62 Comments
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Sci Phi Newsletter's avatar

Agreed with your post. The defenses of Luigi have also revealed that many leftists don't know how our healthcare system works. Physicians and hospitals are the ones charging the exorbitant fees that insurance companies sometimes must deny. Take it up with them too!

Insurance is just one piece of the puzzle.

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Pas's avatar

Let's not carry water for them. When a company enters into an insurance contract, then willingly outsources "claim checking" to "doctors", who denying claims without even reading them, they are not just (most likely) in breach of that contract, but are defrauding people. And people lose QALYs due to this, can't work, and can't spend money on shrimp welfare.

Underwriting gains are 12-18 billion dollars for the industry each year, 2-4%. (And admin costs are ~10%, which is almost pure waste of paper pushing.)

The morally defensible thing is to go bankrupt if premiums were set too low (or negotiate with the policyholders), not harass and lie to sick/recovering people and try to get them off your back with their pesky legal claims and legally binding policies and ... uh, let's just hire someone and let them "deal with this" ... I have a shareholder meeting.

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

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Jasmine C's avatar

Well, this would give more reason to make healthcare system that is ran by the government, where the state is paying them and not by for-profit insurance companies.

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Guillaume Vandenbroucke's avatar

The only way the USA could achieve free healthcare would be to directly pay the existing private hospitals and their physicians, as that is the only current infrastructure and it would be too costly to replace. So the exorbitant fees would now have to be paid by the government and not insurance companies. It's already the case in states like California that have forms of free healthcare. That's what that person meant, that most people don't understand how things work. Same goes for cars. The reason your insurance is so high is because car companies have a monopoly on their parts and have done a great amount of lobbying for it to stay that way. Hence you get a fender bender and it costs 2000 usd for a new number, charged by whatever brand. The insurance company then has to charge us all more money because it costs more money. The solution is free market where anybody could produce parts and sell them regardless of the brand

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Noah Birnbaum's avatar

This seems obviously true. In fact, I don’t even see much debate about it. While there are people that are being like he’s a hero there seem to be very few people writing articles or giving arguments as to why. The general point is clear, but it seems quite weak.

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HobbitBuyer's avatar

I think it may be apathy in the face of people being in thrall to a simple conviction bordering on worship.

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The Critical Citizen's avatar

I think a majority of people just do not care about morality

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Shaun's avatar

Well liberalism was founded on violence, such as the execution of monarchs, Napoleon's conquests, various revolutions, the American Civil War, rapacious colonialism, and the ongoing violence perpetrated with the assistance of the leading liberal powers such as the Saudi war on Yemen and the Israeli genocide in Gaza.

Now to its credit, liberalism has also marked a reduction in violence from past eras, with the ideas of freedom of religion and peaceful transfer of power being a marked improvement.

However the liberal status quo will only last insofar as it manages to keep people satisfied, as it fails to do that we will see more and more targeted violence towards people perceived, rightly or not, as the perpetrators of systemic injustice.

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uenzus's avatar

You are not entirely wrong, but the healtcare system doesn’t seem to be a top issue for most americans, considering that the recent elections were won by Trump and the topic wasn’t even one of the most discussed.

I think the murder has just temporarily incremented the discussion but it will fall off the radar after a while. Imo, one of the main reasons so many people cheer for the murder it’s just the “fuck the rich CEO” sentiment

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Robert Leigh's avatar

100,000s of people die every day. Every death is sad, some are sadder than others, with some being so relatively unsad as to verge on LOL.

Slippery slope arguments are just weak, and this one weakens with every day that passes without a copycat murder.

As to ineffective, I doubt it. If I were a US health insurance CEO my first call would be to double up on personal security for me. My second would be, how about we bring our rejection rate down a couple of percentage points? If that has happened the killing may already be a net lifesaver. Secondly where has liberal debate on healthcare got the US, and how much further is it likely to get it in the next 4 years?

Virtuous assassination is a foundation of western democracy (see under Harmodios and Aristogeiton).

And we don't even know whether this was a crime yet because it is not one till a jury decides it is. We hear a lot about jury nullification being where the jury ignores the law and lets the defendant off but that's misleading. The jury is not in any relevant sense bound to follow any law in reaching a verdict, and its verdict is not open to question. Within the legal and constitutional system we don't know that a crime has been committed. Outside the system, there's every chance that on almost all moral views (leaving aside religious absolutist killing prohibitions) the killing will turn out to be a net good. All it takes is one ill person with 3 or more children to have a claim allowed which would otherwise have been denied, to give a net gain.

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M N's avatar

Osama had four kids, what about his poor kids and brothers and sisters? Why arent we calling him a father but choose to call him terrorist? Because he used violence instead of bureaucracy to kill people? If the US has legitimised revenge killings to right crimes agsinst its people then THAT is the example it sets for its subjects to follow, so sorry dude but you cant have the cake and eat it too…

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Andrew Doris's avatar

Because every halfway intelligent person can think of a dozen morally relevant differences between insurance executives being wrongfully scapegoated for a flawed healthcare system and Osama fucking bin Laden.

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Jos T's avatar

This essay appears to be preaching to the choir. Of course murder is wrong. But to think that our country doesn’t endorse killing is missing the entire public debate.

We Americans, living in economic system entwined with our republic, are part of a system that supports the killing of foreign combatants, the execution of some criminals, the deaths of human embryos and fetuses, and also —where our health care is concerned— the killing of thousands of people every year who can’t access healthcare.

The public debate examines Luigi’s killing of a CEO who was at the forefront of claims denials as a business policy to increase profits.

This isn’t a plain left vs right issue. It’s more of an issue where those from hundreds of thousands of families who have been victimized by these policies versus the also very many who have not.

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Guillaume Vandenbroucke's avatar

You're missing the point. You're right, the system is broken, but killing one CEO won't change anything. There is other options. Countries with universal healthcare began without one, the US is no exception to the rule. I consider myself to be more aligned with the right but I still can't comprehend the private healthcare system in the US as even on an economic level it's awful for the country. But I think eventually it will be like most places in the modern world and become universal

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Ponti Min's avatar

"but killing one CEO won't change anything" -- then what would?

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Chastity's avatar

Electing Bernie Sanders (I-VT) to the Presidency.

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Ponti Min's avatar

A step in the right direction.

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Guillaume Vandenbroucke's avatar

Voting for a party that favors universal healthcare. Remember that the US is a democracy. If such important agendas as universal healthcare never make it it's because there is not enough support from the population. So the only people you can blame is the majority. And being angry and bitter and using violence because a majority thinks different than you is called dictatorship.

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Ponti Min's avatar

No, the US isn't a democracy, because it uses FPTP. This means that there are two big parties who it is almost impossible to dislodge and everyone else gets nowhere, which means that if the thing you want isn't supported by either of the two big parties, there's nothing you can do about it, except maybe shoot a CEO.

In a true democracy, it is possible for people to organise online over an issue that they feel isn't getting enough attention, set up an new political party, stand for election, and (importantly) for every 1% of the vote you get, you also get 1% of the representation. This last part is important because it means the existing parties can never be the gatekeepers of what ideas are deemed reasonable.

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Guillaume Vandenbroucke's avatar

No, if the two parties don't support what you want you can move to another country, not shoot a CEO. I'm pretty sure you are very young to have that type of mentality. The reality is Luigi will spend the rest of his life behind bars and no one will give a shit about him in 6 months time, everyone will go on with their lives, while he waste his for no good reason.

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Ponti Min's avatar

"No, if the two parties don't support what you want you can move to another country" -- which is exactly my point: the USA is virtually unfixable. The only way to fix it, for oneself, is to leave.

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Jos T's avatar

Unfortunately, on the point of Luigi’s violence being “impotent” the author is even more obviously wrong. It was offensive violence by the Black Panthers and the Weather Underground, not defensive violence against protesters, that turned the tide of the Vietnam War and civil rights activists. Donald Trump enacted violence against American citizens in many US cities as police violence and violence against protesters, and on January 6. It was only violence against him personally by his own former supporters that distanced him from violent domestic terrorist groups.

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Jacob's avatar

Isn’t the reason people provide for why he deserved to die the AI denial thing and that he deserved death because of how many people he denied healthcare to for profit (with denial rates significantly increasing recently).

As far as I see it, there are two avenues of justification commonly raised by people.

First is the retributive case, which says that Brian Thompson was an evil person who deserved death but would never be given the death penalty by the state, so a vigilante had to take justice into his own hands. This one depends on whether or not you require a specific right to execute someone for your killing to be moral.

Second I guess is the consequential case, which may say that this will increase people’s awareness of the injustices of the healthcare industry, potentially leading to change if people protest together or enter politics to influence policy in these issues.

Also, I don’t know if you think political violence is ever justified, but if it is sometimes, then arguably rebelling against a system that is killing the working class for the upper class’s profits could be one such case.

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TheKoopaKing's avatar

https://cdn.arstechnica.net/wp-content/uploads/2023/11/class-action-v-unitedhealth-and-navihealth-1.pdf

Haven't and probably won't read the whole thing, but the lawsuit alleges 90% error rate for denials for Medicare recipients. Some relevant things to consider would be: is AI any different from the automated system they and other companies had in place before? Would it be worth it to consumers to increase premiums to afford hiring more manual reviewers? What are the actual profit margins of UHC pre and post this AI change? And was Luigi sane enough to actually care about any of this, or did he just premeditate a high level murder for clout? I'm on team "This is counterproductive and further cements our decay into the normalization of political violence."

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Roko Maria's avatar

The reason we have a legal system at all is because it’s better than mob violence or unceasing feuds. But for the legal system to maintain that legitimacy, it needs to be able to punish crimes with some amount of consistency. When certain classes of criminals (not in a legal sense necessarily) become immune to prosecution, the appetite for vigilante justice will naturally grow. Liberalism must find a way to enforce consequences on the powerful, or it will die.

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Peter Thompson Cl's avatar

Well put!

This guy deserves no more sympathy than Danny Masterson. This was a crime of power--a privileged kid wondering if he could actually get away with murder using a ghost gun. All demented ego. Sure, he scribbled a manifesto on a Greyhound bus while fleeing a murder in which he shot a guy in the back on a public sidewalk, when everyone knows that the only thing ever written on Greyhound buses are suicide notes and letters from parents engaged in cross-country child custody fights threatening to slash somebody's tires.

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Andrew Doris's avatar

Several comments in here are making analogies to the Trump assassination or scapegoating insurance companies/CEOs for our healthcare system's problems, so I'm linking to my post that refutes those arguments here: https://exasperatedalien.substack.com/p/why-do-we-feel-more-comfortable-cheering

An excerpt:

"The failures of U.S. healthcare are systemic, not individual, and they are not “violence” if that word means anything more specific than angry mood response. Even if you think healthcare is a right and that unlimited amounts of it should be available to everyone free of charge, you cannot expect companies to operate as charities within the system we have. Besides, all insurance systems - including government systems like Medicare for All - require denying some coverage, so it’s really confused to equate this practice with responsibility for death and suffering.

Nobody has ever watched their loved one die from the denial of their insurance claims. They have watched their loved ones die from diseases that take time, money, equipment, highly skilled labor, and miracles of medical technology to cure. That distinction matters deeply to moral culpability, in part because all those resources are scarce, and providing more of them - denying fewer claims - involves tradeoffs that hurt other people. Not just executives of companies with 3% profit margins, but other patients and policyholders whose premiums cover the treatment."

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Kaiser Basileus's avatar

Let's talk about how the only thing they ensure is lining their own pockets. It's fraud top to bottom and they deserve no sympathy. A legitimate health care system's primary motivation is to make itself unnecessary.

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Andrew Doris's avatar

Thinking that healthcare wouldn't be necessary if only we had a good enough system is a level of fantasyland I didn't even know existed.

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Kaiser Basileus's avatar

Consider a world in which no one is willing to kill their oppressors, then support Luigi. Tyranny is only ever ended by physical violence. You cannot fix a broken system with it's own broken tools. Only revolution and subversion are ethical.

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Ibrahim Dagher's avatar

Clearly true. However, what’s more interesting is that the reaction by most people suggests that frustration insurance companies, and our healthcare system writ large, is both widespread (bipartisan) and extremely strong. Should be a point of emphasis for political strategists—especially the Democrats—on party platforms in 2028 regarding the government’s role in the insurance market.

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Bobby's avatar

"Mangione, as one who has read the news recently knows, shot dead UnitedHealthcare CEO Brian Thompson on December 4th"

I'm sorry, but how is this not the dictionary definition of libel?

Did he confess? Was he convicted?

Or are you knowingly "publishing a false statement that is damaging to a person's reputation, a written defamation"?

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Ibrahim Dagher's avatar

That something has not yet been legally proven does not entail that its utterance is libel. That would be absurd

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Forrest's avatar

Him not being convicted of the shooting doesn't make it false to say he did the shooting. It's an opinion, just as people have opinions about whether OJ murdered someone, regardless of his conviction.

Is it damaging to Mangione's reputation? I highly doubt you could credibly make that case. If Bentham was the only one to do it, maybe. But you also have every news organization saying he allegedly do it, and writing about the evidence that police said they found.

I agree that to be morally perfect, Bentham should have used "allegedly". But I highly doubt you could convince a jury that a little-read blog meaningfully damaged Mangione's reputation.

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Andrew Doris's avatar

This would be an absurd legal theory even if there remained any shred of doubt about his guilt - but the guy was caught on camera and then found with a manifesto explaining why he did it, and then shouted why he did it to a news camera. Leave law to the lawyers kid.

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Ponti Min's avatar

"The action was little more than impotent rage against the machine."

Yes, but what else can people do? If America was a democracy, it would be possible for a group of activists to come together, form a Universal Healthcare Party, stand for elections and win seats. I would guess about 5% of the public view healthcare as the most import issue, so this new party could get 5% of the vote. By definition, democracies have proportional representation, therefore they would win 5% of the seats in the HoR (so about 20) and the fact they had won lots of seats would be enough to get the issue at the top of politicians' agendas. But the USA isn't a democracy, because it uses FPTP, and for other reasons (such as media and social media being controlled by the rich).

So, because the USA isn't as democracy, it may well be that the most effective way to get an issue to the top of the agenda is to assassinate a healthcare CEO.

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Andrew Doris's avatar

I hate FPTP as much as anyone but "By definition, democracies have proportional representation" is a definition you made up in your head.

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Ponti Min's avatar

Alright then, how about this definition: “a democracy is a country where the government does what the people want”.

Now consider that, to the extent that a body is elected by PR, then what the voters get will reflect what they voted for, i.e. if most voters voted for candidates/parties that supported some proposition P, then most of the people elected will support P too. That’s true under proportional systems but not true under FPTP.

It seems to me that if you accept both of these, you’re coming very close to saying democracy requires PR.

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