The direction of society lately

[bigbill]

With the murder of the insurance CEO, there were some who praised the shooter and justified his actions (if proven guilty). It seems that we have grown numb to wanting someone dead over what they represent versus what they did. Leaving personal feelings out of it, did the CEO do anything that warranted his death? After the Trump assassination attempt where he was wounded, some, including media and celebrities were lamenting that the shooter wasn't more accurate. I don't like Trump, but I certainly wouldn't want a presidential candidate to be assassinated because I don't like him/her. How did we get to the point where people believe it's okay to commit violence against someone they don't like. Trump is a turd, but what action did he do that made it okay for someone to attempt a headshot at a rally? Daniel Penny (the Marine in the subway) was found not guilty, but the narrative immediately after the verdict was that an all-white jury let him off, and the verdict was an example of white supremacy. In that case, I'm concerned that racist accusations are getting used so often that people stop listening, and when an actual racist event event occurs, people ignore it.

I don't mean to roll a grenade, but I think some good conversations could happen around the current state of society and to a great extent, social media.

[j44ke]

I don't think we just got there. I think we've always been there. Assassination has been elemental to our history.

[takashi]

'Anybody know who Lee Harvey Oswald was?'

[bigbill]

Assassination is not new, but how do you all feel about the reaction in social media to the shooter. How many people rejoiced when JFK, RFK, and MLK were killed? How many people thought their killing was justified.

[rwsaunders]

In the case of the United Healthcare CEO perp, I don’t think that the perp is at all well which is sad, but it certainly doesn’t warrant what he did to the victim. We had an employee post about the event on LinkedIn in terms of justifying the shooting and of course, we had to give him the option of pulling the post or ceasing his employment with us as we pay for his LinkedIn subscription. My call to him essentially revolved around the fact that this was a life that was taken and to place himself and his family in the victim’s shoes. Whether it resonated or not is another story. Political and religious viewpoints and beliefs are used to rationalize assassinations every day, right?

[bigbill]

In the case of the United Healthcare CEO perp, I don’t think that the perp is at all well which is sad, but it certainly doesn’t warrant what he did to the victim. We had an employee post about the event on LinkedIn in terms of justifying the shooting and of course, we had to give him the option of pulling the post or ceasing his employment with us as we pay for his LinkedIn subscription. My call to him essentially revolved around the fact that this was a life that was taken and to place himself and his family in the victim’s shoes. Whether it resonated or not is another story. Political and religious viewpoints and beliefs are used to rationalize assassinations every day, right?

I get it about religious viewpoints and beliefs, but this is the U.S., where we should have a certain expectation that we're not going to be killed for our views. In Afghanistan, Iraq, Iran, Syria, etc, your opposing views can get you killed. With the Taliban and ISIS, a woman not covering her head or a person mishandling the Quran would be killed in a public manner. But this was a CEO and I think we, as a society have normalized and given attention to people who spout opposing views that most civilized people would find abhorrent. I'm not sure if people want attention or actually understand what they're supporting.

[robin3mj]

What about being killed because you’re eight years old and dared to get up and attend second grade one morning?

All murders are tragic and unwarranted, but the amount of hand wringing and op-ed ink being spilled over this one last week seems awfully outsized versus everything we’ve allowed ourselves to become inured to over the last 25+ years.

[vertical_doug]

Funny when a Southpark Episode foreshadows real world events.

I'll start by saying the CEO should not be shot. And I don't think he was shot for his beliefs, I think he was shot for the misery the company he heads inflicts on 1000s of Americans daily. (or at least this is the view inside the defendant's mind)

I suspect if you really dig into the company, it has some questionable business practices. This is the heart of the issue in my opinion. I know, and I am sure many of you know people with long term healthcare issues that get frustrated daily dealing with these companies. My heart does not bleed for pay-day lenders that game customers, and my heart does not bleed for companies that game the sick.
It's the whole point behind delay deny.

If I am a Law & Order episode as defense, I am arguing the defendant thought he was protecting thousands of patients from the suffering and pain the company will inflict on them.
Luigi either gets convicted and goes to prison, or gets institutionalized for a long time. But that should not be the end of the conversation. Let's address the healthcare industry for lack of transparency, opaque & complex pricing models, misalignment with lower patient costs, vertical integration and market power. This is what drives the hate.

In 1920, anarchists tried to blow up JP Morgan on 23 Wall Street. (I don't know if the building is still there, but in the 90's you could still see pock marks and scars on the facade.) They say America is in the new gilded age, it seems some of the problems from that time will also reappear.

[Ras72]

I don't think we just got there. I think we've always been there. Assassination has been elemental to our history.

This. We have always been there.

The only difference between then and now is the attention social media can generate on a given subject, action, thought, feeling, etc. Once you have a collective of like minded people - good, bad, or indifferent - this allows for justification of said subject, action, thought, feeling, etc. People then tend to lose sight of rights and wrongs. Jan 6 Capital attacks is an easy example but MANY come to mind. There were people that celebrated the assassination of JFK. They were just behind closed doors and/or small gatherings. They didn't have the megaphone we know as social media.

Since the election, I have unplugged from many news outlets and social medias. For the love of all that's holy, I'm asking myself why this took me so long.

[Tom]

This was the first speech given at the Nobel Banquet. If nothing else gave me something to think about, this sure did.

https://www.nobelprize.org/prizes/ph...hinton/speech/

I know it is not directly related to the original subject but in some sense it is.

[BBB]

A thought provoking topic for sure.

Unfortunately capitalism, or turbo capitalism, has wrought great inequity.

When that same system works its way into essential services, in the current example, health care, or in other areas such as drug production or the provision of food or the cost of housing, then the gap between those at the top of the system and those at the bottom, becomes stark, often painfully so.

Australia is a modern, well heeled western nation, yet we are, like in lots of places, suffering from a cost of living crisis. It was reported in the media the other day that 10,000 people per month were experiencing homelessness, which is up 22% in three years - see here - https://www.theguardian.com/society/...rs-report-says

Yet this is a wealthy country. How can this be? Interest rates are up. Prices are up across the board, including the price of food. If you can't afford to own your own home, renting is astronomically expensive. People are getting left behind. Even if interest rates came off the boil and the cost of living pressures dropped away, the structural problems would remain. Housing would still be expensive, certain segments of society (including politicians) would still have their portfolio of property, and people would still be facing the prospect of homelessness. In a doff of the lid to the recent comments on the 2025 racing thread, we pay the providers of essential services (paramedics, police etc) a pittance and revel in the sportsman getting paid large sums of money to kick a funny shaped red leather ball.

We do however have universal health care in this country. Granted the system is far from perfect, but people don't face a choice between bankruptcy or foregoing life saving medical care.

Either we as a people accept reforms to our capitalist system to make it fairer across the board and provide people who need it a leg up, or we gun down a CEO of a health insurance company in the street. Or worse. Sadly, it will probably take more of the former before we get the later.

Politicians don't help either. Symbolism is easy and seductive - 'Yes we can' is just another way of saying 'Make American Great Again'. In Australia we voted out a dithering and vacuous conservative government in 2022, only for the new government two and a bit years later to flounder in the face of economic head winds, an uncertain political environment at home and abroad, and an electorate that is turning against them. They, like the Democrats, will probably get voted out in the next Federal election (which is due next year). But, you know the PM here managed to recently buy himself a $4.3m house in what was probably a political own goal. He's set. Shame about the homelessness figures per month.

[sk_tle]

This. We have always been there.

The only difference between then and now is the attention social media can generate on a given subject, action, thought, feeling, etc.

This. Everything is now broadcasted and everyone can articulate out loud whatever opinion, as unpopular as it may be, without risk. Even more they will still find an echo chambers and people to validate those opinions.

Trump is a turd, but what action did he do that made it okay for someone to attempt a headshot at a rally?

Given his past track record and the large amount of victims he indirectly killed during Covid time, his own attack on democracy, I could totally see people justifying is murdering as preventive measures. He really did killed and made much more people suffer than Luigi Mangione will ever do in his own lifetime. So how easy is it to judge that?

I am against murder but I also believe that any decent society and democratic system should prevent criminals like Trump to be at the helm of a country and insurances to not behave like UnitedHealthcare. And I am struggling to reconcile the fact that the only difference between revolution and terrorism or tentative coup, is that in the former the actors have been successful and could write the history. Where do one or a society collectively put the cursor where the amount of suffering justify or not a revolt? I am pretty sure that Luigi Mangione action might have been considered acceptable and not considered murder had he not acted as a lonewolf and if millions of people had been in the streets for months to complain about health insurances. Something they would totally do if they were thinking it could lead to a change and were not afraid of being called looters and terrorists.

[sk_tle]

https://pluralistic.net/2024/12/09/radicalized/

https://prospect.org/culture/books/2...y-health-care/

[Mark Kelly]

On the other hand, if we shipped every billionaire in the world and the CEO of every billion dollar company off to mars and then conveniently lost the communications protocol, the world would indubitably be a better place.





Edited to remove inflammatory language that would obscure the point.

[Peter Polack]

Trump showed it was okay to be rude and openly, in his dog whistle way of speaking, say that violence in the process of achieving a goal, is acceptable. His job as president is
to behave as an adult and he has failed in spades. Granted, his wasn't the only influence but it was, and will be significant.

Whether is was "can we just shoot the protesters in the legs?" or suggesting Liz Cheney face a firing squad, Trump was bridging the gap to violence.

The evil things that we only think of or speak of in private should remain that way in a civilized society. Trump made it okay to do otherwise.

[vertical_doug]

I prefer to stay focus on healthcare and the shooting.

Using perplexity.ai, and the 2024 Senate Report

The October 2024 report from the U.S. Senate Permanent Subcommittee on Investigations provides detailed findings on Medicare Advantage insurers' prior authorization denial rates, particularly for post-acute care. Here are the key points from the report:

Major Findings

Denial Rates for Post-Acute Care

- UnitedHealthcare and CVS denied prior authorization requests for post-acute care at approximately three times higher rates than their overall denial rates in 2022[1][5].
- Humana's prior authorization denial rate for post-acute care was more than 16 times higher than its overall denial rate in 2022[1][5].

Increasing Denial Trends

- UnitedHealthcare's prior authorization denial rate for post-acute care increased significantly:
- 10.9% in 2020
- 16.3% in 2021
- 22.7% in 2022[7][9]

- The number of denied claims for skilled nursing centers by UnitedHealthcare in 2022 was nine times higher compared to 2019[8].

Automation and AI Implementation

- UnitedHealthcare implemented multiple initiatives to automate the prior authorization process during this period of increasing denials[7].
- In December 2022, UnitedHealthcare explored using AI and machine learning to predict which denials of post-acute care cases were likely to be appealed[7].

Impact on Care Access

The report concludes that these practices resulted in diminished access to post-acute care for Medicare Advantage beneficiaries[7]. Senator Richard Blumenthal, chair of the subcommittee, stated that insurers have continued to deny care to vulnerable seniors simply to increase profits[5].

Recommendations

The committee staff recommends that the Centers for Medicare & Medicaid Services (CMS):

1. Begin collecting prior authorization information broken down by types of care
2. Conduct targeted audits of insurers
3. Expand regulations on insurers' use of predictive technologies in prior authorization[9]

This report highlights the growing concern over Medicare Advantage insurers' use of prior authorization and AI-driven decision-making processes, particularly in denying necessary post-acute care to beneficiaries.

Citations:
[1] https://www.aha.org/news/headline/20...-care-services
[2] https://www.blackenterprise.com/sena...nied-coverage/
[3] https://www.fiercehealthcare.com/pay...-senate-report
[4] https://www.ahcancal.org/News-and-Co...cess-Care.aspx
[5] https://medicareadvocacy.org/medicar...erage-denials/
[6] https://www.thewellnews.com/medicare...tion-requests/
[7] https://www.blumenthal.senate.gov/ne...erable-seniors
[8] https://www.foxbusiness.com/markets/...vantage-claims
[9] https://www.wsha.org/articles/senate...ntage-denials/
[10] https://www.risehealth.org/insights-...gest-insurers/
[11] https://www.ajmc.com/view/insurers-a...enate-scrutiny
[12] https://hme-business.com/new-senate-...s-should-know/
[13] https://leadingage.org/analysis-sena...roubling-data/

[Too Tall]

Appreciating your conversation Bill and Doug for the high touch data, facts are facts nes pas?

Speaking of prior authorization, if we are going to do this there will be no tolerance for anything less than civil discourse. No if and or but ok?

XXOO

[j44ke]

The push from the corporate sector has been to roll the regulatory environment back to the pre-Roosevelt era. That's Theodore Roosevelt. The brazenness of profit-taking at the expense of individual people in this country has increased dramatically. Trump has perhaps emboldened individuals to say openly what they think in private, but his belief in the corporate transactional model for governance and thus a more thorough corporatization of government has emboldened the corporate sector to reach for those things they have always wanted to do but were constrained by fairness regulation and enforced morality by government. The corrective litigation that results very easily swamps itself and, if it ever does go anywhere, eventually meets a Supreme Court friendly to the needs of the corporate sector. It's not the money, it's the money.

Social media just spreads everything like peanut butter thinned with kerosene across a parched land waiting for a rain cloud with nothing but dry lightning in the forecast.

[rccardr]

"Social media just spreads everything like peanut butter thinned with kerosene across a parched land waiting for a rain cloud with nothing but dry lightning in the forecast."

One of the best metaphors (or is it a simile?) I've read in years.

[steve garro]

I don't think we just got there. I think we've always been there. Assassination has been elemental to our history.

"Assassination Vacation" by Sarah Vowell is a great read.

- Garro.