The shooting of United Healthcare’s CEO, Bryan Thompson, has engrossed the public. The shooting itself was a well-planned and audacious act. But when police apprehended the handsome, Ivy League-educated killer, many were disappointed. They were rooting for him to escape.
The killing has proven more popular than I would have expected. Moreover, this popularity is not confined to the left wing. People across the spectrum have shared their frustrations with the healthcare system and found themselves sympathetic to the killer.
An All-American Murderer
When Luigi Mangione’s background and manifesto were revealed, he appeared to have a good life and a promising future. His social media suggested an intelligent freethinker, whose views and motives were neither clearly left- nor right-wing. He had his first significant encounter with the health system after a serious back injury, and the experience seems to have radicalized him.
His crime is a classic example of “propaganda by the deed.” People who acknowledge intellectually that murder is wrong seem totally unemotional about that conclusion. There’s widespread support for the shooter, while the victim has been dehumanized and reduced to a symbolic avatar for the industry and its sins.
Almost everyone has some story of being abused by the modern health insurance system. It’s even worse for the self-employed, who pay out of pocket for insurance. After paying premiums for years, the injured find themselves in a Kafkaesque battle with their insurance company over coverage, copays, and approved care.
The False Promise of Obamacare
It was not supposed to be this way.
Obamacare was supposed to provide universal coverage and make health care more affordable. After all, the law was called the Affordable Care Act. When the Obama administration proposed the law in 2009, it made many promises to sell it to the public and Congress.
One of the more famous ones was that “if you like your doctor, you can keep him.” Another was that if you like your insurance, you can keep that too. Finally, we were told this law would make us all healthier, as uninsured people would no longer wait until health problems became catastrophic before seeking care, typically in the emergency room.
This was the signature initiative of the Obama presidency, and the law has done none of these things. Care has become significantly more expensive. The quality of care has also gone down, with out-of-pocket expenses rising because of higher deductibles and out-of-pocket limits. Doctors are frequently dropped from plans, leaving patients unable to maintain continuity of care with those whom they have come to trust.
The country has not gotten any healthier, in spite of the enormous amount of money changing hands. The complexity of Obamacare has also led to the proliferation of highly paid billing specialists, administrators, and other overhead, none of which contributes directly to better care, but all of it costs money.
Employer-provided plans—which people like because they’re not taxed as income—remained largely untouched, with government workers receiving some of the most generous benefits of all.
Obamacare modestly expanded the percentage who had insurance coverage by loosening the requirements for Medicaid eligibility. It also mandated a complex system of income-based cross-subsidies within the individual insurance market.
Under Obamacare, people making more money paid full freight for themselves and also paid additional amounts to subsidize those at lower incomes. It did not take a lot of income until the full premium became due—the so-called “Subsidy Cliff”—often cutting dramatically into the profits of those who started small businesses or were self-employed.
This punishment of success and initiative was the most pernicious aspect of the law, a blatant giveaway to preferred Democratic constituencies and insiders, while also functioning as a de facto war on small business.
The Healthcare Experience Has Gotten Worse for Most People
There was, in fact, a robust system of individual insurance before Obamacare. I know because I had it. Back then, I was paying $200 a month for a plan with broad coverage and a $2,500 out-of-pocket limit. A few years into Obamacare, that plan just went away when my insurer canceled it without explanation.
Its replacement was $500 a month and had a $5,000 out-of-pocket limit. Blue Cross has raised the premium annually, but it was the best among a series of bad choices. It now costs $700 a month and has a $7,400 out-of-pocket limit. Those caps double if I go out of network for some reason.
Is the average person going to be able to pay $8,400 a year and also come up with another $7,000 if something bad happens? Also, these numbers double when a family plan is involved. In spite of having Obamacare coverage, large out-of-pocket expenses mean that many people are effectively uninsured.
At the time of the law’s passage, critics (on the left) said that mandating universal insurance coverage would simply be a giveaway to the insurance companies in the absence of a “public option.” By competing with private plans, the public option would serve as a price ceiling. The critics had a point.
Expense is not the only defect of Obamacare. There is also the massive, frustrating inconvenience of dealing with insurance companies. Doctors and patients alike have been worn down by the process. Wait times are long, customer service is indifferent, foreign call centers are common, and the decision-making rules are completely opaque.
Like most people, I’ve spent multiple hours wrangling for coverage of drugs and other care. It is exhausting, and it’s exhausting by design. The goal is to wear out customers and their doctors with long wait times, byzantine review processes, and incomprehensible paperwork requirements.
Even though a well-intentioned law was passed requiring price transparency, the law has no teeth. Thus, it is still nearly impossible to figure out what anything will cost in advance in order to shop around and reduce costs. Any hospital visit leads to months of bills, often from unknown third parties who claim to have provided services.
Obamacare was an overinclusive solution to a single problem: people being dropped from insurers because of preexisting conditions. However, the law ended up wrecking the entire healthcare system, making things worse for the millions of people who were satisfied with their doctors and their insurance.
I do not think Obamacare is a good idea, with or without a public option. Healthcare has become even more of a hybrid of government and markets. As we have seen in defense contracting and higher education, when the private sector and government get into bed with one another, costs go haywire while quality declines.
Today, I expect few people would come to the defense of the system, in contrast to the many who did so in 2008. The COVID episode drove a wedge of trust between patients and the healthcare system. And, even by its own standards, the Obamacare system is failing miserably at providing quality care, universal coverage, and controlling expenses.
In fact, its sustained expense and meager outcomes make people more inclined to look favorably upon socialized medicine, single-payer healthcare, or some other dramatic change to the system.
Luigi Mangione and his fans showed us that millions of ordinary Americans have reached a point of such frustration that they are embracing even darker and more violent solutions to the failures of Obamacare.
Too many Americans believe, or have been brainwashed to believe, healthcare is a right. Back in the day, sitting in Sister Cecilia Marie’s “Social Justice” class, that was the underlying theme. Everything is a right: housing, food, healthcare. All anyone need do is be alive. `Everyone is entitled to these things. No one should have to work for them, nor should anyone have to choose between that vacation/new car/new threads and healthcare for one’s family. All are children of God and therefore entitled to heaven on Earth! Yeah, um, not.
Great arguments arose over the “justice” aspect of confiscating from some people that which belonged to them, and simply giving it to others. What people never consider is that penalizing people who take risks with their capital and rewarding those who don’t leads to a less diverse, less vibrant economy where those capable of innovation or ingenuity are much less willing to take any risks. Society stagnates that way. No progress is ever made. That is the U.S. now. It’s the socialist states of America all brought to you by your government and reckless voters.
Obama’s entire tenure was a disaster for this country and Obamacare was the death knell for what was the best healthcare system in the world. But that isn’t all. Medicare outlays have now overtaken Social Security outlays in the federal budget. Rationing is reality. We told you so. Now, live with it.
When are Americans going to understand that government cannot give you anything? Government takes from others and gives to you. That is fundamentally wrong.
Aside from the many points Mr. Roach makes for the immediate termination of Obamacare, it was Republicans who assisted in the eventual approval of this horrid legislation, and one Republican in particular–Senator John McCain.
It was that petty, vindictive, little man’s vanity that caused him to vote to retain Obamacare, reversing a pledge he’d made to voters that he would vote to spike the legislation. Anger at President Trump–not loyalty to voters or devotion to the country–motivated McCain to vote with Democrats and doom healthcare.
May he rot in Hell.
The push towards universal health insurance has actually derailed access to health care. I can remember, as a young adult, picking a GP out of the phone book & paying the $20 for an office visit when I knew I needed antibiotics for a strep infection – no insurance claim, no delays in knowing what the total bill would be, no struggle to find a doctor in my network that hadn’t already pissed me off at some point.
If the true goal of “healthcare reform” is better quality care for the greatest number of US citizens, remove insurance companies from the equation for everything except catastrophic care and finally give some attention to tort reform. Eliminating the bureaucratic middlemen from between patients and their physicians would not only improve care and reduce costs but would have the added bonus of encouraging the resurgence of small independent family and OB/GYN practices, as would capping medical liability damages to reasonable levels
This is a story about a murderer and a thief.
Luigi Mangione had no right to use force. His life was not being threatened yet he took a life based on opinions and prejudices. Everyone hates medical insurance companies. Luigi was not in a position where self defense was necessary either for himself or for others as was Daniel Penny while involved in the NYC subway altercation. There was nothing moral about this murder. If anything his crime deserves classification as a hate crime.
The thief was not really United Healthcare or their CEO. It was the US government that mandated everyone to pay for health insurance or else suffer fines and penalties while simultaneously forcing the private insurance market to behave in a fashion which created the United Heath Care winner. Such a scheme was based on force. The costs of such a public goal were not earned but were, instead, expropriated.
Prior to the passage of the Affordable Health Care Act insurance was far more affordable, better and was available to people who were willing to pay for it or work for it.
There is no right to any health care, accept by an agreement between the providers and the users.
People who are given care on an emergency basis, by providers, for themselves or their children, should be held accountable. They should not be educated (indoctrinated) to assume that, just like equity belonging to others, they have a right to have it conferred on them by governments capable of coercion actions.
Come on Max. He was a stubborn Irishman who hated Trump. I grew up with dozens like him.