The Extortionate American Health Care

On December 4, 26-year-old Luigi Mangione shot and killed the chief executive of “UnitedHealthcare” B. Thompson in Midtown Manhattan. A few days later the killer was arrested.

Earlier Mr. Mangione posted an X-ray of his spine to social media with the image appearing to indicate a case of spondylolisthesis, a condition caused by vertebrae slipping out of place, which can cause chronic pain. He had a surgery that appeared to be "suboptimal" and the back pain continued to plague him. Insurance companies typically refuse to reimburse such patients and UnitedHealthcare does this quite often. That is probably why Mr. Mangione decided to attack Mr. Thompson even though he wasn't insured by UnitedHealthcare.

He explained his actions in the manifesto.

Manifesto of Luigi Mangione: “It had to be done.”

During the investigation, police came into possession of a manifesto, purportedly written by Mr. Mangione. Here is a part of the document:
“I do apologize for any strife of traumas but it had to be done. Frankly, these parasites simply had it coming. A reminder: the US has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy. United is the [indecipherable] largest company in the US by market cap, behind only Apple, Google, Walmart. It has grown and grown, but as our life expectancy? No the reality is, these [indecipherable] have simply gotten too powerful, and they continue to abuse our country for immense profit because the American public has allowed them to get away with it. Obviously the problem is more complex, but I do not have space, and frankly I do not pretend to be the most qualified person to lay out the full argument. But many have illuminated the corruption and greed (e.g.: Rosenthal, Moore), decades ago and the problems simply remain. It is not an issue of awareness at this point, but clearly power games at play. Evidently I am the first to face it with such brutal honesty.”

I agree with almost everything in the manifesto except the last sentence. Many Americans have also ”faced it with such brutal honesty” when their insurance companies denied their benefits because of ”corruption and greed.” As one of those deceived by insurance companies, a certain Mr. Anderson, 67, of Centerville, Ohio said: “The business model for insurance is don’t pay.”

However, Mr. Mangione is really the first one who has decided to do something about that practically, because it is impossible to defeat these “parasites” by democratic methods, since they are sponsors of both ruling parties which write the laws for the whole country. This is indeed “clearly power games at play” and that is just why ”many have illuminated the corruption and greed ... decades ago and the problems simply remain.”


The murder of B. Thompson has stirred up American society and drawn attention to an existing problem: the health care system in the country is working extremely poorly. The Associated Press states: “For years, patients in the U.S. health care system have grown frustrated with a bureaucracy they don’t understand. Doctors are included in an insurer’s network one year but not the next. Getting someone on the phone to help can be next to impossible. Coverage of care and prescriptions is often unceremoniously denied.”

The reaction of the Americans.

Sympathy for the murdered man and his family was expressed mostly by his colleagues.

The reaction of most Americans was different. Since his arrest, Mr. Mangione received support and has been viewed as a folk hero by many online.
Some people immediately offered Mr. Mangione's lawyer to pay for his services, and attendees at a dance party in Boston cheered when pictures of the UnitedHealthcare's CEO killer appeared on the screen.
Hans Maristela, a 54-year-old caregiver from California have expressed the opinion of the average American by saying that he as a Catholic grieved Mr. Thompson’s death and felt sorrow for his family, but… “And then you know the CEO of this company you pay a lot of money gets $10 million dollars a year, you won’t have a lot of sympathy for the guy.”

On the other hand, as The New York Times wrote: “… Torrent of hate for health insurance industry followed UHC C.E.O.’s killing... It has unleashed Americans’ frustrations with an industry that often denies coverage and reimbursement for medical claims.”

These responses of the Americans suggest that many people have problems with very expensive, confusing, and ultimately extortionate health care system.


The reaction of the future President D. Trump was predictable: he said that “It was cold-blooded ... horrible killing. That's very, very bad, especially the way that it was done.”
Everything is clear here - Mr. Thompson and Mr. Trump both belong to the American elite, which lives at the expense of the people, therefore billionaire Mr. Trump, as the current leader of this elite, sided with the “innocent” multimillionaire Mr. Thompson whose fortune is estimated approximately $43 million. Over the past year, Mr. Thompson has indeed received a $10.2 million compensation package ($1 million in base pay and cash and stock grants). So, Mr. Trump and Mr. Thompson are on the same side of the barricade. On the opposite side are American people who believe for some reason that billionaire Trump as president will be improving their lives - the health care, in particular.

I personally don't feel any pity for the murdered multimillionaire CEO either. He is truly a parasite and it is bad that there are quite a few of them in the US. His money was taken away from the people with the help of the extortionate laws that both major US parties created for their common convenience. The Americans still have not realized that both Democrats and Republicans were simply parasitizing on the country's economy (i.e. on the people). They just imitate vigorous activity and create nothing, but political struggle for the people’s money.

It’s always funny to watсh the bees fighting honey.

It would be interesting to know whom the late Mr. Thompson sponsored or voted for in the last presidential election. Corporate America largely supported Mrs. Harris, so it is likely that Mr. Thompson voted for Democrats, too. Mrs. Harris has built her presidential campaign on the idea that the US as a whole was doing well, and she lost.

Most ordinary Americans supported Mr. Trump, despite all his faults, because he promised to break the existing system in the US and, apparently, he will try to do so. Unfortunately, the people, as usual, believed that businessman and billionaire Trump would, as he said, “drain the Washington swamp” for the benefit of all Americans.
No, the bees do not fight honey. Mr. Trump simply wanted to avoid jail, punish his opponents and make a little extra money, as he did in his first tenure. He will for sure try to repeat that material success.

The Right to Health in the US Declaration of Independence.

Is the right to health (or to qualified and affordable medical care) one of the fundamental human rights described in the US Declaration of Independence? Apparently, yes, although this right is not directly specified there.

Declaration of Independence (July 4, 1776) stated, that ”Life, Liberty and the pursuit of Happiness” are the unalienable rights of every person given by God «which governments are created to protect.»
I would refer the Right to Health into all three of the above categories: «Life» (because ill health leads to premature death), «Liberty» (because ill health greatly limits freedom to speak and act) and «Pursuit of Happiness» (because if there is no health, there is no happiness.)

Unfortunately, «… like the other principles in the Declaration of Independence, this phrase is not legally binding», but the founding fathers spoke there about the ideal (and correct!) principles of governing the state. The ideal is unattainable, yes, but it is something to strive for, and the US governments (elites) have gone very far away from this ideal over the last 248 years. They have learned to make money on ”Life, Liberty and the pursuit of Happiness” of every American. There are about 350 million Americans now, many of them work, pay taxes and various dues (health insurance, in particular), most of which the elite appropriate and get rich from.

This led to the main conflict of the US - the division of the nation into a rich minority and a poor majority, and all other troubles blossomed from this. Americans can see only separate problems: the high cost of living, uncontrolled inflation, illegal immigration, unaffordable health care, unfair bans on abortions, growing gun violence, etc., not noticing the main thing: both major parties have been adopting biased laws and have been abusing their privileged position for many years to the detriment of the interests of people and country.

The state should be interested in healthy (and therefore happy) citizens. Healthy citizens will work better than sick ones and they do not need a social assistance. However, the US elites have turned health care into a source of their income and nothing can be done about that by legal means, because US laws protect mainly the interests of the elites.

Philosophy: Natural and Legal rights.

Some philosophers distinguish two types of human rights, natural and legal ones:
“Natural rights are those that are not dependent on the laws or customs of any particular culture or government, and so are universal, fundamental and inalienable (they cannot be repealed by human laws, though one can forfeit their enjoyment through one's actions, such as by violating someone else's rights). Natural law is the law of natural rights.
Legal rights are those bestowed onto a person by a given legal system (they can be modified, repealed, and restrained by human laws). The concept of positive law is related to the concept of legal rights.”

Luigi Mangione apparently felt that his natural rights were grossly violated by the extortionate US health insurance industry, in particular by the UnitedHealthcare which is the largest company in this field. It often happens in life that natural rights are not very clear, but fair, and legal rights are more or less clear, but unfair, mainly because the rich minority writes them for the poor majority. I wonder what is a greater crime against humanity from the point of view of philosophy or religion: the “cold-blooded, horrible killing” of a multimillionaire-chief executive of a large insurance company or the “cold-blooded, horrible” denial of coverage and reimbursement for medical claims (practically, a robbery) of many Americans by this company?

What will happen to Luigi Mangione now?

A “folk hero” may get a death penalty or a long sentence and spend the rest of his life in prison.
Mr. Mangione was indicted on 11 counts, including first-degree murder and murder as a crime of terrorism. “This was a frightening, well-planned, targeted murder that was intended to cause shock and attention and intimidation… The intent was to sow terror," Manhattan District Attorney Alvin Bragg told recently about the case.

No, that was not an act of terrorism. Mr. Prosecutor, consciously or not, demonizes the image of Mr. Mangione. His action was not aimed at “shock, intimidation and terror.” Mr. Mangione attracted a lot of attention of the Americans to their (and his) existing problem, although it may well be that he did not intend to do so at all. I think that at the trial Mr. Mangione will state that he did everything absolutely consciously and will get the full punishment from the court.

Let me remind you that Alvin Bragg is Manhattan District Attorney who brought Mr. Trump's "hush money" case to the court, but it got stuck there. BBC reports that “… the judge is still yet to decide whether to issue a sentence before Trump assumes office in January, after his term ends in 2029 or not at all.”
Mr. Bragg and the court are more fortunate with Mr. Mangione's case and everything will be much simpler here. Formally, everyone is equal before the law in America, but American Themis could not punish Mr. Trump timely for any of his 4 crimes and now it will be able to take full revenge on Mr. Mangione, who, in my opinion, is an antipode of Mr. Trump in his attitude towards the country and its people.

What will happen to health care in the US?

Nothing. There won't be any special changes, just some small cosmetic improvements because this is the business of large sponsors of both major US parties.
Elon Musk, for example, believes that “… Nothing would do more to improve the health, lifespan and quality of life for Americans than making GLP inhibitors super low cost to the public. Nothing else is even close.” GLP inhibitors are a medication that treats type 2 diabetes and obesity.

I think that the availability of cheap GLP inhibitors will not affect the successful health care extortionate business of corporations which is the main question. Mr. Mangione goes to jail as minimum, the people forget about him soon, and rich medical, pharmaceutical and insurance corporations will keep squeezing their ill-gotten dollars out of the Americans. Until the majority of the people see the harm that the elites are doing to the country and begin to vote correctly, the corporations will not allow the health care system to be reformed in a proper way. They are real, permanent lords of America, not the presidents who serve for 4-8 years the system which Mr. Mangione dared to challenge.

There are different variants of organizing the health care in different countries: public option, multi-payer system, single-payer system, etc. However, the political will is needed to implement any real reform. The ruling elites of the US do not have such will (or even desire), and the people can do nothing because they do not make decisions for the country.

Imposed extortionate laws.

I think that health care and pharmaceutical industry are among the most profitable areas for the US elite to make money. Experts say that the country spends around $4.5 trillion a year (which is not a small amount, about 17% of GDP) on health care and the system still works poorly. On top of that all information about the system is terribly confusing. Considering also the fact that insurance companies practically choose themselves whom to reimburse (or not), they can afford to pay their chief executives $10 million a year. Then American corporations (their owners and CEOs) sponsor the 2 major country's parties, which in return pass the extortionate laws they both need. This is a vicious circle.

For example, I recently turned 65 and didn't want to apply for Medicare, but I'm required by law to do so or face a lifetime and ever-increasing fine. Is this my "Liberty" from the Declaration of Independence?

I have already received a bunch of letters from various companies (including UnitedHealthcare) which very much wanted to “take care” of my health, but in fact were interested just in receiving insurance premiums from me (at least $200 per month). I don't want to get Medicare because I know for sure I will have to prove something to insurance companies to be reimbursed after all my payments. Besides, I know from my Ukrainian experience that if the system is too complicated, it is done on purpose and many representatives of the elite make good money there. I don't want to feed them, but the laws, written by the elites on my behalf and supposedly for my benefit, force me to do so. In reality, these laws work against me and protect the material interests of the elites.

This is the main conflict of many countries (Ukraine, in particular), not only the US. That's why I left Ukraine, and in the US I don't vote for both Democrats and Republicans. They do what I don't need, don't do what I need, live their own separate lives and constantly extort money from me in any possible way. But at least I can see that, many Americans cannot.

Insurance medicine is needed only when citizens cannot pay for their medical services and medicaments on their own. It means that the prices are unreasonable (I’m sure it is done artificially). This is what is happening in the US. Many Americans complain that the prices for medicine and medicaments are too high. The US elites have turned the American health care system into a trillion-dollar business that does not support the health of the nation, but drives many people into the bankruptcy: about 41% of the adults struggle with health care debt. Luigi Mangione and many Americans are against all that, but the American elites (both Democrats and Republicans) do not care. The people of the US cannot do anything about this robbery done by absolutely democratic methods, so then they resort to violent ones.

What needs to be done about health care system in the US?

It’s needed to lower the cost of medical services and medicaments so that every working American can pay to doctors out of their own pocket, just like they buy their food - without the help of insurance. That is the ideal to strive for, but America's elites will not help make it happen.
So then it’s needed to stop “believing” in the honesty of the elites and in the fairy tales that Mr. Trump “will fix it.” And it’s needed to change two current elites by the correct conscious voting. They won't leave on their own, just like US Supreme Court Justice С. Thomas didn't step down after the scandal with the expensive gifts he got from his Republican sponsor. I wonder if anyone would regret Judge Thomas's death other than his family, colleagues and sponsor?

I certainly wouldn't.