Inhumanity and Imbalance
Mammon and His Slave by Sascha Schneider, c. 1896 (public domain - Wikimedia Commons)
“The successful revolutionary is a statesman, the unsuccessful one a criminal.”
We’re now almost a week out from the killing of the CEO of United Healthcare by a vigilante who was seemingly distraught about the draconian policies of that company.
The shock and horror of the murder itself was jarring. Headlines and breaking news declared that an executive had been gunned down in front of a New York City hotel. Then the video footage was released, putting realism to what was previously only pictured in the mind.
The reaction online was another brutal visit from reality, with all corners of the internet celebrating the assassin, creating a folk hero out of him, and fawning over images of him.
The writers of Black Mirror couldn’t create a more perfect dystopian-anarchic story line.
As one USA Today columnist wrote, “The callous disregard for a human life is alarming to witness.”
An emotional and societal volcano seems poised to burst, as people are fed up with being treated like numbers and witness an ever-greater disparity in wealth — two molten rivers constantly churning and flowing beneath a thin surface of bureaucratic tolerance.
It’s this inhumanity and imbalance that are setting us on a collision course.
“One magic word today seems capable of compensating for all sufferings, resolving all anxieties, avenging the past, curing present ills, summing up all future possibilities: that word is revolution…This word has aroused such pure acts of devotion, has repeatedly caused such generous blood to be shed, has constituted for so many unfortunates the only source of courage for living, that it is almost a sacrilege to investigate it; all this, however, does not prevent it from possibly being meaningless.”
Inhumanity
The healthcare industry in the United States is widely panned, for a variety of reasons. Cost, complexity, and bureaucracy are at the top. More specifically, the insurance companies are demonized, largely because of their role as gatekeepers, willing to deny payment for services they deem “medically unnecessary.”
But who decides? Largely bureaucrats, sometimes medical personnel, but often times those who don’t have qualifications to properly review treatment protocols. People who don’t even see the patients.
Customer service representatives, who form the first wave of public interaction, are made less personal by sticking to scripts approved by their legal departments. Good luck finding one with empathy built in.
And more recently at United Healthcare, rather than using actual humans, they implemented artificial intelligence algorithms to cut off rehab care to Medicare patients — a process with a 90 percent error rate.
And that’s on top of UHC’s claim denial rate that is double the national average:
With this level of disdain for basic human dignity, is it any surprise that the public’s reaction to the murder was one not only devoid of empathy but filled with a gruesome glee?
Lest we fall into the same trap, let’s consider that Brian Thompson, CEO of United Healthcare, had family members, friends, and colleagues who genuinely cared about him. He was a human being.
Coincidentally, human beings — 52.3 million of them, to be exact — make up the membership of United Healthcare.
Or, as that USA Today columnist said, “The callous disregard for a human life is alarming to witness.”
Big Industry (Big Pharma, Big Oil, Big Tobacco, Big Auto, etc.) has largely been a nameless, faceless monolith — one that we’re happy to dehumanize because it treats its customers or employees like cogs in a machine.
Since CEOs are thought of as the public face of a company, our ire naturally gets directed at them: they are the first human beings we can identify.
Not any more, though. In response to this clear public outrage, a number of health insurers did the only logical thing: they removed their executives’ names from their websites.
Imbalance
Power and wealth, the twins of the cardinal sin of greed, are never fairly distributed. Currently, there is a wide imbalance between the haves and the have-nots, resulting in frustration.
Insurers hold all the cards in this game, and when they change the rules, members (notice I didn’t say patients) are stuck with having to follow them. Often they can’t leave an insurance plan, because that’s what an employer offers. Or they can’t afford anything else.
A recent rule change announced by Anthem Blue Cross and Blue Shield in Connecticut, Missouri, and New York announced on the same day that the UHC CEO was killed proclaimed that the insurer would not pay for anesthesia if a surgery went beyond an arbitrary time limit.
Anthem was greeted with the kind of response you would think they deserved and quickly rescinded their folly of a plan.
But that kind of change could have added up to a significant bill for unsuspecting patients, who would be unconscious when those services were delivered.
When insurers won’t pay, the debt adds up for patients. In 2019, researchers found that 66.5 percent of all bankruptcies are tied to medical issues.
Tough Decisions
The reason shareholders invest in health insurance companies is not to contribute to the improvement of outcomes or the general health of the insured; it is for one purpose alone: to increase profits.
“Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I break it and forswear myself, may the opposite befall me.”
Some patient care is unprofitable. But when Hippocrates set out in writing what would become his profession’s pseudonymous oath in Of the Epidemics, his first concern was about helping the patient, at the expense of his reputation.
In the great big and bright twenty-first century, health insurers don’t bother with the ethical and reputational elements of the Hippocratic Oath.
They more likely take a Mammonic Oath, bound by sacred words spoken to their accountants and pronouncements to avoid the harsh judgments of disappointed shareholders. That balance sheet has no room for feelings, well-being, or personal stories.
It is high time to reconsider the role of profit in patient care. Other countries seem to be getting their money’s worth.
How do we value human life at scale? It starts with the way we treat every person we come into contact with.
Every human being has and needs a sense of dignity.
Bob Parr knew that in The Incredibles (2004). Too bad his boss at Insuricare didn’t.