Editorial: A sickness in the land

Public reaction to to the assassination of a health insurance executive in New York was as shocking as the murder itself on a sidewalk outside a hotel. The suspected assassin, Luigi Mangione, 26, has been made into a folk hero for gunning down Brian Thompson, 50, a native of Jewell who worked his way to the top of United Healthcare in Minnetonka, Minn. The victim of the shooting was portrayed by many as the bad guy. He was guilty of no crime but was taken out by a vigilante. Those who cheered are twisted by the system just like the shooter.

Our health care system is designed to funnel or deny access to patients. We have a lot of experience with the exploding cost of private health insurance as a small business. Our rates increased as much as 78% in a year, and as much as 40% since the system was “reformed” with Obamacare. We also have a lot of experience with the system rationing heath care in rural areas. When you wait nearly three weeks to hear if you can see a doctor at the University of Iowa heart center, it tends to make a person anxious. When you are told that you must drive four hours for an ultrasound that could be performed in Storm Lake, you begin to wonder whether the patient’s interest is paramount. The first question you are asked at the emergency room is about how you will pay.

It is maddening. At points it is infuriating.

In America, a terrifying number of people think that pulling out a gun is the solution. We have gone mad as a nation. Profit-based rationing and denial for literally vital care make people crazy enough to hail a killer and attempt to justify murder. Many people are so distracted with their hatred of the system that they are willing to throw aside their own humanity and sympathize with the devil.

THE INSANITY WAS further highlighted this week in a North Dakota federal judge’s ruling that Dreamers — children brought to Storm Lake from Latin America by undocumented parents — are not eligible for the paltry benefits of Obamacare. This thanks to 19 state attorneys general, including Iowa’s own Brenna Bird, who sued the US Department of Health and Human Services for finding that Dreamers are lawful residents and deserving of benefits under the Affordable Care Act.

Rather than be eligible for health insurance assistance, the Dreamers will show up at the emergency room or the United Community Health Center with no way to pay. Buena Vista Regional Medical Center is required to treat them. The local, county-owned hospital gets stuck with the cost. The Dreamer gets second-rate care by not being plugged into the health care system. That’s the insanity. The patient could be paying at least part of a premium that would provide cover to the local hospital or clinic. Instead, Attorney General Bird pleads to effectively lock these productive residents of Storm Lake out of the system. It is counter-productive and inefficient, but it is cruel enough to serve political expediency.

IT IS THAT sort of madness, we suppose, that makes people justify murder. When you deny access to health care, the stretch is not that far over the indifference toward life. When you make health care so difficult, people don’t think straight. The people who justify Luigi Mangione are as mad as he is, perhaps driven there by callous capital practice that sorts people on life-and-death questions by their ability to pay. This is what to expect in a pay-to-play politics that sets the rules of health care.

The evidence points a way to prison for Mangione, where he may maintain his perverse folk-hero status until we forget about him and Brian Thompson.

The frustration will remain. Rural hospitals are shutting down maternity wards or closing altogether. Insurance premiums rise as corporations capture record profits. President Trump says he will try again to do away with the Affordable Care Act. Physicians and nurses are overwhelmed. Services are denied or are so far away that it makes you want to give up. That is the point of it — until someone cracks and does something that, in hindsight, you almost could see coming. The raving crowd cheers. It is a symptom of something to be ignored at our grave peril.