One thing that resulted from the killing by Luigi Mangione of the CEO of the health insurance conglomerate known as UnitedHealth is that it has resulted in that company’s practices getting closer scrutiny. And what is being revealed is ugly and bound to create even more anger against the company and its executives.
The whole private health insurance system in the US is systematically flawed and breeds corruption. Putting in private, profit-seeking entities such as hospitals and insurance companies between doctors and patients lead inevitably to fraud and waste and a siphoning off of resources that should go into health care into the pockets of insurance executives. UnitedHeath is by no means an outlier though it may be the most egregious offender because of its size and perhaps its greed.
The conditions for abuse within the Medicare and Medicaid system is clear. The government gives the insurance companies a lump sum, as opposed to per treatment. Whatever remains after the cost of treatment is profit for the insurance company. Hence there is a built in incentive to deny health care and UnitedHealth found many ways to do so.
UnitedHealth Group, the nation’s largest healthcare conglomerate, has secretly paid nursing homes thousands in bonuses to help slash hospital transfers for ailing residents – part of a series of cost-cutting tactics that has saved the company millions, but at times risked residents’ health, a Guardian investigation has found.
Those secret bonuses have been paid out as part of a UnitedHealth program that stations the company’s own medical teams in nursing homes and pushes them to cut care expenses for residents covered by the insurance giant.
In several cases identified by the Guardian, nursing home residents who needed immediate hospital care under the program failed to receive it, after interventions from UnitedHealth staffers. At least one lived with permanent brain damage following his delayed transfer, according to a confidential nursing home incident log, recordings and photo evidence.
“No one is truly investigating when a patient suffers harm. Absolutely no one,” said one current UnitedHealth nurse practitioner who recently filed a congressional complaint about the nursing home program. “These incidents are hidden, downplayed and minimized. The sense is: ‘Well, they’re medically frail, and no one lives for ever.’”
…Under Medicare Advantage, insurers collect lump sums from the federal government to cover seniors’ care. But the less insurers spend on care, the more they have for potential profit – an opportunity that UnitedHealth higher-ups have systematically sought to exploit when it comes to long-term nursing home residents.
…One term that UnitedHealth executives obsessed over was “admits per thousand” – APK for short. It was a measure of the rate that nursing homes sent their residents to the hospital. Under the “Premium Dividend” program, a low APK qualified a nursing home for the various bonus payments the insurer offered. A high APK meant that a nursing home received nothing.
The company’s defense of its practices is disingenuous, to put it mildly.
UnitedHealth said the suggestion that its employees have prevented hospital transfers “is verifiably false”. It said its bonus payments to nursing homes help prevent unnecessary hospitalizations that are costly and dangerous to patients and that its partnerships with nursing homes improve health outcomes.
But why offer bonuses if the people are simply following standard care practices? You offer bonuses if you want people to do more than what is called for and giving it to those who prevent hospitalization is obviously not in the patients’ interest. Some of these arrangements were also done in secret, which obviously suggests that some chicanery is going on.
Whistleblowers also said that nurses were pressured to change patients’ preferences to ‘do not resuscitate’, without their knowledge or consent, when they had not indicated any desire for such a change.
The list of abuses that the article highlights is staggering and infuriating. Is it any wonder that some people are treating Mangione as folk hero?
but it’s just thought crimes, it’s not their fault, we can agree to disagree, justice can’t come from a mob, gotta do it thru a legislature comprised of millionaires with brothers sisters and cousins CEOing in the industry, u kno, or it’s wrong.
Yes, murder is wrong. Were you being sarcastic? You were accidentally perfectly correct.
“Whistleblowers also said that nurses were pressured to change patients’ preferences to ‘do not resuscitate’, without their knowledge or consent, when they had not indicated any desire for such a change.”
So, murder. UnitedHealth employees committed murder. Luigi Mangione killed in self-defence.
unitedhealth should be given an involuntary DNR.
We have death panels.
…
gosh
Luigi Mangione, what a guy. He’s done the world a number of services.
One of those is, to a greater extent than I’ve ever seen in my lifetime, exposing some people for who they really are, in spite of principles they express so often, and so strongly, that you’d be justified in calling them a large part of their identity -- principles they row ALL the way back on when they hear what Mangione did, to whom, and why. It’s been very interesting to watch who really wants to live in a civilised country, and who, when push comes to shove, really wants to live in the jungle with the animals, as long as it’s the right animals getting slaughtered.
There are circumstances in which it is recognised as morally justifiable to kill people in cold blood. One of those is when you’re part of an armed resistance movement in a country that’s been invaded by a hostile foreign military force, like say the Nazis in France from 1940, or the USA after the coup in Hawaii in 1893, or the USA in Grenada in 1983, or the USA in Panama in 1989, or the USA in Somalia in 1992, or the USA in Afghanistan in 2001, or the USA in Iraq in 2003.
I’m not aware of a hostile foreign military force occupying any part of the USA, or indeed any military invasion of the USA of any kind since about 1848, and no properly organised one since 1812, so obviously that justification is not on the table unless anyone knows differently. Anyone?
If you’re in favour of armed, deadly resistance, well and good, but -- resistance to what? To whom? What uniform do the enemy combatants fight in? And if they’re not in uniform… who decides who is a legitimate target? And how? And how are they held accountable for those decisions? I don’t think people have given these things much thought in the rush to lionise Mangione.
Don’t get me wrong, violent revolution against parasitic capitalists and authoritarians isn’t something I’m going to condemn, obviously, but don’t, please, try to pretend you’re on some moral high ground. Condemned to use the tools of your enemy to defeat them. Damned for what you do.
that’s true, i think, anybody doing a murder is diminished for it. but the guy who shot first gave you no choice, dragged you down to that level. the upper class is literally killing us for money every day. the choice is drink your poison like a good child, or… whatever else we can do.
If your adversary has let your dad or aunt die by denying health care, by pre-modern tradition it is vendetta time.
I wouldn’t do it myself, but I respect the quaint traditions people have abroad.
Knock yourself out. After all, we are told all the time we should return to old-fashioned morals.
Correction: “…alleged killing by Luigi Mangione.” Innocent until proven guilty.
Cowboy Bebop: Pierrot Le Fou settles scores with the corporation who used him for medical experiments.
.https://youtube.com/watch?v=mrdKi1wOb4A
I think a lot of this is a debate weighing barbarism against civilization. But it’s not as simple as it might appear at first.
In the US all three branches of the federal government and all state and local governments can be said to have one purpose: to stave off barbarism. This is actually true of all forms of government, even the ones that we don’t like and that we wouldn’t want to live under. But that’s not all they do. All governments, including the representative democracy of our republic, claim some right to enact barbarism of their own. To perform violent acts to achieve their goals. The governments we tend to view more favorably tend to limit this violence in many ways but none forgo it entirely. At the very least, they keep the option of imprisoning some people after they’re convicted of certain crimes. And they claim the right to foricbly deny entry at their borders (the invading army scenario but also smugglers and others who break local laws -- those people aren’t allowed to just walk away after all).
As far as I can tell the only way to have a society that’s perfectly civilized and has no barbarism within it is to populate it with perfect people. And when you find one of those, feel free to tell me. Shared laughter is always appreciated. But forgo the Dear Leaders and Their Holinesses because those aren’t funny anymore.
The Luigi vs United Healthcare situation is not black and white because there’s barbarism on both sides. And different people will place different degrees of importance on various details and aspects of the barbarism involved. And right or wrong, that seems pretty normal to me. People generally seem to place less importance on terrible things if they’re distant. I suspect that a poll might show a correlation between whether Luigi or United Healthcare are viewed more favorably and whether the respondent thinks they can afford to pay likely medical bills. If you think you could easily accrue medical bills you’d be unable to pay, the things United Healthcare does are likely to weigh more heavily for you. Which again, seems pretty normal to me.
A lot of the way we decide who’s more right depends on the details of the barbarism they’ve performed. Did it affect more people? Was it more severe? Was it easy to assess the damage? Were there any details you could consider to be mitigating circumstances? We’re all going to count these things up differently because our situations are not all the same. Different details will hit closer to home for some of us than others.
I think ultimately it’s a bad idea to make assumptions about the moral fortitude of other people based solely on their opinion of this situation. It’s certainly easy to do but only if you ignore a lot of the reasons they might have a different opinion than you do.
This is going off on a tangent, but you may want to know the government is now going even lower than private business on the ethics front.
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Katie Phang:
“Trump Sends HIS GOONS to Do The UNTHINKABLE in Front Of Court”
.https://youtube.com/watch?v=T8uAkSVEcKA
“Dupe and Scoop”
lanir @ 11:
Well put!
I’m not against Luigi going to prison. I am against a system where killing one person with a gun gets you imprisoned but killing several people with a few strokes on a keyboard gets you stock options. I’d love to live in a civilized country, but I don’t believe Canada or the US are all that civilized. If we were, we would be helping the homeless instead of criminalizing them, stopping the slow ongoing genocide of indigenous people in our own borders, and not supporting the faster genocide in Palestine. The US certainly wouldn’t be forcing people to pay into a private insurance scheme where the insurers are incentivized to not cover what people are paying for.
The scary thing is there is going to be a lot more violence before this is all over. People don’t see the value in voting for change when that change never comes when they do vote. I don’t like that it’s heading that way, but I understand it. People can live under the heels of their rulers for only so long.
Okay, then why
?
It seems in your preferred legal system, self-defence still results in prison. That, or you don’t actually believe it to have been self-defence.