Rage Against the (Healthcare) Machine

​Originally published by American Spectator with Dr. Deane Waldman.

The murder of Brian Thompson, CEO of UnitedHealthcare, was a heinous crime allegedly done by Luigi Mangione out of rage against the machine. Presumably, his target was someone who profits from our broken healthcare “machine” or system.

President Obama was overt in Washington’s theft of taxpayer dollars intended to pay for care.

Public frustration with, anger, and even “hatred” toward healthcare may seem justified based on facts, but violence is never the answer. Healthcare seems to turn hard-earned taxpayer dollars into massive health industry profits and wasteful bureaucratic spending. And what does the public get? Questionable insurance policies with promises of care that never materialize, drugs that don’t work, and physicians who spend most of an appointment looking at a computer screen rather than talking with patients.

Last year, the U.S. spent $4.8 trillion on its healthcare system, 17.5 percent of our GDP and more than the entire GDP of Japan. American families spent $31,065, on average, on healthcare costs in 2023, of which 83 percent went to insurance companies. (READ MORE: Federal Bureaucracy Is Biggest Healthcare Rent-Seeker)

Insurance is one of the most profitable industries in the country, so Mr. Thompson may have seemed a symbol of the evils of capitalism against which Mr. Mangione railed in court. Insurance companies typically generate profits by not paying for medical care. They use a 3-D strategy — delay, defer, deny — which was dramatized in the 1997 movie, “Rainmaker,” where a greedy insurance executive denied a claim for payment for the treatment of a cancer patient, claiming the therapy was experimental and therefore not covered. The young man died despite having a potentially treatable condition.

People holding a health insurance policy have been led to believe they will receive timely care. Yet the healthcare machine assigns them a provider. A pharmacy benefits manager chooses their medications. With insurance, the maximum average wait time to see a primary care physician in a mid-sized city is 132 days. Some patients with either Medicaid or Tricare insurance wait so long for care, they die while waiting.

Thus, while nothing exonerates the murder of another person, public outrage seems justified.

Federal Bureaucracy Impedes Care
Moreover, private insurance is not the biggest culprit in taking our money and denying us care. That trophy goes to Washington.

Just recently, Elon Musk, co-leader with Vivek Ramaswamy of the non-governmental DOGE (Department of Government Efficiency), expressed shock at the “skyrocketing administrative costs” of the federal healthcare bureaucracy. He refers to healthcare spending that provides no care.

The word bureaucracy is too insignificant to express all the costly activities between Washington passing a healthcare law and the impact on Americans. The process invariably generates BARRCOME -- bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement. One look at the organizational chart of the Affordable Care Act (ACA) proves how convoluted, complex, confusing, and costly is Washington-controlled healthcare.

Estimates of the cost of BARRCOME range from 31 percent to more than 50 percent of U.S. healthcare spending. Between 1970 and 2010, when the number of physicians doubled, healthcare bureaucrats increased by more than 3,000 percent! No wonder a businessman like Musk would be appalled at an industry where half the money expended produces no value for consumers.

In 2023, Americans paid $4.8 trillion for “healthcare.” Washington took possibly $2.4 trillion of it and paid for BARRCOME workers, not care providers.

President Obama was overt in Washington’s theft of taxpayer dollars intended to pay for care. To defray the cost of ACA BARRCOME, former President Obama and Congress redistributed nearly $800 billion from expected spending on Medicare even as revenue increased, thereby extending the date of insolvency for the program.

There is good reason for Americans’ rage against the healthcare machine. But violence, including murder, cannot be justified. While insurance can be a target for change, the bigger, more appropriate offender is federal spending and the resulting bloated bureaucracy. (READ MORE: Harris’ Healthcare Destroys Health CARE)

Hopefully, the DOGE will use deregulation, spending cuts, and government employment termination rather than life termination to improve patient care at a lower cost. Musk and Ramaswamy have set a goal of cutting $2 trillion from the federal budget. Reducing healthcare BARRCOME would accomplish that task while providing more dollar-efficient, more accessible, and affordable health care.