UnitedHealth

UnitedHealthcare collected premiums from fifty million members. Law required paying eighty-two to eighty-four cents per premium dollar in claims. The remaining sixteen to eighteen cents covered costs and profit. On three hundred billion in premiums, that margin equaled roughly fifty billion in profit. The math was simple. The margin was law. Optum was the second division. Two thousand clinics. One point four billion prescriptions processed yearly. Optum generated two hundred billion in revenue. The design was deliberate: UnitedHealthcare collected premiums from patients. Optum delivered care and managed pharmaceuticals. Both were owned by the same parent. Money flowed from insurance division into care delivery division. One company, two profit centers. Vertical integration created a hidden advantage. When UnitedHealthcare denied a claim to an outside hospital, the savings went to corporate reserves.