Murder is bad. Just putting that out there.

RWL #424

Greetings from The University of New Hampshire! We’re officially in finals week, but since I don’t have any finals, I am done, and my grades are in. Yay! It’s a nice feeling to be done. Lots of other things on my plate, but closing out the semester always gives a small feeling of accomplishment.

A lot has happened this week that I care about, including the overthrow of Syrian dictator Bashar al Assad, which seems to be yet another sign of the unraveling of the Iranian “axis of resistance”. However, I’m going to focus on the murder of United Healthcare CEO, Brian Thompson. I’m not going to follow my usual format. I’ll pull the links into my comments.

Murder is Bad. Full stop.

The murder of United Healthcare CEO, Brian Thompson shocked and dismayed me. What shocked and dismayed me more was the fact that there are people saying he deserved to be killed, and other insurance executives should be killed, too. From an article in Business Insider:

On Facebook, UnitedHealthcare's statement about the murder of its chief executive elicited 46,000 reactions — 41,000 of which employed the laughing emoji. The company quickly turned off comments on the post, but hundreds of users shared it with arch commentary.

That’s a disgusting and shocking lack of empathy. I don’t follow UHC closely, so I didn’t know anything about Thompson at the time I heard about his murder, other than he was a human being. What is becoming apparent as the circumstances develop is that the murderer was from a wealthy family, went to fancy schools, and did not know Thompson personally. It appears he carried out the murder as a political act. Political murder should not be joked about. There should be no statements like, “It’s not right to murder someone, but…”. There should be no “buts” allowed to be addended to a statement about murder. I am intentionally saying murder here, as this was clearly premeditated murder. The only time one citizen can kill another citizen is in self-defense, which is by definition not murder.

The argument in favor of joking about the murder of Thompson that I am reading is that it’s not really about murder, it’s about the fact that he led a terrible insurance company, and therefore was culpable for the suffering and deaths of people who believed they were entitled to care but were denied. Here’s a quote from a popular article by former NYT and WAPO business journalist Taylor Lorenz that is getting a lot of play on the interwebs:

If you have watched a loved one die because an insurance conglomerate has denied their life saving treatment as a cost cutting measure, yes, it's natural to wish that the people who run such conglomerates would suffer the same fate.

As fellow journalist Ken Klippenstein posted, "No shit murder is bad. The [commentary and jokes] about the United CEO aren’t really about him; they’re about the rapacious healthcare system he personified and which Americans feel deep pain and humiliation about."

This is what the media fails to understand. They don't see insurance CEOs who sanction the deaths of thousands of innocent people a year by denying them coverage, often coverage doctors deem medically necessary, as violent.

Journalist Kylie Cheung put it this way: "The way we're socialized to see violence only as interpersonal—not see state violence (policies that create poverty/kill), structural violence, institutional violence—is very deliberate."

Among certain people, this idea of “systemic”, “structural”, and “institutional” violence has become conflated with violence by one individual upon another - i.e., walking up to an unarmed man you have never met and shooting him multiple times until he dies. Shooting someone is fundamentally different than claiming that there is a policy that has caused harm. We actually have to be “very deliberate” to separate these two things because they are different.

The interplay between insurance coverage and the healthcare system is complex. I’ve been aggravated by it and I literally teach classes about it. Every system has a mechanism for rationing care - which is a fancy way of saying every system denies care. It doesn’t matter if it is the US system with its blend of private and government payors, or the British National Health Service, every system makes calls about what care is medically necessary. The NHS is funded by taxes and beneficiaries have no out of pocket expense. But the NHS is notorious for long waits for care it deems necessary. And it also does not offer the same range of care that is available in the US because its economists have determined that the cost-benefit is not sufficient. I have an American friend who lives in the UK. She was unlucky to be diagnosed with breast cancer. She chose to get her care outside of the NHS because she perceived both a quality and access issue, and the threat was too great. Luckily she had the means to do so. Lots of people who live in places with socialized medicine come to the US for their care if they have the means. Big hospitals like Mass General, The Mayo Clinic, and so forth have robust businesses caring for wealthy foreigners.

My point is not to say that the US healthcare system is great. It has flaws. Depending on your points of evaluation it might even be terrible (or it is the most amazing in the history of humanity - it all depends on your points of evaluation). My point is that there is no system where someone won’t say they “watched a loved one die” because they were “denied their life saving treatment as a cost cutting measure”. These stories come out of every system in every country. The policy sets vary and how rationing is done varies. But rationing is done, and people are denied care. Being on the receiving end of a policy decision feels like you are facing against a cold, implacable, and impossible to fight glacier. Having spent almost 26 years affiliated with the US Army in one way or another, this was part of virtually every aspect of my daily life - healthcare, housing, pay, travel, you name it. If you have never served in the armed forces, you have no idea. The people who write those policies almost always think they are addressing a problem and they are usually doing their best to do the right thing. The problem as I have observed it is complexity and the interplay between policies. This is part of why I am in favor of fewer policies in general, and more market forces.

When the policies interact in such a way that they unfairly disadvantage a person or a group, the result really could be death. But that’s not the same thing as one person picking up a gun and shooting another person, unless the policies were deliberately created to disadvantage a person or group (e.g., Jim Crow laws). Where it could be shown that a law is deliberately prejudicial against a particular group, I think that law is unjust and should be changed. But it still does not warrant killing individual people. There are processes for changing laws. Most of the time, disadvantage comes from an interplay of well-meaning laws/policies. It is, as I like to say, ordinary incompetence, not malevolence.

The essential step toward a liberal democracy is individuals giving up their right to violence, except in self-defence, to the state. Then we collectively decide on the policies that govern our society. We don’t murder people whom we blame for policy sets we don’t like. When public figures start to excuse individual violence because the person had it coming because they didn’t agree with them politically, we’re embarking on a journey to chaos and madness. I’m pretty sure people like Taylor Lorenz would not survive long in Mad Max’s world of sanctioned individual violence. A world where all you have to do is be perceived as part of systemic oppression to be a legitimate target of individually perpetrated violence is a frightening world.

If UHC provides bad insurance, I have a suggestion: don’t buy it. In the US you have choices. The thing is, UHC is as powerful as it is because of policy. The PPACA (aka, Obamacare) was supported by big insurers like UHC because the rules it imposed forced all the smaller health insurers out of business. As soon as the PPACA passed, small insurers started going out of business. I could write a whole other newsletter about that. But the best way to keep unwieldy, unresponsive, indifferent, glacier-like companies in check is competition, not regulation. You need the little companies to rise up and take the big companies down by cutting their Achilles. The PPACA is structural violence by the logic of the people who are happy Mr. Thompson was murdered. If you want to get to the proper culprit in this structural violence, you need to point your gun at the person who empowered UHC to be a crappy insurance company. That person would be President Obama. This is the problem with arguing for systemic violence is the same as individual violence: the trail of causality just keeps going. Pretty soon we’re all implicated.

Murder is bad. Full stop. Let’s commit to stop conflating individual violence with policy disagreements.

As usual, willing good for all of you!