remember that not all our patients will understand right away how truly #Valid they really are. It may take them time—time that we here at Althinea Health Partners don’t want to admit we have. So use as many of the above phrases as you want, but make sure they’re off our property within fifteen minutes after you find out that they can’t pay us. If you fail to follow the above guidelines, we will deny your paycheck. TYSM!!

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My book This Won’t Help is on sale right now. Buy it in bulk.

My award-winning essay collection This Won’t Help is on sale right now on Amazon (even I can’t escape the billionaires—and, like any good American, believe I can become one) and it’s available at full price (with an even fuller sense of justice) at Bookshop.org. Better yet, go to your local bookstore. If they don’t have it, ask them to order a few (hundred).

Read it already? Leave a (honest-but-full-of-endless praise) review

This Won’t Help was a Foreword INDIES Gold winner in humor and landed on The New Yorker’s Best Books of 2023 list. But institutions aren’t people — people are people. (At least, they were before Citizens United.) If you liked This Won’t Help, you can give big middle finger to Citizens United and go leave the best review you can muster over on Amazon and Goodreads.

Here’s what some folks have said about This Won’t Help:

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What I’ve been reading

Last year’s report from Ars Technica about UnitedHealth’s use of an AI model that denies care with a “90 percent” error rate:

“UnitedHealthcare, the largest health insurance company in the US, is allegedly using a deeply flawed AI algorithm to override doctors’ judgments and wrongfully deny critical health coverage to elderly patients… The use of faulty AI is not new for the health care industry… But, what sets this situation apart is that the dubious estimates nH Predict spits out seem to be a feature, not a bug, for UnitedHealth.”

A PBS report on a similar rise of denials:

“If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims—sometimes bundles at a time—without reviewing the patient’s medical chart. A job title at one company was ‘denial nurse.’”

Jia Tolentino’s of-the-moment piece for The New Yorker:

“The only way to end up in a situation where a C.E.O. of a health-insurance company is reflexively viewed as a dictatorial purveyor of suffering is through a history of socially sanctioned death.”