Civility is for Civilized Societies

This feels like a real cultural moment. Yesterday I detailed Who Is Allowed to Kill in America and how despite the fact that we still do not know the motive of UnitedHealthcare CEO Brian Thompson’s killer, that has become secondary to the fervent and flippant reaction to it. The injustice of America’s extractive health care system is not some abstract notion to be debated on the internet, it’s physical pain felt every day by people whose sickness is being exploited for profits by companies like UnitedHealthcare. Shooting someone in the back is certainly a kind of violence that has no place in a civilized society, but our society is not civilized. The violence doled out every day by the healthcare system is not seen as violence the same way that shooting someone is, and so it endures while America’s life expectancy declines and people’s rage boils at a system that has proven it is willing to kill them for profit.

404 Media reported today how the most popular type of deleted post by moderators on Reddit is about the UnitedHealthcare CEO, with doctors and nurses authoring many of them.

But on the 500,000-member subreddit for medical professionals, r/medicine, moderators deleted a thread about the news of Thompson’s death after it had gained hundreds of comments, mostly doctors and nurses applauding the news or memeing about it: “If you would like to appeal the fatal gunshot, please call 1-800-555-1234 with case # 123456789P to initiate a peer to peer within 48 hours of the fatal gun shot,” one said. It’s a much different scene in r/medicine than it is in r/nursing: there’s only one thread about the shooting in r/medicine right now, while the nurses have a field day.

A Bankrate survey done earlier this year found that 44 percent of Americans say they cannot afford a $1,000 emergency. Empower research suggests that 37 percent of Americans cannot afford an emergency expense over $400, and the Federal Reserve found that “Twenty-seven percent of adults went without some form of medical care in 2023 because they could not afford it, similar to the share in 2022 but up from 24 percent in 2021.” Two-thirds of people who file for bankruptcy in America cite medical issues as key contributor to it, and a new study found that medical debt is associated with worse health outcomes and more premature deaths.

This is uncivilized, and that finding by the Fed is directly related to health insurance companies denying people’s claims for services they have already paid for. The conditions Americans are forced to endure under our mafia-style healthcare system would never exist in a society built of, by and for the people. This is a what a world built of, by and for capital looks like.

Those reacting with laugh emojis and now-deleted posts 404 Media found like “United Healthcare CEO Brian Thompson’s final [kill:death] ratio (7,652,103:1) lands him among the all time greats,” are reacting to a set of conditions they did not create but are forced to live with. Those demanding civility from people celebrating a currently imagined strike against an unjust system are dismissing real injustices while functionally defending the incivility of the healthcare system.

Reform the healthcare system to one where cancer patients don’t have to explain to a million customer service agents why they have to take the life-saving drug their doctor prescribed them and how they can’t afford $10,000 per pill–all so these schmucks can reserve a hotel ballroom in Manhattan to talk about how else they’re going to fuck people over in order to goose profits by three percent–then we can talk about showing them any kind of respect or civility right now.

People are dying. Some are choosing to die so they don’t leave their families with a mountain of debt to pay down so UnitedHealthcare’s stock price can go up. That sound you hear in the background right now is the Overton Window shifting to parts unknown, and if health insurance executives would like to live in a civilized society one day where all of us don’t have to walk around worrying whether we’ll be shot by a stranger, I suggest they try being civilized themselves first.