Murder in manhattan

Health care under assault

The tragedy of Brian Thompson’s murder in New York yesterday represents the coincident and yet diverging experiences of so many elements of our society at present. CEO of United Healthcare, largest health insurer in the country, Thompson was an Iowa small-town guy who went on to a pinnacle of success most people would only dream. Coworkers retold episodes where his brought hometown humor to meetings as a calming technique in a world full of hyper people. At 50, he not only was living the American dream but dying from it, it would appear.

Yes, he was a corporate CEO, paid fabulously more than most of us dream as we queue for lottery tickets. Yes, it was violence probably—speculation here—resulted from his company denying coverage in a society where we have amazing overall resources. That his shooting occurred in Manhattan (New York rather than Kansas), was all the more stereotypical, it would appear.

But it is the violence. It is the sense inequality so pervasive for millions. It is the sense of helplessness that one takes from this action. To my knowledge, we don’t yet have a suspect in custody for the crime which adds to fear and frustration.

People on social media are not infrequently happy about it. Big business is bad these days. It ought horrify each and every one of us that anyone would be neutral over this simply because someone works for a health care insurance company. Seriously?

On the same day as Thompson died, reports began circulating that Anthem Blue Cross, the affiliate for Connecticut, Missouri, and New York, will no longer pay for anesthesia for surgeries that endure beyond specified lengths of time. In other words, bureaucrats of the private sector rather than government types are determining what Anthem will cover rather than the dictates of health care need. The outrage is predictably and understandably deep, loud, and growing.

Brian Thompson, of course, had absolutely nothing to do with that and I am NOT implying he did. Nor is his cold-blooded murder justified. I abhor violence against anyone. It’s one of my deepest sadnesses for our society today as anyone turns to that remedy as a dispute resolution.

But the futility and sense of betrayal millions of patients are anticipating today are real. This perception that “everything is stacked against me” grows as a mentality when this sort of decision is promulgated. Anthem’s choice may not become the policy of other health insurers or it may well foreshadow massive changes in what coverage we see.

Let’s be straight: health care in America is tres expensive. I remain shocked by what some procedures cost. But, we have fought against a single payer government-run health system in the United States because it would be far inferior health care.

Yet, where is health care going? How accessible is it for all? Or do we mean quality health care for those of us able to pay for it? Do we mean that others are not as deserving or that we will pay for them via the Emergency Room route instead of a private MD office?

Reports are circulating that proposals to pare back disability pay for our veterans, drafted or volunteered, are under discussion in Washington. As I heard someone’s comment yesterday, the only upside to this conversation is that the public has no idea how difficult it is to collect military disability compensation as it is since the claimant must prove she or he incurred the disability while in service to our nation, a higher bar than it sounds. Can veterans’s compensation in other forms be far behind?

All of this occurs as Project 2025 advocates promise to end the Affordable Care Act while scaling back on Medicaid, a federal program similarly supporting those who do not receive health insurance as an employment benefit. Americans hate government-mandated health care when it’s called Obamacare but bought into the Affordable Care Act coverage to address their needs should a health intervention become necessary. Those seeking to end the ACA frequently rush to say they will substitute something better than the “failed program” but never do any details of what would be either affordable, better, or even a program emerge. It’s not as if the ACA was a gold-plated government plan but had a decided free market choice involved. But it offered coverage to those with nothing.

How long will it be before Medicare, the vital but admittedly expensive health care provided to Americans in their declining years after they have contributed their taxes, becomes the ultimate target for the choppers?

Brian Thompson again was not responsible for these public policy questions, only for his role as CEO of the largest health care provider. But, too often Americans think in broad categorizations rather than distinguishing detail. I suspect Thompson’s murder will ultimately come down indeed to a distinguishing detail. But he and his company are only a small part of our country’s health care dilemmas.

Last month’s election supposedly came down to people thinking they were paying too much for the essentials in life—at least that is one argument among a true multitude of explanations. Americans, it would appear, sought to return to safety of a different era with cheaper food, fewer foci on culture (whether immigrants, gender, diversification, or anything else), and fewer mandates such as vaccines. We had an election and what is now clearly a slim plurality of the popular vote led to an electoral victory by one party in all three breaches of government. It is their necessity and privilege to govern as a result of that election.

The irony, however, is that sense of safety so many seek to recapture is disappearing daily for too many Americans Two parallel but completely unequal systems, based not on race but on wealth, are becoming all the more evident. For those who can afford United Healthcare and similar private providers, they can access health care relatively easily and upon demand, albeit at a financial cost they can afford. For those unable to pay for private health coverage, public options are diminishing as health costs increase in concert with Americans’s declining aggregate health whether it’s exploding diabetes rates or substance abuse in its many forms. This is outcome is seemingly what the voters supported so we will all live with the consequences.

The nation’s leaders may make some happy with these changes but I suspect we only seeing the beginning of the sense of fundamental panic for too many Americans who will not be able to negotiate these financial changes— along with the sense they are powerless over any of this. The question is will we see actual, demonstrable improvements in the country’s conditions and—more importantly—an understanding that we got here through our choices as a society? Or, is that really the point? Are we no longer a single society where lives like Thompson’s or the drunk on Admiral Boulevard really have no value at all?

I sincerely welcome your thoughts on this column as I don’t have all the answers but see contradictions. I hope we do find Thompson’s murderer soon as I still believe in equal justice under the law. Please tell me your thoughts, however.

Thank you for taking tie to read this column today and any other day. I welcome your thoughts and those of anyone where you share this. I am especially thankful to the subscribers. I hope you’ll consider becoming a subscriber for 2025, whether for a month or all year.

Some of you are cold and snowed in today so I send you warmth and joy from a hibiscus.

Be well and be safe. FIN

Alyssa Lukpat, Julie Wernau, and Anna Wilde Mathew’s, “UnitedHealth CEO Shot Dead in Targeted Attack Outside Manhattan Hotel”, WallStreetJournal, 4 December 2024, retrieved at https://www.wsj.com/health/healthcare/who-is-brian-thompson-united-healthcare-ceo-shot-cc02476c?st=Qmdp11&reflink=article_copyURL_share