News and commentary for understanding and coping with the years ahead...
Something happened
The murder of a hated insurance company's CEO feels to me like a turning point. Please take a look at the following articles and commentary – from among dozens I've looked at today – that bring early insight to a fast-moving story. I've posted extended comments at the end.
As long as the majority of health insurance in America is run as a private enterprise, it will work according to this logic. UnitedHealthcare’s aggressiveness is exactly the reason its parent company is now the largest health insurer in America. It has undeniably been successful in its primary business goal to deliver profits for its shareholders. Insuring people with high-cost conditions wouldn’t comport with thinking merely in terms of profit, which is why it took the Affordable Care Act to require companies such as UnitedHealthcare to insure people with preexisting conditions.
The author of this Atlantic commentary spends most of his time listing the grotesque flaws of our healthcare system. Only a small portion of the piece states the obvious – that murder isn't the answer. The "coarsening" of society, indeed...
For once, too, it seemed that no extremist factions were quick to blame the murder on ideological opponents, as they typically have in the wake of high-profile shootings throughout the U.S. in recent years (save one Fox News commentator who suggested the NYPD hadn’t yet located the shooter because they were too busy dealing with immigrant crime). Online influencers known to shape a narrative before the facts emerge instead proved willing to wait and see where the case would lead. Within the feverish climate of social media, this made for an unfamiliar sort of restraint — almost as unusual as the street homicide of an American businessman.
Of all the round-ups I've seen about the online response to Thompson's death, this Rolling Stone piece covers the ground best (so far). The most striking element: One of the extreme right-wing's most vile trolls came to the same kind of served-him-right conclusion as so many others have done all over the political spectrum. It's still murder.
One medical doctor, whose identity the Daily Beast confirmed, commented with sympathy for Thompson’s family and said the killer should be charged with murder, but then wondered about the damage the CEO had done. “I cannot even guess how many person-years UHC has taken from patients and their families through denials,” they wrote. “It has to be on the order of millions. His death won’t make that better, but it’s hard for me to sympathize when so many people have suffered because of his company.”
The revulsion people, including medical professionals, feel for Thompson and his industry has overwhelmed sympathy for him and his family. And he was a notably bad actor in a cartoonishly evil industry. (Even his gazillions in loot – sorry, compensation – extracted from unreimbursed sick people wasn't enough for him, apparently.)
[H]ealth care, like so much of the American economy, is becoming financialized, a system focused on making money. Private equity is the canary in the coal mine of for-profit behavior, having moved aggressively into health care. Most large health insurers, such as United, are for-profit, but the degree to which they and other firms have narrowed their focus to their stock values (rather than producing good products and services) has increased dramatically in recent decades. More than a third of hospitals are for-profit, but many not-for-profit hospitals still focus on maximizing their revenues and margins, in part because their chief financial officers have to worry about their bond ratings. (Perhaps also because they have boards filled with bankers rather than health care professionals and patients.) And the easiest way to increase your revenues is by becoming a monopoly. Now, in health care, most markets are too concentrated to support meaningful competition: this is the case for 90% of hospital markets, 65% of physician specialist markets, and 57% of insurer markets. I am a firm believer in markets, but market failure is now pervasive in health care.
This commentary in Stat, probably the best medical journalism site, goes to the deeper mess. Namely, the entire healthcare system is a caricature of capitalism – though for the greedy people capturing all those billions of dollars at the expense of everyone else's bank accounts, and too often their health and lives, it feels like perfection. We should also point a finger at our bought-and-paid-for members of Congress and state legislators. They've created the legal environment that gives these rapacious cartels – which now span almost every industry of any size, not just healthcare – the right to screw over the rest of us.
Class war coming?
I said at the top that this event feels like a turning point. I wish I could say that I think it will be in the right direction, but I fear otherwise.
The Washington Post story above (free link, but here's an alternative link if you find the Post's address requirement obnoxious) is a continuation of a trend that's been developing for some years. The ultra-wealthy and outright oligarchs of our time – the people extracting unimaginable wealth at the expense of other people's well-being, even lives – are terrified.
Who terrifies them? You. Me. The rest of us. Because the bunkers they are building are, in significant part, a hedge against the revulsion they've inspired.
They wouldn't have to hedge if they hadn't overthrown the mid-20th Century's capitalism-with-rules that created the biggest middle class in history. But they and their enablers – politicians in Washington and state capitals; pay-to-order think tanks; pay-to-order economists and other corrupted academics; and so many others – stole our country wealth.
They did it with a rigged form of capitalism that has already created the greatest wealth imbalance since the Gilded Age. Back then, the top few had almost everything – including wholly owned politicians and other levers of power. Regular people, including children, worked 12-14 hours a day for just enough pay to stay alive – and wealth enforced its rule with mercenaries and the police whose bosses they controlled. Sound at all familiar?
We have to take our lives back, but this will take relentless pressure from the grassroots outward and upward. We have to own our lawmakers the only way we can: with organizing, and with votes. This is vastly, vastly easier to say than accomplish.
I want Brian Thompson's murderer punished. I want his death to be a tipping point toward a civil, nonviolent uprising that dislodges his ilk from power. I fear it's more likely to lead to much worse treatment for everyone but those at the top.
The most telling detail in the Post article about those fortresses is so bizarre that I first thought I was reading something from the Onion. The super-high-tech security system company cited in the piece named itself Sauron – and the CEO is totally aware of what that connotes! If you're not a "Lord of the Rings" person, you need to know that Sauron is, yes, an all-seeing eye in the sky – but whose eye is it? The saga's genocidal villain.
Coda: If you are heading toward Medicare age, I can't advise you strongly enough be skeptical of UnitedHealthcare's – or any other insurance company's – "Medicare Advantage" plan. (Get Medicare Part B.) If you don't want to take my word for it (you shouldn't!), read this article, or this one, or any of these...well, you'll get the idea.
How I put this newsletter together
This is a compendium of the reporting and commentary that best explains the America's political, economic, and social conditions – and, most important, how we can find a way back from the dark days ahead. You will rarely find anything here from the New York Times or Washington Post or any of the other Big Journalism companies that failed us so completely during the 2024 elections and are now sucking up – even more than usual – to Donald Trump, his cult, and corporate oligarchs. My focus will be on smaller, more honorable outlets (and individuals). I hope you'll support them with your attention and your money. For more details, please read my About page.
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I spend a lot of time looking for essential coverage, and hope you'll help me by letting me know about the good stuff you find. Let me know.
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Nicholas Florko
Miles Klee
Sean Craig
Elliott S. Fisher
