A Troubling Applause
I have seen many otherwise intelligent, pragmatic, and ethical people over the last several weeks heap praise upon a scion of one of the wealthiest families in Baltimore, who shot a husband and father in the back in cold blood while he walked along a city street.
I encourage anyone gleefully retweeting portraits of Mangione festooned on a canvas like Saint Francis of Assisi to consider the true culprits of the suffering wrought by a dysfunctional healthcare system—and what John Adams meant when he wrote, “We are a government of laws, and not of men.”
The System is Broken
The healthcare system in the U.S. is undeniably broken—a disgrace shaped by a political and economic system that incentivizes profit over patient outcomes. At its core, this dysfunction is the responsibility of the legislative branch of the federal government, whose role is to establish policies that ensure fairness and access. Both political parties have failed in this responsibility. Their reliance on lobbyists and special interests has resulted in inertia, leaving average Americans to bear the burden of rising costs and inaccessible care.
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It’s easy to cast blame on healthcare CEOs, but they operate within a system that incentivizes profit-driven behavior above all else—one they are not empowered to change as a private enterprise. By all accounts, Brian Thompson, the CEO of UnitedHealthcare, was not one of the worst actors in this space. In fact, he made real strides to improve the system, including efforts to remove out-of-pocket costs for lifesaving drugs—an initiative that directly benefited countless people whose lives were beset by illness and pain, and whose lives might have been considerably worse today if United had been led by someone else.
His work, though part of a deeply flawed system, demonstrated a sincere commitment to addressing some of its most glaring inequities. He need not be canonized, nor should his legacy be distorted into a vaunted picture of a selfless public servant. He was a normal CEO who, like all CEOs in a capitalist economic system, was tasked with balancing shareholder expectations of profitability with his own ethical principles and competing notions of the good. He is not to blame for the shortcomings of a government responsible for providing its citizens with healthcare befitting a developed nation. His intersection with the healthcare issues facing our country is a mere symptom of poorly aligned incentive structures within our legislature—a situation that arose from a winding river of prior causes. The distance from the first headwaters to the mouth is too great to scapegoat one man.
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The Human Cost
If this treatment feels too charitable, perhaps it won’t for his two young children, who will now attend schools in which their classmates will continuously play—and replay—videos on their iPhones, all around them and likely at inappropriate volumes, of their father being gunned down by a hooded figure that police later dragged out of a McDonald’s. When they whisked him into the squad car, he was holding handwritten pages that read like a deranged Martin Scorsese fan fiction manuscript, found crumpled on the floor of a psychiatric ward: “So what do you do? You wack the CEO at the annual parasitic bean-counter convention,” writes Mangione. Professors, if you feel this quotation represents moral courage, poke your head outside the faculty lounge and see what the fresh air smells like. In Philadelphia in December, it should be mostly crisp with a hint of grittiness from the damp pavement and smoke billowing from distant chimneys. This may jolt you back to reality with the rest of us.
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The Moral Question
To distract from the central moral question of “Is murder an acceptable means of voicing one’s grievances?” with a lazy non sequitur about a broken system as old and complex as our Republic is as inhumane as the corporate greed you condemn with such withering sanctimony.
There is no maniacal villain in this story that embodies unadulterated evil—though that would be more convenient and perhaps a more viscerally satisfying foe that can be slain with a finality that is complete and symbolically resonant. Instead, it is a Jack London tale of basically ordinary and decent travelers, some with more gear than others, but all fighting to survive in an unforgiving climate that is so cold it’s hard to breathe. The skies are heavy with a gathering storm of our political and economic systems that allow profit to dictate healthcare priorities. Conquering this environment demands systemic change led by a legislative branch willing to put the needs of citizens above those of corporate donors. In a representative democracy, this change happens at the grassroots level in the form of non-violent political activism that ultimately manifests in the voting choices made by citizens who believe in the tenets of our Constitution, the philosophy of the Enlightenment that undergirds it, and the Rule of Law.
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The Social Media Effect
Applauding a mob hit on someone you’ve decided was not a man but a disembodied symbol of distilled corporate greed may afford you a kind of primitive satisfaction. It will feel good and righteous, and you will feel the steady dopamine drip as the likes and follows accrue on your posts decrying injustice and greed in all its forms. But all this happens in the aftermath of your exposure to the social media contagion of short, sensationalist clips that demand little focus or contemplation—preventing you from actually interrogating a complex topic and recognizing that the flowing rapids of economic, social, and historical change that brought us to the river’s delta are far more powerful and difficult to overcome than any one person could ever be.
Applauding a mob hit on someone you’ve decided was not a man but a disembodied symbol of distilled corporate greed may afford you a kind of primitive satisfaction.
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What Happened to Your Empathy?
Professors and blue-checkmark-holders, big and small, I wish you knew how easy it is to be kind and to love someone when you are looking them in the eye, in an exchange of pure conscious energy, in all its beauty and pain. For the love of God, get off social media. It is driving us slowly, algorithmically, into collective insanity. Go out into the world. Become interested in other people instead of recording yourself shouting into a digital ether that offers you nothing of value in return. We can do better than this.
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Two Types of Readers
There are two types of readers of this letter. One can almost hear Brian’s flat and disarming Midwestern accent; he was a CPA and valedictorian of his graduating class at the University of Iowa—the kind that was raised on a farm by blue-collar parents who instilled in him the value of hard work and humility. His friends and colleagues called him “BT,” probably because they liked him, and they perhaps tended to carry him along on their shoulders because he was usually right about most things—yet he was also kind and empathetic. This is not hard to imagine for this reader.
The other reader lacks the ability to envision the aspects of Brian Thompson’s life story that highlight his humanity and basic decency. They simply open their laptops, preen themselves for a moment before turning on their webcams, and launch into their nightly monologue that echoes in their sparsely furnished Washington Heights apartment, with none of the trappings of a woman’s nesting, or the loving chaos that accompanies a home with young children. They shout incredulously into the ether, “How can I see Luigi as anything but a kind of folk hero?” Their heart rate quickens as they see other X users reacting to their charisma in real time.
But the silence is their answer.
Professors and blue-checkmark-holders, big and small, I wish you knew how easy it is to be kind and to love someone when you are looking them in the eye, in an exchange of pure conscious energy, in all its beauty and pain. For the love of God, get off social media.
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