A Broken System

Susan Estrich on Dec 14, 2024

What does it mean that an alleged murderer has become a folk hero, that literally millions of people in this country have taken his side -- in social media, at least, if not as potential jurors -- in a case of cold-blooded murder? What does it mean that the McDonald's employees who reported him have had to resort to police protection to deal with the threats against them?

It would be shocking, if it weren't so understandable.

Our health care system is broken. It causes unbelievable suffering. Of course it is wrong to take pleasure in the murder of anyone.

But understandable? Yes.

Luigi Mangione is "hot." That certainly adds to his appeal. But what is driving the reaction to his crime is not his good looks, but the almost universal frustration with health insurance companies, and the trials and tribulations of dealing with them.

The question: Is Trump listening? Does he get it?

The Affordable Care Act allowed millions of Americans to buy into a system that previously excluded them if they had preexisting conditions. I remember the bad old days, when you just couldn't get health insurance if you weren't healthy. I remember trying to purchase a PPO plan for my nanny, similar to what I received from my employer, who had gastritis. She took a Nexium every day. That was enough for her to be turned down by all the PPO plans. The only plan I could buy for her was Kaiser Permanente's HMO, which later saved her life, and then later failed to provide her with the preventive care that should have diagnosed her cancer before it was Stage 4. Trust me, I can hold my own in the HMO horror stories that I used to do on my talk radio show.

By the time my kids aged out of my own health insurance plan, the ACA -- Obamacare -- had made it possible to buy into PPO plans for individuals, without regard to preexisting conditions. Thank God, and the government. Until you get sick.

Then you discover all the things that even the most expensive plans you can buy don't cover. Then you discover the nightmare that is supposed to be the best health care system in the world. For some, maybe.

My daughter has long Covid. As anyone who suffers from it knows, and there are millions of people who do, long Covid does not just mean that it takes you longer than most to recover from Covid. The virus triggers a host of horrible syndromes, including chronic fatigue syndrome and post-exertion malaise. It leaves many of its sufferers house-bound if not bed-bound. There is no known cure. So even the best doctors who specialize in it (and all seem to be "out of network") are left trying to alleviate its symptoms with experimental treatments, using drugs off-label to see if they work. Almost none of it is covered by insurance. What are people without money to pay for all of it out of pocket supposed to do?

I used to be good at fighting with insurance companies. My sister, who used to work for a major insurance company on health care claims, taught me all the tricks of getting supervisors, threatening to go to the state insurance commissioner, cutting through the bureaucracy. I remember some years ago, I managed to help a secretary at my old firm reverse a decision denying her -- on the eve of surgery -- approval for desperately needed back surgery by intuiting the email address of the medical director and pretending to know him. But it takes more energy than people fighting serious illness can muster to also fight with insurance companies. It's gotten harder, and these days, I mostly give up and take out my credit card. This is how so many people end up bankrupt because of medical care costs. This is how Mangione ends up being a folk hero.

Asked what he would replace the Affordable Care Act with, Donald Trump said only that he had "concepts" of a plan. That just won't do. Is he willing to reform the system -- take on the private insurance lobby? There is no sign that he is. And the industry, instead of hiring more private security for its leaders, needs to take on the frustration and anger that has come boiling to the surface in the reaction to the assassination of the CEO. Greater transparency is essential. Better customer service is essential. Something has to change.

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To find out more about Susan Estrich and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.