Inhumanity and Imbalance
Without empathy and dignity, we are on a collision course
“The successful revolutionary is a statesman, the unsuccessful one a criminal.”
—Erich Fromm, 1941
We’re now almost a week out from the killing of the CEO of United Healthcare by a vigilante who was seemingly distraught about the draconian policies of that company.
The shock and horror of the murder itself was jarring. Headlines and breaking news declared that an executive had been gunned down in front of a New York City hotel. Then the video footage was released, putting realism to what was previously only pictured in the mind.
The reaction online was another brutal visit from reality, with all corners of the internet celebrating the assassin, creating a folk hero out of him, and fawning over images of him.
The writers of Black Mirror couldn’t create a more perfect dystopian-anarchic story line.
As one USA Today columnist wrote, “The callous disregard for a human life is alarming to witness.”
An emotional and societal volcano seems poised to burst, as people are fed up with being treated like numbers and witness an ever-greater disparity in wealth — two molten rivers constantly churning and flowing beneath a thin surface of bureaucratic tolerance.
It’s this inhumanity and imbalance that are setting us on a collision course.
“One magic word today seems capable of compensating for all sufferings, resolving all anxieties, avenging the past, curing present ills, summing up all future possibilities: that word is revolution…This word has aroused such pure acts of devotion, has repeatedly caused such generous blood to be shed, has constituted for so many unfortunates the only source of courage for living, that it is almost a sacrilege to investigate it; all this, however, does not prevent it from possibly being meaningless.”
— Simone Weil, 1938
Inhumanity
The healthcare industry in the United States is widely panned, for a variety of reasons. Cost, complexity, and bureaucracy are at the top. More specifically, the insurance companies are demonized, largely because of their role as gatekeepers, willing to deny payment for services they deem “medically unnecessary.”
But who decides? Largely bureaucrats, sometimes medical personnel, but often times those who don’t have qualifications to properly review treatment protocols. People who don’t even see the patients.
Customer service representatives, who form the first wave of public interaction, are made less personal by sticking to scripts approved by their legal departments. Good luck finding one with empathy built in.
And more recently at United Healthcare, rather than using actual humans, they implemented artificial intelligence algorithms to cut off rehab care to Medicare patients — a process with a 90 percent error rate.
And that’s on top of UHC’s claim denial rate that is double the national average:
With this level of disdain for basic human dignity, is it any surprise that the public’s reaction to the murder was one not only devoid of empathy but filled with a gruesome glee?
Lest we fall into the same trap, let’s consider that Brian Thompson, CEO of United Healthcare, had family members, friends, and colleagues who genuinely cared about him. He was a human being.
Coincidentally, human beings — 52.3 million of them, to be exact — make up the membership of United Healthcare.
Or, as that USA Today columnist said, “The callous disregard for a human life is alarming to witness.”
Big Industry (Big Pharma, Big Oil, Big Tobacco, Big Auto, etc.) has largely been a nameless, faceless monolith — one that we’re happy to dehumanize because it treats its customers or employees like cogs in a machine.
Since CEOs are thought of as the public face of a company, our ire naturally gets directed at them: they are the first human beings we can identify.
Not anymore, though. In response to this clear public outrage, a number of health insurers did the only logical thing: they removed their executives’ names from their websites.
Imbalance
Power and wealth, the twins of the cardinal sin of greed, are never fairly distributed. Currently, there is a wide imbalance between the haves and the have-nots, resulting in frustration.
Insurers hold all the cards in this game, and when they change the rules, members (notice I didn’t say patients) are stuck with having to follow them. Often they can’t leave an insurance plan, because that’s what an employer offers. Or they can’t afford anything else.
A recent rule change announced by Anthem Blue Cross and Blue Shield in Connecticut, Missouri, and New York announced on the same day that the UHC CEO was killed proclaimed that the insurer would not pay for anesthesia if a surgery went beyond an arbitrary time limit.
Anthem was greeted with the kind of response you would think they deserved and quickly rescinded their folly of a plan.
But that kind of change could have added up to a significant bill for unsuspecting patients, who would be unconscious when those services were delivered.
When insurers won’t pay, the debt adds up for patients. In 2019, researchers found that 66.5 percent of all bankruptcies are tied to medical issues.
Tough Decisions
The reason shareholders invest in health insurance companies is not to contribute to the improvement of outcomes or the general health of the insured; it is for one purpose alone: to increase profits.
“Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I break it and forswear myself, may the opposite befall me.”
— Hippocratic Oath
Some patient care is unprofitable. But when Hippocrates set out in writing what would become his profession’s pseudonymous oath in Of the Epidemics, his first concern was about helping the patient, at the expense of his reputation.
In the great big and bright twenty-first century, health insurers don’t bother with the ethical and reputational elements of the Hippocratic Oath.
They more likely take a Mammonic Oath, bound by sacred words spoken to their accountants and pronouncements to avoid the harsh judgments of disappointed shareholders. That balance sheet has no room for feelings, well-being, or personal stories.
It is high time to reconsider the role of profit in patient care. Other countries seem to be getting their money’s worth.
How do we value human life at scale? It starts with the way we treat every person we come into contact with.
Every human being has and needs a sense of dignity.
Bob Parr knew that in The Incredibles (2004). Too bad his boss at Insuricare didn’t.
There’s so much to learn,
On this issue of insurance coverage, I have a minor contribution. My younger sister had a total mastectomy this year after her insurance denied coverage of an MRI directed biopsy needed when the lumps were much smaller and where she had a breast implant for over 20 years. The cancer grew until the next mammogram caught it. I imagine too many of us have stories like this.
Here is my unique contribution to the discussion of being shocked by the callous response of people to this CEO's murder. My sixth year as a lawyer, I got another prosecution job after leaving IEPA. Although I was a civil prosecutor solving environmental problems with injunctions, I learned the term "misdemeanor murder" when a particular man was found shot in the head and face down dead in a ditch. At the time I was horrified by the term but I see it now in this instance of what could be a capital offense (first degree) murder.
The colloquial "misdemeanor murder" is where the person murdered has been such a harmer to so many others that we, in law enforcement, are relieved that the person is dead and can no longer go on harming others. It's kind of a good riddens attitude. This is usually a real scumbag who beats women, breaks into occupied homes to steal or who has killed other people with impunity. Murders don't usually have witnesses. It's not that there is glee at the death of the person known to be a violent criminal, but there is a real karmic kind of sense of relief and justice.
I see the sentiment at work in the comments that disregard this murdered man as though he were not a person with a wife and kids and a life to live. These writers are attributing much death to his policy decisions. Obviously, we need universal health care to have real justice and equality in our society. This issue needs attention even as this is not the way to give it attention.
No one has said it but I personally wonder what efforts have been taken to find other shooters or murderers in NYC - what a man hunt and yay for honest observers so we catch him to get accountability for his actions of ultimate devastation. I just haven't seen any other manhunts for any other murder victims of late. I don't see a folk hero and I don't see any deterrence effect on corporate behavior from the young murderer's actions, just more lives ruined by what is the most heinous crime, murder.
I guess he lost his job in the video Scott! Well that feels good....motto >>> get and keep the right jobs with bosses that care for you and others....not themselves! Oh yes about companies that don't care....yes it is wrong and needs to be changed....at the same time the CEO that was murdered is a human being with a family that will never see him again. He was killed by a misguided and sick person that had every privilege most people would agree would give him some firm foundation and yet did not learn anything about Agape Love and a simple commandant of Thou shall not kill because someone thinks they are God...there's only one of those and if we only focused on God and the love for one another he asks the world may be way better off!