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THE VIEW FROM HERE - Once again we are inundated with an idiot meme – “Violence is never the answer.” Of course, violence is often the answer! This time the meme has become ubiquitous because of Luigi Mangione’s abs. Let’s be honest if Luigi looked like DA Alvin Bragg, he’d have no support. There is far more to it than Luigi being hot and charismatic. His violence was definitely an answer. Luigi’s shooting of United HealthCare’s CEO Brain Thompson brought to the national consciousness the existence of mass murderers preying upon us. Not only are health insurance executives murderers, but they are supported by craven politicos and vilely corrupt judges.
The nation must confront the fact that violence was the answer because America’s health insurance is a type of Russian roulette. You place down your premium dollars, and the spinning wheel may land on health, on terrible suffering, or on death. One-third of United HealthCare claims were denied. Yes, CEO Thompson’s company was an industry leader. Whose actions killed more people? CEO Thompson’s or Syrian dictator Bashar al-Assad’s?
Americans are aware that something has been horribly wrong with America’s health insurance system. Decades ago, states were passing laws against corrupt insurance carriers who wrongfully denied claims. In fact, in 1974 Congress passed ERISA (Employee Retirement Income Security Act) which was designed to protect pensions and health insurance issued by employers and unions. A lot has happened in the last fifty years.
As a former health insurance company employee and as a former Plaintiffs attorney who sued health insurance companies for their Bad Faith denials, my experience may shed some light on why Luigi Mangione’s violence did solve a huge problem. Luigi was the right guy at the right time to thrust into national consciousness the existence of mass murderers amongst us.
There Is No Such Thing as Health Insurance
Back in 1968 when I was only just out of college, an employment agency sent me on interviews with multiple health insurance companies. After my initial test with Aetna in Los Angeles, I asked the scorer how I did. He responded that I qualified for every job in the company including CEO and sent me to San Francisco for interview by the Aetna’s VP in charge of Group Health Insurance. He had a huge corner office overlooking the SF Bay and he told me, “there is no such thing as health insurance.”
Aside #1:
I am not that brilliant. All insurance companies used the same intake test which I had taken about 7 times in the last week so that I could check the right answers as fast as my fingers would fly. Then, I devoted my time to figuring out the answers to the harder math questions.
The VP explained that health, like food, was something which was not subject to insurance as people always needed health. The only question was how to pay for health care. By focusing on accidents and illness, people were insured against only a few events. Back in the 1950's, it seems that executives believed that health insurance would be like life insurance where most people would pay premiums for decades before the company had to pay a large claim. Since not everyone has an accident, those events too could be subject to insurance. In old days when only the affluent could afford health insurance, the system more or less worked — until the sales departments started selling more policies and the executives cut premiums to gain a larger market share. The premium war quickly reduced premiums so much that the companies did not have enough cash to pay the medical bills.
Why Did They Follow this Fool’s Route?
The VP explained that Aetna and other insurers wanted to prevent the country from adopting socialized medicine. Aetna was covering its health insurance losses with the profits from life insurance. What did health insurers do when they could not cover their losses were too great? Two solutions: (1) Employer sponsored health insurance and (2) Wrongfully deny claims. At first the health insurance industry tried to have employers pick up the excess costs as they had deep pockets. For a while, employers could buy off Unions demands for higher wages, by offering benefits packages, e.g. better pension and health insurance, thinking that higher wages were immediate costs but health insurance premiums were future costs. Also, a healthier workforce was more productive.
No doubt, the actuaries again screamed, “Insanity,” but no one listened. The group health insurance policies were still promising far benefits than the premiums could cover. Thus, underpaying claims became the prime way to remain solvent and then to become vastly wealthy.
Judges Support Corrupt Health Care Companies
In the mid 1980s, Dr. Jim Takeda and Bill Whitten sued Northwestern Insurance for wrongfully under paying Whitten’s bills by $622 dollars. The doctor and the patient joined forces since the wrongful denials harmed both doctors and patients. Either the doctors or the patients bore the financial burden of underpayment, but the straw that broke the camel’s back in the Takeda-Whitten case was Northwestern’s attitude of “Screw you. There’s nothing you can do.” Thus, Takeda-Whitten sued Northwestern, but rather than sue for $622, they sued on a class action basis over Northwestern’s practice to systematically and knowingly underpay claims.
How Did We Know Northwestern Had Such a Practice?
Their attorney wrote a letter accusing Northwestern of “singling out my clients for special treatment in wrongfully denying their claims.” In reply, Northwestern asserted that it had not singled out Takeda - Whitten since they routinely underpaid claims by using an outdate Workers Compensation schedule. Thus, Takeda-Whitten had admission of Northwestern’s wrongfully denying on a class wide basis. Northwestern written admission was the basis of the lawsuit.
Skipping over the intervening years of litigation, federal Judge Davies certified the class action, i.e., allowing the case to process on a class basis that Northwestern had wrongfully underpaid about $600 Million in claims. (In today’s dollars, $600 Million would be $1,727,151,459.85. Yes, $1.7 Trillion.) Two weeks later, Judge Davies called all the attorneys to a meeting where he related that as a new appointee to the bench, he did not know that presiding judge Manuel Real had a deal with the insurance industry to never allow a class action to be certified against an insurance company. Manny Real ordered Judge Davies to de-certify class. At the time, most if not all health insurance companies, had standardized claims denial practices similar to Northwestern’s. Hence, $1.7 Trillion in 2024 dollars was the tip of the and industry wide iceberg.
More Judicial Corruption, Pilot Life Ins. Co. vs. Dedeaux, 481 U. S. 41 (1987)
Because Health Care Insurance was actuarially unsound, politicians had a choice (1) Tell the truth about the true costs of health or (2) give insurers immunity for wrongfully denying claims. The first road was a long road to a healthy America; the second quickly resulted in massive suffering and thousands of needless deaths. The courts chose the second approach with Sandra Day O’Connor’s decision Pilot Life Ins. Co. vs. Dedeaux, 481 U. S. 41 (1987). Very long story short, Dedeaux did two things: (1) It provided de facto immunity to deny claims and (2) it pre-empted tens of thousands of state court lawsuits against insurance companies into federal court and dismissed them. Congress could have amended ERISA, thereby overruling the Dedeaux case and starting us on the track to decent health care. Insurance company lobbyists made certain that Congress did nothing.
ObamaCare
In brief, ObamaCare did as much as could be done. For example, ObamaCare does not allow insurance companies to deny coverage for pre-existing conditions. As people get older, insurance companies would find more and more items in a medical history as an example of pre-existing condition. High blood pressure became pre-existing heart disease. Severe colds two years ago became prior pneumonia. While people may dispute a wrongful denial, they often die during the process. Hence, the meme Delay, Deny, Defend. Assuming one survives the years of trial court litigation and gets a jury award, the insurer can appeal, adding years more the lawsuit.
Unlike a personal injury lawsuit, where the injured person can collect money for his/her pain and suffering from which the attorney takes 33% to 45% as his fee, ERISA does not permit any money award for the years of pain and suffering. An ERISA judge may in his discretion award attorney fees. Yep, if one prevails in the corrupt judicial system, the system decides how much to award the patient’s attorney.
Aside #2:
ERISA is not the only place where judicial corruption runs rampant. California plaintiff attorney, Thomas Girardi, solved this problem by bribing the judges in all sorts of cases. It seems, however, that the judges demanded so much loot that Girardi started paying the judges from the plaintiffs’ awards. This practice resulted in over 200 State Bar complaints against Girardi by the injured people who received nothing from their multi-million dollar cases. The last California Chief Justice Tani Gorre Cantil-Sakauye was in power for 100 of those complaints and she reportedly dismissed every single one. Attorneys who object to corruption, however, are disbarred on the basis of false, manufactured evidence.
Yes, violence was the answer to the question, “What does it take to wake up Americans to the mass suffering and mass murders being committed to aggrandize the profits of a few?”
(Richard Lee Abrams has been an attorney, a Realtor and community relations consultant as well as a CityWatch contributor. You may email him at [email protected])
