Grief and grins

A broad daylight execution-style street murder in front of a major hotel in a busy, high-end part of town would normally be a story with guaranteed shock value that would dependably evoke sympathy for almost any random or targeted victim.

But when Brian Thompson, CEO of UnitedHealthcare, the private insurer with a record that beats all competitors in the devious business art of denying life-enabling treatment to desperately afflicted policyholders, was felled by bullets that left casings inscribed with nomenclature that as a consummate professional he would have recognized and made him smile, the pity of the tragedy, though beyond mitigation, was starkly muffled by cheers from much of social media.

That's inexcusable but understandable. Bitterness and cynicism are, in this instance, as natural or at least inevitable as empathy and indignation. 

Thompson may or may not have been a profoundly decent individual. He was condemned by adverse presumptions that were inquiry-proof. That's because his role was bigger than his personhood. It was about what he represented, not what he might have exemplified in his personal life.

He took a bullet for heartless corporatism. Being its symbol depersonalized and doomed him.

Instantaneously upon his death there was an epidemic of gallows humor. It was cruel, witty, revelatory and to-the-point: "Our records indicate that you failed to obtain prior authorization before seeking care for the gunshot wound to your chest.” Another said, "Thoughts and deductibles to the family. Unfortunately, my condolences are out-of-network.”

When exasperated, agonized and haunted by people or policies that are to blame (whether by passive complicity or active promotion), for one's irreconcilable human losses, survivors will lash out. "What goes around, comes around" is faint consolation, but it's better than none.

The insurance industry is widely despised for its merciless imperviousness to the lessons of compassion.

As an entrepreneur by trade, Thompson dealt in death. To acknowledge poetic justice is not to celebrate his demise. He was an adherent to the dictates of the bottom line, the accursed language of medical coding, and the bitch metrics of the industry. 

There is no moral equivalence between the slayer and the slain. His killer is no folk hero. Had Thompson been in any other line of work and they chanced to meet at a party, they might have become lifelong pals. That's what sometimes happens with soldiers of opposing armies when their bayonets are retired postwar. 

Recently, Anthem Blue Cross Blue Shield decided, according to the American Society of Anesthesiologists, to "no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes.” 

That suggests that patients in the midst of their lung transplant, who develop an acute complication that requires ten minutes to stabilize, thereby delaying completion of the operation beyond the minutes permitted by the insurance company, would be liable for the costs of anesthesia beyond that point, as stipulated on a document coercively signed prior to surgery to legally cover the insurance company's asses.

If I were a casting director for a theater of psychotic performance art, I'd have auditioners improvise a skit based on this idea, and anyone who could do justice to its almost hilariously vile precept, would get a lifetime contract. 

What's next: drive-thru mastectomies?

After Thompson's murder, Anthem rescinded their plan. But for how long? Until public memory fades like disappearing ink? The pretexts for their original plan have not changed, only the optics have. Like Governor Kathy Hochul's yo-yoing about congestion pricing.

Of course, Anthem couldn't fess up, having been caught with their pants down, so they had to craft language to imply that it was all a matter of misunderstanding: "To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary services. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well- established clinical guidelines.”

This disclaimer was proofread by the devil and vetted in hell. It's legalese gobbledygook. It's in the venom-loaded slippery ambiguity of words like "necessary,” “clarify,” “appropriateness,” “well-established” and “guidelines.” All of these can be manipulated to suit the taste buds on the corporate tongue.

Before yanking its stillborn brainchild, Anthem advised its New York providers that "claims submitted with reported times above the established number of minutes will only pay up to the CMS (Center for Medicare and Medicaid Services) amount,” which is referred to a "Physician Work Time" values.

Anthem is superior to many other private insurers. Many others are even worse torchbearers for this cheesy industry.

The murder of the UnitedHeathcare CEO did not touch the public like most other high-profile cases. Some rationalized it as "what goes around, comes around" or as affirmative retaliation in the face of extreme provocation. 

What perverse satisfaction might the hunted forest animal feel when its predator's gun fatally backfires? Is satisfaction vindicable or is it perverse to relish an ersatz oppressor sewing what he reaps?

Common Dreams, the online news outlet, observed that "The mass reaction ( to the murder) is a reminder that there is a constant deadly class war being waged against working-class Americans.” Is there an imperative to "embrace economic populism and end close association with corporate power?” 

That's doctrine informed by the primal screams of the aggrieved.

An NBC report cites a patient suffering from Lou Gehrig's disease who needed machines to help her breathe or talk, but was denied coverage and could then communicate only by blinking until she perished. It's entirely plausible that the doctor employed by the insurance company may have been rewarded with stock options and salary bonuses in exchange for pimping their credentials.

In the aftermath of the super-millionaire's murder, tips and theories from online sleuths were in uncommonly short supply. Ninety percent of comments following the announcement of the murder on UnitedHealthcare's website were whimsical and sarcastic, including many smiling emojis. 

A $60,000 reward was posted within days. Even when there is a probability of recurrence and high risk to the public if a suspect is not apprehended, the sum is a small fraction of what was offered in the Thompson affair. Maybe it was calculated according to a new metric like that promulgated by the anesthesia-restricting folks. Maybe it is linked to a victim's standing in society's pecking order.

Violence is, in a sense, no less characteristic of the medical insurance industry than of the military. The snipers are in their boardroom fatigues. Brian Thompson's killer drafted himself into morally bankrupt special forces service without commission or warrant. He took it upon himself.

But the true vigilante was destiny.