In Killing of Executive, a Health Reform Opening

Plus, Eurabia; the press’s situational solidarity

A sign at Boston Children’s Hospital. Photo: The Editors.

The right and even the sensible center’s main reaction to the brazen gunning down in Midtown of UnitedHealthCare executive Brian Thompson has been to denounce the far left for celebrating the violence.

Fair enough, under the circumstances. The celebrations are worth denouncing, and the violence itself deserves denunciation.

And at some point, once the homicide has been solved and prosecuted and Thompson has been appropriately mourned, someone will turn some creative energy to solving, or at least dramatically improving, the issues that have been so vexatious to so many users of health insurance.

Anonymous law enforcement officials told the Associated Press that, as the AP put it, “The words ‘deny,’ ‘defend’ and ‘depose’ were found emblazoned on the ammunition, echoing a phrase used by insurance industry critics.”

EconTalker Russ Roberts, the president of Shalem College in Jerusalem, posted, “A few years back when I was a full-time employee of Stanford, one of my family members needed an operation and Blue Cross Blue Shield refused to cover it. I spent hours in a Kafkaesque dance with BCBS bureaucrats debating medical issues and trying to explain our case. At one point I was so frustrated with the run-around and the miscommunication that I actually considered going down to BCBS headquarters in SF and going to the CEOs office and demanding to see him so I could explain how dysfunctional his organization was how unpleasant my experience had been. I was pretty upset.”

Roberts’s experience matches my own and that of many other people I know. Either they or their employer or both spend lots of money for health insurance, and then have to fight to get the insurance to pay for medical care when it is needed, or face significant, unpredictable, and opaque out-of-pocket expenses, with little opportunity for shopping around other than during a yearly “open enrollment.” No amount of regulating around appeals processes, outlawing of “surprise” billing, or mandating of price transparency seems to make a dent in the issue. Electronic medical records certainly haven’t solved it.

I understand many of the contributing factors. The patient is caught between the employer wanting to control costs, the physician or hospital provider wanting an adequate reimbursement, and the insurer trying diligently to make sure that procedures are indeed medically necessary. Yet it frequently seems like the insurers have a policy of denying all claims initially in hope that at least some customers won’t bother to appeal and will just pay the bills themselves out of pocket. And when you have the stress of a pressing medical issue, an insurance company that won’t pay what you think it should just adds to the stress. I’ve been on conference calls to try to sort out these issues where the hospital blames the insurance company, the insurance company blames the hospital, they both blame the system, and the customer-patient remains stuck with a larger-than-expected bill.

ObamaCare did not solve this. “Medicare for all” will not solve this. The best way to solve it would probably be to combine doctors, hospitals, and insurance company in a single system with a strong culture of doing what is best for the patient, and then try to encourage two or three of such systems to compete for market share by providing the best patient care and the best value. But there are plenty of parts of America where there’s a single local hospital or where doctors are scarce or where one insurance company has a dominant market position. Various retailers with operational and customer-service skill have eyed parts of the system—Amazon mail order pharmacy, Costco hearing aids—but would-be newcomers face real entry barriers. Regional incumbents are entrenched, and true national scale is unusual.

If President Trump wants to defeat Bidenflation, getting a handle on consumer and business health care costs is part of the story. It could also fit with his “make America healthy again” agenda. Yet the real fix in health care is unlikely to emerge from a politician. It is likely to come instead, eventually, from some entrepreneur who sets out with an ambition to be a health insurance executive who patients and doctors both want to hug and cheer rather than shoot and kill.

The press’s situational solidarity: “The Wall Street Journal is becoming more and more obnoxious and unreadable,” Donald Trump complains. “They haven’t written a good story about me in YEARS. Somebody over there ought to look at what they’re doing. The only one worse than them is stupid, China-centric Forbes Magazine!”

What’s humorous about this is that because Trump is attacking vaguely center-right outlets, hardly anyone else in the press corps is hyperventilating about it. Nothing in Harvard’s Nieman lab or at the Columbia Journalism Review, both of which have been quick to criticize Israel for its crackdown on terrorists using news organizations as cover.

On November 26, Trump took aim at what he called the “failing New York Times.” He said, “They write such phony ‘junk,’ knowing full well how incorrect it is, only meaning to demean. Magot Hagerman, a third rate writer and fourth rate intellect, writes story after story, always terrible, and yet I almost never speak to her. They do no fact checking, because facts don’t matter to them. I don’t believe I’ve had a legitimately good story in the NYT for years.” I think the Times leans left, but the Bernie Sanders types consider it the “corporate media” and think it’s been too sympathetic to Trump. Some of the far-left types consider Haberman a Trump stenographer, which may be why they aren’t rallying to her defense, either.

There are moments when the press rallies round in a unified fashion to defend itself against these sorts of attacks and denounce them as incipient fascism or contrary to the spirit of the First Amendment, but for whatever reason, this doesn’t seem to be one of those times. Maybe the press thinks the public agrees with Trump on these matters. Maybe they are waiting for Trump to attack NPR, or PBS, or the Atlantic, or the New Yorker, or ProPublica. Maybe they lack the confidence to defend themselves. Maybe they figure a robust defense would only give Trump’s criticisms more attention than they deserve.

Biden complained about the press, too, in less stringent terms.

Anyway, things can change quickly. Trump spent a lot of time after the 2020 election complaining about Fox News, and now he’s staffing his administration from it. It could be the most important reason the press hasn’t made more of a fuss about Trump’s complaints is that they know, by now, that there’s an element of theater to them. His annoyance is sincere, but he’s not likely to lock any publishers in prison the way some of the newspapers (though not the Wall Street Journal editorial page, at least) were cheering on the effort to prosecute Trump.

A.G. Sulzberger took to the Washington Post in September to publish a long geshrei about Trump’s “aggressive and sustained efforts to undermine the free press.” Where is Sulzberger now that it’s Forbes and the Wall Street Journal coming under fire? I think the threat to the press from Trump has been overstated, but to the extent that people are going to raise an alarm about it, it seems that a single standard should apply regardless of the outlet Trump happens to be targeting.

Eurabia: “LONDON, Dec 5 (Reuters) - Muhammad was the most popular name given to baby boys in England and Wales in 2023, ousting Noah to take the top spot, official figures showed on Thursday,” Reuters reports.

It sent me to Googling Eurabia. Wikipedia describes it as “a far-right, anti-Muslim conspiracy theory that posits that globalist entities, led by French and Arab powers, aim to Islamize and Arabize Europe, thereby weakening its existing culture and undermining its previous alliances with the United States and Israel.” The Guardian has a story from 2019 “The myth of Eurabia: how a far-right conspiracy theory went mainstream.”

Like the August 2024 prematurely denounced as disinformation riots, the idea of a rising Arab and Muslim population in Europe, or in the U.K., may be one of those things that was prematurely described as a “conspiracy theory” or a “myth.” No doubt plenty of people named Muhammad are and will be strong contributors to and loyal citizens of England and Wales. And no doubt, too, out of fact patterns such as these are generated both anti-immigrant cultural anxiety as a political issue and developments such as a halt in some British arms exports to Israel and the Oxford Union disgracing itself.