Compassion fatigue after a NYC sidewalk murder

The assassination of a health insurance executive steps outside a Midtown Manhattan hotel before sunrise on Dec. 4 has exposed long simmering public rage. 

Not at our gun culture. Not over our dangerous streets. The rage was directed at amoral actions by the health insurance industry, a major factor in the dysfunction of our health care system. 

In an age when we are often at the mercy of corporate greed — being fleeced at the supermarket, spied on and manipulated by tech companies, deprived of choice by megamergers — nothing can compare to the outrage of watching loved ones suffer needlessly because of someone else’s profits. 

Right now, few Americans can feel completely comfortable in their ability to receive basic health care. Because it does not take a lot to become health care insecure pretty much overnight. 

Your health insurance plan could be canceled, and the new one is twice as expensive, or more so, with less coverage, as mine recently was.

Your Medicare Advantage program could suddenly no longer be accepted by the only hospital system in your state.

Your health insurer, whom you pay regularly, can mysteriously deny the medicine, device  or procedure that your doctor ordered, and the review process is obscure and fraught, especially when time is short.

These now common events — all triggered not by bad doctoring, but rather by an insurance industry whose driving force is profit — can result in both terror and rage. I know this personally, and so does almost everyone I know. 

Here in Rhode Island, we consistently cite issues around access to health care as main political concerns. The Rhode Island Foundation’s recently released new five-year plan repeatedly references health, as did the plan before it, and probably the one before that.

But somehow we just cannot seem to make it better; we actually seem on track to make it worse. While the Affordable Care Act (ACA) provided affordable access, and assurances, to many Americans, the incoming administration seems hostile to any government involvement in health care, including the ACA but also Medicaid and Medicare.  Insurers are now feeling emboldened to deny even more services including, incredibly, limiting the time a patient can be under anesthesia during surgery (a plan that was recently rolled back only after extreme reactions by the public and elected officials).

There is no real mystery as to why it is difficult to make a change. It has to do with America’s persistent and irrational commitment to allowing market forces to control aspects of our lives that should not be subject to them. We want to believe that our economic system rewards the worthy. But perhaps now, when market forces are depriving so many of us of our health and even our lives, it can change the way we think about our systems.  

United Healthcare CEO Brian Thompson probably thought he was just being a good corporate leader, maximizing profits for his shareholders and himself. I feel for his family as they bear witness to the many expressions lacking sympathy for his death.

But we make a mistake if we ignore the fact that this lack of compassion is a symptom of a real problem, and I do not mean the cruelty of social media. I mean the cruelty of our system, and this is not new. Corporate leaders often crow about “the new Gilded Age,” but in their ahistorical blindness, they are ignoring the fact that the rise of unfettered capitalism in the 19th century, which allowed children to die and be maimed in factories, for example, prompted violence then, too. Even the series, “The Gilded Age,” does not skip this part. Strikes, riots and violence against employers helped usher in an era of social change that included protections for human life and happiness that were deemed more important than anyone’s right to make money.

We still believe that there should be ethical limits to what can be subject to market forces. We cannot buy and sell other people. We cannot sell our biological organs. We cannot actively prevent people from having access to breathable air, or usable water. We cannot even sell cigarettes to children.  Laws are passed to prevent and protect us from those who seek to profit by killing or harming others.

But for some insane reason, we have allowed health insurance companies to do exactly these things. And now, it seems clear, Americans want to see a change. Again.