Is Product Management Partially to Blame for Recent Healthcare Headlines in the U.S.?

If you’re a product manager and you think these headlines don’t reflect on your work, think again. Every system, policy, and product you launch sends ripples into the world—sometimes waves. When we prioritize cost-cutting over compassion, efficiency over ethics, or metrics over humanity, we set the stage for exactly these kinds of disasters. Ignoring the risks doesn’t absolve us—it implicates us.

1. Anthem’s Anesthesia Fiasco

Anthem’s time-limit policy on anesthesia was a catastrophe waiting to happen. My own wife’s 35-minute regular colonoscopy anesthesia was partially denied—seriously? What’s next? Cutting electricity to hospitals after a two-hour surgery cap?

If you’re a product manager involved in something like this, ask yourself: “What’s the worst that could happen?” And then go find out! Use simulations to test your assumptions before they harm people. Incorporate proactive telemetry to monitor how policies perform in the real world—don’t just launch and pray.

PESTEL analysis can help here:

• Political: What are regulators and governments likely to do if this backfires?
• Economic: How do financial pressures on patients play into outcomes?
• Social: How will this affect trust in your brand or the industry?
• Technological: Are your systems monitoring for unintended consequences?
• Environmental: Yes, even environmental—does this ripple out, e.g., wasted resources?
• Legal: What’s your exposure when patients suffer due to shortsighted policies?

I mean, think about it, if a physician feels the need to hurry up to keep the costs down, something is going to get missed or botched, and any 'savings' gained will go towards lawsuits, brand rehab, and perhaps trying to avoid a trip to 'Club Fed.' Doesn't sound like a winning play to me.

2. AI in Healthcare: Stop Hoping, Start Preparing

AI is amazing—until it isn’t. Automated prior authorization? Sounds great, until the algorithm denies someone’s cancer treatment and there’s no human in sight to fix it. Hope that “it’ll all work out” is a reckless gamble.

Here’s what you can do instead:

• Simulate Failures: Don’t assume the algorithm works. Test it under the worst conditions.

• Human Safeguards: AI should assist, not replace, human judgment. Keep people in the loop for high-risk decisions.

Hope isn’t a plan; proactive telemetry is. This means monitoring AI’s impact both internally and externally:

• Internal Telemetry: Are the algorithms performing as expected? Is there bias in the decisions (e.g., disproportionately affecting specific groups)? Are system overrides and escalation mechanisms functioning in real-time?
• External Telemetry (via PESTEL): Political: Is the system running afoul of regulatory trends? Social: Are we unintentionally harming trust or equity? Legal: Could these decisions lead to lawsuits or compliance breaches?

By embedding telemetry into both internal systems and external dimensions and by adding simulations and human safeguards, you’re not just watching the machine—you’re proactively watching its impact on the world. AI is only part of the equation; your job is to ensure it works for people, not against them.

3. UnitedHealthcare CEO Shooting: Symptom of a Broken System

The tragic shooting of UnitedHealthcare’s CEO isn’t just a freak event—it’s potentially a sign of public outrage against a system that’s opaque, unfair, and dehumanizing. It NEVER EVER justifies violence. Nonetheless, when people are denied care and dignity, anger finds a target—and no one is immune.

Product managers, we’re not spectators here. We design the systems that frustrate, alienate, and enrage people. If we aren’t advocating for empathy, transparency, and fairness, we’re just greasing the wheels of the machine that crushes them.

The Fix: Simulate, Monitor, Adapt, Expand

You don’t get to claim success by crossing your fingers. Simulate, monitor, and adapt—or prepare for your headline moment.

• Simulate Failures: Test your product like you’re trying to break it. Plan for the worst.
• Proactive Telemetry Everywhere: Internally monitor algorithm performance, escalation systems, and operational metrics. Externally use PESTEL to track political, social, economic, and legal risks in real time.
• Design Human Safeguards: AI should assist decision-making, not replace accountability.
• Build for People, Not Metrics: Make humanity—not efficiency—your north star.
• Adapt Continuously: Data is only useful if you act on it. Fix problems as soon as they arise.

You don’t hope systems like these will work. You make damn sure they do.

Additional Reading:

• Anthem BCBS reverses plan to cap anesthesia coverage after time limits : NPR
• Centers for Medicare & Medicated Services issues AI guidance for MA plans as senators ramp up scrutiny
• If your health insurance denies a claim, this tool uses AI to help you fight back - Fast Company
• How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them — ProPublica
• Lawsuits take aim at use of AI tool by health insurance companies to process claims - CBS News
• What to Know About Brian Thompson, UnitedHealthcare CEO Killed in NYC - Newsweek