Michael Clayton in NYC

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This news item, of an executive from a healthcare conglomerate who is shot in what looked like a planned execution on a New York City sidewalk, is scarily reminiscent of that classic movie starring George Clooney and Tom Wilkinson. The last time I came across a headline that was so close to popular fiction was this D.C. murder, which featured a local businessman, a manhunt, and the horror/comic story of a pizza-ordering killer, and the victim’s family was Greek—basically all the ingredients of a George Pelecanos novel.

I guess it makes sense that, if writers can think up plots like this, real people can act in those ways. It’s still just so horrible.

P.S. James Heathers discusses the situation.

32 thoughts on “Michael Clayton in NYC”

  2. Occam’s Razor says that it was what it looks like. A killing motivated by hatred of the medical insurance industry.

    However, a lot of commenters are jumping to conclusions that it was 100% definitely that. And it is possible that it was a hit for some other reason (for example a financial motivation leading to a contract hit) and insurance retribution was a cover. Again, it’s unlikely, but I would still keep an open mind as an investigator (like examine his emails and phone records and the like, to see if he had any specific beef with someone.)

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  3. Finally an online place where it is described as horrible. I feel like I’m living in a different world now with all the online glee about how he deserved it. Feels like attitudes towards violence are shifting.

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    • People are mostly venting about the healthcare system because they were also screwed by it.
      This is far more extreme than what’s happening today, but during the French Revolution (partially caused by the price of bread), financial speculators were lynched by mobs for their roles in driving up the cost of grain.
      If people are suffering, they will eventually resort to violence.
      The only way to solve the problem is to fix the system.

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      • Social media is largely manufactured. It only takes a few “authorities” to normalize an idea, amplified by a bot/troll “consensus”.

        A good portion of actual people will then follow along with whatever it is.

        The hatred towards this guy (no one ever heard of) is most reminiscent of the covid social media campaign.

        Maybe they bought too many treasuries (see chart 7: https://www.fdic.gov/news/speeches/2024/quarterly-banking-profile-first-quarter-2024), the rate cuts are slower than anticipated, and he planned to blame the deteriorating financial situations on the vax?

        Then again, rather than blame the faceless (totally not fascist) gov-corporate bureaucracy responsible for ridiculously expensive and ineffective healthcare, people will prefer scapegoats. He will just be replaced by someone else who is legally required to maximize shareholder value.

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    • Yeah, I don’t get that. At least the anti-Trump types mostly did not cheer the assassination attempts. And even mostly spoke out against them.

      But I see people like Krystal Ball at Breaking Points, with the quickest “it was wrong BUT…” And then pivot to showing all the online hate crap on her screen. Like she thinks that’s the cool kid thing to do. Like AOC’s dress or something.

      I mean this guy is just an insurance executive. Not even President “Hitler”.

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    • Nick:

      Yes, this also is horrible. It’s not quite the subject of a George Clooney movie, but it would fit in the genre of youth gang movies (A Clockwork Orange, Boyz n the Hood, etc.). I get your implicit point that some crimes get a lot more media attention than other roughly equivalent crimes.

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      • I have not seen Boyz n the Hood but A Clockwork Orange is an apt connection.

        5+ NYT reporters on the beat, a $10,000 NYPD bounty, and a $50,000 FBI bounty for the crime that (imo) is less threatening to the average New Yorker. Granted, I am not a CEO but I also speak English so I am not in the risk set for either of these murders.

        I know this kind of institutional bias is nothing new but it rankles me to see it so starkly.

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      • Anon:

        There are physical descriptions, just not in that particular news report.

        From one of the news articles:

        The three suspects fled the stabbing on foot. They are described as being in their 20s with dark complexions.

        One was wearing a green jacket, white pants and white sneakers. Second was wearing red pants and a red hooded sweatshirt with a black jacket, also had a black backpack. Third was wearing red sweatpants, red hooded sweatshirt, black jacket and blue and white sneakers.

        Unlike the other murder, it seems there’s no security footage so it makes sense that the description will be more vague. Also, as Nick said, this murder is not getting saturation coverage, so less detail all around. According to the CDC there are something like 25,000 homicides a year in this country, and we have less news media than ever before, so I guess that only some of these will be covered at all, let along be covered in enough detail that they provide physical descriptions of the killers.

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        • Also “dark skinned” is kind of an interesting detail…almost a euphamism. I mean the witness was close enough to hear the conversation! But could not name the race? Or maybe he couldn’t tell if they were black or Indian. Yeah roight. Possible sure. But not good Bayesian betting odds.

          Oh…and there’s so many murders and so little media space to cover them? What? I mean there’s space to cover the conversation! But not the description? BS.

  6. Whoa…crickets here….

    Well, I suppose Bidden will break the silence in the morning after the amphetamine train delivers to the WH: “Yesterday the FBI apprehended a Right Wing Terrorist with a Manifesto Literally By Hitler in his pocket in the killing of United Health Care CEO. However, we shouldn’t rush to conclusions. It may be possible that the kiling was justified, as some information suggests that Brian Thompson was a violent man who didn’t vote for Harris. Also there are indications that the terrorists’ age and education may not have allowed full development his brain. Thus, his brain may have been Litterally Directed to perform the killing by Literally Hitler. Even as we speak, the our Highly Professional FBI is working dilligently to create evidence to blame Literally Hitler and release the poor misguided victim of this crime. The FBI will get to the bottom of this and keep Americans safe”

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    • Anon:

      1. Regarding your first paragraph: This is not primarily a current events blog. We sometimes post things related to news items (as above) but you shouldn’t expect regular updates! For that I recommend you go to regular news sources.

      2. Regarding your second paragraph: You’re getting all worked up at Biden for making a statement that he never made, some weird paragraph full of misplaced capitalization. I get that you’re arguing with someone, but it’s not Biden or me or any of the commenters here!

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    • Supposedly it was the healthcare industry’s inability to help his mom, the insurance scamming (of taking her money then weaseling out of paying when needed) on top, followed up by the ominous progression of his own health issues:

      https://archive.is/2024.12.09-230659/https://breloomlegacy.substack.com/p/the-allopathic-complex-and-its-consequences

      Seems there is pretty widespread sympathy for his complaints, but then its misdirected at a CEO legally requires to maximize shareholder value.

      The real culprits:

      1) Sociopathic corporate behavior. A corporation is just a group of people who paid the government for access to a special legal system. If the behavior of corporations is not as you desire, your problem is with the government/regulations not any individual company (the game, not the player).

      2) NHST and the crappy medical treatments it produces. If you go back to 1950, healthcare was affordable, the doctor even made housecalls, and the vast majority of treatments all had better than 10% chance of benefit. Now we have preclinical research replicating at 20%, while the vast majority of newer treatments are very expensive and benefit only ~1% of the people they are tried on (NNT ~100).

      A step forward would be to create seperate insurance pools for NNT < 10 and “moonshot” NNT > 10 treatments.

      Ie, insurance should probably be denying *more* claims (and be much cheaper as a result). People do not realize they are paying for others to “try out” things with like 1% chance of working.

      How cheap could a high-deductable NNT < 10 plan be? Like say a $20k deductable that will only pay if you could justify over 10% chance of benefit?

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      • Regarding your “real culprits:”
        I agree with a number of your assertions, but will highlight a few disagreements. CEOs are not “legally” required to maximize shareholder value. They are accountable to their shareholders and can be removed if they don’t maximize value and their shareholders wish to hold them to account in that way. They still have their own moral responsibility regarding their actions.

        You are correct that it is the system that is the real problem. Personally, I don’t think there is a workable system of private insurance – at least without such major regulations on quality of care that we might as well have it government provided. I realize this is a controversial area with much that can be said on all alternatives. But I think that multiple private insurers “competing” mostly on contracting with employers is bound to result in highly inefficient, inequitable, and distasteful results. In any case, I agree with your desire for a high deductible catastrophic option – that is what insurance is supposed to be. The fact that almost all insurance options in the US are the inverse of that (competing on routine care with limits – at least without the ACA – on total coverage, is evidence of failure of the insurance industry.

        I don’t agree with insurance pools based on NNT cutoffs. But I take your basic point that much treatment has very little chance of working. The question is who should make the choices about such treatments. Asking patients and their families to weight the benefits and costs seems inhumane to me – at least, given the huge disparities in wealth that we have. Having centralized decisions about this (such as the NHS) has many problems, but seems better to me. I think there is no “solution” that is not messy and without many problems. This is an area where the least bad option makes more sense to me than hoping to find something ideal.

        Finally, I would not like to see the insurance industry denying more claims. I think the underlying problem we might agree on – too much expensive treatment take place with little hope of success. But leaving it to insurers to make those judgements sets the stage for grossly inequitable (recognized as a value judgement) way to achieve reform.

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        • I think “denying more claims” that Anoneuoid mentions comes in two forms 1) just not covering routine care, and so if you made a claim for the $15 to have a nurse do a monthly allergy injection, instead of them covering $10 and you paying $5 it’d just not be covered. Thus compared to the things we’re covering now, like 99% of it would be “denied” just based on the structure of high deductible plans.

          Then there’s the question of denying things like $1M cancer treatments that have a 99% chance of extending your life less than 18 days. These sorts of things will need to be denied in any society, we can’t all have access to unlimited funds to try things that are extremely unlikely to work, on the theory that 1% of people might get a “jackpot”.

          But ultimately I agree with you Dale that the system is unlikely to work as for-profit. The thing we want to maximize is human flourishing. Spending too little = human suffering, and spending too much on speculative stuff compared to proven stuff = human suffering, so the right spending amount has some middle-value where a maximum of flourishing occurs.

          But profit is easy to maximize, take the largest amounts you can in premiums, and refuse any care at all… It’s trivial to see that it’s got the wrong attractor. To get it to be in the right place would require so much regulation that you might as well just be rationing it with govt rules anyway.

        • Then there’s the question of denying things like $1M cancer treatments that have a 99% chance of extending your life less than 18 days.

          I was more thinking of “blockbuster” drugs like blood pressure and cholesterol meds. If the sponsor can’t narrow down the potential patients to show NNT < 10 (ie, by ~10x from the current NHST-based standard), then it would get included in the more expensive “moonshot” insurance.

          But profit is easy to maximize, take the largest amounts you can in premiums, and refuse any care at all…

          Presumably there is some kind of competition involved?

        • Competition? very little, unfortunately. One major complication is that most insurance policies are contracts between employers and insurers – the actually insured people are not directly involved. So, an insurer that provides substandard coverage is not directly in competition with “better” insurers. They can offer the employer lower rates, and provided that the employees don’t register too many complaints, the incentive to switch insurers is muted. Add to this rampant asymmetric imperfect information about quality of care and you have a competitive mess. I am quite pessimistic about finding workable competition between insurers unless you standardize what insurance covers. Of course, once you standardize it, then the virtues of competition may largely disappear.

        • They are accountable to their shareholders and can be removed if they don’t maximize value and their shareholders wish to hold them to account in that way.

          “Value” is an inherently subjective metric. It doesn’t have to mean maximum short-term gain in stock value so that elite shareholders can maximize short-term gain and then get out. It can also mean long-term, sustainable business plans that being return to employees and the surrounding community.

          – too much expensive treatment take place with little hope of success.

          That can get a bit tricky. There are treatments now that are considered more or less routine (say an ablation for a-fib) that might have once been considered an expensive treatment with little hope of success

          A big problem with the health insurance industry is one that I’ve not seen discussed much – the “float,” which is where they often derive the bulk of their profit. They invest the huge sums of money they get from premiums and take their cut in effect before they pay service providers. It’s kind of a hidden factor that ultimately has to represent an opportunity cost that is basically shared by premium payers and providers. It’s a scam.

      • Complete digression: the “manifesto” supposedly attributable to Mangione appears to be published by an independent journalist. Other media (e.g. Newsweek) claim it is accurate. The police have been pretty silent about the contents of the manifesto and most media have reported the police line that little new about the motive has been found. If the manifesto is real, then quite a lot about the motive is known, since it describes in detail his mother’s lengthy experience with UnitedHealth’s treatment of her claims.

        I see this as a strange, but increasingly common, case of inability to find the truth. The manifesto appears real and would explain a lot. The fact that the police have not released any details and most media are not providing more makes me have some doubt. One potential reason to not release the details is fear of encouraging copycats (but I find that logic strained, as the absence of details has not really diminished that risk, in my opinion).

        So, as is becoming typical, truth is hard to determine. I’ve also seen reference to documents being shared on X (which I don’t ever look at) that purport to be expanded versions of the manifesto – but I haven’t seen any reference that such an expanded version exists.

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      • I don’t know precisely what Anoneuoid meant by “denying more claims” but Daniel raises an interesting point. I agree that there are many resources expended on health care where there is little chance of significant benefits (either near the end of life or where there are very low probabilities of success and/or severe paid caused by treatments). This means there are claims that “should” be denied. However, the question is: who should deny these? I really don’t want my private insurer denying them. Most insurance contracts cover “medically necessary” care or contain clauses like “customary” care. If an insurer said they will use their own doctors to determine this (which is roughly the practice that many use to deny claims, often only to rescind the denials after protests), I would be reluctant to sign such a contract. It is likely not enforceable, other than being defended by examining the practice used by other providers (often it defaults to treatments that Medicare will approve).

        As fraught with problems as it is, I’d rather see the government take a leading role in denying such claims. An example was the Oregon Medicaid case (https://www.oregon.gov/oha/HPA/DSI-HERC/Pages/Prioritized-List-Overview.aspx), a painful and lengthy public process to rank treatments. Hard choices must be made, and I don’t want to see any small group deciding whether treatment X should be used on an 80 year old person without substantial public input into the process. I don’t see how a private insurer could do this. It is worth noting that in the Oregon case, the public process ranked treatments but the Oregon legislature determined funding. That established the line between what would and would not be provided. It leads to controversy for sure, but I can’t imagine any process that would not lead to such controversy. What we currently have is an opaque process subject to poor incentives and horribly incomplete (and asymmetric) information.

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  7. First I learned about academia and how “the incentives” are (supposedly) to blame for many things wrong there, and now I learn about “the system” in insurance and how it is responsible for things wrong there if I understood things correctly.

    Man, what troubles with all these things like “incentives” and “the system”. I am wondering whether they magically appear all of a sudden and where such things might not be present. I mean can I work as a carpenter or something like that without being afraid of being negatively influenced by certain “incentives” or some sort of a “system” there?

    Maybe work at a grocery store? Are there “incentives” there that might influence, or even cause, me to act in ways that might not be good for other people? Or, is it safe to work there now but at any moment some “system” might fall out of the sky and completely control the entire thing leaving me helpless to make any decent decision or go find another job?

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    • Carp:

      We talk a lot about social science on this blog, and, yeah, incentives and systems are part of what we study in social science. I get that you want to argue about all this, but I think you’d be better off doing this on some site like twitter or 4chan where you can unleash all your political debating.

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