Only Anecdotal

We have all been captivated in the aftermath of Brian Thompson’s brazen murder in New York. As the news was announced, many speculated that the gunman was either a frustrated United Healthcare customer or hired by one. As we have seen in the last few days, the apprehended suspect did, indeed, face debilitating pain, though the details of his medical journey have not been made public.

Beyond the reckless gun violence that seems to define our country, we like to think of our society as a morally ethical one. We are a democracy, with laws in place to punish crimes like this, including the vigilante crimes that to some seem justifiable. In the end, this was a murder, the premeditated killing of a human being, and this is without a question wrong.

Some have called the murderer a hero. By this argument, United Healthcare is an evil corporation, and killing the CEO is a statement against all that the insurer has done to harm its customers.

The murderer is no hero.

Whatever the outcome of a trial, however, we cannot deny that the murder has brightened the spotlight on much that is wrong with healthcare in the United States. Despite the high premiums we pay for health insurance, the process of getting medical care approved and funded can seem nearly impossible, especially for those who need it the most.

I have read many arguments in response to discussions lately that insurance is not intended to cover normal care… and in fact, I remember a time, years ago, when this was true. When I was little, my mom wrote a check to the doctor for ordinary visits. Ha! So long ago! Private pay feels quaint now–or exclusive, limited to the private care psychiatrists, med-spas, membership concierge practices. In reality, ordinary healthcare, even one office visit, is largely unaffordable without insurance, and still unpredictable despite pricing transparency laws that have gone into effect since 2021. Reduced prices negotiated for health insurance plans create a two- (or more) tier system with much higher prices for those who want to pay out of pocket.

Insurance or not, the research and study involved in making predictions about costs for care are overwhelming, and harder still to navigate while sick or injured. People are talking about this loudly again, with media coverage and attention from Congress. Anger today is palpable, as if we just realized that the countless hours we spend on hold with our insurers are the experience of nearly everyone, and not isolated incidents. Protests, strikes, marches all seem overdue, but demonstrations have seemed so ineffective to the monstrosity of a system where the decision-makers seem so cut off from ordinary people.

For the last fifteen years, I have seen firsthand that for most people, often very sick people, it is not the illness or condition that is the primary point of suffering; it is the maneuvering necessary to secure treatment and payment for that treatment. How horrible is that?

Worry about payment shocks and all too often, bankrupts people who get sick. Many of us have delayed or deferred care that was not urgent, often due to cost, either defined or potential, and most of us now have fought at least one battle to have our care approved. Copays for ongoing treatment often are a barrier, though some ongoing therapies may cost far less in the long run–and improve quality of life overall. Ordinary devices and services could improve life for so many, but think of all that is rarely covered by insurance: dental care, hearing aids, any sort of long-term care support services (community-based or institutional)… If the human condition includes a certain amount of physical disability throughout a lifetime, a morally ethical society would take our likely need for healthcare into account within the framework of human rights. I am not the only professional who has seen jaws drop as people who have paid for years into a system figure out that the gold-standard plans they paid into for years are more like lead: heavy, impenetrable, and toxic.

Back in 2012, Robert Wood Johnson Foundation, Harvard School of Public Health, and NPR released a study called “Sick in America” (https://www.kff.org/wp-content/uploads/sites/2/2012/05/charts.pdf). It was not the first study of the issue, but it struck me at the time because of what I was seeing, and because the study compared perceptions of medical care and health insurance based on the illnesses and conditions people had experienced. For those who had chronic conditions requiring care for over a year, favorable responses dropped enormously.

Since that time, the COVID epidemic has brought healthcare concerns to the forefront. Several years past then, we have faced the burnout of medical staff, inflation, hospital closings, and an aging population that needs medical care more than ever. We are in trouble, and it has hit nearly all of us close to home. None of what I am saying here is new. The Affordable Care Act may well have eliminated exclusion to payment for pre-existing conditions, for example, but we never managed to remove the greed from the equation. Critics of single-payer systems have long pointed to the evil elements of a supposedly socialist health payment system, named them death panels who would restrict our care. The death panels are the insurers we have now. We all know this, and yet we remain complacent in our swallowing of what capitalism allows to trickle down to us.

I hate the fact that a man was murdered, and hate even more that a man was likely murdered to make a point about greed and the injustices in our healthcare system. Vengeful violence only perpetuates the system.

Many people feel completely helpless to faceless corporations and their enablers. Our country is suffering. The murder of Brian Thompson has highlighted the worst aspects of our country: gun violence and corporate greed. I hope that this time will be different, that changes will come to bring back a system that nurtures its citizens instead of perpetuating a class struggle.

We condemn human rights violations abroad so often, and we have so many freedoms and advantages in the United States. And still, more and more people find themselves locked out of rights because of financial struggles stemming from nothing more than the human condition. What more will it take for us to restore our humanity?