If United We Stand, Healthcare Will Fall?

My healthcare experience & how it relates to this moment.

Luigi Mangioni

If you've been on the internet or reading the news this past week, you've doubtlessly heard of Luigi Mangioni, the apprehended suspect in the shooting of the United Healthcare CEO last week. His name and entire internet backstory, including his Goodreads Reviews, have become fodder for analysts, news pundits, and memesters alike. The firestorm of attention feels so very 2024 and also unlike anything I've experienced in a while.

There are many factors that play into why this man is having his moment in time (which I'll explore later), but one fact cannot be denied. He is really hot.

So, if you'll indulge me. Here's a two-piece edition. The first half is my own experience with the insurance industry, and the second is an analysis of what this might mean down the line.

A little pathos before some logos. I hope you enjoy it!

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When I moved to the city in 2017, I started work at Apple at the beginning of October. I was making 19.25 an hour. Part-time employees at Apple don't get company-sponsored health insurance until 90 days from their start date, and I'd been off my parent's health insurance since I was 19. So I went online to the healthcare marketplace, got promptly overwhelmed and confused, and selected Oscar, an insurance that was sleek, shiny, and millennial. I didn't really think much of it since I was just waiting it out until my Apple insurance kicked in at the beginning of January.

Then, on December 16th, I woke up with searing pains in my stomach. After a terrible callback, I went to Urgent Care (11am), and they said it was appendicitis, but I needed a CT Scan to confirm. The closest and only place that was in-network with my 'fancy' insurance was a thirty-minute travel away. After making it there (1ish), I sat in pain for a few hours while the dye made its way through my body. The scan happened, and they confirmed and told me I really needed to go to an emergency room.

I searched for another in-network hospital and hopped on the subway. I was already trying to save money since I had no idea how much this was going to cost me. I rode the train to 116th Street. I staggered across the Columbia campus in a full blizzard, arrived at the Mount Sinai emergency room, and asked to have my appendix removed (5pm).

I sat in the ER (still in brutal pain, but with a little morphine) for another four hours, waiting for a room to open up. At this time, some med students came in to ask if they could try to ultrasound my appendix for science; that way, in the future, folks wouldn't have to get a CT Scan (I ended up getting billed for that, too). Finally, at about 9, I got moved to a non-private room. I was told that I'd either be able to get the surgery at 1am or 7am the next morning. Finally, at one am, they took my pesky appendix out.

I woke up the next morning, and the first thing I asked was how soon I could be discharged. I thought that they might charge you by the hour, but I had no clue. A friend of mine came to pick me up, and I got out of there as soon as I could. I knew there would be a bill, but I had no idea how much it would be.

I got back to work too soon and picked up as many shifts as I could at the Apple Store. I worked basically full-time in order to offset the bill I knew was coming. Then, one cold March day, the letter arrived. A crisp envelope from Mt. Sinai with a bill for $4,500 dollars.

Now, this is not a lot, all things considered, for a hospital bill, but for a kid in New York, there was no way I could pay it. So, I started the process of appealing to my health insurance. I quickly found out there was nothing they could or would do.

Next, I went to a social worker. She told me that Medicaid could retroactively pay for anything that had happened in the last three months. I nearly cried with relief. This was my only hope. She said that all she needed were my last two paychecks to prove my income, the last two paychecks that showed I'd worked almost overtime in order to prep for what was coming. Based on those two paystubs, I made about $19,000 per year. The Medicaid cutoff was $16,000.

Now, I paid $1,000 in rent each month. So that $19,000 was really $7,000. And that's if I could pick up double the shifts from other employees. Minus the $4,500, which gave me a spending budget of $6.86/day without any other expenses.

My last and final option, she told me, was to go back to the hospital and beg. If you go to hospitals and plead your case, they can grant you charity and help you with the cost of your bill. So that's what I did.

I will never forget Miledy (mi-LADY), who sat across the desk from me while I cried, in equal parts frustration, embarrassment, and overwhelm. She listened to my story, and after about half an hour, she went to talk to her boss. The best they could do was cut my bill in half and offer me a payment plan. It wasn't the outcome I'd hoped for, but it still meant the world to me.

I paid half the bill over time, and once I booked Footloose in 2019, a full two years later, I was financially stable enough to go in and pay the rest. It had been a weight hanging over me, and I was so excited to put this chapter behind me. When I went to the bill pay portal, the remaining $1,200 was gone. I had no idea how or where it had gone, and because I'm a nervous person, I called to see what had happened for fear of being sued for not paying. Somehow, the remainder of my loan had been wiped away.

My ordeal was behind me, but it took me weeks to really believe that it was truly over.

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Now, my story is not a bad one. A bill for $4,500 is minuscule compared to the bills that I've seen circulating on the internet over the past few days. I had support, family, housing, and health. I don't tell you this to say "woe is me," but to illuminate how confusing and stress-inducing the healthcare/insurance system is in America, even for someone who is as privileged as I am. To this day, I still don't understand all the intricacies of how my insurance works, and I have tried at length to get it under my control. I've denied myself care because I was worried about costs, I've been hit with major bills when I thought things were covered, and I'm currently waiting for my insurance to fix an issue that happened in April.

And so many Americans feel the same way, as evidenced by how viral this moment has become. No matter what, people have very strong opinions about this killing. Many say that it's justice, and others say that violence is never the answer. Suddenly, the left, who are still recovering from the brutal blow of the election, have someone who speaks the right's language of violence, except now it's with a cause we can get behind. Because we love a cause, and we love a good story. It's how we communicate.

And here we have a news story that feels like it's straight out of a Batman movie. A young, handsome man brazenly and dramatically assassinates a corrupt billionaire before escaping New York City and captivating the nation before and after his arrest. The shells he used said "deny," "defend," and "depose" (three tactics used by insurance companies to deny claims), and if that's not drama, I don't know what is.

Luigi took down a corrupt billionaire through violence for his ideals and the ideals of the common man. That is what we're told in our stories, which is good. All of these stories tell us that we should root for him. And since so many people are, can you blame them?

But speaking of Batman, another factor that cannot be overlooked is our relentless desensitization to violence (I mean, watch any recent Batman/Joker film). We see violence, shootings, and guns daily in our news and in our media. Think about how many times you've seen a violent murder on a show, but we still can't show a sex scene without it being labeled obscene or pornographic. Look how trans bans are being delivered under the bigoted guise of pornography while gun control laws are nowhere to be seen.

So now we have this strange combination. This man is quickly becoming something of a proletariat hero, and he also happens to be very sexy. There's humor, scandal, drama. His music and book reviews have all been circulated. The rumors of his sexuality are circulating faster than tornado winds, and gay meme pages have absolutely been on fire with anything about Luigi. But beneath all the humor and the coverage is a deep hurt and pain in him that so many people feel mirrored in themselves. He was driven to an unimaginable act because of his situation and his trauma with the healthcare industry, and it's a situation that we must not look away from.

And we aren’t looking away from it due to his looks themselves. We are exalting him in large part because of his looks. If you’re hot in this world, you can get away with anything, and in this case, it can spur the masses to near hysteria. From a gay lens, the desire to be trendy and have a funny take about someone hot, well, we gays couldn’t resist the moment, and neither could the world. It makes me wonder what the headlines would be if he were less attractive or of a different race.

But those are hypotheticals not worth entertaining because, like it or not, he’s hot, and he’s everywhere. One piece of his media that I've seen circulating recently that I found interesting was his review of Industrial Society and Its Future or the Unabomber Manifesto, which I want to wrap up with. Due to some quotes, I'm not sure if these words were written by him or just quoted, but the message still stands.

"He had the balls to recognize that peaceful protest has gotten us absolutely nowhere, and at the end of the day, he's probably right. Oil barons haven't listened to any environmentalists, but they feared him.

When all other forms of communication fail, violence is necessary to survive. You may not like his methods, but to see things from his perspective, it's not terrorism; it's war and revolution. Fossil fuel companies actively suppress anything that stands in their way, and within a generation or two, it will begin costing human lives by greater and greater magnitudes until the earth is just a flaming ball orbiting third from the sun.

Peaceful protest is outright ignored, and economic protest isn't possible in the current system, so how long until we recognize that violence against those who lead us to such destruction is justified as self-defense. These companies don't care about you, your kids, or your grandkids. They have zero qualms about burning down the planet for a buck, so why should we have any qualms about burning them down to survive? We're animals just like everything else on this planet, except we've forgotten the law of the jungle and bent over for our overlords when any other animal would recognize the threat and fight to the death for their survival. "Violence never solved anything" is a statement uttered by cowards and predators."

Tonight, a friend said that this made her think of the French Revolution, and I can't help but feel the same. In the aftermath of the election, it feels like all establishments are on the brink of collapse, and we are waiting for the storm to hit. Things are not working for so many people, and the helplessness, resignation, and rage are simmering. World War I began with the assassination of one man, and I believe that this assassination has enough thought and dramatics to spark a movement, although hopefully not a war. This shooting was a statement, but in our isolated social media landscape, will it be enough to push our culture and class wars over the edge? Will we look back on this and see it as the start of the war between the common man and the billionaires? Will it unite the working class of left and right? Will it finally expose a nationwide grief and pain so strong that we have no choice but to come together to lead to something greater?

I really hope so.

All my love, Aidan