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Healthcare and Its Victims, by Luigi Mangione

tzrider said:
Unless there is some evidence that Luigi was acting in self defense by shooting a guy in the back with a silenced pistol, we know all we need to to say he was unreasonable.
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Trolley problem notwithstanding?
 
byke said:
Noooooo, you don't know whether or not it's reasonable without knowing the reasons why and you yourself said that we don't know what informed his decision. So again, in what manner would it be acceptable to think of him as unreasonable?

And this is all dancing around the point, which is that people like the shooting and don't like the idea of the shooter being an idiot.
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If only he'd written down why he did what he did.

Oh well. Guess we'll never find out.
 
Jammer said:
In this era of towering skyscrapers, artificial intelligence humming quietly through hospital corridors, and the endless litany of self-congratulation over the triumphs of medical science, I find myself compelled to break my silence. Our civilization boasts of its healthcare systems as if they were not only the apex of scientific achievement, but also a paragon of human morality. Yet I stand here, pen in hand, seething with indignation, filled with profound sadness, and forced at last to cast aside all pretenses. I must speak the truth: our modern healthcare system, especially in this country, is a cathedral built on sand—beautiful in its architectural conceits, but rotten at the foundation, a monument to hypocrisy and greed. Do not mistake my words as those of a lunatic or a lone fanatic. On the contrary, I have observed long and hard, meticulously compiling evidence, listening to the cries of the afflicted, and studying carefully the machinery of oppression that masquerades under the guise of healing. To some, I may appear as an isolated voice, an aberration within a culture that seems hypnotized by the glow of technological progress. But I know there are countless others who share my despair, who have looked, with aching hearts, upon loved ones left untreated, patients bankrupted by basic therapies, researchers stifled by corporate interests, and communities abandoned by hospitals that deem their existence “not profitable.” My decision to articulate this scathing condemnation arises not from hatred of humanity, but from a profound love for what humans could be if we only tore away the veil.

The Illusion of Care

We have long been told to trust the medical establishment, to believe that doctors and nurses, with their stethoscopes and white coats, stand as paragons of virtue. Indeed, many individual practitioners do sincerely devote their lives to healing the sick. But individuals alone, no matter how compassionate, struggle futilely within an institutional framework that undermines their noblest intentions at every turn. Healthcare as it currently stands is not designed to keep people healthy. It is designed to maintain a perpetual market for healthcare services, pharmaceuticals, and insurance policies. Our society brandishes statistics: improved survival rates for certain cancers, the advent of robotic surgeries, targeted gene therapies, and so forth. Yet behind these numbers, carefully chosen by public relations departments and government spokesmen, lurks a grim truth. The overall metrics of health—infant mortality rates, maternal health outcomes, life expectancy compared to other industrialized nations—tell a story of persistent failure, regression, and moral collapse. These discrepancies are not accidental. They are symptoms of a system that never had true universal care at its heart. When we say “healthcare,” we summon a reassuring image of a caring physician at a patient’s bedside. Yet, observe more closely: that bedside is now crowded by administrators, insurance adjusters, corporate attorneys, and pharmaceutical representatives. The doctor stands there, to be sure, but they are outnumbered, outmaneuvered, and often overshadowed by the intricate lattice of profit-oriented bureaucracy that defines the modern medical world. When the patient cries out in pain and seeks relief, the response that returns to them is not simply that of a healer ready to help, but of a cost-benefit analyst weighing whether their suffering is worth alleviating given the balance sheets. We are told that competitive markets improve quality and lower costs. This is the refrain of our times, the economic dogma that has been allowed to infiltrate even our perception of the sanctity of human life. But if competition were truly the engine of improvement, why do we witness skyrocketing prices for common drugs that have existed for decades? Why do hospitals close in rural areas, leaving entire regions bereft of care for hours around, simply because the population density is too low to justify investor interest? Why do insurers find convoluted ways to deny claims, to pile up obscure terms and conditions, all to ensure that their profit margins remain robust?

A System Designed to Fail

It is a mistake to call our healthcare system “broken.” To do so would suggest it once functioned well and now falters by accident. But this system was never designed to safeguard the health of the many; it was engineered with the aim of financial gain for the few. It is a labyrinth deliberately constructed of administrative barriers, obfuscated billing practices, and legal complexities. This is not an unintended consequence—this is the blueprint. Bureaucracy swallows countless billions that could have built hospitals, funded research into neglected diseases, or delivered treatments to remote regions. Instead, those billions vanish into the machinery of profit, into ever-expanding layers of management and red tape. Insurance companies have become medical gatekeepers, wielding outsized power over decisions that rightfully belong to physicians, caregivers, and patients themselves. With every referral, every denied claim, every inflated cost for a pill that costs pennies to manufacture, they tighten the noose around public health. The apparatus is designed to confuse and exhaust patients until they simply give up, accepting substandard care or crushing debt. It is a system that counts on resignation, on the quiet despair of individuals who lack the means to fight back. I have watched this unfold from the inside. I have seen the incessant forms, the endless cycles of “pre-approvals,” the letters informing patients that their treatment—no matter how necessary, how urgently prescribed by their physician—is not “covered.” I have witnessed patients be told that their life-saving procedures must wait until an elusive committee of cost analysts determines whether their existence holds sufficient monetary value. I have seen healthcare institutions, purportedly philanthropic, gleefully profit off human pain, turning patients into revenue streams rather than human beings in need.

The Human Cost of Indifference

Every abstract policy, every line of fine print in an insurance contract, has a human face attached. Behind these faceless mechanisms are real lives unraveling. Families teeter on the brink of financial ruin because they dared to seek help for a sick child. Elders ration their medication—cutting pills in half, skipping doses altogether—because the market demands a price that can mean the difference between eating and treating a chronic illness. The cruelty is not confined to one class; it spreads and infiltrates the very fabric of our communities. The supposed moral society allows these tragedies to go on, day after day, in plain sight. Meanwhile, at the summit of this colossal edifice of inequity, the executives of vast health conglomerates earn salaries and bonuses that dwarf the cost of entire medical wings. They dine lavishly, clinking glasses and celebrating their fiscal quarters while, just a few floors below, patients beg for help and healthcare workers struggle with understaffing and burnout. The irony is as obscene as it is deliberate. As some lives are prolonged with the best treatments money can buy, others are cut short by conditions easily treated were it not for the cruelty of cost-based rationing. We pour billions into the development of groundbreaking drugs, yet we erect paywalls so high that only a fortunate fraction of patients will ever see them. The promise of modern medicine lies not only in its discoveries but in its equitable distribution—a promise we have so brazenly betrayed. I have lost friends—good, hardworking individuals—who slipped through the cracks because they could not afford the tests, the scans, the referrals. I have watched family members endure humiliating phone calls, pleading with insurance representatives who could not care less about their plight. I have seen the despair etched into their faces as they realize their options have run dry. It is a quiet kind of torture, a slow, bitter death of hope and trust in a system that was supposed to provide solace, not suffering.

A Call to Arms: Revolt Against the Status Quo

Words alone are not enough, though I must start here. Actions, no matter how shocking, seem necessary to awaken a population lulled into accepting this desolation as normal. My manifesto is a desperate attempt to shake the foundations of a world that has allowed itself to be governed by heartless spreadsheets and corporate-led moral arithmetic. When I act, I do so in the name of humanity, not spite. It is not hatred that drives me, but the very opposite: love for a people who have been betrayed, compassion for those who die unremarked and unmet within the shadows of this market-driven machine. Our current passivity has been the nourishing soil in which this vile system thrives. We must not only acknowledge the problem but commit ourselves to radical, systemic changes. The solution does not lie in half-measures or superficial reforms but in a complete reimagining of how we structure healthcare. We must strip the profit motive from medicine. We must eradicate the legal structures that allow insurance companies to profiteer on misery. We must demand transparency, accountability, and equity at every stage. Healthcare should be a public good, not a speculative venture. Look at the models around the world where universal coverage is not just a slogan, but a reality. Study the nations that refuse to let a single individual go untreated because of an inability to pay. Understand that this transformation is not a pipe dream but an attainable goal, provided we have the courage to wrest power back from those who have proven, time and again, that they do not deserve our trust. We must demand that our leaders confront the issue head-on, tearing down the frameworks that perpetuate healthcare inequality. We must push for policies that prioritize patient outcomes over corporate earnings, that place moral purpose above shareholder dividends.

My Legacy and Your Responsibility

If my words and actions serve as a catalyst—if they spark a shift in your perspective, or perhaps even a grand movement—then my life will not have been lived in vain. I have chosen this moment to speak my truth because I know that many others feel it too but remain in silence, fearing repercussions, or simply overwhelmed by the scale of the catastrophe. Let my voice echo for them. Let it represent the countless silent sufferers who have not been allowed the dignity of proper care. I do not ask for your pity, nor do I seek your admiration. I do not want my name etched in stone as a martyr. Instead, I beg of you: scrutinize the system that calls itself “healthcare.” Look beyond the sensationalism that will inevitably surround my actions—spun by media outlets that rely on shock value. Penetrate the veil and see the underlying disease. Question every assumption about why a pill costs hundreds of dollars, why a specialist is out of reach, or why an insurance claim can be denied with impunity. Challenge every premise that leads to the commodification of health. I hope that future generations might look back at this turbulent era and wonder how we tolerated such cruelty under the guise of care. I hope they will marvel at how we once let human beings suffer and die while wealth piled up at the top, and I hope they will praise the efforts of those who dared to resist. If what I do today contributes a small brick to the foundation of a new healthcare paradigm, one defined by equity, compassion, and universal access, then my role in this story is meaningful. This manifesto is my final testament, my earnest appeal to the conscience of a world that has grown too comfortable with moral contradictions. Let the cost of my sacrifice be not in vain. Let it serve to ignite a transformative discussion and, more importantly, real action. The world desperately needs a healthcare system that honors its name: a system that is centered on healing and grounded in love, not money. Through this plea, I offer you a choice: continue to stand by as millions suffer, or join in building a legacy of decency, empathy, and genuine care.

In raw desperation—and with a sliver of hope—

Luigi Mangione
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Amen brother - whether he actually wrote that or not.
 
One thing everyone is missing is that western medicine is just the wrong modality for back problems. Back problems are often a lifestyle problem, and can't usually be treated with pills and surgery. The correct approach is to learn a movement practice that slowly reverses the lifestyle induced dysfunctionality, like yoga or pilates.

If you want to see the clearest expression of it, just watch everyone's feet as they walk. 90% of people walk duck footed, indicating tight hamstrings, poorly functioning quads and illiospsoas, and probable lower back dysfunction. I see just as many fit young beautiful people walking duck footed as older infirm people. When you walk your feet are supposed to be straight. hardly anyone does it this way.
 
byke said:
Okay just keep in mind what you're also saying, which is that someone with debilitating back pain, can or should be out there walking, running, travelling, etc. etc.
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Back in college I had a really bad mtn bike crash and compressed two vertebrae in my neck and two on my lower back. I've spent twenty five years working as a fish and wildlife biologist, wading through rivers carrying immense weight. My body is destroyed.

Most of the time I carry on just fine. Sure I have pain about 95% of the time. I don't take pain killers although I have a prescription for gabapentin and take it rarely, usually when I need to sleep.

Every now and then my back goes out. When it does, I'm not getting up off the floor. I'm done.

But when it isn't out, I'm still Mtn biking, hiking, and acting like a normal person
 
mercurial said:
One thing everyone is missing is that western medicine is just the wrong modality for back problems. Back problems are often a lifestyle problem, and can't usually be treated with pills and surgery. The correct approach is to learn a movement practice that slowly reverses the lifestyle induced dysfunctionality, like yoga or pilates.
Click to expand...

It’s not the wrong modality when things reach the point of advanced stenosis. And sometimes these problems have origins other than poor posture or gait. Often a person won’t realize the stenosis is developing until they experience symptoms and by that time, yoga and Pilates won’t do bupkis.

My own case is the one I know the best. I can’t say whether I’m an outlier, but might be in some respects. My spine has developed stenosis at both ends, originating from a bad day of snowboarding about 30 years ago. I was “learning” to snowboard on an icy day, kept catching my heel side edge and getting pile driven into the ground ass first. Being too stubborn to stop, I did this about 25 times and caused real damage to disks.

Two weeks after the trip, my right arm went numb. I saw a chiropractor for the first time, who found the disks in my neck had compressed to about 20% of normal clearance. After a year and a half of adjustments three times a week, the clearances were about 80% of normal and the numbness had cleared up. At that point, I stopped treatments and lived life.

In 2012, I awoke one morning with a crick in my neck and my left arm began to fade away. I could feel the progression of loss of strength and sensation over the next two hours. Chiro treatments did nothing. At the time, our health plan prescribed PT, which also did nothing. They refused to get images. When I changed plans, we finally got a diagnosis via MRI: stenosis at six levels in the cervical spine. Two vertebrae were fused from birth, which put greater stress on the other disks. Nerve roots were being impinged by bone growth and the spinal canal had narrowed to the point where there was no clearance between bone and cord.

Pilates wasn’t going to fix that. Neither was PT, chiropractic or any other manipulation. My posture is good and I don’t walk duck footed. Surgery was the only logical option. One fusion, a laminectomy and four laminaplasties later, my spine began to heal and the nerve function returned. Eight months after the surgery, I was cleared to resume all normal activities, so I free soloed a frozen waterfall to celebrate.

A couple of months ago, I had a surgery on the lumbar area to decompress the nerve roots there. The procedure was more straightforward, drilling holes in the lamina and hogging out the nerve canals to get clearance back. Time will tell how long lasting this is, but so far, so good. This stenosis too, is likely the result of disk compression from that day of snowboarding many years ago, There had been no symptoms in that area at the time, so nobody looked there.

At the moment, this is as good as it gets. By the time there is abnormal bone growth, the only way to relieve symptoms is to get the bone growth out of there. One might make a case that some sort of regular manipulations earlier in my life would have avoided the need for surgery later, but I’ll never know.
 
^ did you wear a back brace for recovery? My mom did. Surgery helped her too but, it was a painful and difficult process. Stenosis is a MFer.
 
After the neck surgery, I wore a brace for six weeks and couldn’t drive during that time. The lower back surgery did not require a brace. They did cut a bunch of muscle and wanted me to wait about a month before bending, lifting or twisting. It was relatively easy. The surgery itself left a four inch incision, but was outpatient.
 
tzrider said:
It’s not the wrong modality when things reach the point of advanced stenosis. And sometimes these problems have origins other than poor posture or gait. Often a person won’t realize the stenosis is developing until they experience symptoms and by that time, yoga and Pilates won’t do bupkis.

My own case is the one I know the best. I can’t say whether I’m an outlier, but might be in some respects. My spine has developed stenosis at both ends, originating from a bad day of snowboarding about 30 years ago. I was “learning” to snowboard on an icy day, kept catching my heel side edge and getting pile driven into the ground ass first. Being too stubborn to stop, I did this about 25 times and caused real damage to disks.

Two weeks after the trip, my right arm went numb. I saw a chiropractor for the first time, who found the disks in my neck had compressed to about 20% of normal clearance. After a year and a half of adjustments three times a week, the clearances were about 80% of normal and the numbness had cleared up. At that point, I stopped treatments and lived life.

In 2012, I awoke one morning with a crick in my neck and my left arm began to fade away. I could feel the progression of loss of strength and sensation over the next two hours. Chiro treatments did nothing. At the time, our health plan prescribed PT, which also did nothing. They refused to get images. When I changed plans, we finally got a diagnosis via MRI: stenosis at six levels in the cervical spine. Two vertebrae were fused from birth, which put greater stress on the other disks. Nerve roots were being impinged by bone growth and the spinal canal had narrowed to the point where there was no clearance between bone and cord.

Pilates wasn’t going to fix that. Neither was PT, chiropractic or any other manipulation. My posture is good and I don’t walk duck footed. Surgery was the only logical option. One fusion, a laminectomy and four laminaplasties later, my spine began to heal and the nerve function returned. Eight months after the surgery, I was cleared to resume all normal activities, so I free soloed a frozen waterfall to celebrate.

A couple of months ago, I had a surgery on the lumbar area to decompress the nerve roots there. The procedure was more straightforward, drilling holes in the lamina and hogging out the nerve canals to get clearance back. Time will tell how long lasting this is, but so far, so good. This stenosis too, is likely the result of disk compression from that day of snowboarding many years ago, There had been no symptoms in that area at the time, so nobody looked there.

At the moment, this is as good as it gets. By the time there is abnormal bone growth, the only way to relieve symptoms is to get the bone growth out of there. One might make a case that some sort of regular manipulations earlier in my life would have avoided the need for surgery later, but I’ll never know.
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Wow, Andy, sorry to hear about you going through that!

I had a similar experience, trying out snow boarding with experienced snow boarders about 29 years ago, but I only took 5-6 tailbone thuds into the hard snow. It sucked.
 
stangmx13 said:
This murder was in many ways a protest over the state of healthcare in the US.
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A protest killing? Where does that take us? The shooter's words above read as if he's taking his own life, but then he prints a gun and shoots someone unrelated to him personally. It's a justification for homicide, that's all. He's a coward, that's all.

mercurial said:
One thing everyone is missing is that western medicine is just the wrong modality for back problems. Back problems are often a lifestyle problem, and can't usually be treated with pills and surgery. The correct approach is to learn a movement practice that slowly reverses the lifestyle induced dysfunctionality, like yoga or pilates.

If you want to see the clearest expression of it, just watch everyone's feet as they walk. 90% of people walk duck footed, indicating tight hamstrings, poorly functioning quads and illiospsoas, and probable lower back dysfunction. I see just as many fit young beautiful people walking duck footed as older infirm people. When you walk your feet are supposed to be straight. hardly anyone does it this way.
Click to expand...

Yeah, back problems aside, the large majority of America does very little (if any) to preserve their own health. Very. Little. Western medicine has learned that quick fixes and elixirs (as advertised) are the fixes the fat part of the bell curve Americans, will be satisfied with. Yeah, they'll complain still, but so long as the scripts are filled, party on. Most won't modify their lifestyle choices to better their own health. Some are unable to physically, but the large part that are able to don't know how to and/or don't want to commit to decisions that take away from their satiation and idleness. Some hate reading these statements, but the first and most important step in fixing America's health care problem is imparting citizens with health knowledge at an early age and letting them make their own choices for treatment(s).

FWIW, preventative medical expenses are non deductible. Employers who provide such to an employee must consider the value as compensation (taxable to both). We could start there....
 
Damn Andy. I knew a bit of that, but not the whole story. Good on you for fighting through.
Had my fair share of back shit and I know what it feels like to be stuck on the ground in agony like Mike.

I feel very lucky to be mostly pain free after two discs naturally fused. I did not want surgery and the Doc said he thought they would if I could manage the pain for a few years. It was terrible with spells where a nerve sent me into massive pain. Ice, electricity, pain meds etc. but I never stopped doing aerobics or weight lifting.

Back on the suspect being nabbed. I just heard on the radio it was a Bay Area cop who sent the lead on him to NY / PA. His Mom filed a missing persons report some 5 months ago when she lost contact with him. A Leo recognized the face and remembered the missing persons report and matched up the photo's sending on the message this could be your guy. Pretty awesome work there.
 
WRT “taking his own life” as I mentioned earlier, martyrs have on the past burned themselves alive in protest. All that does is result into a dive into the protester’s life.
In this case, Luigi, the accused, technically has ended his life by murdering his dragon in cold blood. He has also achieved the unachievable, he’s turned the focus into the well paid “evil doers” who are taking over our lives.
 
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