i think the topic of agency is an interesting point here. for the sake of time i will define agency as 'having an effect on the world.'
if you only look at a screen all day, of course you'll feel like what you do has no effect on the world. you aren't looking at the physical realm where you can have an effect. if you look away from the screen you can suddenly exercise your agency by making a sandwich or cultivating a garden. screens can be addicting as in 'easy farming game with no struggles makes me feel like im progressing.' but screens can also be this onslaught of things it feels like you cannot affect (war, politics, etc.) which also takes away your sense of agency.
imo, people just need to descope. instead of 'omg i need to solve healthcare' work on a solution within your local community where you can have an impact. 'omg omg climate change so bad' ok start by planting more trees in your locality. i have seen this happen. it's not as easy as a video game but it's not too hard either.
you will not solve healthcare unless you spend decades gaining the training and network to do so. which you can. i could still decide to go to law school and devote my life to that. i just have other goals.
also the 'is luigi sane or insane' debate is boring. we are all a mix of rational and irrational.
"Vigilantism is always wrong. If you celebrate someone gunning down a defenceless person in the street, then you advocate for a world in which this is an acceptable thing for anyone to do. You in fact advocate for a world in which a stranger can decide that you’re also a bad person, and gun you down in the street. In such a world, I promise you, your health insurance would cost much more."
Except it makes some unjustified philosophical leaps. To take a really tired example:
"If you celebrate someone assassinating Hitler, then you advocate for a world in which assassinating political leaders is an acceptable thing for anyone to do."
Not equating Brian Thompson with Hitler, of course, but I find this oft-echoed "refutation" of vigilantism unsatisfactory, resting as it does on the extraction of an (arbitrarily?) broad principle from a particular moral decision.
It echoes the stubbornness of pacifists who believe that violence is out of the question regardless of the stakes. As a system becomes more unjust and more exploitative, there will be an increasing number of people who will reject the system and believe that vigilantism is justifiable. That's not to say that it was in this case, but the fact that so many people feel that it was should be a wakeup call to people who feel they live good lives and benefit from the system.
I think more often it's vengeance that starts to seem like the only answer. What makes this case stands out is the vigilantism and ideological motivations which inherently seem less desperate and more calculated. As to your question, I am really not sure. I think growing animosity creates more inherent uncertainty. Whether that leads to systemic change, or to perpetually increasing resentment on both sides, is up to the people to decide.
I believe this article accurately describes the phenomenon.
In the law of the jungle, vigilantism is the main means of self defense.
In the rule of law, vigilantism is given up to higher powers to let those higher powers defend you, much more than your own resources can allow.
But the key question is what happens when the rule of law restricts instead of protects? Indeed when rule of law becomes increasingly sophisticated, the line between protection and restriction is blurred - if you are forced to buy healthcare for your own good, at exorbitantly high prices such that you have no savings, is that a protection or a restriction? How much of modern society's rule of law is really protection, and how much of it is handcuffs—a reduction of agency?
What is interesting is that the framework denotes not a return to vigilantism as the solution, but to become the ultimate victim, so as to incite large groups to bite each other as an enactment of justice for the victim.
Lots remains to be said on the subject but to decry vigilantism as wrong is to perceive the world in dignity culture, failing to see that the world is moving on from it, if it hasn't already.
"How much of modern society's rule of law is really protection, and how much of it is handcuffs—a reduction of agency?
"What is interesting is that the framework denotes not a return to vigilantism as the solution, but to become the ultimate victim"
All one needs do is look at the current (last 5? 10? 15? years) of MASSIVE increases in gun purchases. Especially, and I laugh with disgusted delight, at all the THOUSANDS of "anti-gun liberals" suddenly swamping gun stores to buy self-protection guns they mostly do not learn to use. When "the govt" (the agent) to whom/what you have outsourced your protection (or health care) STOPS providing those and you discover you are naked in the jungle: "suddenly" providing for your own care or protection becomes hugely important.
I sort-of/mostly agree the 'cure' is not vigilantism. But when one IS trapped in a corner by the likelihood of denial-of-coverage that is bankrupting thousands -- or a random physical attack ANYwhere, at ANY time, by any number of violent invaders -- then praying, barking, or biting (see progression of defense) ceases to be enough. “Agentism” requires more agency than sitting on hold for hours TRYING to get coverage – OR calling 911 and waiting 20+ minutes for “out-sourced protection” to arrive. (No insult to cops: Police are MAINLY to take the reports after the crime – NOT to protect or prevent. (Esp. not when “defund the police” is the local chant!)
When (and how) does one TAKE BACK agency that had been castrated?
Who decides when the “system” is unjust enough to justify vigilantism?
If a “system” (whatever one means by that, that’s why it’s in “ “) is unjust or perceived to be so to someone then that person can go opt out. That doesn’t give them the right to murder someone in order to bring justice to the system. (No need to get into how that murder doesn’t guarantee justice will prevail and if it doesn’t it’s impossible to undo).
Practically speaking it is a critical mass of people who decide, everyone has their own threshold of what is tolerable. When people are mostly content with their institutions but a few people are not and resort to vigilantism, those people will be branded terrorists by the rest of the population. If a significant portion of the society is not content, the vigilantism will be seen in a different light. If things continue to deteriorate then these institutions eventually become untenable. Institutions which are ultimately just networks of people will be forcibly replaced by networks of other people.
It's up to us who are relatively comfortable with the system (the current collection of institutions that drives our society) to ensure that enough people are comfortable so that we avoid getting anywhere near this critical mass. We are humans and human beings have the appetite for violence if things get difficult enough, they don't need an imaginary 'right to murder' for this to happen
I think you're confusing his argument with the common hypothetical related to killing Hitler as a baby. As far as I can see from his comment, there's no mention of the assassination occurring before his crimes were committed.
Reminds me of the plot of Minority Report, but predicting the future is very difficult when you consider all the ecological variables. If not Hitler, a similar ideologue could have committed equivalent atrocities by scapegoating another minority group for the country’s economic woes.
Or how about a more radical and yet plausible idea to extend groups further: what if another ideologue had actually taken Hitler’s place and done even worse?!
That’s why this exercise is silly and we shouldn’t be so arrogant to believe we know the answer to these hypotheticals so easily.
Completely agree. For this same reason I strongly dislike the anti-appeasement argument that has justified much of American interventionist foreign policy since WW2.
The Hitler argument only works in 202/20 hindsight with 100% certainty of the future. When do you propose Hitler should have been assassinated? In his crib? No, if you really think it through, the only logical time is after damage had already been done. Even then, what happens when you martyr him? Does this action then make his ideas stronger or weaker for those he leaves behind? Nobody has a crystal ball. Thete is a distinct possibility his assassination would have strengthened the Nazi party and the world might look very different today.
There is a time for violence, but using it to try to win a political disagreement is not one of them. This way lies the death of all that we hold dear.
"Using (violence) to try to win a political disagreement..." That's how you frame that killing? There is a desperation among working class people that has been ignored for decades. The CEO of
Sorry. Brian Thompson approved the use of an AI to decide claims. It was wrong 70% of the time. Denying a claim could very well be a murder. You seem to be far removed from the knowledge that working class people are drowning. You don't seem to have knowledge of what you're addressing. You're claiming a moral, logical argument? It misses the mark by a lot.
I'm not condoning Thompson's murder. But I definitely understand the motivation for murdering him. Brian Thompson was on his way to a chard holder meeting. Do you understand what that means?
These insurance companies should be out out of business. Period. It's an immoral endeavor. It's gambling.
I am a clinician who fights with insurance (including UHC) constantly on behalf of my patients. I have masters degree in health policy and have studied insurance in great depth. What is your resume? Make a good argument. Please resist temptation to character assassinate (or actually assassinate!)
Regarding national Healthcare, do you assume this will result in fewer denials? You would be mistaken to think that is the case with Medicare or Medicaid currently, or would be the case with expansion of these programs. Though I do agree that private insurance of all kinds is highly problematic. My next article soon will discuss this complex subject in greater depth.
All we hold dear that is ALREADY lying on its deathbed, gasping out the last chances to regain health?
Absolute truth: What CANNOT continue, WILL NOT continue.
The upcoming financial crash will end this country. (You ready?) "We" have filled the country with literal millions of "military-aged men" -- many of whom have DEEP (and legit!) 'beefs' against "us" -- and do not that all those various groups are NOT armed! What do you think is prepped in the backrooms of the 66+ CCP POLICE STATIONS spread across the U.S.? (Why did OUR govt know about them for some years; and we only found out by happenstance because a (White) man in Seattle "turned vigilante" to RESCUE a middle aged Chinese woman screaming for help as two "Chinese policemen" were dragging her to some bland building. Should HE have just let her get dragged away to who-knows-what?
We KNOW China was sending containers full of weapons -- including a technologically cool "missile launcher in a 52' container" -- we CAUGHT at least one missile launcher -- and at least several shipments of "weapons of war" as our govt describes them. How many containers did we miss? The VERY few mosques that have been entered by "our agents" sometimes turn out to have an ARMORY. The cartels are building up weapons storehouse acvross our wide wide open borders.
"We" have brought in many thousands of military-aged men with legit beefs with "us" for the destruction we have wrought in THEIR homelands! Many various Middle Easterners. Afghanis. Iraqis. Iranians. Russians. Ukrainians. PICK your country -- and how many of these men lost family (in an ENTIRELY family-centered cultured) have "we" been responsible for the deaths and destruction of? THEY do not have a strong sense that vigilantism is bad or unlawful. THEY have their own culture's belief that it is "just desserts."
Yes, there are almost always exceptions to any rule.
Here, it is reasonable to assume that nearly everyone who would state the quote Gurwinder used would agree that vigilantism when the victim is one who directly ordered the deaths of millions of innocent people, and all of the reasonable countries (regarding their perspective of Nazi Germany) with power in the world are trying to stop them militarily, is justified.
Those circumstances are extremely rare, so adding that (somewhat obvious) exception to the rule whenever stating it can seem unnecessary.
Well, I'm not merely pointing out that exceptions exist. The point is that they exist *because* the moral question is not simply whether vigilantism is always right or always wrong. And so it is not answered by simply inventing an incredibly sweeping categorical imperative and claiming it refutes itself. Surely, if we want to make any progress on the issue, we need to be clear about the terms of the debate. Which, as I have tried to indicate with the (extreme) Hitler example, really comes down to whether the victim was a sufficiently bad person.
I agree that optimally such statements should be amended to not be an absolute that can easily argued against by those stating the obvious “but what about Hitler”.
However, saying that vigilantism is only right when the victim is a sufficiently bad person leaves far too much open to interpretation (especially to those with misguided reasoning) as I’m sure most of us would agree.
Simply adding: “if formal mechanisms of justice or intervention are unable, yet willing to stop them by any means, vigilantism may be morally justifiable” could be an option, but then some may come up with sound arguments against that as well, such as whether death should be the punishment.
A rule that addresses all contingencies and is not open to interpretation would need to be created. If it is well crafted enough, I’m sure many people on both sides of this argument would be likely to agree it makes sense.
Formal mechanisms of justice in which jurisdiction? For a German of the time, the local formal mechanisms were not willing. The same is true for comparably less bad or powerful people, like for instance many slavers throughout history.
Hitler is the extreme example to make sure that whether the person in question deserves it doesn't need to be debated first, but I'm sure you too could think of plenty of less bad people to slot into the "murdering them would be good actually" category. Like all the lesser murderous dictators in history and still ruling today, especially if it's not guaranteed that they will be replaced by someone worse. And probably also their worst right hands and collaborators, i.e. your Goebbels and Himmler equivalents. Or do you disagree?
I’d challenge anyone who disagrees to explain how the circumstances of successfully committing vigilante murder against an individual who has ordered the deaths of over a million innocent people are NOT extremely rare.
The number of such cases in the last century is in the low double digits. Having the ability to out maneuver their security, and have the perfectly aligned timing to pull it off is very unlikely. It doesn’t take much to realize that when you think about it.
It is easy to see why vigilantism is bad. It is because it is unlawful.
And I think that you are not paying enough attention to that. It is unlawful and we have not even begun to make a moral case against it on the basis of murder.
Even if it is remotely possible for it to be permissible in Nazi Germany, it doesn't by any stretch of the human imagination spill over to the United Healthcare CEO's situation. We are not living in Nazi Germany.
So as a thought experiment, the solution is to take over the government, rewrite the laws by whatever method, and then put the CEO in front of a revolutionary tribunal and then appoint luigi as the executioner? Then its perfectly “legal” to blast his brains out.
The law is just what the government says it is and can enforce with violence. The issue with vigilantism is that, in theory, its less fair and just than a legal system and it violates the public order. (In modern societies, I’m not going to get into premodern or frontier societies where things can work differently)
In a well functioning country in which there is high trust between citizens, relying on the legal process is obviously the superior method….
"It is easy to see why vigilantism is bad. It is because it is unlawful."
So, driving 65 in a 55 mph zone is "bad"? That law forced on us to restrict driving to 65 was to save GASOLINE, and yet was pitched 'to save lives' in order to manipulate the public!
You might also consider why it is and always has been the HUMAN condition. It pains me to point out (because a concept so often misused by those I consider nearly my enemies) but it is true that BOTH sides in any conflict BELEIVE they had/have the the right of it. Taking the side you were taught is virtuous and right to commit your group's atrocities and discarding entirely that the OTHER side had equally important and persuasive reasons they thought, on EQUALLY "virtuous and persuasive" grounds means merely, and always, the victors write the history books!
Exactly, as you say, it is possible for it morally correct in the extreme case of Hitler in Nazi Germany, but the United Healthcare's CEO does not even come close to meeting those extreme "qualifications". For one, he didn't directly have a hand in anyone's death, among many other glaring differences. (I see I should have noted this for clarity)
Broadly speaking the argument is really an extension of the Categorical Imperative. If you want to punish criminals for their perceived crimes as a vigilante, but don’t want to be punished by others for your perceived crimes, you are using others as a means to an end (their obedience of the law as way to enable your particular behavior).
Now the categorical imperative has flaws, but no, your example is not one of them. If you say “Assassinating Hitler is good but assassinating other leaders is bad” that is immoral, because you are dependent on others choosing to follow a rule differently from you. The correct usage would be “assassinating leaders who commit genocide is good” because this rule can be followed to its logical extension, generally without internal conflicts.
Similarly though, one could then reframe the vigilantism argument as such “Vigilante justice against persons or groups whose actions break and the law, and which civil authorities refuse to prosecute, is justified.” In which case I think this is a good claim. If I murder someone, and the police refuse to prosecute me, I think it’s okay if someone else decides to take matters into their own hands. Vigilante justice is bad, not because it’s “unfair”, but because it’s generally ran at a lower evidence standard, and weakens the perceived authority of the state. In short, vigilantism is an bandaid solution to inefficient government prosecution with significant negative externalities, and is therefore bad from a utilitarian perspective.
> Now the categorical imperative has flaws, but no, your example is not one of them. If you say “Assassinating Hitler is good but assassinating other leaders is bad” that is immoral, because you are dependent on others choosing to follow a rule differently from you. The correct usage would be “assassinating leaders who commit genocide is good” because this rule can be followed to its logical extension, generally without internal conflicts.
If that was the problem (and Kant wasn't just naive abstract moralist), then how about doing it to "billionaire CEOs is good"? Anybody can follow that out to its logical extension, generally without internal conflicts!
I understand that you are not equating Brian with Hitler, but your statement seems to imply that both situations have something resembling an equal footing which I have to point out that they do not.
Besides that assumption what philosophical justification does the OP need to make, to make the proposition that the unlawful taking of another's life is morally outrageous?
I suppose my point is that there's no hard-and-fast moral proposition in either case. Finer distinctions should be made. I disagree that vigilantism is something bad in itself. Nor is unlawful murder necessarily morally outrageous. In the end you have to do the hard work of judging whether the victim was a "bad" person, and whether alternatives avenues for justice exist.
Gurwinder, to be fair, makes some relevant points–was the CEO really responsible for these insurance denials? Did the denials really kill people? Those are good places to start.
In other words, there's room for important moral debate here. It would be a shame to dismiss the entire issue by clinging to the blanket assertion that "vigilantism is always wrong". That seems unreasonably dogmatic.
"was the CEO really responsible for these insurance denials?"
Did he and his peers EVER EVER try to rebalance the 'promise' and 'denial' they sold?
No, a single CEO could not and cannot make enough change to be effective or even noticed. However, what I just typed may also be a unwarranted exaggeration: using AI (being PROUD to be using AI) to create nearly THREE TIMES as many denials as the NEXT closest insurance co. Then, throw in the actual U.S. LAW, with jail and fines as the stick, if the CEO does NOT hold shareholder payouts as the HIGHEST value of the company... And lawsuits BY shareholders if -- rewards FROM shareholders -- if he keeps profits and payouts UP!
See? NEITHER (or rather, NO) side has clean hands!
That’s a thought-provoking point—extracting broad principles from specific cases can oversimplify the moral complexities involved.
I find that celebrating the assassination of Hitler doesn’t automatically mean endorsing all political assassinations, but it does invite questions about when, if ever, vigilantism is justified.
But surely the point is that, given the widely varying notions of morality in the world, anyone could make a 'moral' decision to shoot anyone. You can't say that extrapolating the latter moves from the moral to the arbitrary without claiming that there was an objective morality to the first action.
"Vigilantism is always wrong" sounds to me like an oversimplification and binary thinking. An often overlooked example for vigilantism is Japanese PM Shinzo Abe's assassination which uncovered a long list of issues and caused major publlic backlash towards Abe and his ruling party
There are lots of reasons why vigilantism is a bad idea. In the quoted example it suggests health insurance would be higher. In the Hitler example, the bad idea would be the possibility of someone worse taking over or reprisals. The Allies did try assassination during the war https://en.wikipedia.org/wiki/Assassination_of_Reinhard_Heydrich The reprisals for this were awful. Following this the Allies did not use political assassination even though suggestions were made for the assassination of Hitler by double agents.
Additionally I think comparing vigilantism to assassination in war is not a good comparison. A better comparison would be assassination of JFK/Huey Long where there are viable alternatives other than murder to achieve your political aim as in this case. In a war or facing a dictator you may feel that the short-term deaths are worth it in the long run and equation which does not really fit in a peace-time democracy.
I think this is similar to “if you had a Time Machine then you’d go back and assassinate him” but that’s sort of an impossible scenario since we can’t travel back in time, and no one at the time knew for certain what would happen
In a vacuum, violence is unacceptable, sure. But protests are often futile in bringing real change, debates have been rendered meaningless by talking-heads that would rather “win” debates in the marketplace of ideas instead of having basic discussions based on rationality, and the options people have the opportunity to vote for are many times not in support of a change in the system; even if they were, they often get overrun by the rest of the establishment (see Bernie Sanders).
Big Health Insurance, a system whose sole purpose is to gatekeep healthcare (since the actual providers of healthcare are the nurses, doctors, surgeons, and the like) has so much misery and blood on their hands. When all other options have been exhausted, then who is to say that vigilantism isn’t the logical conclusion? How will predators in our societies be stopped when they can not be held accountable by any other means?
Now, I largely consider Luigi’s alleged actions to be a fruitless sacrifice, and I would never personally wish death upon Thompson. Without going to much into my politics, I can state that I am personally for Prefigurative politics (the good ol’ Anarchist way), but I still think that this pseudo-pacifism is absolutely jarring.
Violence is systemically done against citizens every single day. It is baked into our societies, and in the context of Big Health Insurance, it is a feature and not a bug. But apparently, the violence of ruling institutions doesn’t count, only the acts of interpersonal violence. The slippery slope arguments for the case against vigilantism are honestly insulting.
And for Gurwinder, I honestly expected more from you in this article. You chirp about Agency, but the Agency of those that are at the top of the corporate pyramid at crooked institutions like the Health Insurance business apparently is ignored here, because apparently, this system is “no one’s fault”. You even go on to emphasize the agency of the shooter, but completely neglect the agency of the ones who uphold the current status quo.
Deeply disappointing narrative from a guy who tries to emphasize critical thinking.
Every part of this argument makes me sick to my stomach. The helpless little guy crushed by the system is the most tired fucking trope out there. Nobody is willing to take responsibility for anything, always looking for someone else to bail them out. Wonder why Americans are so sick and why health insurance costs so much? Look at your average fucking American. Obesity, drugs, junk diet. The problem with your argument is that the system is more than just the corporations. The customers are part of that system and their habits drive the economics of the industry. Why does UHC make such demonic profits? Because Americans are too fucking stupid to take care of themselves. You may as well be advocating for somebody to shoot your fat neighbor. FOH.
I think that your comment is... not well thought out, but I'll still try to answer it in good faith since I think that you definitely do raise important points.
BHA, you can be as sick to your stomach as you want, but it should not spark controversy to point out the existence of systemic problems. "The helpless little guy crushed by the system" is not a trope, it is the reality for millions of Americans, even across institutions (even across countries, lol, the US finds a way to crush people even outside of the US).
Yes, the system is more than just corporations, I have never denied this or argued against this. But I am not going to pretend that there aren't corporations within this system that can not take part in the blame. After all, the existence of Big Health Insurance is the reason why so much of healthcare in the US is gatekept behind a paywall, that's literally their business model! Most developed countries do not have the same problems regarding healthcare as Americans do. For example, millions of people depend on health insurance companies to cover the cost of medical care to get it. When they can’t access care without coverage, it’s the same as being denied care altogether which most of the developed world can NOT relate to. This is not something that Americans can merely "personal responsibility" their way out of.
You also raise the point that I should look at the average American, and recognize their drug use, junk diet, and obesity as a problem. Of course, these are problems! But when that is the "average" American, doesn't it support the claim that many of these problems are systemic? If millions of people in a relatively concentrated area (the country of the United States of America) experience the exact same problems, do you not think that it indicates the existence of a broader systemic problem instead of personal failings alone? Put it into perspective: In much of the rest of the world, people don't have the same problem, or at the very least, they don't have these problems to the same extent as Americans do.
Furthermore, I really dislike the essentialism of Americans in this part of your comment: “...Americans are too fucking stupid to take care of themselves.” It raises the question of why they would somehow be uniquely stupid. Is it hardwired in their DNA to be stupid, fat, and addicted to both drugs and junk food at a level that most other societies are not?
I also think that it is unfortunate that you don’t bring up any other failings instead of apparent personal ones. I think that you actively not doing that, even when my comment emphasized it, shows your affinity to this topic in general. Hopefully, you will allow for more nuance the second time around.
And lastly: “You may as well be advocating for somebody to shoot your fat neighbor.” This I’m not even going to entertain lol.
I think that’s a fair judgement of my comment. I’m finding it hard to put into words how frustrating it is to see so many people embracing something so awful. I shouldn’t be surprised I guess, but the amount of negativity I see directed at anyone who dares to point out how counterproductive and dangerous the glorification of violence is has really shaken me and it’s taking me some time to sort out what it is that is so viscerally abhorrent to me. So thanks for replying, I have thought through it and this is probably what I should have written in response:
I will be the first to say that many if not most corporations are evil and that they have arrogated themselves into a corporate personhood that makes it all but impossible for regular people to deal fairly with them. I can also see that the healthcare system in the US is involved in victimizing a lot of people, sometimes purposefully and/or fraudulently. But victimization alone can’t explain what’s happening at the macro level and that’s what the argument has been reduced to. This line of reasoning is what’s so annoying to me: The health insurance companies are to blame and their CEOs are in charge so they are personally responsible for the suffering of millions and deserve to die. That’s literally the argument I hear you and hundreds of people making. If I’m missing some nuance please educate me. Cold-blooded murder nor its threat represent a solution to a societal problem that transcends industry, demographics, etc. Societal problems are not solved with violence. They can only be solved by people modifying the behaviors that contribute to the problem. Blaming the CEO is not an effective tactic. Killing the CEO is even worse, especially because it feels so good for misguided people who favor magical solutions.
This ideology, like so many retarded trends emerging in this country, poisons its followers. It’s a soporific, nothing more, encouraging people to see themselves as victims rather than the primary actors in their own stories. That’s what bothers me so much. It’s so American to blame everyone else for our problems when it’s only ourselves who are capable of addressing the problem. Smash the system, kill the evildoers, profit! It’s juvenile and will do nothing but delude small minded people into thinking that their outrage can change something. If we want to change this dynamic we have to do more than kill. We have to build, and no one is talking about that. A revenge fantasy cannot solve a systemic issue no matter how hard we wish it would.
Bin Laden didn't get a trial. Not everyone gets a trial. This CEO was the accomplice in more deaths than Bin Laden. I don't feel bad about either getting killed and the chances of the CEO ever going to trial for those deaths are less than zero.
"This CEO was the accomplice in more deaths than Bin Laden."
Any proof for this claim?
Denying a claim isn't murder.
Also, the idealistic notion that "All health care should be free and unlimited" is infantile utopianism, every system rations and has delays that result in death.
Thompson is only an "accomplice in... deaths" when his work is judged against an unlimited utopian principle and also only if you believe that the State or some other entity bears ultimate responsibility for every life and every death.
He was the sub-CEO of the division that was responsible for creating the system that generated algorithmic denials that denied 91% of cases, mostly erroneously.
Brian made $10m in 2023. Kim Keck, CEO of BCBS, made $4m. That $6M delta came from SOMETHING profitable that his team drove, and that something profitable was increased denials. It's worth it to note that comp comes before margins - the vast delta in comp going to this guy and the other executives like him is part of why United "only" has 6-7% margins.
To save money, this CEO authorized denial of claims by AI which almost certainly denied claims that should have been authorized. In other words, his choices directly led to the deaths of thousands if not tens of thousands of people and brought him (and his shareholders) millions of dollars.
Yes, health care resources aren't infinite and need to be rationed somehow. The way they should be rationed is via NIH "death panels" who decide on care standards and cutoffs based on QALY's, not on an executive deciding "I'd like another ski chalet" and driving initiatives that increase denials and internal profitability.
Your claims about profits, margins, salaries, chalets etc don't come close to proving that "his choices directly led to the deaths of thousands if not tens of thousands of people", this seems hyperbolic to say the least.
Just because someone has a claim denied DOES NOT equate DIRECTLY with murder—people have claims denied for all sorts of reasons, including the fact that it may cost tens of thousands to extend their lives a few mos or that a doctor, hospital or drug co may be charging an enormous price for a drug or procedure that the insurance co doesn't cover. If the insurance co decides not to pay for an expensive treatment to keep an octogenarian alive another month or two does that make them morally equivalent to MURDERERS?
Does Keck's $4m salary mean that Keck doesn't deserve to be murdered? Do the health bureaucrats in other countries who deny various expense forms of end-of-life care also deserve to be executed for murder? Who decides where the line is drawn?
—The way they should be rationed is via NIH "death panels"—why shouldn't these people be murdered too? Is it the profit motive itself that renders someone an enemy of humanity that can be killed in cold blood without a trial?
Hey, I'm not an expert on the American health care system, I don't pretend to be and I wouldn't defend it anyway, as I like everyone else has had hassles and been denied claims and coverage etc.
The point I'm trying to make is that supporting or excusing vigilante political murder is a barbaric exchange of the rule of law for the law of the jungle and that it opens up a Pandora's Box of political violence that won't necessarily lead to anything better, in fact it could lead to things being much uglier, more brutal and violent.
People hate CEOs and politicians for all sorts of reasons, people hate oil cos, tech cos, drug cos, bankers, hedge funders, landlords etc etc—why don't they deserve to be murdered in the street too?
You raise an important concern: where do we draw the line between moral outrage and justifying violence? Once vigilante actions are excused, the door opens for chaos rather than justice. It’s a slippery slope—if every hated figure becomes a target, society devolves into unchecked brutality.
I guarantee neither you nor anyone having temper tantrums about health insurance has paid or ever will pay enough in premiums to cover their own health care expenses.
If one cannot converse with the most basic knowledge on a topic, one ought to keep one’s thoughts in one’s head unless and/or until they take the initiative to learn.
For those of us who know how it actually works, these noxious “takes” presenting gross falsehoods as truths swing between hilarious and pitiful.
“ Denying a claim isn't murder.” Any proof for -this- claim? Maybe all claim denials should be done in person by the CEO. I wonder how many they would get through before the obvious outcome we saw on the streets of NYC? They’re very brave when people aren’t real to them and just a method for increasing wealth. I’d like to see you stand in front of someone who lost a family member to denied health insurance and say “ Denying a claim isn't murder.” I mean, if you’re ok with that, you’d make a great CEO or serial killer.
Like I said, Luigi and his defenders are wielding an idealistic utopian standard—no health care should ever be rationed, no claims ever denied, all bills tests procedures etc should be free and unlimited—that exists nowhere on earth and are using it 1) to justify murder in cold blood; 2) paint yourself as somehow morally superior to everyone who doesn't share your absolutism.
And of course denying a claim isn't "murder"—the unlawful premeditated killing of one human being by another—because people have claims denied all the time, most of them have nothing to do with death and because a system responsible for over 300 million people will never be perfect and the State or any other entity doesn't have the power of life and death over us all.
Be careful of blurring the distinction between the (clear) legal definition of murder, and the (contested) moral definition. Why should the legal definition be relevant to a moral debate? People are angry because they believe CEOs are indirectly causing deaths which the legal system overlooks.
Also, who's saying healthcare should be free and unlimited? Are you sure you're not attacking a strawman here?
Except for the constant problem of delays and wait times for certain kinds care in those countries, in all countries with socialized systems of health care, eg four months to see a specialist or 90 days to receive non-elective surgery. In Sweden a third of the patients wait longer. This is because there is unlimited demand and limited supply. (In addition, the Canadian healthcare system kills more people through assisted suicide than guns kill people in America.) And then there is the Canadian woman who had her right leg amputated after complications following a knee replacement surgery. The complications arose from a post-surgery infection. In late November, a surgeon at Winnipeg's Health Sciences Centre began removing dead tissue from her right knee, with the intention of stitching her up later that day after she was seen by an orthopedic surgeon at Concordia Hospital. But she couldn't be transferred back to HSC to see the surgeon because there wasn't a bed available. Instead, she languished for eight days at Concordia with a painful open wound. Once she finally got to HSC, she was told her leg was no longer salvageable and had to be amputated. Very sad story. Free for her, but not unlimited.
While HS never used the word murder, and instead decided to opt for using the word "killed" in the context of those who meet their demise within the Health Insurance system, your argument against their comment nevertheless is on the basis that denying a claim isn't "murder"; a legal definition of unlawful and premeditated killing. You purposely changed the goalpost so that you could defend Health Insurance companies, the gatekeepers of healthcare so that you could "debunk" that argument on a legal basis. I think people here are largely talking about this issue on a moral basis, and you trying to turn it into an exclusively legal argument is just... ugh man, do better.
The original claim was: Thompson was an "accomplice in more deaths..." and the question of the "CEO ever going to trial for those deaths."
Obviously implying both some level of malice and of responsibility for deaths and also that he could be charged in a court of law for this—thus introducing the legal aspect, which is what I responded to.
If someone is responsible in some way for the deaths of many others isn't the implication some kind of "murder"?
Mine was entirely a moral argument (killing/murdering also exist in the moral realm), and I used the definition of murder as a way to define the term (the term being "killed").
The comment implied that not only was Thompson responsible for multiple deaths, but that he deserved to be on trial for them, as they were committed for nefarious, greedy motives aka not killing, which could be accidental or incidental, but murder. It's all there in the comment I responded to.
Expect we all know that merely looking at what the current laws say is a cheap cop-out for actually critically engaging with an analysis of Thomposon's role as a potential mass murderer/killer, and the condemnation for the system that he was a part of.
We both know that you are correct in saying that "denying claims isn't murder"....Yes, but only within the existing justice system! But my God, laws have been wrong before, and somebody arguing that Thompson is responsible for deaths, has profited off of deaths, deserves to be on trial for these deaths, etc, doesn't need to be within the framework of the current legal system. But it is precisely on that basis that you argue. You invoking the legal term "murder", which is not simply a synonym for "killing", completely flips the conversation. It goes from "the acts of this man warrant legal scrutiny" to "the acts of this man do not warrant legal scrutiny... simply because the current laws don't allow for it". That's my objection.
So no, this is not a cheap semantics argument, it is the recognition that the laws that ordinary people are bound to rarely apply to institutions or to individuals who can overpower the justice system through money, status, or connections.
Once again, it is you who wrenched my comment out of context when you accused me of introducing the legal aspect.
The comment said: "the chances of the CEO ever going to trial for those deaths are less than zero." Thus here is the legal issue I was responding to and that i did not introduce.
"Thompson's role as a potential mass murderer/killer, and the condemnation for the system that he was a part of."
And really frankly this makes you too unserious a person to waste my time with any longer. "A potential mass murderer" lol cmon—this is hysterical nonsense. If Thompson was a "a potential mass murderer" then so is every politician and congressman etc who helped erect our system as well as the boards and investors of all insurance cos. That's a lotta murderers!
Thompson was just one node in a giant sprawling patchwork network that began long before he was born and that will not be changed by his murder. If he deserves to be murdered in the street then so do pharma execs, oil execs, gun manufacturers, missile makers, hedge funders etc etc...
"the acts of this man do not warrant legal scrutiny... simply because the current laws don't allow for it"...This is quite the motte and bailey switch!
I never once said or even implied that Thompson nor anyone else was above legal scrutiny—I just said that murdering him in the street was barbaric and stupid and could very well make things worse not better.
"The laws that ordinary people are bound to rarely apply to institutions or to individuals who can overpower the justice system through money, status, or connections."
Yes, welcome to reality at last. There is no place on earth and never has been where "individuals who can overpower the justice system through money, status, or connections" don't exist—not in countries with national healthcare, not in socialist states, not in the Biden White House. This is the natural state of humanity, there is always an unfair hierarchy and always some people who can gain systems—but instead of murdering our way out of this, through centuries of wars and political reform we've exchanged the law of the jungle for the rule of law, which is still better if not perfect and which is always changeable and fixable in free democratic countries like ours.
But hey, I'm really not trying to convince you of anything. If you think shooting CEOs in the back is justice, feel free. I encourage you to live by your principles.
Well, Nazi Germany also had all kinds of layers of bureucracy and processing until somebody finally actually killed someone more directly. Often it wasn't even through execution, so they could say "forcing people to work is not murder".
> Also, the idealistic notion that "All health care should be free and unlimited" is infantile utopianism, every system rations and has delays that result in death.
And if those delays are only practical, and not out of profit and greed, that's not a problem...
Ok then… Denying a claim is not the equivalent of imprisoning people based on their ethnicity, religion, ideology, etc, and using them as slave labor that will eventually be killed.
Der CP, there are numerus countries that have universal healthcare that is free and if it is not free, it is at least very affordable. Countries like France, Belgium, Denmark and Germany all have free healthcare Systems. And ALL of the countries don't even come close to US GDP. The US healthcare System is set up for Profits and not for acutal healthcare.
My friends and family under say age 35 who are always online are immersed in Luigi mania; my friends and family who are grownups with jobs and kids have never mentioned it and certainly don't condone it.
There's millions of impotent keyboard warriors out there salivating to see some street violence and to be able to justify their bloodlust because "it's for a good cause."
Social media is a playpen for lost souls and other bored children of the internet age.
Yikes, I’m sorry but your thoughts are detached from reality because of your emotional reaction to this story. Just ask yourself if a health insurance company makes money by denying a claim, and what their core business model is, lastly ask why insurance exists in the first place at all. If you have the patience then I recommend you to look up what the dual processes of reserving and pricing are in insurance and how these are heavily regulated, lastly I’d recommend learning about actuarial value and how that is enforced by government agencies (for a quick explainer you can google “Obamacare metal tiers” and there should be some explainers that pop up in Google search)
Funny you say that because this is the only part I outright disagree with! Iain Lim has already given an example as to why, but the claim is too strong. You can celebrate a given assassination without advocating for a world where anybody assassinating anybody is acceptable, if you slice things properly. That said, there's certainly a narrower truth that a consequence of celebrating an assassination you like publicly or even just outside the confines of your own mind is probably a forwarding of assassination broadly, and you are unlikely to like all that comes from that. However, that still doesn't mean you're advocating for that. Similar to incitement, this doesn't meet that bar.
Let us assume for a minute that it is possible to "celebrate a given assassination without advocating for a world where anybody assassinating anybody is acceptable", I will like to honestly ask: on what grounds are you celebrating the aforementioned assassination?
The headline says the CEO deployed it, but the body asserts no such claim, and the lawsuit, or at least that one document from it, doesn't even name him personally.
The CEO would be ( or definately ) aware of it. Interesting the company refused to respond when asked about it. - I guess they would if matter is a inprogress lawsuit. It would be a serious accusation about the denial rate.
I think it misses the point completely. "A world in which a stranger can decide that you’re also a bad person, and gun you down in the street." is not a hypothetical, it is the lived reality of millions of Americans. Preventable deaths (police killings, road violence, health care denial, homelessness) might be legal, and many people might not see them as preventable, but they are no more morally defensible than premeditated murder. We only accept them as a coping mechanism. We are made to feel helpless to prevent systemic violence by people like Brian Thompson. This is why his death was celebrated by so many.
"Vigilantism is always wrong. If you celebrate someone gunning down a defenceless person in the street, then you advocate for a world in which this is an acceptable thing for anyone to do."
Indeed. The claim of the state to possess the only legitimate right to engage in violence other than in self-defense is unconvincing unless it can be relied upon generally to engage in that violence when it is justified. If the society you are embedded in allows egregious assault on you then you are certainly justified in doing what needs to be done on your own.
"You in fact advocate for a world in which a stranger can decide that you’re also a bad person, and gun you down in the street."
"Can gun you down" is here conflated with "is justified in gunning you down". Nothing about thinking Mangione might have been justified in shooting Thompson requires me to believe that some other random somebody is justified in shooting any other random somebody.
Let's bring in a parallel nonfatal situation as an analogy for dissection:
I would argue that the confidential info release vigilantism of Chelsea Manning was wrong, because she simply bulk collected and dumped information with no greater principle than the US being broadly acting badly. She failed to use any discernment or principles.
I would argue that the confidential info releases by Edward Snowden were heroic, as he had a particular issue in mind and was confident that he had tried other methods for making authorities aware, and that the type of change he sought had only been effected by whistleblowers in the past.
I think any type of crime is similar in that there could be cases where any crime could be seen as justified civil disobedience because there is no justice within the system. Mangione does not meet this standard, of course.
This is the passage that stood out to me the most in this article and agree it's beautifully expressed. I, in fact, do advocate for such a world and I'm willing to accept the consequences of that world in their entirety.
I wonder how many others actually agree with the whole package here or who just want to make an exception in this one case.
My issue with you parading your interaction with Luigi is that you're blatantly disregarding his privacy by sharing details that he may have intended to keep between the two of you in your one-on-one conversation. It’s shocking that you’re willing to throw away his support and confidentiality for the sake of a few likes and clicks. Frankly, if I were in your position, I’d feel ashamed.
On top of that, what happened to the presumption of innocence? Calling Luigi 'the murderer' in your essay is reckless when he’s only been accused (on what seems to be at best, loose evidence so far). It’s unfair, doubly so considering how supportive he has been towards you.
I use the word "alleged" where appropriate and I've kept the most personal things Luigi told me secret. Beyond that basic decency, my loyalty lies not with Luigi but with the facts, wherever they may lead. That has always been the guiding principle of my blog – truth no matter who it’s for or against – and Luigi knew that when he became a founding member. In fact, it was why he did so.
Did it occur to you he was leaving a trail? Did you consider the extreme empathy schools like Yale and Harvard have towards their mentally ill students? And how mental heath professional don’t insist bi-polars or schizophrenics take their medication? Did another commenter not know ‘innocent before proven guilty’ is a legal norm and not a public prohibition? It’s too bad Luigi didn’t read ‘The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions’ by Jonathan Rosen.
As for insurance denials, has anyone noted that private equity has bought up hospitals, physical rehabilitation centers and charge rates compatible with extortion? How about surgical devices? And pharmaceuticals. Read a hospital’s itemized list of charges and you may not think RFK JR is such a crank. The one true thing Luigi has said is he is no expert. Part of the OWS 10% pissed he hasn’t slid into a non-profit nepo career that would make him look like a savior. Like Ted,he apparently found another way.
Your response is troubling for several reasons. Privacy isn’t conditional on someone’s online presence. Respecting one-on-one conversations is about basic decency.
Also, who are you to make such an assured claim as to label Luigi as such? Are you privy to all the evidence, or have you appointed yourself judge, jury, and executioner?
Using terms like 'alleged' isn’t about being soft, it’s about respecting the truth and acknowledging that none of us, least of all you, are in a position to make absolute claims without due process.
Until proven otherwise, Luigi remains accused, not convicted, and your rush to condemn him says more about your biases than the case itself.
It is basic journalism to use the word "alleged" to describe someone accused of a crime. As a reporter, I was especially careful to do so.
Here's an explanation:
"Finally, until a judicial authority has rendered a decision, a suspect or defendant has not been proved guilty of the charges or allegations against him. Not only is it unethical to describe this individual as, say, a "murderer" or "embezzler" without the qualification of words like "accused" and "alleged," but such descriptions could turn you into a defendant yourself -- for libel." -- from newscript.com
It’s terrifying that someone like you could end up on a jury. Your insistence that he is not an alleged murderer but a murderer stems solely from reports you’ve seen in the media or online. For the love of God please keep in mind that every single person that has been exonerated by DNA or a confession by someone else, etc, also had an abundant number of media reports and police reports stating they were guilty.
It's the need to make assumptions that he isn't qualified to make! All of it is opinion that isn't fact. Can we just wait for the trial to get a better picture.
Actually, I do not agree that the cost of healthcare in America are standard for its income. According to the National Health Expenditure Accounts, the average healthcare spending in 2023 was $14,570 per person. According to the United States Census Bureau, the median income of an American is $37,585. That means that the average person in America spends 38% of their yearly income on healthcare alone. Whereas in Britain, the average income is £37,430 and the average healthcare spending per person is £2,989, according to the Office for National Statistics. Which equals less than 1% of the average persons income goes to healthcare per year. See the difference?
There is so much wrong with your post that it's depressing it has so many likes.
But to put it simply:
- The calculation you use to determine income and spending for the median American is wrong (you can't use generic national figures to say much about the median American). For instance, instead of merely looking at nominal average income, you need to be looking at PPP Actual Individual Consumption per Capita (AIC) as that gives a better indication of *disposable* income, which is what we really want to measure. The US has much higher household disposable income per capita than the UK, which is something median income won't tell you.
- You're comparing US and UK healthcare as if they're like-for-like, but they're vastly different systems. The way costs are calculated for these systems are not comparable.
- You disprove nothing by showing that the US spends a larger percentage share of income on healthcare; of course countries with more disposable income spend a higher percentage share of income on healthcare, wouldn't you?
- I acknowledge in my article that, although US healthcare costs are broadly in line with its (disposable) income, they're still more expensive than they need to be, and this seems to be due mainly to administrative inefficiency (but overall has many different causes).
- The stats you provide are unreliable because they're derived using flawed methodology.
- I acknowledge in my article that, although US healthcare costs are broadly in line with its (disposable) income, they're still more expensive than they need to be, and this seems to be due mainly to administrative inefficiency (but overall has many different causes).
What different causes? You're glossing over the pain caused by 64% of all bankruptcies in the US - getting sick. (Perhaps the income isn't so disposable?)
I'm not trying to nitpick - I genuinely feel the biggest flaw in your article is glossing over the culpability of the CEO for saving money with AI-powered claim denials instead of working on what you claim are obvious redundancies in— claim administration? (He was a Dad trying to keep costs low, including for policyholders.)
“Getting sick.” How does one “get sick” after all? It just happens to them? No, half of it is simply bad habits of the individual. I’m so sick of the victim mentality on display here. Oh we had to kill the CEO because the system is exploiting us. Here’s a fucking news flash: take fucking care of yourself and you won’t be a victim. Take care of yourself so there’s money in the insurance pool to treat people who are actually the victims of circumstance, not voluntarily killing themselves with drugs, alcohol, and garbage diets. These arguments are so pathetic. Everyone wants to talk about agency and the responsibilities of the elite to society but it’s always someone else who has to change. The only positive change possible has to come from within. Advocating for a simple, violent solution that singles out one part of a complex system isn’t going to do a fucking thing except add more fuel to the fire consuming our society.
I did not study economics and have never heard of Actual Individual Consumption per Capita. From what I understand, and correct me if I’m wrong (but please be nice I’m literally just a girl trying to learn) AIC looks at consumer goods and services purchased directly by households and services provided by non-profit organizations or the government for individual consumption and it measures it “by the total value of household final consumption expenditure, NPISH final consumption expenditure and government expenditure on individual consumption goods and services” (OECD) and I would assume divides it by population (since its per capita)? Then disposable income is the amount of income a person has after taxes are taken out. Then to find the disposable income per capita for a country you take all of that and divide it by that countries population?
The problem with AIC and disposable income is that it does not take into account any wealth disparities. In America, the Federal Reserve data show that the least-wealthy 50 percent of U.S. households hold very little of the nation’s wealth (less than 4 percent), while the households with wealth in the top 10 percent hold over two-thirds. This would mean looking at the country overall we all look to be in pretty good shape but then why are so many Americans living paycheck to paycheck. I agree the AIC does take more into account but it fails to account for the massive wealth disparity in America.
The NHS budget is nowhere near high enough to provide even basic levels of care for the population size, which is why the UK has problems like ambulances turning up many hours after they were called, or hospitals trying to claim that being put on a chair in a corridor is just as good as a regular ward.
This also ignores the severe rationing that goes on. In the US people complain about care being denied by health insurance, but on inspection it's often some incredibly rare or experimental new advance that just isn't available in the UK at all, no matter what you do or are willing to pay.
You can't compare US healthcare to the UK by this point unfortunately. The UK system is in full blown collapse. The US healthcare system just isn't. The biggest complaint Americans seem to have about their system is that it doesn't offer even more luxurious levels of care than it does, because basic care is already more than covered.
I’m a nurse and I studied abroad in South Africa (evaluating their universal healthcare). Is it a perfect system? No. But there is also the option of private healthcare for those who can afford it and don’t like the wait times. And most importantly everyone has access to healthcare whereas in America, 8% of the population is uninsured and nearly 1 in 4 adult Americans are underinsured. I don’t see the problem in caring about your fellow humans and wanting them all to have access to healthcare…healthcare is a human right. (And the awesome thing about having other countries do it first is we can learn from their failures. Like the one in Britain. Just because one country fails at universal healthcare doesn’t mean there isn’t a way to implement it). But hey I would also settle for the government becoming more involved in insurance, hospitals, and big pharma capping the amount they can charge for services or drugs.
No it isn't. This is the kind of sloppy thinking that leads countries to ruin.
Other people doing things for you is NEVER a human right, let alone something as vague and ill-scoped as healthcare. Just think about it, please. You're a nurse. If someone turned up on your doorstep and announced you needed to treat them right there and then, for free, because "healthcare is a human right", how would you feel? What about the next 100 people who did it?
yes, the number of uninsured and underinsured is about 44% in the US.
there are people who are insured who cannot pay because of required co-pays and high deductibles.
the Commonwealth Fund report that you cite is a very good source.
the remark made by the previous UK commenter Alistair that denials of claims by US insurers are "often (for) some rare or experimental new advance" is woefully uninformed.
i think the topic of agency is an interesting point here. for the sake of time i will define agency as 'having an effect on the world.'
if you only look at a screen all day, of course you'll feel like what you do has no effect on the world. you aren't looking at the physical realm where you can have an effect. if you look away from the screen you can suddenly exercise your agency by making a sandwich or cultivating a garden. screens can be addicting as in 'easy farming game with no struggles makes me feel like im progressing.' but screens can also be this onslaught of things it feels like you cannot affect (war, politics, etc.) which also takes away your sense of agency.
imo, people just need to descope. instead of 'omg i need to solve healthcare' work on a solution within your local community where you can have an impact. 'omg omg climate change so bad' ok start by planting more trees in your locality. i have seen this happen. it's not as easy as a video game but it's not too hard either.
you will not solve healthcare unless you spend decades gaining the training and network to do so. which you can. i could still decide to go to law school and devote my life to that. i just have other goals.
also the 'is luigi sane or insane' debate is boring. we are all a mix of rational and irrational.
"Vigilantism is always wrong. If you celebrate someone gunning down a defenceless person in the street, then you advocate for a world in which this is an acceptable thing for anyone to do. You in fact advocate for a world in which a stranger can decide that you’re also a bad person, and gun you down in the street. In such a world, I promise you, your health insurance would cost much more."
This is beautifully expressed.
Except it makes some unjustified philosophical leaps. To take a really tired example:
"If you celebrate someone assassinating Hitler, then you advocate for a world in which assassinating political leaders is an acceptable thing for anyone to do."
Not equating Brian Thompson with Hitler, of course, but I find this oft-echoed "refutation" of vigilantism unsatisfactory, resting as it does on the extraction of an (arbitrarily?) broad principle from a particular moral decision.
It echoes the stubbornness of pacifists who believe that violence is out of the question regardless of the stakes. As a system becomes more unjust and more exploitative, there will be an increasing number of people who will reject the system and believe that vigilantism is justifiable. That's not to say that it was in this case, but the fact that so many people feel that it was should be a wakeup call to people who feel they live good lives and benefit from the system.
When people feel cornered by injustice, the idea of vigilantism often starts to seem like the only answer.
It’s less about the act itself and more about the desperation it signals.
Do you think this growing sentiment could push the system to change, or will it just reinforce the divide?
I think more often it's vengeance that starts to seem like the only answer. What makes this case stands out is the vigilantism and ideological motivations which inherently seem less desperate and more calculated. As to your question, I am really not sure. I think growing animosity creates more inherent uncertainty. Whether that leads to systemic change, or to perpetually increasing resentment on both sides, is up to the people to decide.
https://www.skeptic.com/reading_room/honor-dignity-victim-cultures/
I believe this article accurately describes the phenomenon.
In the law of the jungle, vigilantism is the main means of self defense.
In the rule of law, vigilantism is given up to higher powers to let those higher powers defend you, much more than your own resources can allow.
But the key question is what happens when the rule of law restricts instead of protects? Indeed when rule of law becomes increasingly sophisticated, the line between protection and restriction is blurred - if you are forced to buy healthcare for your own good, at exorbitantly high prices such that you have no savings, is that a protection or a restriction? How much of modern society's rule of law is really protection, and how much of it is handcuffs—a reduction of agency?
What is interesting is that the framework denotes not a return to vigilantism as the solution, but to become the ultimate victim, so as to incite large groups to bite each other as an enactment of justice for the victim.
Lots remains to be said on the subject but to decry vigilantism as wrong is to perceive the world in dignity culture, failing to see that the world is moving on from it, if it hasn't already.
"How much of modern society's rule of law is really protection, and how much of it is handcuffs—a reduction of agency?
"What is interesting is that the framework denotes not a return to vigilantism as the solution, but to become the ultimate victim"
All one needs do is look at the current (last 5? 10? 15? years) of MASSIVE increases in gun purchases. Especially, and I laugh with disgusted delight, at all the THOUSANDS of "anti-gun liberals" suddenly swamping gun stores to buy self-protection guns they mostly do not learn to use. When "the govt" (the agent) to whom/what you have outsourced your protection (or health care) STOPS providing those and you discover you are naked in the jungle: "suddenly" providing for your own care or protection becomes hugely important.
I sort-of/mostly agree the 'cure' is not vigilantism. But when one IS trapped in a corner by the likelihood of denial-of-coverage that is bankrupting thousands -- or a random physical attack ANYwhere, at ANY time, by any number of violent invaders -- then praying, barking, or biting (see progression of defense) ceases to be enough. “Agentism” requires more agency than sitting on hold for hours TRYING to get coverage – OR calling 911 and waiting 20+ minutes for “out-sourced protection” to arrive. (No insult to cops: Police are MAINLY to take the reports after the crime – NOT to protect or prevent. (Esp. not when “defund the police” is the local chant!)
When (and how) does one TAKE BACK agency that had been castrated?
Beautifully said
Vigilantism, writ large throughout human history, is THE reason why modern human beings are capable of living in civilized societies. https://pmc.ncbi.nlm.nih.gov/articles/PMC10427284/
Who decides when the “system” is unjust enough to justify vigilantism?
If a “system” (whatever one means by that, that’s why it’s in “ “) is unjust or perceived to be so to someone then that person can go opt out. That doesn’t give them the right to murder someone in order to bring justice to the system. (No need to get into how that murder doesn’t guarantee justice will prevail and if it doesn’t it’s impossible to undo).
Practically speaking it is a critical mass of people who decide, everyone has their own threshold of what is tolerable. When people are mostly content with their institutions but a few people are not and resort to vigilantism, those people will be branded terrorists by the rest of the population. If a significant portion of the society is not content, the vigilantism will be seen in a different light. If things continue to deteriorate then these institutions eventually become untenable. Institutions which are ultimately just networks of people will be forcibly replaced by networks of other people.
It's up to us who are relatively comfortable with the system (the current collection of institutions that drives our society) to ensure that enough people are comfortable so that we avoid getting anywhere near this critical mass. We are humans and human beings have the appetite for violence if things get difficult enough, they don't need an imaginary 'right to murder' for this to happen
Agreed!
Except your argument assumes one knows a priori that Hitler will be Hitler. No one can predict the future enough to justify murder.
I think you're confusing his argument with the common hypothetical related to killing Hitler as a baby. As far as I can see from his comment, there's no mention of the assassination occurring before his crimes were committed.
You made a good point about the Hitler example. But what do you think the main idea of his argument is?
Reminds me of the plot of Minority Report, but predicting the future is very difficult when you consider all the ecological variables. If not Hitler, a similar ideologue could have committed equivalent atrocities by scapegoating another minority group for the country’s economic woes.
The reason for WW2 was the Treaty of Versailles.. and we can all blame the arrogance of post WW1 France and England for that.
Leaders always create their own enemies through unfair and arrogant actions.
Stalin comes to mind? Mao and his minions? Pol Pot?
HUMANS are violent. START there!
(Maybe ask WHY Hitler is humanity's "worst-ever demon" across the world, when, if compared to Stalin, he was a complete PIKER!? Who manipulates whom?)
Or how about a more radical and yet plausible idea to extend groups further: what if another ideologue had actually taken Hitler’s place and done even worse?!
That’s why this exercise is silly and we shouldn’t be so arrogant to believe we know the answer to these hypotheticals so easily.
Completely agree. For this same reason I strongly dislike the anti-appeasement argument that has justified much of American interventionist foreign policy since WW2.
The Hitler argument only works in 202/20 hindsight with 100% certainty of the future. When do you propose Hitler should have been assassinated? In his crib? No, if you really think it through, the only logical time is after damage had already been done. Even then, what happens when you martyr him? Does this action then make his ideas stronger or weaker for those he leaves behind? Nobody has a crystal ball. Thete is a distinct possibility his assassination would have strengthened the Nazi party and the world might look very different today.
There is a time for violence, but using it to try to win a political disagreement is not one of them. This way lies the death of all that we hold dear.
"Using (violence) to try to win a political disagreement..." That's how you frame that killing? There is a desperation among working class people that has been ignored for decades. The CEO of
Sorry. Brian Thompson approved the use of an AI to decide claims. It was wrong 70% of the time. Denying a claim could very well be a murder. You seem to be far removed from the knowledge that working class people are drowning. You don't seem to have knowledge of what you're addressing. You're claiming a moral, logical argument? It misses the mark by a lot.
I'm not condoning Thompson's murder. But I definitely understand the motivation for murdering him. Brian Thompson was on his way to a chard holder meeting. Do you understand what that means?
These insurance companies should be out out of business. Period. It's an immoral endeavor. It's gambling.
National healthcare. Period.
I am a clinician who fights with insurance (including UHC) constantly on behalf of my patients. I have masters degree in health policy and have studied insurance in great depth. What is your resume? Make a good argument. Please resist temptation to character assassinate (or actually assassinate!)
Regarding national Healthcare, do you assume this will result in fewer denials? You would be mistaken to think that is the case with Medicare or Medicaid currently, or would be the case with expansion of these programs. Though I do agree that private insurance of all kinds is highly problematic. My next article soon will discuss this complex subject in greater depth.
All we hold dear that is ALREADY lying on its deathbed, gasping out the last chances to regain health?
Absolute truth: What CANNOT continue, WILL NOT continue.
The upcoming financial crash will end this country. (You ready?) "We" have filled the country with literal millions of "military-aged men" -- many of whom have DEEP (and legit!) 'beefs' against "us" -- and do not that all those various groups are NOT armed! What do you think is prepped in the backrooms of the 66+ CCP POLICE STATIONS spread across the U.S.? (Why did OUR govt know about them for some years; and we only found out by happenstance because a (White) man in Seattle "turned vigilante" to RESCUE a middle aged Chinese woman screaming for help as two "Chinese policemen" were dragging her to some bland building. Should HE have just let her get dragged away to who-knows-what?
We KNOW China was sending containers full of weapons -- including a technologically cool "missile launcher in a 52' container" -- we CAUGHT at least one missile launcher -- and at least several shipments of "weapons of war" as our govt describes them. How many containers did we miss? The VERY few mosques that have been entered by "our agents" sometimes turn out to have an ARMORY. The cartels are building up weapons storehouse acvross our wide wide open borders.
"We" have brought in many thousands of military-aged men with legit beefs with "us" for the destruction we have wrought in THEIR homelands! Many various Middle Easterners. Afghanis. Iraqis. Iranians. Russians. Ukrainians. PICK your country -- and how many of these men lost family (in an ENTIRELY family-centered cultured) have "we" been responsible for the deaths and destruction of? THEY do not have a strong sense that vigilantism is bad or unlawful. THEY have their own culture's belief that it is "just desserts."
WHY do you not know these things?
Yes, there are almost always exceptions to any rule.
Here, it is reasonable to assume that nearly everyone who would state the quote Gurwinder used would agree that vigilantism when the victim is one who directly ordered the deaths of millions of innocent people, and all of the reasonable countries (regarding their perspective of Nazi Germany) with power in the world are trying to stop them militarily, is justified.
Those circumstances are extremely rare, so adding that (somewhat obvious) exception to the rule whenever stating it can seem unnecessary.
Well, I'm not merely pointing out that exceptions exist. The point is that they exist *because* the moral question is not simply whether vigilantism is always right or always wrong. And so it is not answered by simply inventing an incredibly sweeping categorical imperative and claiming it refutes itself. Surely, if we want to make any progress on the issue, we need to be clear about the terms of the debate. Which, as I have tried to indicate with the (extreme) Hitler example, really comes down to whether the victim was a sufficiently bad person.
I agree that optimally such statements should be amended to not be an absolute that can easily argued against by those stating the obvious “but what about Hitler”.
However, saying that vigilantism is only right when the victim is a sufficiently bad person leaves far too much open to interpretation (especially to those with misguided reasoning) as I’m sure most of us would agree.
Simply adding: “if formal mechanisms of justice or intervention are unable, yet willing to stop them by any means, vigilantism may be morally justifiable” could be an option, but then some may come up with sound arguments against that as well, such as whether death should be the punishment.
A rule that addresses all contingencies and is not open to interpretation would need to be created. If it is well crafted enough, I’m sure many people on both sides of this argument would be likely to agree it makes sense.
Formal mechanisms of justice in which jurisdiction? For a German of the time, the local formal mechanisms were not willing. The same is true for comparably less bad or powerful people, like for instance many slavers throughout history.
Hitler is the extreme example to make sure that whether the person in question deserves it doesn't need to be debated first, but I'm sure you too could think of plenty of less bad people to slot into the "murdering them would be good actually" category. Like all the lesser murderous dictators in history and still ruling today, especially if it's not guaranteed that they will be replaced by someone worse. And probably also their worst right hands and collaborators, i.e. your Goebbels and Himmler equivalents. Or do you disagree?
"Those circumstances are extremely rare"
Another ahistorical lie. Who taught you that -- and why?
I’d challenge anyone who disagrees to explain how the circumstances of successfully committing vigilante murder against an individual who has ordered the deaths of over a million innocent people are NOT extremely rare.
The number of such cases in the last century is in the low double digits. Having the ability to out maneuver their security, and have the perfectly aligned timing to pull it off is very unlikely. It doesn’t take much to realize that when you think about it.
It is easy to see why vigilantism is bad. It is because it is unlawful.
And I think that you are not paying enough attention to that. It is unlawful and we have not even begun to make a moral case against it on the basis of murder.
Even if it is remotely possible for it to be permissible in Nazi Germany, it doesn't by any stretch of the human imagination spill over to the United Healthcare CEO's situation. We are not living in Nazi Germany.
> It is easy to see why vigilantism is bad. It is because it is unlawful.
Lots of unlawful things are good. Freeing slaves was unlawful too for example...
And the opposite, lots of legal things are bad.
So as a thought experiment, the solution is to take over the government, rewrite the laws by whatever method, and then put the CEO in front of a revolutionary tribunal and then appoint luigi as the executioner? Then its perfectly “legal” to blast his brains out.
The law is just what the government says it is and can enforce with violence. The issue with vigilantism is that, in theory, its less fair and just than a legal system and it violates the public order. (In modern societies, I’m not going to get into premodern or frontier societies where things can work differently)
In a well functioning country in which there is high trust between citizens, relying on the legal process is obviously the superior method….
Is this a well functioning country?
Either way is debatable at this point. Still a lot better than most countries these days.
Compared to south america, the middle east, or Africa we’re still sitting pretty.
"It is easy to see why vigilantism is bad. It is because it is unlawful."
So, driving 65 in a 55 mph zone is "bad"? That law forced on us to restrict driving to 65 was to save GASOLINE, and yet was pitched 'to save lives' in order to manipulate the public!
You might also consider why it is and always has been the HUMAN condition. It pains me to point out (because a concept so often misused by those I consider nearly my enemies) but it is true that BOTH sides in any conflict BELEIVE they had/have the the right of it. Taking the side you were taught is virtuous and right to commit your group's atrocities and discarding entirely that the OTHER side had equally important and persuasive reasons they thought, on EQUALLY "virtuous and persuasive" grounds means merely, and always, the victors write the history books!
Exactly, as you say, it is possible for it morally correct in the extreme case of Hitler in Nazi Germany, but the United Healthcare's CEO does not even come close to meeting those extreme "qualifications". For one, he didn't directly have a hand in anyone's death, among many other glaring differences. (I see I should have noted this for clarity)
So, Von Stauffenburg really was a traitor?
Broadly speaking the argument is really an extension of the Categorical Imperative. If you want to punish criminals for their perceived crimes as a vigilante, but don’t want to be punished by others for your perceived crimes, you are using others as a means to an end (their obedience of the law as way to enable your particular behavior).
Now the categorical imperative has flaws, but no, your example is not one of them. If you say “Assassinating Hitler is good but assassinating other leaders is bad” that is immoral, because you are dependent on others choosing to follow a rule differently from you. The correct usage would be “assassinating leaders who commit genocide is good” because this rule can be followed to its logical extension, generally without internal conflicts.
Similarly though, one could then reframe the vigilantism argument as such “Vigilante justice against persons or groups whose actions break and the law, and which civil authorities refuse to prosecute, is justified.” In which case I think this is a good claim. If I murder someone, and the police refuse to prosecute me, I think it’s okay if someone else decides to take matters into their own hands. Vigilante justice is bad, not because it’s “unfair”, but because it’s generally ran at a lower evidence standard, and weakens the perceived authority of the state. In short, vigilantism is an bandaid solution to inefficient government prosecution with significant negative externalities, and is therefore bad from a utilitarian perspective.
Soap box. Ballot box. Bullet box.
> Now the categorical imperative has flaws, but no, your example is not one of them. If you say “Assassinating Hitler is good but assassinating other leaders is bad” that is immoral, because you are dependent on others choosing to follow a rule differently from you. The correct usage would be “assassinating leaders who commit genocide is good” because this rule can be followed to its logical extension, generally without internal conflicts.
If that was the problem (and Kant wasn't just naive abstract moralist), then how about doing it to "billionaire CEOs is good"? Anybody can follow that out to its logical extension, generally without internal conflicts!
I understand that you are not equating Brian with Hitler, but your statement seems to imply that both situations have something resembling an equal footing which I have to point out that they do not.
Besides that assumption what philosophical justification does the OP need to make, to make the proposition that the unlawful taking of another's life is morally outrageous?
I suppose my point is that there's no hard-and-fast moral proposition in either case. Finer distinctions should be made. I disagree that vigilantism is something bad in itself. Nor is unlawful murder necessarily morally outrageous. In the end you have to do the hard work of judging whether the victim was a "bad" person, and whether alternatives avenues for justice exist.
Gurwinder, to be fair, makes some relevant points–was the CEO really responsible for these insurance denials? Did the denials really kill people? Those are good places to start.
In other words, there's room for important moral debate here. It would be a shame to dismiss the entire issue by clinging to the blanket assertion that "vigilantism is always wrong". That seems unreasonably dogmatic.
"was the CEO really responsible for these insurance denials?"
Did he and his peers EVER EVER try to rebalance the 'promise' and 'denial' they sold?
No, a single CEO could not and cannot make enough change to be effective or even noticed. However, what I just typed may also be a unwarranted exaggeration: using AI (being PROUD to be using AI) to create nearly THREE TIMES as many denials as the NEXT closest insurance co. Then, throw in the actual U.S. LAW, with jail and fines as the stick, if the CEO does NOT hold shareholder payouts as the HIGHEST value of the company... And lawsuits BY shareholders if -- rewards FROM shareholders -- if he keeps profits and payouts UP!
See? NEITHER (or rather, NO) side has clean hands!
That’s a thought-provoking point—extracting broad principles from specific cases can oversimplify the moral complexities involved.
I find that celebrating the assassination of Hitler doesn’t automatically mean endorsing all political assassinations, but it does invite questions about when, if ever, vigilantism is justified.
But surely the point is that, given the widely varying notions of morality in the world, anyone could make a 'moral' decision to shoot anyone. You can't say that extrapolating the latter moves from the moral to the arbitrary without claiming that there was an objective morality to the first action.
"Vigilantism is always wrong" sounds to me like an oversimplification and binary thinking. An often overlooked example for vigilantism is Japanese PM Shinzo Abe's assassination which uncovered a long list of issues and caused major publlic backlash towards Abe and his ruling party
Yep.
There are lots of reasons why vigilantism is a bad idea. In the quoted example it suggests health insurance would be higher. In the Hitler example, the bad idea would be the possibility of someone worse taking over or reprisals. The Allies did try assassination during the war https://en.wikipedia.org/wiki/Assassination_of_Reinhard_Heydrich The reprisals for this were awful. Following this the Allies did not use political assassination even though suggestions were made for the assassination of Hitler by double agents.
Additionally I think comparing vigilantism to assassination in war is not a good comparison. A better comparison would be assassination of JFK/Huey Long where there are viable alternatives other than murder to achieve your political aim as in this case. In a war or facing a dictator you may feel that the short-term deaths are worth it in the long run and equation which does not really fit in a peace-time democracy.
I think this is similar to “if you had a Time Machine then you’d go back and assassinate him” but that’s sort of an impossible scenario since we can’t travel back in time, and no one at the time knew for certain what would happen
In a vacuum, violence is unacceptable, sure. But protests are often futile in bringing real change, debates have been rendered meaningless by talking-heads that would rather “win” debates in the marketplace of ideas instead of having basic discussions based on rationality, and the options people have the opportunity to vote for are many times not in support of a change in the system; even if they were, they often get overrun by the rest of the establishment (see Bernie Sanders).
Big Health Insurance, a system whose sole purpose is to gatekeep healthcare (since the actual providers of healthcare are the nurses, doctors, surgeons, and the like) has so much misery and blood on their hands. When all other options have been exhausted, then who is to say that vigilantism isn’t the logical conclusion? How will predators in our societies be stopped when they can not be held accountable by any other means?
Now, I largely consider Luigi’s alleged actions to be a fruitless sacrifice, and I would never personally wish death upon Thompson. Without going to much into my politics, I can state that I am personally for Prefigurative politics (the good ol’ Anarchist way), but I still think that this pseudo-pacifism is absolutely jarring.
Violence is systemically done against citizens every single day. It is baked into our societies, and in the context of Big Health Insurance, it is a feature and not a bug. But apparently, the violence of ruling institutions doesn’t count, only the acts of interpersonal violence. The slippery slope arguments for the case against vigilantism are honestly insulting.
And for Gurwinder, I honestly expected more from you in this article. You chirp about Agency, but the Agency of those that are at the top of the corporate pyramid at crooked institutions like the Health Insurance business apparently is ignored here, because apparently, this system is “no one’s fault”. You even go on to emphasize the agency of the shooter, but completely neglect the agency of the ones who uphold the current status quo.
Deeply disappointing narrative from a guy who tries to emphasize critical thinking.
Every part of this argument makes me sick to my stomach. The helpless little guy crushed by the system is the most tired fucking trope out there. Nobody is willing to take responsibility for anything, always looking for someone else to bail them out. Wonder why Americans are so sick and why health insurance costs so much? Look at your average fucking American. Obesity, drugs, junk diet. The problem with your argument is that the system is more than just the corporations. The customers are part of that system and their habits drive the economics of the industry. Why does UHC make such demonic profits? Because Americans are too fucking stupid to take care of themselves. You may as well be advocating for somebody to shoot your fat neighbor. FOH.
I think that your comment is... not well thought out, but I'll still try to answer it in good faith since I think that you definitely do raise important points.
BHA, you can be as sick to your stomach as you want, but it should not spark controversy to point out the existence of systemic problems. "The helpless little guy crushed by the system" is not a trope, it is the reality for millions of Americans, even across institutions (even across countries, lol, the US finds a way to crush people even outside of the US).
Yes, the system is more than just corporations, I have never denied this or argued against this. But I am not going to pretend that there aren't corporations within this system that can not take part in the blame. After all, the existence of Big Health Insurance is the reason why so much of healthcare in the US is gatekept behind a paywall, that's literally their business model! Most developed countries do not have the same problems regarding healthcare as Americans do. For example, millions of people depend on health insurance companies to cover the cost of medical care to get it. When they can’t access care without coverage, it’s the same as being denied care altogether which most of the developed world can NOT relate to. This is not something that Americans can merely "personal responsibility" their way out of.
You also raise the point that I should look at the average American, and recognize their drug use, junk diet, and obesity as a problem. Of course, these are problems! But when that is the "average" American, doesn't it support the claim that many of these problems are systemic? If millions of people in a relatively concentrated area (the country of the United States of America) experience the exact same problems, do you not think that it indicates the existence of a broader systemic problem instead of personal failings alone? Put it into perspective: In much of the rest of the world, people don't have the same problem, or at the very least, they don't have these problems to the same extent as Americans do.
Furthermore, I really dislike the essentialism of Americans in this part of your comment: “...Americans are too fucking stupid to take care of themselves.” It raises the question of why they would somehow be uniquely stupid. Is it hardwired in their DNA to be stupid, fat, and addicted to both drugs and junk food at a level that most other societies are not?
I also think that it is unfortunate that you don’t bring up any other failings instead of apparent personal ones. I think that you actively not doing that, even when my comment emphasized it, shows your affinity to this topic in general. Hopefully, you will allow for more nuance the second time around.
And lastly: “You may as well be advocating for somebody to shoot your fat neighbor.” This I’m not even going to entertain lol.
I think that’s a fair judgement of my comment. I’m finding it hard to put into words how frustrating it is to see so many people embracing something so awful. I shouldn’t be surprised I guess, but the amount of negativity I see directed at anyone who dares to point out how counterproductive and dangerous the glorification of violence is has really shaken me and it’s taking me some time to sort out what it is that is so viscerally abhorrent to me. So thanks for replying, I have thought through it and this is probably what I should have written in response:
I will be the first to say that many if not most corporations are evil and that they have arrogated themselves into a corporate personhood that makes it all but impossible for regular people to deal fairly with them. I can also see that the healthcare system in the US is involved in victimizing a lot of people, sometimes purposefully and/or fraudulently. But victimization alone can’t explain what’s happening at the macro level and that’s what the argument has been reduced to. This line of reasoning is what’s so annoying to me: The health insurance companies are to blame and their CEOs are in charge so they are personally responsible for the suffering of millions and deserve to die. That’s literally the argument I hear you and hundreds of people making. If I’m missing some nuance please educate me. Cold-blooded murder nor its threat represent a solution to a societal problem that transcends industry, demographics, etc. Societal problems are not solved with violence. They can only be solved by people modifying the behaviors that contribute to the problem. Blaming the CEO is not an effective tactic. Killing the CEO is even worse, especially because it feels so good for misguided people who favor magical solutions.
This ideology, like so many retarded trends emerging in this country, poisons its followers. It’s a soporific, nothing more, encouraging people to see themselves as victims rather than the primary actors in their own stories. That’s what bothers me so much. It’s so American to blame everyone else for our problems when it’s only ourselves who are capable of addressing the problem. Smash the system, kill the evildoers, profit! It’s juvenile and will do nothing but delude small minded people into thinking that their outrage can change something. If we want to change this dynamic we have to do more than kill. We have to build, and no one is talking about that. A revenge fantasy cannot solve a systemic issue no matter how hard we wish it would.
This is so lazy. I’m so happy Civil Rights leaders of the last century didn’t give up when their candidates failed.
Deeply unserious answer
I am deeply committed to nonviolence. You should be too. It works, murder does not.
Are you still deeply committed to nonviolence even when it is done by ruling institutions?
Yes, I am actively against the death penalty.
Couldn’t have worded it better.
Bin Laden didn't get a trial. Not everyone gets a trial. This CEO was the accomplice in more deaths than Bin Laden. I don't feel bad about either getting killed and the chances of the CEO ever going to trial for those deaths are less than zero.
"This CEO was the accomplice in more deaths than Bin Laden."
Any proof for this claim?
Denying a claim isn't murder.
Also, the idealistic notion that "All health care should be free and unlimited" is infantile utopianism, every system rations and has delays that result in death.
Thompson is only an "accomplice in... deaths" when his work is judged against an unlimited utopian principle and also only if you believe that the State or some other entity bears ultimate responsibility for every life and every death.
> Any proof for this claim?
He was the sub-CEO of the division that was responsible for creating the system that generated algorithmic denials that denied 91% of cases, mostly erroneously.
Brian made $10m in 2023. Kim Keck, CEO of BCBS, made $4m. That $6M delta came from SOMETHING profitable that his team drove, and that something profitable was increased denials. It's worth it to note that comp comes before margins - the vast delta in comp going to this guy and the other executives like him is part of why United "only" has 6-7% margins.
To save money, this CEO authorized denial of claims by AI which almost certainly denied claims that should have been authorized. In other words, his choices directly led to the deaths of thousands if not tens of thousands of people and brought him (and his shareholders) millions of dollars.
Yes, health care resources aren't infinite and need to be rationed somehow. The way they should be rationed is via NIH "death panels" who decide on care standards and cutoffs based on QALY's, not on an executive deciding "I'd like another ski chalet" and driving initiatives that increase denials and internal profitability.
Your claims about profits, margins, salaries, chalets etc don't come close to proving that "his choices directly led to the deaths of thousands if not tens of thousands of people", this seems hyperbolic to say the least.
Just because someone has a claim denied DOES NOT equate DIRECTLY with murder—people have claims denied for all sorts of reasons, including the fact that it may cost tens of thousands to extend their lives a few mos or that a doctor, hospital or drug co may be charging an enormous price for a drug or procedure that the insurance co doesn't cover. If the insurance co decides not to pay for an expensive treatment to keep an octogenarian alive another month or two does that make them morally equivalent to MURDERERS?
Does Keck's $4m salary mean that Keck doesn't deserve to be murdered? Do the health bureaucrats in other countries who deny various expense forms of end-of-life care also deserve to be executed for murder? Who decides where the line is drawn?
—The way they should be rationed is via NIH "death panels"—why shouldn't these people be murdered too? Is it the profit motive itself that renders someone an enemy of humanity that can be killed in cold blood without a trial?
Hey, I'm not an expert on the American health care system, I don't pretend to be and I wouldn't defend it anyway, as I like everyone else has had hassles and been denied claims and coverage etc.
The point I'm trying to make is that supporting or excusing vigilante political murder is a barbaric exchange of the rule of law for the law of the jungle and that it opens up a Pandora's Box of political violence that won't necessarily lead to anything better, in fact it could lead to things being much uglier, more brutal and violent.
People hate CEOs and politicians for all sorts of reasons, people hate oil cos, tech cos, drug cos, bankers, hedge funders, landlords etc etc—why don't they deserve to be murdered in the street too?
You raise an important concern: where do we draw the line between moral outrage and justifying violence? Once vigilante actions are excused, the door opens for chaos rather than justice. It’s a slippery slope—if every hated figure becomes a target, society devolves into unchecked brutality.
It's either the rule of law or the law of the jungle.
Choose wisely!
🙄 Your post is typical of people who know *nothing* about health insurance, much less AI, yet make sweeping claims.
People don't need to know a lot about health insurance to know they got screwed over by health insurance.
I guarantee neither you nor anyone having temper tantrums about health insurance has paid or ever will pay enough in premiums to cover their own health care expenses.
If one cannot converse with the most basic knowledge on a topic, one ought to keep one’s thoughts in one’s head unless and/or until they take the initiative to learn.
For those of us who know how it actually works, these noxious “takes” presenting gross falsehoods as truths swing between hilarious and pitiful.
Emotions aren’t valid indicators of reality.
“ Denying a claim isn't murder.” Any proof for -this- claim? Maybe all claim denials should be done in person by the CEO. I wonder how many they would get through before the obvious outcome we saw on the streets of NYC? They’re very brave when people aren’t real to them and just a method for increasing wealth. I’d like to see you stand in front of someone who lost a family member to denied health insurance and say “ Denying a claim isn't murder.” I mean, if you’re ok with that, you’d make a great CEO or serial killer.
Like I said, Luigi and his defenders are wielding an idealistic utopian standard—no health care should ever be rationed, no claims ever denied, all bills tests procedures etc should be free and unlimited—that exists nowhere on earth and are using it 1) to justify murder in cold blood; 2) paint yourself as somehow morally superior to everyone who doesn't share your absolutism.
And of course denying a claim isn't "murder"—the unlawful premeditated killing of one human being by another—because people have claims denied all the time, most of them have nothing to do with death and because a system responsible for over 300 million people will never be perfect and the State or any other entity doesn't have the power of life and death over us all.
Your keyboard hysterics change none of this.
Be careful of blurring the distinction between the (clear) legal definition of murder, and the (contested) moral definition. Why should the legal definition be relevant to a moral debate? People are angry because they believe CEOs are indirectly causing deaths which the legal system overlooks.
Also, who's saying healthcare should be free and unlimited? Are you sure you're not attacking a strawman here?
Except for the constant problem of delays and wait times for certain kinds care in those countries, in all countries with socialized systems of health care, eg four months to see a specialist or 90 days to receive non-elective surgery. In Sweden a third of the patients wait longer. This is because there is unlimited demand and limited supply. (In addition, the Canadian healthcare system kills more people through assisted suicide than guns kill people in America.) And then there is the Canadian woman who had her right leg amputated after complications following a knee replacement surgery. The complications arose from a post-surgery infection. In late November, a surgeon at Winnipeg's Health Sciences Centre began removing dead tissue from her right knee, with the intention of stitching her up later that day after she was seen by an orthopedic surgeon at Concordia Hospital. But she couldn't be transferred back to HSC to see the surgeon because there wasn't a bed available. Instead, she languished for eight days at Concordia with a painful open wound. Once she finally got to HSC, she was told her leg was no longer salvageable and had to be amputated. Very sad story. Free for her, but not unlimited.
This comment is kinda interesting tbh.
While HS never used the word murder, and instead decided to opt for using the word "killed" in the context of those who meet their demise within the Health Insurance system, your argument against their comment nevertheless is on the basis that denying a claim isn't "murder"; a legal definition of unlawful and premeditated killing. You purposely changed the goalpost so that you could defend Health Insurance companies, the gatekeepers of healthcare so that you could "debunk" that argument on a legal basis. I think people here are largely talking about this issue on a moral basis, and you trying to turn it into an exclusively legal argument is just... ugh man, do better.
Let's see:
The original claim was: Thompson was an "accomplice in more deaths..." and the question of the "CEO ever going to trial for those deaths."
Obviously implying both some level of malice and of responsibility for deaths and also that he could be charged in a court of law for this—thus introducing the legal aspect, which is what I responded to.
If someone is responsible in some way for the deaths of many others isn't the implication some kind of "murder"?
Mine was entirely a moral argument (killing/murdering also exist in the moral realm), and I used the definition of murder as a way to define the term (the term being "killed").
The comment implied that not only was Thompson responsible for multiple deaths, but that he deserved to be on trial for them, as they were committed for nefarious, greedy motives aka not killing, which could be accidental or incidental, but murder. It's all there in the comment I responded to.
ugh man, semantics are cheap, do better.
Expect we all know that merely looking at what the current laws say is a cheap cop-out for actually critically engaging with an analysis of Thomposon's role as a potential mass murderer/killer, and the condemnation for the system that he was a part of.
We both know that you are correct in saying that "denying claims isn't murder"....Yes, but only within the existing justice system! But my God, laws have been wrong before, and somebody arguing that Thompson is responsible for deaths, has profited off of deaths, deserves to be on trial for these deaths, etc, doesn't need to be within the framework of the current legal system. But it is precisely on that basis that you argue. You invoking the legal term "murder", which is not simply a synonym for "killing", completely flips the conversation. It goes from "the acts of this man warrant legal scrutiny" to "the acts of this man do not warrant legal scrutiny... simply because the current laws don't allow for it". That's my objection.
So no, this is not a cheap semantics argument, it is the recognition that the laws that ordinary people are bound to rarely apply to institutions or to individuals who can overpower the justice system through money, status, or connections.
Once again, it is you who wrenched my comment out of context when you accused me of introducing the legal aspect.
The comment said: "the chances of the CEO ever going to trial for those deaths are less than zero." Thus here is the legal issue I was responding to and that i did not introduce.
"Thompson's role as a potential mass murderer/killer, and the condemnation for the system that he was a part of."
And really frankly this makes you too unserious a person to waste my time with any longer. "A potential mass murderer" lol cmon—this is hysterical nonsense. If Thompson was a "a potential mass murderer" then so is every politician and congressman etc who helped erect our system as well as the boards and investors of all insurance cos. That's a lotta murderers!
Thompson was just one node in a giant sprawling patchwork network that began long before he was born and that will not be changed by his murder. If he deserves to be murdered in the street then so do pharma execs, oil execs, gun manufacturers, missile makers, hedge funders etc etc...
"the acts of this man do not warrant legal scrutiny... simply because the current laws don't allow for it"...This is quite the motte and bailey switch!
I never once said or even implied that Thompson nor anyone else was above legal scrutiny—I just said that murdering him in the street was barbaric and stupid and could very well make things worse not better.
"The laws that ordinary people are bound to rarely apply to institutions or to individuals who can overpower the justice system through money, status, or connections."
Yes, welcome to reality at last. There is no place on earth and never has been where "individuals who can overpower the justice system through money, status, or connections" don't exist—not in countries with national healthcare, not in socialist states, not in the Biden White House. This is the natural state of humanity, there is always an unfair hierarchy and always some people who can gain systems—but instead of murdering our way out of this, through centuries of wars and political reform we've exchanged the law of the jungle for the rule of law, which is still better if not perfect and which is always changeable and fixable in free democratic countries like ours.
But hey, I'm really not trying to convince you of anything. If you think shooting CEOs in the back is justice, feel free. I encourage you to live by your principles.
> Denying a claim isn't murder.
Well, Nazi Germany also had all kinds of layers of bureucracy and processing until somebody finally actually killed someone more directly. Often it wasn't even through execution, so they could say "forcing people to work is not murder".
> Also, the idealistic notion that "All health care should be free and unlimited" is infantile utopianism, every system rations and has delays that result in death.
And if those delays are only practical, and not out of profit and greed, that's not a problem...
Ok then… Denying a claim is not the equivalent of imprisoning people based on their ethnicity, religion, ideology, etc, and using them as slave labor that will eventually be killed.
Der CP, there are numerus countries that have universal healthcare that is free and if it is not free, it is at least very affordable. Countries like France, Belgium, Denmark and Germany all have free healthcare Systems. And ALL of the countries don't even come close to US GDP. The US healthcare System is set up for Profits and not for acutal healthcare.
Wild to see people becoming this deranged in real time
It's mostly internet poisoning.
My friends and family under say age 35 who are always online are immersed in Luigi mania; my friends and family who are grownups with jobs and kids have never mentioned it and certainly don't condone it.
There's millions of impotent keyboard warriors out there salivating to see some street violence and to be able to justify their bloodlust because "it's for a good cause."
Social media is a playpen for lost souls and other bored children of the internet age.
Most of America isn't qualified to weigh in. Let America do what it does best. Make it about themselves!
Yikes, I’m sorry but your thoughts are detached from reality because of your emotional reaction to this story. Just ask yourself if a health insurance company makes money by denying a claim, and what their core business model is, lastly ask why insurance exists in the first place at all. If you have the patience then I recommend you to look up what the dual processes of reserving and pricing are in insurance and how these are heavily regulated, lastly I’d recommend learning about actuarial value and how that is enforced by government agencies (for a quick explainer you can google “Obamacare metal tiers” and there should be some explainers that pop up in Google search)
Bin Laden didn't get a trial because he was ambushed and refused an offer of surrender. He was never captured.
Funny you say that because this is the only part I outright disagree with! Iain Lim has already given an example as to why, but the claim is too strong. You can celebrate a given assassination without advocating for a world where anybody assassinating anybody is acceptable, if you slice things properly. That said, there's certainly a narrower truth that a consequence of celebrating an assassination you like publicly or even just outside the confines of your own mind is probably a forwarding of assassination broadly, and you are unlikely to like all that comes from that. However, that still doesn't mean you're advocating for that. Similar to incitement, this doesn't meet that bar.
Let us assume for a minute that it is possible to "celebrate a given assassination without advocating for a world where anybody assassinating anybody is acceptable", I will like to honestly ask: on what grounds are you celebrating the aforementioned assassination?
https://www.yahoo.com/news/murdered-insurance-ceo-had-deployed-175638581.html
The headline says the CEO deployed it, but the body asserts no such claim, and the lawsuit, or at least that one document from it, doesn't even name him personally.
The CEO would be ( or definately ) aware of it. Interesting the company refused to respond when asked about it. - I guess they would if matter is a inprogress lawsuit. It would be a serious accusation about the denial rate.
Oh yeah he was surely aware. Just the grabbing claim that he deployed it… skeptical.
I'm not! This one was very bad!
I think it misses the point completely. "A world in which a stranger can decide that you’re also a bad person, and gun you down in the street." is not a hypothetical, it is the lived reality of millions of Americans. Preventable deaths (police killings, road violence, health care denial, homelessness) might be legal, and many people might not see them as preventable, but they are no more morally defensible than premeditated murder. We only accept them as a coping mechanism. We are made to feel helpless to prevent systemic violence by people like Brian Thompson. This is why his death was celebrated by so many.
"Vigilantism is always wrong. If you celebrate someone gunning down a defenceless person in the street, then you advocate for a world in which this is an acceptable thing for anyone to do."
Indeed. The claim of the state to possess the only legitimate right to engage in violence other than in self-defense is unconvincing unless it can be relied upon generally to engage in that violence when it is justified. If the society you are embedded in allows egregious assault on you then you are certainly justified in doing what needs to be done on your own.
"You in fact advocate for a world in which a stranger can decide that you’re also a bad person, and gun you down in the street."
"Can gun you down" is here conflated with "is justified in gunning you down". Nothing about thinking Mangione might have been justified in shooting Thompson requires me to believe that some other random somebody is justified in shooting any other random somebody.
"
Let's bring in a parallel nonfatal situation as an analogy for dissection:
I would argue that the confidential info release vigilantism of Chelsea Manning was wrong, because she simply bulk collected and dumped information with no greater principle than the US being broadly acting badly. She failed to use any discernment or principles.
I would argue that the confidential info releases by Edward Snowden were heroic, as he had a particular issue in mind and was confident that he had tried other methods for making authorities aware, and that the type of change he sought had only been effected by whistleblowers in the past.
I think any type of crime is similar in that there could be cases where any crime could be seen as justified civil disobedience because there is no justice within the system. Mangione does not meet this standard, of course.
Interesting pov, thank you for bringing up this non-fatal angle, it's been rare to find unique perspective in this highly controversial debate
This is the passage that stood out to me the most in this article and agree it's beautifully expressed. I, in fact, do advocate for such a world and I'm willing to accept the consequences of that world in their entirety.
I wonder how many others actually agree with the whole package here or who just want to make an exception in this one case.
My issue with you parading your interaction with Luigi is that you're blatantly disregarding his privacy by sharing details that he may have intended to keep between the two of you in your one-on-one conversation. It’s shocking that you’re willing to throw away his support and confidentiality for the sake of a few likes and clicks. Frankly, if I were in your position, I’d feel ashamed.
On top of that, what happened to the presumption of innocence? Calling Luigi 'the murderer' in your essay is reckless when he’s only been accused (on what seems to be at best, loose evidence so far). It’s unfair, doubly so considering how supportive he has been towards you.
I use the word "alleged" where appropriate and I've kept the most personal things Luigi told me secret. Beyond that basic decency, my loyalty lies not with Luigi but with the facts, wherever they may lead. That has always been the guiding principle of my blog – truth no matter who it’s for or against – and Luigi knew that when he became a founding member. In fact, it was why he did so.
Did it occur to you he was leaving a trail? Did you consider the extreme empathy schools like Yale and Harvard have towards their mentally ill students? And how mental heath professional don’t insist bi-polars or schizophrenics take their medication? Did another commenter not know ‘innocent before proven guilty’ is a legal norm and not a public prohibition? It’s too bad Luigi didn’t read ‘The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions’ by Jonathan Rosen.
As for insurance denials, has anyone noted that private equity has bought up hospitals, physical rehabilitation centers and charge rates compatible with extortion? How about surgical devices? And pharmaceuticals. Read a hospital’s itemized list of charges and you may not think RFK JR is such a crank. The one true thing Luigi has said is he is no expert. Part of the OWS 10% pissed he hasn’t slid into a non-profit nepo career that would make him look like a savior. Like Ted,he apparently found another way.
Luigi is supporting a blogger; there is no presumption of privacy; Gurwinder isn’t Deep Throat.
Also, Luigi is a murderer.
In societies like ours, the State steps into the role of the victim and tries the suspect on behalf of the aggrieved party.
So, only the state has the responsibility to use marshmallow terms like “alleged“.
Luigi is not the alleged murderer. He is the murderer.
Your response is troubling for several reasons. Privacy isn’t conditional on someone’s online presence. Respecting one-on-one conversations is about basic decency.
Also, who are you to make such an assured claim as to label Luigi as such? Are you privy to all the evidence, or have you appointed yourself judge, jury, and executioner?
Using terms like 'alleged' isn’t about being soft, it’s about respecting the truth and acknowledging that none of us, least of all you, are in a position to make absolute claims without due process.
Until proven otherwise, Luigi remains accused, not convicted, and your rush to condemn him says more about your biases than the case itself.
It is basic journalism to use the word "alleged" to describe someone accused of a crime. As a reporter, I was especially careful to do so.
Here's an explanation:
"Finally, until a judicial authority has rendered a decision, a suspect or defendant has not been proved guilty of the charges or allegations against him. Not only is it unethical to describe this individual as, say, a "murderer" or "embezzler" without the qualification of words like "accused" and "alleged," but such descriptions could turn you into a defendant yourself -- for libel." -- from newscript.com
It’s terrifying that someone like you could end up on a jury. Your insistence that he is not an alleged murderer but a murderer stems solely from reports you’ve seen in the media or online. For the love of God please keep in mind that every single person that has been exonerated by DNA or a confession by someone else, etc, also had an abundant number of media reports and police reports stating they were guilty.
It's the need to make assumptions that he isn't qualified to make! All of it is opinion that isn't fact. Can we just wait for the trial to get a better picture.
Actually, I do not agree that the cost of healthcare in America are standard for its income. According to the National Health Expenditure Accounts, the average healthcare spending in 2023 was $14,570 per person. According to the United States Census Bureau, the median income of an American is $37,585. That means that the average person in America spends 38% of their yearly income on healthcare alone. Whereas in Britain, the average income is £37,430 and the average healthcare spending per person is £2,989, according to the Office for National Statistics. Which equals less than 1% of the average persons income goes to healthcare per year. See the difference?
https://datacommons.org/place/country/USA?utm_medium=explore&mprop=income&popt=Person&cpv=age,Years15Onwards&hl=en
https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29
https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/bulletins/annualsurveyofhoursandearnings/2024#:~:text=Median%20gross%20annual%20earnings%20for,%2C%20an%20increase%20of%206.9%25.
There is so much wrong with your post that it's depressing it has so many likes.
But to put it simply:
- The calculation you use to determine income and spending for the median American is wrong (you can't use generic national figures to say much about the median American). For instance, instead of merely looking at nominal average income, you need to be looking at PPP Actual Individual Consumption per Capita (AIC) as that gives a better indication of *disposable* income, which is what we really want to measure. The US has much higher household disposable income per capita than the UK, which is something median income won't tell you.
- You're comparing US and UK healthcare as if they're like-for-like, but they're vastly different systems. The way costs are calculated for these systems are not comparable.
- You disprove nothing by showing that the US spends a larger percentage share of income on healthcare; of course countries with more disposable income spend a higher percentage share of income on healthcare, wouldn't you?
- I acknowledge in my article that, although US healthcare costs are broadly in line with its (disposable) income, they're still more expensive than they need to be, and this seems to be due mainly to administrative inefficiency (but overall has many different causes).
- The stats you provide are unreliable because they're derived using flawed methodology.
Further information on all the above points: https://randomcriticalanalysis.com/why-conventional-wisdom-on-health-care-is-wrong-a-primer
Maybe you could go into more of this:
- I acknowledge in my article that, although US healthcare costs are broadly in line with its (disposable) income, they're still more expensive than they need to be, and this seems to be due mainly to administrative inefficiency (but overall has many different causes).
What different causes? You're glossing over the pain caused by 64% of all bankruptcies in the US - getting sick. (Perhaps the income isn't so disposable?)
I'm not trying to nitpick - I genuinely feel the biggest flaw in your article is glossing over the culpability of the CEO for saving money with AI-powered claim denials instead of working on what you claim are obvious redundancies in— claim administration? (He was a Dad trying to keep costs low, including for policyholders.)
“Getting sick.” How does one “get sick” after all? It just happens to them? No, half of it is simply bad habits of the individual. I’m so sick of the victim mentality on display here. Oh we had to kill the CEO because the system is exploiting us. Here’s a fucking news flash: take fucking care of yourself and you won’t be a victim. Take care of yourself so there’s money in the insurance pool to treat people who are actually the victims of circumstance, not voluntarily killing themselves with drugs, alcohol, and garbage diets. These arguments are so pathetic. Everyone wants to talk about agency and the responsibilities of the elite to society but it’s always someone else who has to change. The only positive change possible has to come from within. Advocating for a simple, violent solution that singles out one part of a complex system isn’t going to do a fucking thing except add more fuel to the fire consuming our society.
I did not study economics and have never heard of Actual Individual Consumption per Capita. From what I understand, and correct me if I’m wrong (but please be nice I’m literally just a girl trying to learn) AIC looks at consumer goods and services purchased directly by households and services provided by non-profit organizations or the government for individual consumption and it measures it “by the total value of household final consumption expenditure, NPISH final consumption expenditure and government expenditure on individual consumption goods and services” (OECD) and I would assume divides it by population (since its per capita)? Then disposable income is the amount of income a person has after taxes are taken out. Then to find the disposable income per capita for a country you take all of that and divide it by that countries population?
Am I understanding that correctly?
The problem with AIC and disposable income is that it does not take into account any wealth disparities. In America, the Federal Reserve data show that the least-wealthy 50 percent of U.S. households hold very little of the nation’s wealth (less than 4 percent), while the households with wealth in the top 10 percent hold over two-thirds. This would mean looking at the country overall we all look to be in pretty good shape but then why are so many Americans living paycheck to paycheck. I agree the AIC does take more into account but it fails to account for the massive wealth disparity in America.
I https://www.cbpp.org/research/poverty-and-inequality/a-guide-to-statistics-on-historical-trends-in-income-inequality#:~:text=Federal%20Reserve%20data%20show%20that,percent%20hold%20over%20two%2Dthirds.
The NHS budget is nowhere near high enough to provide even basic levels of care for the population size, which is why the UK has problems like ambulances turning up many hours after they were called, or hospitals trying to claim that being put on a chair in a corridor is just as good as a regular ward.
This also ignores the severe rationing that goes on. In the US people complain about care being denied by health insurance, but on inspection it's often some incredibly rare or experimental new advance that just isn't available in the UK at all, no matter what you do or are willing to pay.
You can't compare US healthcare to the UK by this point unfortunately. The UK system is in full blown collapse. The US healthcare system just isn't. The biggest complaint Americans seem to have about their system is that it doesn't offer even more luxurious levels of care than it does, because basic care is already more than covered.
I’m a nurse and I studied abroad in South Africa (evaluating their universal healthcare). Is it a perfect system? No. But there is also the option of private healthcare for those who can afford it and don’t like the wait times. And most importantly everyone has access to healthcare whereas in America, 8% of the population is uninsured and nearly 1 in 4 adult Americans are underinsured. I don’t see the problem in caring about your fellow humans and wanting them all to have access to healthcare…healthcare is a human right. (And the awesome thing about having other countries do it first is we can learn from their failures. Like the one in Britain. Just because one country fails at universal healthcare doesn’t mean there isn’t a way to implement it). But hey I would also settle for the government becoming more involved in insurance, hospitals, and big pharma capping the amount they can charge for services or drugs.
https://www.commonwealthfund.org/publications/surveys/2024/nov/state-health-insurance-coverage-us-2024-biennial-survey
> healthcare is a human right
No it isn't. This is the kind of sloppy thinking that leads countries to ruin.
Other people doing things for you is NEVER a human right, let alone something as vague and ill-scoped as healthcare. Just think about it, please. You're a nurse. If someone turned up on your doorstep and announced you needed to treat them right there and then, for free, because "healthcare is a human right", how would you feel? What about the next 100 people who did it?
Consider the Hippocratic oath.
yes, the number of uninsured and underinsured is about 44% in the US.
there are people who are insured who cannot pay because of required co-pays and high deductibles.
the Commonwealth Fund report that you cite is a very good source.
the remark made by the previous UK commenter Alistair that denials of claims by US insurers are "often (for) some rare or experimental new advance" is woefully uninformed.