Alternate Title: Canary in the Coal Mine?
Many Americans are pleased that the CEO for America’s largest health insurer was assassinated in Manhattan last week. That is the state of American healthcare in 2024.
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Social media and TikTok videos galore. A Reddit thread of nurses piled on. Below is a lookalike contest of the gunman held in Washington Square.
“Who Likes Their Private Health Insurance?” was an article idea I’ve wanted to do for a long time. but didn’t think it was worth it. I wasn’t around for the healthcare debate of Obama’s first term, but I know it was an epic saga that got watered down from what was originally a Republican plan. The opposition to it essentially came from Americans content with the status quo.
I just could not get my head around that. I had been frustrated with health insurance ever since moving to the United States in 2019. As a single twentysomething, I had health insurance from a Fortune 500 employer for a few years, then didn’t have it as a grad student bartender.
In South America, I mostly didn’t have insurance. You can show up at a hospital, get care and pay the bill out of pocket. I did that even for pregnancies and surgeries. Once I had three children I started buying health insurance, but not having it isn’t financially reckless like it is in the States. If you go naked in America, you could lose everything, even without a family.
Fast forward to 2019, as a self-employed head of household, I don’t have an employer to provide insurance for my family of five. I have to buy it as an individual. Sometimes my wife gets a job and we have to switch everything over to the company plan. And then she’ll miss the children and quit the job, forcing me to go back to the drawing board. It was a minor pain, but a pain nonetheless.
Then I got hit with a denial of coverage. I tried to fight, but it was truly Kafkaesque. There is no right or wrong, and there is no human on the other side. You don’t get anywhere. You either capitulate or take a hit to your credit score. All in it cost me about $5000, for a completely routine treatment, something so common it’s not worthy of mention. It would have been less than $50 in Peru.
Five thousand hurts, but it’s a hit I can handle. It strikes a deep fear in what could happen, what else they could deny. It’s a huge source of stress and worry hanging over your head. I considered dropping coverage and allocating the money I was paying for insurance into a high-yield money-market account. I was advised against this. What if I was hit with a real emergency? Like cancer or a catastrophic accident? You have to pay for health insurance unless you have millions stacked up.
I never wrote “Who Likes Their Private Health Insurance?” because I thought nobody would care. Nobody likes it, but nobody really cares. I was wrong. Apparently people do care.
There are a lot of people out there who my hit would cripple for months or more. There are a lot of people with their own stores, worse stories. Hundreds of thousands who go bankrupt every year. Studies estimate between 40% and 67% of personal bankruptcies in the U.S. are caused by medical bills. That’s insane!
- Four of every $10 spent on healthcare goes to insurance companies.
- The healthcare industry accounts for over 17% of the American economy.
- Americans per capita spend twice as much as the rest of the developed world, with the worst outcomes in terms of life expectancy and chronic disease.
Our healthcare economy kills entrepreneurship. This is supposed to be something we are the best at, but the number of Americans who own their own business is at an all-time low. As an entrepreneur, I understand exactly why. It’s a huge risk to go without employer insurance, especially if you have a family.
I feel obliged to pay the standard lip service about “Thou shalt not kill.” I want to feel sorry for this guy. He’s about my age, an elite corporate executive. Probably treated people around him kindly and with integrity. His children are now fatherless. The public celebration of his killer must be wrenching for his family.
On the other hand, there is a balance in blood and money on the industry’s books. A lot of the comments mentioned how much economic hardship on the masses while this guy was among the top 0.01%. It sounds noble to say you can’t put a dollar figure on a human life, but we effectively do it all the time in litigation, particularly class actions (good look in Netflix film, Worth).
There is also a balance in blood. By denying coverage, how many days, months and years did UnitedHealthcare shave off of the lives of their clients? They certainly saved some lives too affording coverage they didn’t have to, but it’s safe to say they’re in the red overall. Compare that number to how many days the gunman took away from Brian Thompson. If I had to guess, UnitedHealthcare probably owes more employee life to the death side of the ledger.
The negative balance on the books would explain why society is almost happy about this assassination, and the story could serve as a canary in the coalmine for our politics. We have a nutty system that doesn’t make sense for most people. But unlike, say, the nonsensical laws on guns, this one has many more victims who cross demographics and political lines.
As an American, I myself know the instinctual contempt for anything that smells of socialism. I had it as recently as 2020 when “Medicare for All” was bandied about. But today’s political lines are very different from Obama’s first term, since the realignment of the Republicans toward the working class. Healthcare reform could be a wedge between the old corporatist Republicans and the ascendant MAGA wing.
I recently made the argument for and against the Democrats pressing ahead with a hard-left, “eat the rich” kind of economic populism after losing the 2024 election to Donald Trump. Healthcare reform could be the kind of lightning rod issue that Republicans can’t answer.
Maybe the new Republican party would roll with the punches. Donald Trump has ever worried about a medical bill in his life, but JD Vance has. And Donald Trump is astute enough to know his base has does.
I’ve heard Trump fans allege he would confront Big Pharma. All said and done, he did more for their bottom line than any president in my lifetime (Trump or maybe George W. Bush). At some point you have to deliver on economic populism. Eventually anybody will see through bullshit.
I opposed Donald Trump’s movement from the beginning, but it’s important to set the example and show that we moderates are willing to see what he can do to improve the nation. He may be the crusader for the common man many people believe he is, the perfect leader uniquely placed to drag Republicans away from the corporate status quo. Let’s see if the new Republican Party can walk the walk.
There are many ways to skin a cat, but in the end we’re talking about a guaranteed public option. “Health care: America vs. the World” offers a good look at systems in Canada, UK, Australia, Taiwan and Switzerland.
There are tradeoffs. I’m always loathe to say any issue is all so simple because it’s good vs. evil and we just need to choose good and afterward everything will be fine. But it’s clear that our healthcare system is a mess, and a lot of people aren’t happy.
Maybe nothing happens as usual, but the outpouring of support for a murderer feels very different. Feels like something real is underneath. Is this assassination a canary in the coalmine for healthcare?