Do you have
healthcare insurance coverage? According to the Peter G. Peterson Foundation,
most Americans (92%) have some form of coverage. This number accounts for
approximately 305 million people. However, that leaves 8% or over 25 million without insurance. The Affordable Care Act (Obamacare) allowed many
more to get access to healthcare by removing the pre-existing restriction
clauses and by adding young people to their parents' insurance. Still, the costs
for individual coverage remain out of reach for many. The Supreme Court
decision to remove the mandate for coverage weakened the original plans to
average costs across many generations. High deductibles, common to many
marketplace plans, made access more difficult for some families.
Still, most people
say they are satisfied with their employer-based healthcare. Some plans covered
mandated minimums but little more, while others have expanded their services. Many
of the problems and complaints come from issues of access. Patients must go to
a provider in their plan, or have to pay more or have services denied. At other
times, the insurer requires a second opinion or offers few specialty choices. If
a denial is appealed, a subsequent decision may be delayed. These are the
concerns that lead many to speak out about the lack of care provided by their
plan.
When a person
is in pain, or ill, the last thing they want to do is argue with their insurance
about covered services. Yet too often, this is the case, and care delayed can
be the difference in life or death in cases such as rapidly expanding malignancies,
for example.
I worked for
many years in the healthcare industry and have seen these issues from multiple sides,
Facilities, Providers, Patients, and Insurers. I have audited medical records from
doctors, hospitals, and nursing homes. I know that most try to provide good care
but are sometimes constrained by external forces. Although there is some fraud
in the industry, most claims are legitimate and should be paid as they are
submitted. Managed care organizations (MCO’s) in my opinion, to save money for
their stockholders, brought in the bean counters to measure every aspect of the
patient encounter. For example, some physicians were told they could only
address a single complaint in a visit and not answer extraneous questions.
However, when one is a senior citizen, such as I am, often multiple conditions
are interrelated and must be addressed. Medical visits should not be like
checkouts in the grocery store.
Looking back to
my childhood, I see a different medical picture. Then doctors and others had fewer
tools in their treatment tool box, but still made house calls when it was
necessary. The doctor knew the family and could make a social assessment if necessary.
They knew to ask questions about food security, domestic violence, and loss of
jobs. Today, it is difficult to build up trust and have a relationship with a
provider one sees twice a year for 12 minutes.
This leads me
to the recent issue of vigilantism. The Internet exploded with people
applauding the random killing of a healthcare executive. This man was a father,
a husband, and a respected person in his profession. Just because he worked in
healthcare for a major company, should his killing be justified? What does that
make of us as a society? No matter how disliked his employer is, nothing
justifies his cold-blooded killing.
The basic facts,
as most people already know, the CEO of United Health Care, Brian Thompson, was
murdered on a New York City sidewalk. After an intense search for the suspect, the
police released a photo that was widely displayed. Although he was masked, surveillance
cameras captured enough of an image that led to the arrest of a suspect in
Altoona PA.
There, patrons
of a McDonald’s saw a resemblance with a young customer and called local police,
who arrested a young man after verifying his identity.
Authorities
described finding a written manifesto in his backpack that indicated his issues
with medical care he received before and after back surgery. It included references
to the Unabomber, Ted Kaczynski. This reference was also taken up by the sudden
followers this had on the Internet. Memories are short, Kaczynski was not a
hero, he was a person with grudges and grievances who deliberately wounded
several persons and killed others with his package bombs. Over a period of almost
twenty years, he targeted people whom he believed were harming the environment
or promoting increased uses for technology.
Novelist Maxim Loscutoff
wrote a novel about the Unabomber and the American West called Old King. When
speaking to a high school class about this novel, he learned many of them
considered the Unabomber a hero. In a column for the New
York Times, he describes:
“To many young people living in a system of extreme economic
disparity, in a world they believe is on the verge of ecological collapse, the
Unabomber represents a dark, growing ideological desperation. To them, his
ruthlessly intellectualized turn to violence can seem justified.
But what is lost in this lionization of
one of the most notorious terrorists in American history is that for Mr.
Kaczynski, the desire to kill came first, and the ideological justifications
followed. Lonely rage defined him, and he spent far more time tormenting his
neighbors than he did on his grandiose plans to bring down industrial society.”
“Watching video of Mr. Mangione’s detention, and listening to the
words he shouted to the media, I felt a profound sadness. I saw a young man
with a promising start in life lost in naïve convictions, and poisoned by his
newly formed and corrupt ideology.
Violent men have always gained followers,
but Mr. Kaczynski’s continued influence is mostly intellectual. He had a
showman’s instinct for manipulating the crowd, and intuited that the advance of
technology and collapse of the environment would be the two dominant crises of
the 21st century. He callously identified the environmental movement as being
the most socially acceptable justification for his crimes, even though he
privately denigrated environmentalists in his journals, and proudly littered,
poached and illegally logged on national forest land around his cabin.
Decades later, the health insurance
industry is now a catalyst for rage in contemporary society — denying people
medical care, denying doctors payment and bankrupting patients while making
hundreds of billions of dollars in profit. Its avarice affects people of all
stripes, and the disturbingly widespread support for Mr. Thompson’s killing
online is evidence of the boiling river of resentment running beneath our
streets.
Plenty of young people are alienated from both sides of the political
spectrum, and trying to create their own patchwork philosophies. They’ve seen
little meaningful reform from either political party in their lifetime, get
their information from a wide range of sources of varying reliability and take
pride in forming their own opinions.”
This
explanation does not excuse the actions of this young man who allegedly killed
someone he did not know and had had no contact with. There is no history of him
ever having been a client of United Health Care. He grew up, a young man of
privilege with a recognized intellect, and graduated from prestigious universities.
How did he choose this path? We may never really know as he now seems alienated
from most of society.
The American
Psychological Association describes the emotions that lead to such actions
briefly.
Why some people resort
to vigilantism—to the admiration of many
The psychology behind vigilantism is complex, involving
individual traits, societal influences, emotion, and reasoning
“At the contextual level, their
research shows vigilantes often see their environments as filled with
violations of norms and rules, and they lack faith in authorities to address
these issues effectively. This perception motivates them to seek out and punish
“perpetrators” outside of the formal justice system. “Vigilantes are not purely
motivated by sadism,” Chen said. “To their perception, they are doing this for
public good or to help other people.”
Feeling good about bad
acts
Supporters of vigilantes share the
belief that the justice system fails to punish perceived wrongdoing. Isabel
Pinto, PhD, director of the Social Psychology Lab at the University of Porto,
conducted research showing that when people perceive formal institutions of
social control, such as the justice system, as ineffective, they are more
likely to support harsh and informal measures to punish those they see as
offenders (Pinto, I., et al., Peace and Conflict: Journal of Peace
Psychology, Vol. 30, No. 3, 2024).”
The
Washington Post wrote an editorial about this incident that said in part:
“Those who excuse or celebrate Mr. Thompson’s killing reveal an
ends-justify-the-means sentiment that is flatly inconsistent with stable
democracy. An all-things-are-warranted mindset also animated the mob at the
Capitol on Jan. 6, 2021, and campus
protesters who have hailed the “martyrs” of Hamas — groups very
different in their degrees of moral transgression and practical impact, but
similar in their embrace of extreme measures to right perceived wrongs. To
repeat: Most Americans probably reject this kind of thinking. But social media
makes what would have previously been ignorable fringe expressions more
prominent.
Some
who do not countenance the killing itself have nevertheless tried to treat it
as an occasion for policy debate about
claim denial rates by health insurance companies, an admittedly legitimate
issue. That’s fine in principle, but we’re skeptical that this particular
moment lends itself to nuanced discussion of a complicated, and heavily
regulated, industry.
Controlling
health-care costs requires difficult trade-offs, the essential one being
between access and cost. Insurers, whose profits are capped by federal law,
must contend with consumer demand for ready access to high-priced specialists
and prescription drugs — and, at the same time, premiums low enough that people
can afford coverage. Many dislike the way the nation’s private-sector-led
insurance system manages the trade-offs. But even the most generous state-run
health systems in other countries also have to face them. Certain forms of care
are delayed, or not even offered, to conserve finite resources for the
treatments that are believed to deliver the most value for money
Americans’ best response is to support leaders and
legislation that improve health-care outcomes by restraining premiums, cutting
unnecessary costs and investing in care that works. A debate on one small piece
of this complex set of issues will occur next year, when Congress is to
consider whether to keep temporary Obamacare enhancements that have boosted
enrollment.”
So,
in conclusion, no one seems to have the answers to our health industry costs/care
dilemma, but maybe discussions are getting started. But, whether we solve this
issue now or later, we need to start. We also need to speak out strongly
against violence as a solution to this and other societal concerns.
Before I close, I send best
wishes to all as we enter the holiday season and look forward to the New Year.
Til
next time-Peace!
