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).
> 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.
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"?
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.
>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.
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.
> 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.
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.
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.
Readit News
>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.
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.
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).
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.
What’s the problem, again?
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.
https://www.scientificamerican.com/article/fearful-memories-...
https://www.nature.com/articles/nn.3594
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.
Deleted Comment
"Descendants of Holocaust Survivors Have Altered Stress Hormones": https://www.scientificamerican.com/article/descendants-of-ho...
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.
> 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.
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 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.
At some level of oppression violence is obviously indicated. The whole of the current Western order is premised on that.
At some point it’s too far. Today is not that day.
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.
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 …
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.
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.
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.
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.
Once that starts, that’s a forest fire that burns in ways no one can control.
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.
The (more likely) real [1] one isn't as easily dismissed.
0 - https://leadstories.com/hoax-alert/2024/12/fact-check-fake-m...
1 - https://www.kenklippenstein.com/p/luigis-manifesto
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.
> 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.
0. https://substack.com/@gurwinder/p-147486907 1. https://www.bbc.com/news/uk-scotland-scotland-politics-65945... 2. https://fossilfueltreaty.org/
Dead Comment
This is an absolutely massive number. It could easily prevent hundreds of unnecessary deaths per year.