A Shooting with a Twist
Anger towards a victim of a fatal shooting and praise of the shooter was not on my Bingo card of things that will happen in 2024. And yet, it happened. On December 4th, Brian Thompson, the CEO of United Healthcare, the largest health insurance company in the nation, was shot and killed outside his hotel in New York City. Several days later, a suspect, Luigi Mangione, was arrested. It was the shot heard around the world. Some things happened as expected when a CEO of a big company is killed. The media stays in a constant state of breaking news as they learn more about the incident, the police begin a manhunt, do several press releases, and everyone wants to hear from the President. Social media, the pulse point of the people, reacted in a surprising way. The normal response to an unexpected death is that people offer prayers and condolences to the loved ones. Look up the recent school shooting in Wisconsin, and we offered quite a few prayers and condolences. This was not the case on December 4th.
What appeared on social media was unexpected. It reminded me of the opening song from Wicked. “No One Mourns the Wicked” when the munchkins celebrated the death of Elphaba, whom they deem wicked. On social media, one could read several thousand posts stating, “my condolences and prayers are out of network” or “access to my support and prayers is denied as not medically necessary.” No one knew who shot the CEO, but many hailed the shooter as a modern-day Robin Hood or an American hero. And post after post told of a person who had lost a loved one due to a denial or delay in medical care. Some shared the difficulty they were having getting a necessary medical procedure approved by their insurance company. The killing of an insurance CEO hit a nerve.
(There are, on average, 123 deaths due to gun violence per day in the U.S. I couldn't have been the only person who wondered who the other 122 victims were on December 4th).
Hitting a nerve
The shooter hit a nerve. The police stated that the ammo he used was inscribed with “Delay, Deny, Depose.” Those three words have become a battle cry in America regarding the state of our healthcare system. Some believe it is in reference to a book published in 2010, Delay, Deny, Defend, by Jay Feinman. The book is about insurance in general and corporate tactics to delay making decisions on claims, deny payment on claims, and defend their actions in court. It offers an insider's view of how insurance companies use premiums they receive and examples of insured people who had trouble with their claims. The book deals more with home insurance than health insurance, but the theory and outcome are the same. Except when health insurance claims are denied, people physically suffer, and, yes, some of them die due to lack of proper and timely healthcare.
However, when the suspect changed the last D from defend to depose, it changed the meaning. No longer was it about the three strategies insurance companies utilize to maintain high profits for their shareholders. It now meant two strategies they use and the way the shooter chose to respond: fatally shooting the CEO of the country's largest healthcare insurance company. According to all the praise for the shooter on social media, many others see it as a valid response to a for-profit healthcare system that many believe puts profits before the lives of its members: we can depose those who utilize the tactics of delay and denial. In the past few weeks, people have tattooed the "deny, defend, depose" battle cry on their bodies. A quick search on Etsy of “Delay, Deny, Depose” and you will see stickers, t-shirts, and hats with those three words on them for sale. You will see a camouflaged baseball cap with the words “CEO Season” embroidered on it. One woman, Briana Boston, has been arrested, charged with threats to conduct a mass shooting or act of terrorism, and held on a $100,000 bond because she ended her phone call with a Blue Cross customer service representative by saying, “Delay, deny, depose. You people are next.” She called them because Blue Cross denied two of her claims. According to many news sources, donations are pouring in to help pay her legal fees.
Jay Feinmen may have been right about the last "D" in the title of his book, Defend. The day after the shooting, Anthem Blue Cross Blue Shield announced they were not going to limit the amount of anesthesia per procedure, a policy they announced a few days prior to the shooting. Subscribers from many insurance companies report that their authorization for a procedure that had been pending for quite some time was suddenly approved. This murder (perhaps assassination is a more apt description) has started a conversation that many have wanted for years.
Will the murder of a CEO lead to lasting change?
Some have argued that the murder of a healthcare CEO is not how we make changes in our healthcare system because murder for any reason is a terrible thing. Others have argued that denying people needed healthcare is legalized murder and is also a terrible thing. We can expect Mangione to go to trial and to prison if found guilty. It remains to be seen whether health insurance companies will change how they treat their members or if they will do what they did to Briana Boston and have them arrested for threats made out of frustration than real intent. One thing is certain, and recent events have born it out, a lot of Americans have firsthand experience of the healthcare crisis. Medical debt is the number one cause of bankruptcy in the U.S., and a full 41% of all adults carry some healthcare-related debt. Time will tell if their anger and the strange community of outrage at the nation's healthcare system that sprang up following Thompson's murder will translate into real political action. But, unfortunately, with time come other things to draw our attention, such as drones over New Jersey, before any real change can be made.
Learn more
The Hidden History of American Healthcare
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