Healthcare Vigilantism

 

 

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!