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“Is it ever OK to Celebrate Death?”
Presented by Howard Gibson
On Wednesday December 4, 2024, the CEO of UnitedHealthcare Brian Thompson, was ambushed and murdered as he walked from his hotel in New York city, to an investor's meeting. The shooter, Luigi Mangione, was arrested in a McDonald's restaurant in Altoona, Pennsylvania, shortly afterwards. While people like Tim Walz, Amy Klobuchar and Jacob Frey have expressed dismay at the shooting, Thompson and the health insurance industry are being demonized on social media, and Mangione is being presented as some sort of social hero. (see note 1 below)
Is it acceptable for us to use violence, even deadly violence, against people we perceive as evil? If we do not agree with the killing, may we express sympathy with the killer?
UnitedHealthcare
UnitedHealthcare is a subsidiary of UnitedHealth Group, which is a multinational for-profit health insurance company. It is ranked eighth on the 2024 Fortune Global 500 and the largest in the health care sector with a market capitalization of $473.3B. In 2023, UnitedHealth Group made $22B in profits. They are the most profitable health care company in the US. Senator Elizabeth Warren claims that United Health is the most aggressive abuser of upcoding practises, cheating taxpayers of $3.7B. (See Notes 2 and 3 below for further details)
Media Response
As of 2024-12-22, it is getting difficult to find all the YouTube videos saying that violence is bad, but that Brian Thompson had it coming. There were quite a few. (for more responses, see Note 4 below)
The YouTube channel run by lawyer Leeja Miller, did a video on vigilante justice in which she compared the deaths of Jordan Neely with that of Brian Thompson, both inflicted by white men. The killer of Neely has been acquitted by a New York jury. She mentioned the Bernard Goetz back in 1984. Miller states that vigilantism is a product of a weak state, in which citizens do not expect help from anyone. There is literature backing her up on this. Author Randolph Roth argues that homicide rates are high when people do not feel part of the government and society and they need to command respect. W. Fitzhugh Brundage in his book on lynching, reports how southerners had...
...an intense distrust of, and indeed, downright aversion to, any actual exercise of authority beyond the barest minimum essential to the existence of the social organism.
Miller even mentioned the case of a Chinese grocer here in Toronto who chased, caught, and hog-tied a local, habitual thief. He was acquitted in court afterwards of assault and confinement.
Is it okay to laugh at the death of a CEO?
Some Thoughts
(see below Note 5 for more details)
Is violence okay if the final outcome is (mostly) good?
Will the outcomes of terrorist violence be good?
Is violence the correct word to describe medical insurance misbehaviour?
Are violent revolutions the best ways to achieve social and political change?
Consider that if we can kill people we have determined to be evil, other people can kill people they have determined to be evil.
Do we need laws specifically against terrorism? What is terrorism?
NOTES
1. The Principles in the Shooting
Brian Thompson
Brian Thompson grew up on a farm in Iowa. He went to the University of Iowa, and he graduated with a bachelor's degree in business administration, majoring in accounting. He was the valedictorian of his graduating class. He started at PricewaterhouseCooper as a CPA, and was promoted to management. He joined UnitedHealth Group in 2004, and was promoted to CEO of UnitedHealthcare (UHC) in 2021. He was murdered, allegedly, by Luigi Mangione, on 2024-12-04.
Thompson was an active supporter of the Special Olympics. Apparently, Thompson was separated from his wife, he has been convicted of driving under the influence, and accused of insider trading.
Luigi Mangione
Luigi Mangione was born to a prominent Maryland family of Sicilian descent. He attended a private, all-boys secondary school, from which he graduated as valedictorian. He received spinal fusion surgery, insured by Blue Cross Blue Shield. He attended University of Pennsylvania, graduating with a Master of Science in Engineering in computer and information science. He studied math and artificial intelligence. He worked for a video game company as an intern, and then as a data engineer for a car retail company. He worked remotely, and his employment ended in 2023.
In the summer of 2024, Mangione stopped posting on social media. In November, his mother contacted the San Francisco Police Department and reported him missing.
2. United Health Group and the US Health System
Rank
Company
Market Share 2023
1 UnitedHealth Group 15%
2 Elevance Health 12%
3 CVS (Aetna) 12%
4 Cigna 11%
5 Health Care Service Corporation 7%
6 Kaiser 7%
7 Blue Cross Blue Shield of Florida 2%
8 Blue Cross Blue Shield of Michigan 2%
9 Centene 2%
10 Blue Shield of California 2%
The Top 10 Biggest Health Insurance Companies in 2023
UnitedHealthcare has four main divisions...
UnitedHealthcare Employer and Individual
Health benefit plans and services for large national employers and individuals.
UnitedHealthcare Medicare and Retirement
Health and well-being services to individuals age 65 and older.
UnitedHealthcare Community and State
Serves state programs that care for the economically disadvantaged, the medically under-served, and people without the benefit of employer-funded health care coverage, in exchange for a monthly premium per member from the state program.
UnitedHealthcare Global
Provides nearly 2.2 million people with care and benefits services in South America.
In 2023, UnitedHealth Group made $22B in profits. They are the most profitable health care company in the US. By revenue, they are the eleventh largest company in the world. Senator Elizabeth Warren claims that United Health is the most aggressive abuser of upcoding practises, cheating taxpayers of $3.7B.
Upcoding is the practice of submitting codes for medical conditions that are more severe than what was diagnosed by the physician. This is done to get higher reimbursement. The practice is fraudulent.
UnitedHealth Group is accused of having the highest rate of claims denials in the industry, at 32%. The industry average is 16%. The lowest on the chart was Kaiser Permanente at 7% This claim has been challenged. Information on things like claim denials is hard to find. The source of the data is an article on Value Penguin. The claims have not actually been denied. They are merely hard to prove. Value Penguin updated their chart December 18. Kaiser Permanente's claim denial rate now is claimed to be is 6%.
3. Healthcare in General
The biggest problem with medical insurance in the USA is prior authorization. A wide range of medical care must be authorized by the insurers before a physician can do anything. A very nice article on the Business Insider website claims that prior authorization applies to less than 2% of claims, and that prior authorization ensures that more conservative treatments are not more appropriate, and that the treatment follows the latest medical guidelines. The article is Sponsored by UnitedHealthcare.
According to the AMA, prior authorization is...
...a health plan cost-control process that restricts patient access to treatments, drugs and services. This process requires physicians to obtain health plan approval before delivery of the prescribed treatment, test or medical service in order to qualify for payment.
Healthcare Costs
American health care is grossly expensive, as can be seen on the figure to the right. This drives up the cost of medical insurance. Half of US residents claim that it is difficult to afford health care. Around one in five Americans claim that they do not fill in prescriptions because they cannot afford it. Four in ten adults report having debt due to medical or dental bills. In 2023, the average cost of a day in the hospital is $2,883. California is the most expensive at $4,181, and Mississippi the cheapest at $1,305. Lots of normal surgeries exceed $100,000. 60‑65% of US bankruptcies are due to medical expenses.
Investopedia's six reasons healthcare is so expensive in the US...
Multiple Systems
U.S. healthcare is complex, with separate rules, funding, and health insurance systems
Rising Drug Costs
Drug costs outside the US are regulated by governments.
Higher Salaries for Medical Professionals: Average salary for a US family doctor is $239,200. In Germany this is $183,000, in Canada $194,777, and in the UK $138,000.
Profit-Driven Hospitals: American hospitals are expensive. A hip replacement in the US costs $28,167. The next most expensive one is New Zealand at $16,622. In the US, a C‑section is $11,326. The next highest cost is Switzerland at $7,948.
Defensive Medical Practices
American physicians and hospitals are trying to not get sued. They order too many tests.
Varying Healthcare Prices
Due to the complexity of the market, health care providers are able to charge what the market will bear.
The insurance companies are on the hook for this, and they are in a frenzy to reduce costs.
The book Delay Deny Defend, by Jay M. Feinman is being shown off quite bit. This is all about the insurance industry, but there is not much about health car.
4. More Responses
YouTube — BYTE-GEIST — The Ethics of Violence: Fanon and Arendt.
YouTube — Amanpour and Company — What’s Behind the Lionization of Luigi Mangione?.
Celebrating Brian Thompson's Killing Is Ghoulish, Steven Greenhut, Reason.
5. Notes on Thoughts
In 1776, the United States declared its independence from the British Empire. In the end, the revolution succeeded, and the United States was set up as a functional country, with a functional government, and mostly, the Rule of Law. Over the next two hundred years, a whole bunch of other revolutions took place, all of which ended badly. The subsequent French Revolution was successful at overthrowing the old Bourbon monarchy. They set up a legislature, which was dominated by fanatics, who beheaded every aristocrat they could get their hands on, followed by the beheading of most of their fellow legislators. Power eventually was seized by a military adventurer. After a protracted war that may have killed a larger percentage of Europeans than WWI, the Bourbon's were placed back in power.
Adam Zamoyski's book Holy Madness is a study of revolutions that took place from the American Revolution, to the Franco-Prussian War. Zamoyski claims that the revolutions in Latin America replaced a not completely awful Spanish administration with a bunch of corrupt, unstable regimes. Revolutions in Poland, Hungary and Russia provoked increased repression from the Russian and Austrian empires. Revolutions in eastern Europe against the Ottoman Empire eventually succeeded, resulting in a bunch of unstable, squabbling states who eventually provoked the First World War.
The twentieth century saw the Russian Revolution which succeeded, and which established a police state far worse then anything the old czars did.
When you initiate violence against the state, you need to accomplish the following...
Defeat the authorities. Don't get shot between the eyes by a SWAT team. Don't provoke a general massacre by the authorities, or at least, win the resulting battle. You can designate the victims as martyrs.
Establish a stable, functional government. As the winner of an armed revolution, you have no mandate to govern. All sorts of heavily armed people will think they should be in charge. Game of Thrones anyone? Your new political system must manage an orderly succession of power. Your retirement, death, and/or your overthrow by your palace guard, can also provoke the Game of Thrones mode. When told that George Washington had voluntarily stepped down from the US presidency, King George III replied that If he does that, he will be the greatest man in the world.
Finally, you need to observe all of those civil rights you were fighting for. You probably won your revolution by not observing people's civil rights.
Consider that if we can kill people we have determined to be evil, other people can kill people they have determined to be evil. Abortionists anyone? In the USA, right wing people are way better armed than left wing people. The book cover linked at the bottom of this page may be the work of a crank. It may be more mainstream than you realize.
Do we need laws specifically against terrorism? What is terrorism? Leeja Millar mentions the killing of nine blacks in a church in South Carolina, where the perpetrator was not prosecuted for terrorism. Miller displayed and read Mangione's manifesto. Should we care about the manifestos of murderers? LegalEagle interviewed defence attorney Mitchell Epner, who observed that terrorism is just about the only charge Mangione has a defence against. A number of recent cases have featured prosecutors grandstanding and messing up the outcomes. Look up the trials of George Zimmerman, and of Michael David Dunn. Dunn eventually was convicted, but the jury was hung on the original first degree murder charge. Terrorism, is all about violence and destruction. Murder, assault and vandalism all are covered by the criminal code. Is terrorism thought crime?
In 1961, Laurie Pritchett, the police chief of Albany, Georgia realized that he could be facing civil rights protesters. Not an idiot like the infamous Bull Connor, he read up on civil rights organizations, their leaders, and the general philosophy of nonviolence. He understood that demonstrations would be held in order to provoke a reaction from the authorities, with the protesters overflowing local jails. They would submit to arrest peacefully, so there was no need for official violence. He ordered his police to be as non-violent as possible, and to suppress white bystanders if necessary. He arranged for nearby towns and counties to provide jail space. If he charged protesters with violating local and state segregation laws, the convictions would be appealed to federal court. Charges for creating a disturbance, failure to obey an officer, loitering, and other minor offences, could be kept local. When demonstrators showed up, Pritchett was careful to maintain a friendly relationship with the press. The demonstrations soon happened, with Martin Luther King showing up, but it all fizzled out. Pritchett's tactics worked.
If you have a time machine, should you go back and murder baby Hitler?
Further Notes
United
UnitedHealthcare is spelled as one word. There seems to be a trend. The accounting firm PricewaterhouseCoopers (PwC) is also spelled as one word.
MassShooters
I am not willing to identify mass shooters by name. They want to be famous. I am not willing to accomodate them.
Pritchett
Laurie Pritchett was interviewed for the documentary Eyes on the Prize, all about the civil rights movement.
References
Visual
Ranked: The Largest Health Insurers in America — Visual Capitalist
Brazen
YouTube — The Young Turks — UnitedHealthcare CEO Fatally Shot In 'Brazen, Targeted Attack'
Vigilante
YouTube — Leeja Miller — Is Vigilante Justice The Answer To America's Problems?
Terrorism
YouTube — Leeja Miller — When Does Murder Amount To Terrorism?
Laugh
YouTube — Leeja Miller — Are We Allowed To Laugh When A CEO Dies?.
Terrorist?
YouTube — LegalEagle — Luigi the Terrorist? Federal Prosecution?
SpeakOut
YouTube — Wall Street Journal — After UnitedHealthcare CEO Killing, Doctors Speak Out
Flawed
YouTube — Firstpost — UnitedHealth Executive's Murder Exposes "Flawed" American Healthcare: Key Issues Explained. Firstpost is an Indian news and media website.
Battle
YouTube — Democracy Now — UnitedHealth vs. Patients: NYC Man's Battle to Get Lifesaving Drug Highlights Broken Health System.
Rage
YouTube — Democracy Now — Deny, Defend, Depose: UnitedHealthcare CEO Killing Highlights Widespread Rage at Healthcare Industry.
Warren
YouTube — electron media group inc. — Elizabeth Warren Grills United Health CEO Months Before Luigi Mangione Murder
Verify
Why we can’t VERIFY a chart showing UnitedHealthcare denies more claims than other insurers, Megan Loe, Verify.com. I found this story posted on a YouTube channel, but this is the source of it. It is also linked by News Centre Maine.
Denial
Insurance Claim Denials: Worst Companies and How to Appeal, Written by ValuePenguin Staff, Value Penguin.
Upcoding
Upcoding Medicare: Is Healthcare Fraud and Abuse Increasing?, Alberto Coustasse, National Library of Medicine.
Prior
How UnitedHealthcare is transforming the prior authorization process for patients and providers — Business Insider. There is no author credit. The article is sponsored by UnitedHealthcare.
7Prior
7 prior authorization terms that drive every doctor to distraction — American Medical Association (AMA)
HealthCost
Americans' Challenges with Health Care Costs, Lunna Lopes, Alex Montero, Marley Presiado, and Liz Hamel, KFF. This has something to do with industrialist Henry J. Kaiser.
HealthDebt
Hospital and Surgery Costs — Maureen Milliken — Debt.org.
6Reasons
6 Reasons Healthcare Is So Expensive in the U.S. — Investopedia.
SiCKO
SiCKO, A Film by Michael Moore, 2007. Available on YouTube as of 2024-12-22.
Roth
American Homicide, Randolph Roth, The Belknap Press of Harvard University Press.
Brundage
Lynching in the New South — Georgia and Virginia, 1880-1930. W. Fitzhugh Brundage, University of Illinois Press.
Bloom
Suspicion Nation, Lisa Bloom, Counterpoint Berkley. All about the killing of Trayvon Martin, and the subsequent murder trial.
Zamoyski
Holy Madness: Romantics, Patriots and Revolutionaries 1776-1871, Adam Zamoyski.
Wash
George Washington's Resignation, The Maryland State House website.
Feinman
Delay, Deny, Defend, Jay M. Feinman. Available in Kindle format from Amazon.com.
RaceBeat
The Race Beat, Gene Roberts and Hank Klibanoff, Alfred A. Knopf.