Luigi Mangione and 'magic bullet' medicine

Why did Luigi Mangione allegedly target UnitedHealthcare CEO Brian Thompson?

The original consensus was something like: He had chronic back pain that surgery didn’t help (or even made worse) and that his insurance company wouldn’t pay to fix.

It’s possible the 'system' had a share in derailing Mangione’s life, but surely there are many other factors, including the belief that all pain requires treatment.

But apparently the surgery, which he had no problem paying for, was a success. On Reddit, he raved about it and even recommended it to others. There is no record of him complaining about back pain after the surgery.

We do have a record of Mangione complaining of other maladies: Lyme disease, irritable bowel syndrome, and brain fog — all relatively new conditions often regarded as having a psychosomatic component.

Chronic endless pain

I have a good understanding of this because I come from a family of doctors, and my mother is one of these chronic endless pain people. I also worked in Big Pharma branding for two years, as well as for other creepy, well-funded Silicon Valley health start-ups on the agency side.

Via these experiences, I have come to basically the same conclusion that RFK Jr. has. The American for-profit health/pharma system is the most evil single institution on earth. It's also the most powerful.

This should've become obvious during COVID, where it literally took over the world. It should also be obvious given that it currently has the power to mutilate our own children, sometimes against our will, and to addict them to expensive drugs they will have to take for a lifetime.

I'm dubious that what we're seeing with UnitedHealthcare and Luigi Mangione is the whole story, but I'm more interested in the glaring contradiction at the heart of the alleged killer’s motive, seemingly expressed in the message left on the shell casings: “Defend, deny, depose.”

Among Mangione’s online sympathizers, even those who don’t go so far as to applaud the assassination claim, believe there’s a coherent political message behind it. But that rests on a faulty assumption about pain: that it must always be "treated" via medicines and surgeries.

Physical diagnosis, spiritual condition

This assumption certainly benefits the pharma industry — the more patients with chronic and consistent pain, the better. The only limit is what their insurance is willing to pay. As rapacious as insurance companies may be, some claims actually should be denied.

It’s not uncommon to get a physical diagnosis for a spiritual condition. I've seen my mother go through this her entire life, always with some new pain somewhere or some all-encompassing bulls**t diagnosis like "fibromyalgia" that gives pharma open access to her insurance funds.

Literally millions of aging single women suffer from various versions of chronic pain. They have been told, not by insurance companies, but by pharma companies and the media, that this pain is the result of treatable illnesses. Yet, somehow the more profits are made, the more “treatable” new illnesses pop up in need of cures.

But when none of them work, which is actually a quite common occurrence, what exactly is an insurance company supposed to do? Just pay endless claims forever, knowing that nothing will work? Denying the claims at least communicates that it’s time to try something else besides paying pharma companies with perverse incentives.

Whose profit?

It’s true that companies like UnitedHealthcare shouldn't exist in the first place. Even Adam Smith, father of market capitalism, said specifically that certain products were too elastic to be handled by a market, and medicines would certainly fit that category. The fear surrounding a person's health, and the desperate reliance on authority, warps the market and creates a terrible potential for very deep, evil, and pervasive abuse.

This is exactly what has happened, and it's eaten the globe. But in this instance, it doesn’t seem that UnitedHealthcare's "profit motive" had much to do with Mangione’s struggles. Of course, Mangione’s alleged manifesto encourages us to see his motivations as purely political rather than personal. He is targeting the “parasites” to blame for America’s extremely expensive yet extremely ineffective health care system.

As a diagnosis of what needs to change, the manifesto, if you could even call it that, is unsatisfactory. It ignores the bad actors upstream of the insurance companies: the doctors who offer unnecessary surgeries for hundreds of thousands of dollars and the pharma companies that run commercials telling everyone that chronic pills are the solution to their chronic problems.

Bad pharma

It’s mind-boggling that such commercials are so prevalent. Pharma has become the single biggest advertiser in all media by a massive margin: It literally keeps the mainstream media alive. A culture that heavily restricts cigarette ads should ask itself why it gives free reign to legal international drug cartels to spread their sales pitches. What impact does that have on public health?

We saw the impact during COVID, where people abandoned family members to die because the TV told them to do so. And who was the TV being controlled by? Pfizer (pharma) and Fauci (public health). Not by the insurance companies who had to foot the bill.

It’s possible the “system” had a share in derailing Mangione’s life, but surely there are many other factors, including the belief that all pain requires treatment. Maybe in a less stubbornly secular society he would’ve been able to understand his suffering as a necessary — or at least inevitable — consequence of being alive. Maybe then a father would not have been murdered in cold blood.

But our society has no concept of beneficial pain. In fact, we’re obsessed with eliminating pain entirely. That’s why our medical ideal is to match cause and cure so precisely that one treatment can eradicate a disease with maximum efficiency — and without any collateral damage.

This power such treatments promise is so seductive that it’s easy to succumb to wishful thinking, if not outright delusion. It’s right there in the name we commonly use for them: magic bullets.