When Dr. Nicholas Rosenlicht, a Berkeley psychiatrist and author, heard that United Healthcare CEO Brian Thompson had been shot and killed on a Manhattan street on December 4, he was stunned by the act. I felt sad.
But even before the shell casings with the words “delayed” and “denied” were discovered, and even before Luigi Mangioni was arrested on Monday with a handwritten manifesto, insurance companies were avoiding paying claims. I was using the tactics I used to. blame the medical industry Rosenlicht, who prioritized profits over patients’ lives, could understand why so many members of the public readily embraced Thompson’s killer as a folk hero.
“People are really frustrated,” Rosenlicht said. “We have all felt dehumanized and helpless by our health care system, to the point where the shooter is seen as something like Robin Hood. We can all understand his motives.”
Rosenlicht, a clinical professor at the University of California, San Francisco School of Medicine, has worked in psychiatry for 40 years and practices on Solano Street, but he himself is dissatisfied with the American health care system.
his first book, my brother’s keeper” was published on October 1st with the subtitle “The untold story behind the mental health business and how to stop the abandonment of the mentally ill.” The book focuses on mental health and is a scathing review of the healthcare system in general in the “only developed country”, where the mid-last century healthcare system as a “model for the world” has evolved into a “bloated embarrassment”. Offering criticism. Healthcare is a business, not a government function. ”
In 1953, the government subsidized employer health insurance, which was run by private companies, by making it tax-free, and some insurance companies, like Blue Cross, were originally not-for-profit. But some for-profit companies realized they could “kick out the people who aren’t making a profit and go after the rich,” Rosenlicht said. As healthcare costs increased, exceeding 7% of GDP in the early 1970s, public concern also increased. The Health Maintenance Organization Act of 1973, which applied free market theories of competition and efficiency to health care, was intended to reduce costs, but it actually backfired, Rosenlicht said.
“It was well intended,” he said. “The idea was to introduce a business model to keep costs down. Instead, it turned health care into a business venture rather than a benefit to society.”
Healthcare currently accounts for 20% of GDP.
Rosenlicht cited statistics from the Commonwealth Fund, an independent research group that analyzes health, showing that the U.S. pays more than twice what other developed countries pay, yet it pays less in terms of health outcomes. He said he was always at the bottom. Since 2004, long-term care systems have become popular around the world. September 19, 2024, Report A comparison of systems in 10 countries, including the United States, Australia, Canada, Germany, the United Kingdom, and Sweden, found that the United States has the highest health care costs, yet has shorter life expectancy and higher mortality and morbidity rates. It turned out.
In his book, Rosenlicht calls the nation’s largest company, serving about 50 million people, a prime example of the “bigger is better” approach that encourages comfort and monopoly to maximize both market share and profits. It cites medical insurance company United Healthcare.
According to forbesUnitedHealthcare has the highest premiums in the nation and rejects more claims than any other insurance company, at a rate nearly double the industry average. The company was recently accused in a Senate report of denying care to patients recovering from falls and strokes in its Medicare Advantage plans, and is facing a class action lawsuit for using AI algorithms to automatically deny payments. are.
Rosenlicht also cited the tremendous growth of the healthcare industry, which is now the largest and most profitable sector for private equity and venture capital investment. UnitedHealthcare’s profits rose from $15 billion in 2009 to $32.4 billion in 2023, which Rosenlicht considered “sneaky” when combined with Thompson’s more than $10 million salary. are.
Still, Rosenlicht doesn’t believe in placing the blame for exploitative industries solely on the shoulders of one business owner. “Does he deserve to be killed? No,” Rosenlicht said. “He was just a talented CEO of a health care company. The problem is that the system has the wrong incentives.”
Rosenlicht said the business model built is to deny as many people as possible and charge as many people as possible. “They make money by overcharging through the Medicare Advantage program and by overcharging taxpayers for services that could be done cheaper or are unnecessary.”
Rosenlicht cited a 2022 Gallup poll that found more than one-third of Americans reported that they or a family member had postponed treatment because of cost, including one in four. This includes cases where more than one person has severe symptoms. The proportion of people who are uninsured jumps to 83%.
As for Thompson’s murder suspect, Mangione, Rosenlicht characterized his behavior as consistent with someone in need of psychological care.
While some Mangione defenders see Mangione’s actions as a form of violent radicalism that will ultimately create change, Rosenlicht argues that Mangione’s mental health struggles led him to I believe that he has changed from being an excellent high school valedictorian, star athlete, and gamer to someone who is essentially self-centered.・Acts that cause harm.
Rosenlicht sees similarities between the Thompson shooting and the acquittal of Daniel Penny in the strangulation death of Jordan Neely, a homeless man with a history of mental illness. The incident also happened within the next few days in New York. He sees these as two symbols of a broken health care system.
While Mr. Mangione’s failure to get the help he needed led to acts that garnered public sympathy, Mr. Penny did not even see Mr. Neely “as a human being,” Mr. Rosenlicht said, adding that Mr. The jury agreed and refused. Convict Penny of murder or manslaughter. “Shouting, abusive, horrible people – they are an abomination to us.”
In his book, Rosenlicht shows how the inability of people with mental illness to receive the treatment they need contributes to homelessness and the prison system.
Rosenlicht grapples with a broken and “bloated” health care system within his specialty and practice, where patients who need psychiatric help may not be able to afford it. He said patients end up paying 15 times more out-of-pocket than primary care to see a psychiatrist for a variety of reasons.
Psychiatrists are often unwilling to negotiate pricing with insurance companies, and patients often seek to avoid the stigma that comes with having mental health services listed on their medical records. Rosenlicht accepts Medicare and offers sliding scales to his patients, but he does not deal with private insurance companies himself. He said he would rather spend time with patients than “fight with insurance companies.”
Furthermore, for-profit insurance companies also do not treat mental illness the same as physical illness. “It shouldn’t make any difference whether it’s the brain or the liver,” he says.
To improve health care, Rosenlicht supports single-payer systems like Medicare (which is preferred over private insurance by most enrolled Americans) and brings health care into the realm of government and public health. I support returning it to .
“It’s time to make health care a right and allow governments to provide basic care to humanity,” he said.
