Tuesday, December 10, 2024

I hope you read it.




Luigi Mangione, 26, was arrested by local police at a Pennsylvania McDonald’s with a “hand-written” manifesto describing “ill-will toward corporate America,” false identification and a 9mm “ghost gun” potentially “made on a 3D printer,” New York Police Department Chief of Detectives Joseph Kenny said.

Assassinations are despicable. I don’t care if the targets are politicians or mafia bosses. It’s the method I despise. For those who are old enough to remember the killing of Patrice Lumumba, then JFK, then Malcolm X, then MLK, then RFK, every assassination is (I hate this word) a trigger. Assassinations are destabilizing. The shooting of Archduke Franz Ferdinand set off the First World War. Targeted violence has always been a sign – an augury – that the social order is breaking down. I would have preferred to see Osama bin Laden brought to justice so that we might have understood his methods and motives. I know that trials can be rigged, corrupted, and biased, but so far the courtroom is the best place we have in which to decide between guilt and innocence – and to assign an appropriate punishment. Assassination is a death sentence without the benefit of a judge or jury.

All of which is to say that I was deeply horrified by the assassination of Brian Thompson, the CEO of UnitedHealthcare, in cold blood, in broad daylight, in front of the Hilton hotel, in Manhattan.

As I write this, the gunman remains at large, but his motives were clearly written on the casings of the bullets he used: “deny” and “delay”. Many would argue that those are the two favorite activities, the go-to business practices, the bold-faced words in the scripts, that health insurance employees are instructed to follow. As a consequence, Thompson’s killing has set off a storm of conversations and internet postings about the deep wounds that the medical insurance industry has inflicted on Americans who made the mistake of trusting their carriers to provide adequate coverage.

It’s a pity that Thompson’s murder is being politicized – as the latest eruption of the left’s destructive rage or as the sign that a gun-lover is brandishing his muscle. Brian Thompson’s murder is a criminal response to a criminal situation. The only consolation – the only good that could come of it – would be if his death led to some serious soul-searching, to a concerted attempt to understand why an apparently affable CEO inspired such violence and hatred.

Deny. Delay. Everyone knows what those words signify in reference to medical insurance. Doctors and patients agree that our healthcare system is seriously broken. It hardly needs to be said that medicine, in the United States, reflects and further deepens our profound economic divide. Not long ago, my husband’s longtime doctor left his practice to join a medical concierge service that charges $60,000 per person per year. Soon after, I found myself in the waiting room of an upstate New York urgent care center, watching patients ask the receptionist if they could pay the $35 co-pay in $5 monthly installments.

The critique of the national health services in Canada and in Europe was always that one had to wait months for a medical appointment. But now, in this country, we have discovered that an appointment with a specialist might take months to arrange, and (depending on one’s insurance) will be anything but free, as it would be in countries with state-sponsored systems.

Long before Thompson’s killing, people had been talking about the loved ones who suffered and died because of an insurer’s refusal to pay the cost of a treatment or of long-term care. If the extremity and cruelty of these companies’ cost-cutting measures didn’t so often strip patients of their life savings and their homes, they might almost seem like a joke.

Recently, an insurance company in the north-east decided, and later (after a public outcry) rescinded its decision, to limit the hours of anesthesia for which a surgical patient could get reimbursed. Should the anesthesiologist, midway through a long surgery, turn off the hose and tell the patient to bite the bullet? Or should the patient be billed thousands of dollars for those last few hours? And before we blame the doctors for these high fees, let’s remember that the anesthesiologists are paying fortunes in malpractice insurance … to the companies that are being paid by both the doctor and the patient.

What’s puzzling is why people who have suffered so much because of the current system are so reluctant to try something else. What would be lost if we instituted healthcare for all? Our freedom? Our control? Our ability to choose? The bad news is all that is already gone. The only things that might be diminished would be the annual bonuses and stock options of the insurance company executives.

So let me be clear. I’m sad about Brian Thompson’s death. The mess we’re in wasn’t his fault. Our problems are so much larger than he was. He was an unlucky, visible symbol of everything that’s gone wrong with our healthcare system.

I’m sad about the rage and desperation that caused someone to write “deny” and “delay” on the bullets he aimed at Brian Thompson. But mostly what I’m sad about is the fact that we, as a society, are so willing to accept a status quo that dooms our neighbors to suffer and die without the medical care they need. The writer Lucy Sante has said that we are in the 33rd year of the Reagan administration – an observation that has never seemed more apt. More than three decades have passed since we were told that we were on our own, that the miseries of our neighbors were not our problem, and that we should continue to allow the industries that the unfortunate Brian Thompson represented to profit from our tragic, unrecoverable losses.

Francine Prose is a former president of the PEN American Center and a member of the American Academy of Arts and Letters and the American Academy of Arts and Sciences.

1 comment:

  1. Kod informatičara s diplomom elitnog fakulteta iz Ivy lige pronađen je rukom pisani manifest u kojem optužuje korporacije za zdravstveno osiguranje da zgrću profit na štetu bolesnih.

    Policija nije objavila tekst, ali na konferenciji za novinare čitali su njegove dijelove. Načelnica njujorške policije Jessica Tisch rekla je da tekst otkriva "motivaciju i način razmišljanja" Luigija Mangionea. NYT prenosi kako Mangione u manifestu piše da se ispričava zbog neugodnosti i traume, ali kako je to "moralo biti učinjeno", spominje izrijekom UnitedHealthcare, uz široku osudu osiguravajućih kompanija zbog toga što profit stavljaju ispred medicinske skrbi o oboljelima. Kompanije nastavljaju zlorabiti našu zemlju za stjecanje goleme zarade, jer im je američka javnost to dopustila. "Ovo su paraziti htjeli", navodi se u manifestu. Dok su dionice UnitedHealthcarea rasle, očekivani životni vijek u Americi nije, kritizira se u tekstu. Mangione u njemu, prenosi NYT, preuzima odgovornost za ubojstvo: kako bih vas poštedio duge istrage, tvrdim da nisam radio ni s kim, napisao je. Ne spominje Briana Thompsona.

    U tekstu koji se proširio mrežom X, navodnim manifestom Luigia Mangionea, poručuje se da bi zdravstvo trebalo biti javno dobro, a ne špekulativni pothvat. Pitanje je je li riječ o stvarnom tekstu koji je u posjedu njujorške policije, jer u njemu se ne spominju ni UnitedHealthcare, niti "paraziti". Tekst je napisan kao proglas, u kojem Mangione svoj čin naziva "žrtvom" i poziva da ga se ne slavi, nego da se preispita zašto jedna tableta košta stotine dolara, zašto je specijalist nedostupan, ili zašto osiguranje može nekažnjeno odbiti zahtjev za plaćanje troškova liječenja. Dovedite u pitanje svaku premisu koja vodi prema komodifikaciji zdravlja, prema tretiranju zdravlja kao robe. Očekuje da će se buduće generacije pitati kako smo tolerirali takvu okrutnost pod krinkom zdravstvene njege, da će se čuditi kako smo nekoć puštali ljudska bića da pate i umiru dok se bogatstvo gomilalo na vrhu, i nada se da će pohvaliti napore onih koji su se usudili oduprijeti.

    "Ako ono što radim danas pridonosi maloj ciglici u temelju nove paradigme zdravlja, definirane jednakošću, suosjećanjem i univerzalnom dostupnošću, onda je moja uloga u ovoj priči značajna. Ovaj manifest moja je posljednja oporuka, moj najiskreniji priziv savjesti svijeta, koji se previše naviknuo na moralne kontradikcije. Neka cijena moje žrtve ne bude uzaludna. Neka posluži za pokretanje transformativne rasprave i, što je još važnije, za stvarno djelovanje", ističe se u navodnom manifestu. Svijet očajnički treba zdravstveni sustav, navodi se, ali takav koji je usredotočen na liječenje i temeljen na ljubavi, a ne na novcu.

    Ostavio je na mjestu ubojstva čahure s upisanim riječima "Poricati", "Braniti" i "Odbaciti". To je slično naslovu knjige iz 2010. "Delay Deny Defend", koja kritizira zdravstvena osiguranja zbog pretjeranog odbijanja zahtjeva za financiranje liječenja. Ubojstvo menadžera velike osiguravajuće korporacije izazvalo je lavinu bijesa na društvenim mrežama, gdje su brojni izražavali frustracije zbog vlastitog negativnog iskustva s osiguravateljima.

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