So this guy had a few twitter exchanges with Luigi and he thinks the US healthcare system isn't that bad? Doesn't really seem like an article for HN. But as long as we're here I think, sort of like Luigi, I'll let other people argue about whether the US healthcare system functions well or efficiently. But as for this:
>While it’s true that UnitedHealthcare has the highest denial rate for medical claims, the CEO doesn’t set the approval rate of a health insurance company’s payouts — that’s done by the actuaries, who themselves are constrained by various considerations, such as the need to keep costs low, including for policyholders.
By this logic, what can Brian Thompson be said to be responsible for? It's very strange to me to assign more responsibility for a companies denial rates to its actuaries than the actuaries' bosses bosses boss. So why exactly does UHC have higher denial rates than other companies? It just happens to be that it's actuaries are more frugal? This explanation doesn't hold water and I think it's a strange response to the shooting of a CEO to say, well actually CEOs aren't responsible for the things their corporations do. Of course they are, now they aren't solely responsible, but they probably have more responsibility than any other single individual. It can be completely true that killing Brian Thompson was wrong AND that he was no saint, being responsible for (and getting rich off of) large amounts of human misery inflicted on UHC policy holders by the organization he headed.
One of the author's points was that if United took no profit, it could only very slightly increase services. The only ethical thing that Thompson could have done is advocated for the dissolution of his and his competitors' firms, which would have had him out of a job quickly.
The actual problem is the system where United exists at all. Health insurance provides exceedingly little value for a very high cost.
One issue now is that being in the way of healthcare is now so large as to have its own gravity. Just healthcare administration (no caregiving or treatment) is now about 2% of GDP itself.
Restructuring healthcare would mean tens of thousands out of a job.
No, you've misapprehended the critique; in fact, your comment here isn't even coherent. If you eliminate United altogether, you get a grocery store circular discount on health care; in other words: health care is still altogether too expensive. So the "actual problem" can't be the system supporting health insurance; the problem has to be elsewhere.
It's not hard to see where it is! Go look up the 2022 NHE, which includes a giant spreadsheet breaking down where all the spending is in the system (you want the "by type and program" sheet).
Looked at the table and could not plainly see the problem. Would imagine that time series presented like with an analog of Tim Morgan's Energy cost of Energy for energy markets might help..
> The only ethical thing that Thompson could have done is advocated for the dissolution of his and his competitors' firms, which would have had him out of a job quickly.
Since UHC is a publicly traded company, this action would actually be illegal sice teh CEO's job is to protect the shareholder.
I can image many people here have stock in these companies. So, tell me who is responsible? There is greed everywhere you look if you are honest with yourself.
IT unemployment is currently under 4% because the folks that got laid off found new jobs. If you eliminate an entire industry, the unemployed will have a tougher time finding a new job.
The dislocation would be far larger than the tech layoff.
The article seems quite level-headed and thoughtful.
That said, this jumps the gun:
> The idea that trauma is passed down epigenetically is not only unscientific, it’s also un-agentic; if you believe your trauma is hardwired into your DNA, you’re prone to passively accept it rather than actively trying to overcome it.
Recent research is pretty convincing that the "folk wisdom" of trauma being passed down to later generations is a real thing.
Edit: and I'll add that the mice were able to overcome the inherited trauma, too, so you could argue that it's actually an empowering concept. Even though we can't control what we inherit, this shows you can overcome it.
Yes, it's no more "un-agentic" than the fact that trauma can be transferred psychologically during one's upbringing. Is there any evidence that this kind of trauma is trivial to overcome compared to the kind that's "hardwired into your DNA"?
Maybe not necessarily; it might turn out to be both with a little more research done? Out of many psychological phenomena, this seems like it could actually be quite research-able.
It seems to me that going from "F1 and F2 generations of mice respond differently to the smell of acetophenone if their parents were exposed to it" to "well, human trauma is inherited and there isn't anything we can do about violent behavior" is somewhat far-fetched and smells like neo-eugenics.
If the bait wasn't too traumatizing, could I interest you in a dessert? No acetophenone flavor, I promise.
> In summary, we have begun to explore an under-appreciated influence on adult behavior—ancestral experience before conception. From a translational perspective, our results allow us to appreciate how the experiences of a parent, before even conceiving offspring, markedly influence both structure and function in the nervous system of subsequent generations. Such a phenomenon may contribute to the etiology and potential intergenerational transmission of risk for neuropsychiatric disorders, such as phobias, anxiety, and post-traumatic stress disorder. To conclude, we interpret these results as highlighting how generations can inherit information about the salience of specific stimuli in ancestral environments so that their behavior and neuroanatomy are altered to allow for appropriate stimulus-specific responses.
I’ll take the bait: junk DNA, arguments against epigenetic expression, the irrelevance of the guy microbiome. Wrong and wrong and wrong NYT biosciences editor!
Mainstream consensus on this as reported in the popular press is nothing like the actual credence of the guys in lab coats. I know serious biotech people at serious schools who won’t fuck with mMRNA vaccination personally. As long as they’re not quoted on it.
When you get your bioscience from The Atlantic? Be ready to be wrong soon.
Real scientists don’t mouth off like this. They choose an emphasis when writing a grant application like a cover letter.
The writers of the beigeness might deny it, but assassination can work. Shinto Abe is just the most recent example. The "win condition" of the immediate destruction of the rentseeking healthcare-insurance complex in the US is a strawman. The killer achieved his goal and his success was greater than he probably imagined.
The truth is that the average person is indifferent to the murder, or right-down approving. HN is a bubble about this for obvious reasons. This a stronger signal for the power-brokers to take it easy and fix some of the perverse incentives than a long career in activism.
We live, and always have lived in a world in which a stranger can decide that you’re a bad person, and kill you. Knowing this reality isn't condoning it, or believing that common political violence is a good state of affairs.
> scope remains for negotiation and compromise and peaceful resolution
I feel like the murderer wouldn't be so widely commended if that were true. Justice is what is supposed to prevent vigilantism, and apparently lots of people here felt that the murder was just.
I’m still advocating for peace, but over time the argument isn’t getting any fucking easier to make, that’s for fucking sure.
The Kleptocracy has a year, two at the outside to make some concessions near as I can tell, before they can’t walk the streets of NYC safely full stop. Or Chicago, or …
Agreed, indeed: when the people feel that justice fails them, vigantilism takes its place.
We'd all do well to, in our rush to decry the murder itself, be mindful of the mistake of losing sight of the reason behind the massive support for Mangione's actions.
> We'd all do well to be mindful of the mistake of losing sight of the reason behind the massive support for Mangione's actions.
This is what I fear the most. It creates an ideological divide. Those who seem his action as justified do have reason to hold their beliefs. The justice system often fails people and we often hear and feel more and more these days. It is not about statistics, it is about "the vibe." At the same time, those who do not feel his actions are justified (myself included) have reason for their side too. Both sides have evidence and the truth is that the decisions are being based on different criteria. It's not even that we often disagree with the facts (of course, we often do too), but more that we care more or less about certain things. And if we can't at least understand why others have made their decisions, at least understand why others feel a certain way, then we have no hope of solving any of these problems that we both seem to care about.
What I fear is that while screaming that vigilantism isn't ever justified, that this very same act justifies it.
I think it can be argued that once a seemingly decent, mentally healthy person murders rather than a pervert cannibal or social outcast then the justification for the murder should be reasonable.
>I feel like the murderer wouldn't be so widely commended if that were true. Justice is what is supposed to prevent vigilantism, and apparently lots of people here felt that the murder was just.
OK then, what crime did the CEO commit? Simply presiding over a business that people don't like, which he has no real power to change, is not a crime in any sense.
Vigilantism only makes sense when there is no justice for real obvious crimes with known guilty parties. And even then, it has many downsides.
A loud minority (or even majority) of people condoning this does not make it right. In the absence of an articulable crime for which the victim is responsible, this is simple murder. You can rationalize it all you want but your logic could be used to justify lynch mobs.
Why isn't it a crime to preside over a company that prioritizes profit over people's lives? The Nazis couldn't claim "I was just running the concentration camp" as a defense. The CEO of a company has the most power to change it, and definitely enough power to say "fuck this, find another CEO".
>It would be more effective to go out and kill your neighbors who vote differently than you, and reject things like single payer healthcare or reform.
I can't tell if this is a joke or not but I'll argue as if it isn't. First of all, nobody knows if single payer or any reform would lead to anything better. It's a complex issue that boils down to trying to get something for nothing (or at a price lower than the limited supply of healthcare dictates), which leads to enslaving other people to pay for one's own needs. You can do something about corporate corruption such as in the insurance industry. But state corruption is much more insidious. If you feel that strongly about state-sponsored healthcare then there are lots of other countries you can choose to live in that allegedly have the benefits you want, rather than just hating or doing harm to your neighbors. Furthermore, the MAJORITY of people who approve of the current system aren't going to stand by helpless as random wannabe tyrants attack them.
Comparing a CEO of an insurance company to a Nazi officer running a concentration camp is so stupid I don't even know where to begin.
Insurance companies aren't overtly or covertly killing people. They might not be paying for their healthcare in every single instance where they should. As a business, they must decide what services to cover and at what price or they won't be in business for long. They face extensive regulation to ensure that they are not doing exactly the thing you're accusing them of. Yes that means everything has a limit.
Luigi was a rich kid. Neither he nor his family had any business with this insurance company or the CEO, as I understand it. So this action on his part is the result of some insanity plus radicalization, perhaps by people like yourself who have the gall to compare 100% legal businesses to Nazi concentration camps. Our political discourse has really degraded in my lifetime, with one large faction now frequently accusing everyone they disagree with of being Nazis. No good can come of this.
>The CEO of a company has the most power to change it, and definitely enough power to say "fuck this, find another CEO".
Perhaps he could change something but you can't articulate what that is exactly, because you don't care. You just hate the industry as a whole. Even if the industry needs a lot of improvement, it is entirely legal and regulated, and not a charity. The CEO has no reason to leave because he's got a great job at what most people regard as an upstanding business.
It could be argued that Luigi's murder of this CEO and the public reaction to it could make insurance worse. How? Think about it. What competent CEO-type would want to work at a company if it might put a target on his back? A lot of normal people would not want to. So you're less likely to get a competent and relatable CEO, and more likely to get a cutthroat or incompetent one. The kind of person who doesn't care that lots of people would celebrate his death just for having held the position. And an incompetent one could lead to more deaths, because insurance is basically a finance business that must make enough money to cover its expenses. If they go broke, then nobody is getting covered.
It was not widely commended; that it looks that way is an artifact of how our media is structured. We tend now to look at the world through a band-stop filter that amplifies the most activating ideas.
@tptacek I think people mean assassinations on tape are usually universally condemned.
Luigi has tens of thousands of women lining up to marry him, multiple academics doing long pieces about how to achieve jury nullification, and saying he’s the bad guy is not a popular move basically anywhere with a lot of people in it.
If it’s amplified then the amplifier is the public.
You are describing a very small number of highly-activated people responding to a media environment. I think it's especially telling that you cite women "lining up to marry him"; his support, as you're depicting it, is characterized by deeply irrational behavior. I agree.
I think I’m still openly condemning the violence without dismissing the fucking broad based anger around it. There are a large number of us who are very pissed off but still seeking compromise.
There are a very fucking small number of people who own any significant equities, or have their interests actually materialize politically.
That’s the group I’m lobbying to get your shit correct before Luigi is fucking everywhere.
"Widely" could mean a lot of things - it doesn't appear to have anywhere close to majority support, but more than 15% of Americans (and almost half of young people) think it was at least acceptable:
That's an extrapolation from a poll, not literally 50 million people, and you can get 15% of a poll sample to say almost anything, including (first thing that popped up in my Google search) that Hitler was good actually.
> At some point it’s too far. Today is not that day.
It's not a switch. When your level of oppression rises, the probability of violent acts increases. When the level is high enough, you have a sudden cascade of events releasing pent up anger, which we typically call a revolution. You can't predict the moment exactly. We don't have a revolution yet, but tensions are rising.
The US political system is at all time low of responsiveness to the needs of its citizens. Congress has been dysfunctional longer than Mangione has been alive.
It makes sense that a young man would lash out this way. Violence should indeed be the last resort, and for many folks the alternatives are dwindling.
In case I haven’t been clear enough on this point: I want no part in any revolution in which the revolutionary has no goal bigger or better than a purely local shuffling of advantage to themself.
The only revolution I’m willing to die for is one where the goal is a better model: a better way for people to live.
I cannot see a way that killing people is a path to a better world. Killing people without thought or empathy is what the adversary does.
I think we can flip everything upside down via wit and endurance and humanity and sheer will.
The 'point' differs among individuals. In turn it is dependent on their circumstances and ideals. There isn't one specific moment where there will be collective agreement on its justification.
You seem to be working from some kind of principles like justice? Or fairness? We do not live in that world. I was just reading today another story in the Washington Post about how the US stole Native American children and many died.
The US isn’t a society governed by justice, fairness, or even the truth. The rich should be scared because so many support this “execution”.
Of course, they are way ahead, and Robin Hood’s merry supporters will find out that prince john has an army of mercenaries happy to take his coin.
Google reveals the CEO who died and other United Healthcare executive's are being investigated for insider trading, enriching themselves by many millions. (And conversely, others must have lost millions. ) Also being investigated for fraud.( I thought this may be possible cause for murder, but it appears not. )
We don't have to retcon subtle rationales onto the murder; the guy wrote a manifesto. It was bad, and dumb, as writers from both ends of the political spectrum and points between have observed.
His actions touched a nerve. If you want to try and smear the alleged manifesto, go ahead, but I don't think you'll be changing many minds. And by the way, there's no shortage of "writers from both ends of the political spectrum and points between" who broadly agree with its points.
Luigi is more popular than Joe Biden lol [0]. 60% of New Yorkers would acquit him [1] (100,000 sample size).
Your second link seems to be fabricated. I'd guess it's an invention of AI. A survey of 100,000 people is extremely large, and would be quite expensive to administer, and its source as given as "PoliticsVideoChannel", a twitter account with 200,000 followers. There's no link to the survey. My guess is, if it's based on anything, the Twitter account ran a poll which got 100,000 votes. That's quite different than a survey of 100,000 New Yorkers.
The social media section gives quotes from several accounts that I don't think exist. Like, it's the only result is you search "@JusticeSeekerNYC".
Given you were talking about people being duped by a fake manifesto I am not sure why you'd share this link.
No, you just tried to imply that the "real" manifesto was somehow difficult to dismiss. That's the one I was referring to. It's obviously easy to dismiss --- it literally dismisses itself at one point, saying that other people understand the problems better than he does. I'd be interested in what led you to think it was strong.
"The poll, conducted by PoliticsVideoChannel". Heh.
I don't know the US deem assassination justified, or we're seeing the end of the world, but the descriptions of this guy reads like that of garden variety arrogant kiddo: one that label anything he hasn't seen as either aboriginal primitive isms or obvious display of neural deficiencies.
No, Luigi, that police officer wasn't being overly complicit, he's annoyed that you're not gathering bystanders around the man and calling 911(119) yourself, doubly so because you're not getting it.
It makes me livid when people write that vigilantism is never right. It speaks volumes about how little nuance there is in their own lives. I think these same people would denounce civil disobedience in the time of the civil rights movement and would joke about Seneca Falls if they were born a century younger. The overconfidence disgusts me.
I imagine that their point is not that they are the same, but that the attitudes correlate. The absolutist view about vigilantism, where they see no possible place for violence in any situation, could translate to the idea that one should protest quietly, preferably indoors and change will come soon enough™. Which seems to be the case [0]. He groups up completely different social movements ranging from the highly organized, reactions to an active conflict, to decentralized mobs, naming them "neotoddlerism". Saying that:
> The Civil Rights movement succeeded because it was guided by leaders who had clear, specific, and realistic goals, and were able to negotiate to achieve them.
Implying that Just Stop Oil doesn't fulfill these characteristics sans the prominent leaders. Their original objective seems to have happened [1] (JSO influence is debatable of course) and have defined new clear goals [2]. Lumping this with Israel-Palestine outrage on Twitter and the UK riots seems to make the criteria for not being effective social movements a.k.a "neotoddlerism" is "I don't like it / They annoy me".
Would this attitude result in "denouncing / joking about Seneca Falls" with era appropriate socialization? Doesn't seem that far farfetched.
> If UnitedHealth Group decided to donate every single dollar of its profit to buying Americans more health care, it would only be able to pay for about 9.3% more health care than it’s already paying for.
This is an absolutely massive number. It could easily prevent hundreds of unnecessary deaths per year.
It's significantly less than the growth in health care spending over the last 5 years. Was health insurance affordable 5 years ago? Then it doesn't matter.
The author mentions his favorite philosophy is stoicism. A stoic could never hope to understand the motivations of someone like Luigi. A stoic could never bring about change.
Marcus Aurelius, the famously stoic Roman emperor, made liberal reforms during his reign like increased welfare, orphanages, higher taxes on the wealthy and famine relief. You can use stoicism as a shield to hide under, or to fight behind. It's up to the wielder.
> when I asked him if he was voting in the presidential election, he scrunched his nose and said he wasn’t crazy about Trump or Biden, but liked some of the things RFK Jr. was saying. I regard RFK Jr. as a crank who regularly pushes harmful pseudoscience, but I didn’t mention it so as not to derail the conversation.
Interesting! I agrees he's a crank, but RFK jr seems to appeal to a specific personality type that's common among high-powered individuals. People that like to appear scientific, but hate going along with certain things despite a strong scientific consensus. I recently had a very surprising conversation with a company director where they sang RFK's praises, and came down firmly in the alt-right camp's position on classic trigger topics like Ivermectin, fluoride and COVID. This is someone who outwardly advocates being data-driven and loves phrases like "data doesn't care about your beliefs". And yet their entire view on these topics coincides with the cherry-picked data and misleading interpretations in RFK's book.
> 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.
I somewhat disagree, our democracies were built on violent, illegal revolutions. Vigilantism is not always wrong.
> I told him about my favorite philosophy, Stoicism, and how it could teach him to ignore distractions and focus his mind on living more deliberately.
It's funny how many of these online libertarian-ish guys preach "stoicism", a philosophy which famously asks you to be satisfied occupying your "natural" place in the universe, be it slave or Emperor or the Roman Empire.
Ultimately, I think this culture of "agentism" pushes some to a particular brand of individualism, in which it may seem that history is written by great men, heroes, who take actions in their own hands.
We need to stop saying this. No one believes it. While I wholeheartedly believe this is correct in this instance (Luigi Mangione should not be celebrated for shooting Brian Thompson), there are instances where it is. While you should not go back in time to kill Hitler, we sure see a war to stop him as not only justifiable but honorable. When the rule of law fails, there has to be some other option. There are king killers we revere just as king killers we condemn.
We should stop saying this because we can be nuanced. It's okay to have edge cases. There are circumstances where it is justified to run a red light or abandon a truck trailer. All rules are made to be broken, because no rule can be perfectly specified. Language is limited and time marches on. It does no good to continue saying this, in this way.
Vigilantism is __rarely__ justified, and this is not an instance where it is. But we also must admit that this instance has sparked a larger national conversation. One that was going on for a long time but was routinely quickly quenched. This action catalyzed the conversation and gave it much more fire. __THIS__, I feel deeply uncomfortable with. There's certainly ways to do this same thing without killing a person (even an evil person), and I would hope that we can do better as a society to do that (you, me, and everyone. Not just "them", "US"). We shouldn't need to kill someone to have a real conversation, to solve problems, to get angry, to make change. It's here and I don't want to kill that conversation now that it has catalyzed, but neither do I want that to be the lesson learned from this. Because if it is, then vigilantism is justified much more often, and __that__ is not something we want. That is precisely how we end up creating the reality that everyone wants to avoid when they say "vigilantism is _always_ wrong."
This is a sensitive topic, and I think we should be careful. There's always ways to misinterpret others, especially if you try. But it is hard to listen, to see past the words, and find the intent. It is easier to fight and pick sides, especially when we're on the same one, than it is to actually solve problems. Problems that are complex, nuanced, and need deep understanding and care to resolve. It is easy to make them simple and pick tribes on that. Many of us want the same end goal, and we can do better by focusing on that. If we reach an impasse, so be it, but we should at least try.
>While it’s true that UnitedHealthcare has the highest denial rate for medical claims, the CEO doesn’t set the approval rate of a health insurance company’s payouts — that’s done by the actuaries, who themselves are constrained by various considerations, such as the need to keep costs low, including for policyholders.
By this logic, what can Brian Thompson be said to be responsible for? It's very strange to me to assign more responsibility for a companies denial rates to its actuaries than the actuaries' bosses bosses boss. So why exactly does UHC have higher denial rates than other companies? It just happens to be that it's actuaries are more frugal? This explanation doesn't hold water and I think it's a strange response to the shooting of a CEO to say, well actually CEOs aren't responsible for the things their corporations do. Of course they are, now they aren't solely responsible, but they probably have more responsibility than any other single individual. It can be completely true that killing Brian Thompson was wrong AND that he was no saint, being responsible for (and getting rich off of) large amounts of human misery inflicted on UHC policy holders by the organization he headed.