Legalized Murder is OK; ONLY In America
Celebrating… || CEO Thompson || Victims of Policy || Operational Practices || Metrics Prove the Malady
|| Progress No More || Where?
Celebrating a Killer is the Wrong Response
I’ve never wished a man dead, but I have read some obituaries with great pleasure.
– Mark Twain
It has been 45 days since an assailant with a 3-D printed gun shot and killed the CEO of United Healthcare on the streets of Manhattan. Immediately, before we even knew the name of the assailant, people were celebrating both the assassination and the supposed hero. Except — at least in my book — heroes do not shoot their presumed enemies in the back.
The reason was not well understood at first. Many assumed the shooter had a beef against the healthcare giant — for some procedure not paid for by the for-profit insurance giant which killed his grandma, or similar — or that this was supposed to represent a rising up against the bloated system designed to make and keep people sick while corporate fat-cats pocketed millions.
Why celebrate political violence? The loudest denouncements came from the political right, with members saying “we don’t celebrate political violence” and similar mantras constantly in front of any camera they could put themselves in front of, especially on Faux News. That is pure irony coming from a paRty which lauds a soon-to-be re-inaugurated criminal who promised to pardon the Jan. 6 rioters who bashed in the heads of police officers and smeared shit on the walls of The United States Capitol.
When it comes to elephant in the room of American social injustice, and why this healthcare CEO’s murder stirred up such deep emotions, we need to peer deeper.
CEO Thompson is Just PART of a Failed System
CEO Brian Thompson (and, to be fair, the company which owns United Healthcare (UH), UnitedHealth Group (UHG)) have a decades-long history of being a bad actor in the drama of an upside down, unjust and unfair system, one that exists ONLY in the U.S. of A.. THAT is what we should be talking about. That is what we, as a nation, should, with purpose, be working toward changing. And though the murder was a tragedy, it is a needle in the haystack of everyday tragedies thrust upon us by a uniquely wasteful and harmful healthcare system.
To start with, UHG is not “good people.” Recently they have been part of an investigation by the Justice Department into anti-trust violations. And for several years — mostly under Thompson’s leadership of UH — further investigations including false claims, overbilling, algorithm use leading to unjust denials, and multiple states investigating those denials.
UnitedHealth Group is worth more than $450,000,000,000. Yes, that is “billion” with a “b”. It did not do this by distributing healthcare. It did this by denying payments and keeping Americans sick. This is not unique to UHG/UH. That is the playbook throughout the entire unjust and only-in-America system.
Victims of Policy
NO OTHER COUNTRY has a system like ours. We are the only advanced/OEDC nation which does not understand healthcare is best administrated as one of “the commons,” like the police, firefighters, schools and libraries, road construction, courts, etc. Treated as a “universal” or “single payer” system, healthcare becomes less expensive. Treatment is equal and not denied because someone makes minimum wage or is homeless (another American crime/injustice I wrote about elsewhere).
And the stories are horrifying.
Consider:
Laura Burnham from Kalamazoo, MI, in a 45mph accident was freed from her vehicle by paramedics and rushed to the hospital. Her insurance co. bill is covering exactly $00.00 for the ambulance ride because it was not pre-approved. She said “I don’t know exactly when I was supposed to pre-approve it, y’know, like after I gained consciousness in the car, before I got in the ambulance or I should have grabbed my cell phone off of the street and called them while I was in the ambulance…It’s just crazy.”1
And yet this type of idiocy happens. Every single day.
Only in America.
Los Angeles teen Nataline Sarkisyan needed a liver transplant to save her life. Payment, thus treatment, was denied by CIGNA. Yet never underestimate the power of community. The story was picked up by a local news station, and it went national. Several top officials of the company, including the Chief Medical Officer, denied the appeal. After a few more days, a liver which would have been perfect to save the teen went to a less-worthy donor who could afford the operation.
During the PR crisis, Kekst & Company was contacted by executive Wendell Potter.
Larry Rand, one of Kekst’s founders, was blunt with CIGNA’s senior executives. “Look, Carol, you have to make this go away,” he told [Carol] Petren in an emergency conference call. “Approve the transplant – now.”
That call persuaded them to overrule their own policies and slightly dent corporate proffits, just this one time, to save this particular teenager’s life.
Writing that he was “relieved . . . for Nataline’s family,” Potter said he felt like a load had been lifted.
“I imagined how joyous and hopeful my wife and I would be,” he wrote, “to hear from our insurance company–which would be CIGNA–that a procedure that might save [his daughter] Emily’s life had been given ‘clearance.'”
He tried to reach out to Nataline’s family to let them know the good news, but they were at a protest put on by the California Nurses Association .. It took a few hours, but he finally got the good news to them, and the hospital began the preparations for the surgery.
“But a few minutes after 10 p.m.,” Potter wrote, “my phone rang at home. There would be no need for CIGNA to cover the transplant after all. Nataline had just died.”2
That, and the dozens of other episodes Wendell Potter dealt with in his years in the healthcare denial industry prompted him to quit and become a loud proponent of the ACA, and an active proponent of a completely changed, fair system. Because, as he explains in his book3, companies do not make a profit distributing care, however necessary or fair it may seem to the rest of us.
Only in America.
Sarah Broughton, 20, was the kind of person you would want as your neighbor. She put herself through school to become a social worker who wanted to do good and take care of those less fortunate; those most of us brush to the side, and make invisible in our daily lives, namely special needs children. I’ll let US Representative Ro Khanna of CA take it from here:
. . . she came down with a simple sinus infection. Such a condition is usually managed by a primary care physician and an ordinary specialist. However, Sarah did not receive treatment because she could not afford health insurance.
Six months before she fell ill, Sarah applied for Medi-Cal, California’s Medicaid system, but her paperwork kept getting lost. The county was so overwhelmed that her family went through three different caseworkers trying to get medical coverage, but each time they were told to start over. Like more than 28 million Americans without any healthcare, for Sarah, getting sick meant facing crippling medical bills and harassment by debt collectors.
So she ignored the pain, only going to the emergency room when it became too much to bear. By that point, the simple sinus infection had grown powerful, spreading to her brain, swelling it, and causing irreversible damage. It was simply too late. On the day Sarah passed away, her family received a letter saying that her Medi-Cal coverage had been approved. She was doing everything right, but the system failed her. Her life was cut short because the wealthiest country in the world has not yet prioritized healthcare.
The question is: Should a young woman who is 20 years old die of a simple sinus infection in the United States of America? If we care about the lives of people like Sarah, if we believe that healthcare is a basic right, then it is long past time to have Medicare for All. Every American should be guaranteed decent, basic healthcare from the day they are born.
What you have just read was from a transcript in the Congressional Record4.
And this happens in only one otherwise advanced country in the world.
Only in America.
Operational Practices
Not only are the stories of the pain caused to individuals by our unjust and wasteful system heartbreaking, the operational practices should be making your blood boil.
If you think the healthcare industry here is on your side, consider:
Humana created bonuses for doctors who would uphold the highest review denial rates. Dr Linda Pinot left the company because she became disgusted by the blatant injustices she was part of, where a minimum of a 10% denial rate was the mantra. “Any payment for a claim is referred to as a ‘medical loss’, that’s the terminology the industry uses”5.
In other words, denying people sometimes life-saving healthcare is good business.
Only in America.
Consider people who were approved for procedures then denied during “underwriting” because of once having a yeast infection, or even having a broken foot although the condition denied was treatment for a brain aneurism, even having been skiing 2 years previously — despite there being no connection. In addition, treatments & medications can be denied despite being well-established and long-established and medically accepted treatments & medications which are accepted by the entire medical community; these become labelled “experimental” and appeal after appeal keep life saving care until the insured patient dies. Yes, this actually happens. Or just imagine being denied treatment for cervical cancer because you are only 22, and the rejection reason was the patient is “too young” to have developed that malady (although that young is moderately rare, it does happen, even if not caused by HPV).
That happens, every day, because of the unjust system we have in place.
Only in America.
After Thompson’s murder, the UHG Facebook page posted the usual “…deeply saddened…” stock response citing him as a “..highly respected colleague and friend..” and that they were working with police and their hearts go out…blah..blah..blah. Of course the tens of thousands of people who were harmed during Thompson’s 10 years at the helm of UH were not mentioned. That post was taken down after over 21,000 laugh emojis were posted in response6.
So, my question is this:
Why Is This Not Called Legalized Murder and/or Torture?
After all, the entire industry, right down to the scam of Medicare Advantage for seniors, is in the business of NOT providing care, just bilking citizens out of their (and their employer’s) money, running up the costs for us and for companies, then spending millions to convince us it’s all in the interest of us, the consumer. What we need to start doing is pointing out not only these facts, but that UH was the provider with the worst coverage percentage rate. Maybe that is why Thompson was targeted.
Jacob Weindling writes
Violence is antithetical to a functioning society, and if we can just go around assassinating whoever we want, then human civilization has failed in America. But why does this violence, of pulling out a gun and deliberately killing someone, resonate more with so many than the violence doled out every day by Brian Thompson’s company?
Denying insurance claims is violence. The astronomical cost of health care in America forces people to choose between death and bankruptcy every year, which is exacerbated by insurance companies trying to weasel their way out of their commitments in the name of profit maximization. A 2016 study found that the cost of cancer care is nearly as deadly as cancer itself. We don’t think of this kind of stuff as violence because it is baked into our assumptions about how a capitalist society functions, but that doesn’t make the impact of this system on people any less violent7.
Metrics Prove the Malady
There are 535 members of Congress, and over 2,400 healthcare lobbyists. And where we have 1 million physicians, there are 1.4 million people employed by the health insurance industry to deny care to patients and pay to providers, stifling smaller practices who often have to take out predatory payday loans to keep their businesses afloat (conveniently offered by subsidiaries of the very same insurance companies8).
And there is only 1 place in the world which has a titled position called a “denial nurse”9.
Only in America.
Where does this get us? Citizens of countries with proper healthcare systems live longer than citizens of the U.S. of A. If you were a Canadian you could be expected to live 3 years longer than your American neighbors to the South. Why? Because their system simply works better, is much more fair and less expensive.
The World Index of Healthcare Innovation’s Commonwealth Fund reports:
Despite having the most expensive health care system, the United States ranks last overall compared with six other industrialized countries—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—on measures of quality, efficiency, access to care, equity, and the ability to lead long, healthy, and productive lives, according to a new Commonwealth Fund report. While there is room for improvement in every country, the U.S. stands out for not getting good value for its health care dollars: it spent $7,290 per capita on health care in 2007 but ranks last among seven countries. The Netherlands, which spent $3,837 per capita on health care that year, ranks first10.
The Kaiser Family Foundation notes “Generally, the U.S. performs worse in long-term health outcomes measures (such as life expectancy), certain treatment outcomes (such as maternal mortality and congestive heart failure hospital admissions), some patient safety measures (such as obstetric trauma with instrument and medication or treatment errors), and patient experiences of not getting care due to cost11.”
Among 11 OECD industrialized nations, we are dead last in healthcare performance.
1 | United Kingdom |
---|---|
2 | Switzerland |
3 | Sweden |
4 | Australia |
5 | Germany |
6 | Neatherlands |
7 | New Zealand |
8 | Norway |
9 | France |
10 | Canada |
11 | United States |
12.
The World Index of Healthcare Innovation ranks us #32 in fiscal sustainability. Yet despite #Fuckublicans constantly saying their main concern is “the kids,” we rank 33 in infant mortality, below such countries as Latvia and Slovakia, Slovenia and Estonia13.
Among The Organization for Economic Cooperation and Development (OECD) Better Life Index of nations, life expectancy here is 78.9 years. That is below that of Czechia, Chile and Slovenia. Each and every other country ranking higher have single-payer or universal healthcare systems14.
Progress No More
I do not know if you’ve noticed, but I do seem to blame one paRticular political paRty for this dysfunction. Because what I hate is hypocrisy. Do you state loudly that your paRty is for “fiscal responsibility”? Do you constantly rally against “government waste and inefficiency”? Then booting the for-profit healthcare system should be on the top of your agenda every day while you are in office supposedly to serve the people.
But what have I heard from friends and relatives who consider themselves Republicans? Just a few weeks ago while discussing this with a cousin (whom I love, but disagree with on maybe 80% of everything) said, and I quote, “That is socialized medicine, so that is socialism and we don’t want socialism.” I couldn’t even get her to listen to rational points posted elsewhere in this post. Some people are bricks, who listen only to respond, some people are sponges, who listen only to listen, think, and either support or change their mind. And some, like my cuz, can only think deep enough to repeat the mantras they hear in entertainment media like Faux News, OEN and Newsmax.
And yes, I do strictly blame Republicans.
Let’s go over the history: each and every effort made by members of Congress on a national level and legislative bodies on state levels to make things better are fought against by #Fuckublicans. Let us please not forget there have been 63 efforts to overturn the Affordable Care Act, which made (minor) strides to make the system more fair and equitable15 and they even shut down the government for 16 days because of their ACA temper tantrum16. That is the 3rd longest shutdown in our history.
The ACA included funding which would have helped states to both pay for and collect use taxes on healthcare for the disabled, homeless and low income people amongst us. But in a country run mostly by #Fuckuplicans, that is antithetical to the Common Good. Proof? Only in Republican run states was there an effort to not be given the money to expand services. 10 states, bastions of Republican Redness (and weirdly including Wisconsin)17 went to the Supreme Court to prevent the helping of people in their states. Unfortunately for all of us, those states won, being granted exceptions to be able to reject the aid.
For more information on these efforts, read this Fact Sheet
So, let’s put this in the perspective of a hospital. Someone in a gap who cannot afford insurance and makes more than the Medicaid max, breaks their leg. The hospital uses its resources to repair and stabilize, costing the hospital thousands of dollars. Not being able to bill insurance, the hospital eventually puts the patient bill into collections, which destroys their credit and makes getting apartments and sometimes even a better paying job more difficult. The hospital has to eventually write this off as a loss, and the state is never able to collect taxes on the procedures.
Everyone looses.
Does that sound like fiscal responsibility, the great bugaboo of the Republican Party? Let’s count the ways …
Medical debt — something not part of any other countries’ system — is the #1 cause of bankruptcy for families in the US18. That is not because Americans or American families are fiscally irresponsible, it is because someone had the gall to be involved in a slip and fall, an auto accident or get diagnosed with late-stage cancer.
Let’s talk administrative costs. What percentage of every dollar goes to administrative costs in our for-profit system? Roughly 17%. For Medicare? 1.1%. Why is that? It is because Medicare does not spend millions on television commercials, radio ads, newspaper and magazine ads, billboards and ad flyers pushed into our magazines. Nor do they have costly stock buybacks, executives paid with golden parachutes worth hundreds of millions of dollars, stadiums called “Medicare Field,” corporate jets or bonuses for administrators who reject the most claims.
In our system, we spend roughly $4,000,000,000,000 on healthcare every year. With a proper system, we could save $200,000,000,000 on administrative costs and still have money to fund vision care, dental care, mental care, and stop bankrupting our families.
Fiscal responsibility?
In the United States, we have to have extra expenses to run businesses and have employees. It is a system which drains businesses of billions of unnecessary dollars every year. It is called liability insurance. When I owned a medical staffing company, even at the smallest amount of contract employees, the liability insurance was stifling. Without it, we were in massive jeopardy. With it, we were left with too little money to pay for a proper marketing agenda and other business-friendly needs. Basically, we were fucked and closed down.
More proof? In Detroit, Dodge made the Durango. Across the water in Windsor, Ontario, they also made the same vehicle. The workers in both plants were well paid, unionized and had healthcare. But because the workers in Detroit had their healthcare partially paid for by Dodge, PLUS Dodge had to pay for liability insurance in case one of their workers was injured on the job (again, no other country has this), the Durango vehicles made in Windsor, even after being shipped across the Ambassador Bridge, cost far less and became more profitable for Dodge.
Isn’t that fucked up?
Well, it doesn’t have to be. It all depends on how you vote.
Where?
It is true the stories above may not effect you. If the conduction system of your heart is not pulled by these uniquely American healthcare horror stories, there are many, many more to be found19. When will you finally give a fuck? Will it be when someone you like or even love dies or becomes bankrupt from this bass-ackward system? Or maybe when it happens to you?
Quite frankly, I hope not.
But it happens, here, on a daily basis.
Only in America.
- https://www.youtube.com/watch?v=YbEQ7acb0IE 9:36 to 10:18 ↵
- Hartmann, Tom, The Hidden History of American Healthcare: Why Sickness Bankrupts You and Makes Others Insanely Rich, p. 23. See also https://abcnews.go.com/GMA/CancerPreventionAndTreatment/story?id=4038257&page=1 ↵
- Potter, Wendell,
- https://justfacts.votesmart.org/public-statement/1239939/medicare-for-all#.XL3hpehKg2w ↵
- https://youtu.be/YbEQ7acb0IE?si=MhcK4eHgmoUTzPmK&t=1099 18:19 to 19:20 ↵
- https://bsky.app/profile/kylietcheung.bsky.social/post/3lcjzf4qhuk2w ↵
- https://www.splinter.com/who-is-allowed-to-kill-in-america ↵
- https://youtu.be/frr4wuvAB6U?si=FjHf2fXFasfFY4qH ↵
- https://youtu.be/frr4wuvAB6U?si=AGTCTZ03Z6YGJ5-u at 5:40 ↵
- https://www.commonwealthfund.org/publications/newsletter-article/us-ranks-last-among-seven-countries-health-system-performance#:~:text=U.S.%20Ranks%20Last%20Among%20Seven,ranks%20last%20among%20seven%20countries ↵
- https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ ↵
- https://www.citizen.org/article/dead-last-u-s-health-care-system-continues-to-rank-behind-other-industrialized-countries/ ↵
- https://apps.who.int/gho/data/node.sdg.3-2-viz?lang=en ↵
- https://www.oecdbetterlifeindex.org/topics/health/ ↵
- https://www.newsweek.com/houses-63rd-attempt-dismantle-obamacare-fails-also-422418 ↵
- https://en.wikipedia.org/wiki/2013_United_States_federal_government_shutdown ↵
- https://www.kff.org/status-of-state-medicaid-expansion-decisions/ ↵
- https://www.abi.org/feed-item/health-care-costs-number-one-cause-of-bankruptcy-for-american-families ↵
- https://www.google.com/search?q=american+healthcare+horror+stories&oq=american+healthcare+horror&gs_lcrp=EgZjaHJvbWUqBwgAEAAYgAQyBwgAEAAYgAQyBggBEEUYOTIHCAIQABiABDIICAMQABgWGB4yCAgEEAAYFhgeMg0IBRAAGIYDGIAEGIoFMg0IBhAAGIYDGIAEGIoFMgoIBxAAGIAEGKIEMgcICBAAGO8FMgoICRAAGIAEGKIE0gEJODEzOWowajE1qAIIsAIB&sourceid=chrome&ie=UTF-8 ↵