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Assassination of United Healthcare CEO

Back to the thread topic, Mangione has been charged with second degree murder. That might sound surprising, but it's mostly just a quirk of New York law.
Under New York state law, a first-degree murder charge only applies to a narrow list of aggravating circumstances — for example, when the victim is a judge, police officer, first responder, or when the killing involves a murder-for-hire or intent to commit terrorism, several legal experts told CNN.

In Mangione’s case, he could be charged with first-degree murder if the investigation uncovers evidence showing he had a plan to commit terrorism, such as plotting the killing of other health insurance executives, said David Shapiro, a lecturer at the John Jay College of Criminal Justice.

If convicted of second-degree murder, Mangione faces at least 15 years to life in prison, while a first-degree murder charge carries a minimum of 20 years to life in prison.
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plague311 said:
I'm simply not going to engage with this anymore. If you want to simp for the insurance companies, and make excuses for their ridiculous profits and absurd costs and fees then go right ahead but I won't be arguing it with you. You're not changing your mind, and I'm not changing mine. If you're happy with what's happening then you and I have no common ground.
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You aren't arguing, you're simply unable to support your positions. I don't want to change your mind, I simply want to know if your reasoning is accurate to begin with. That is not a high bar.

I Am The Scum said:
Back to the thread topic, Mangione has been charged with second degree murder. That might sound surprising, but it's mostly just a quirk of New York law.
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I understand the reasoning but does terrorism require actual intent to kill others himself? Seems clear his intent is to change policy and intimidate others in the field through violence. Im sure it's a matter of finding the evidence that makes that a slam dunk for trial but it seems the broad strokes are already present.
 
plague311 said:
But someone would be able to afford those houses, right? They wouldn't just sit vacant and if they did then they'd be torn down and turned into something else. But point taken, you would, as well, have to find ways around something like that. It sucks, it would be tough, but so is 38 million, just over 10% of our country, living in poverty, 650,000 people filing for bankruptcy (more than 60% of all personal bankruptcies) and so on, and so on.

I doubt the effects would end there either. You'd see all sorts of sectors have to change how they operate. As you said, if you're affected then so too would the construction business in general, which would then go to the realty market, etc. etc. Sounds like a damn good time to me.
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Abso- ◊◊◊◊◊◊◊ -lutely. Those beach houses wouldn't be selling for north of a million anymore; basically no one could afford them. But they wouldn't stay empty or be razed- their value would have to plummet. That sends the real estate market into a nosedive. We all remember what happpens when the real estate market tanks, and what that does to the Dow and interest rates and all.

It will be one bumpy-assed ride, is all i'm saying. On net, I'm in. I'd rather see the poor taken care of than the rich. The rich already understand that they would no longer be rich if anything remotely like this happens, so they are already staunchly against it.
 
rdwight said:
You aren't arguing, you're simply unable to support your positions. I don't want to change your mind, I simply want to know if your reasoning is accurate to begin with. That is not a high bar.
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And I feel the exact same about your "positions". You haven't supported anything. You've cried about how terrible the insurance industry is being treated, nothing more. My reasoning is as accurate as yours is but I understand that some people need to feel like they're the true skeptics with the true reasoning and everyone else is just not supporting their positions.
 
I'm pretty sure prosecutors like to bring charges they think they can explain to a jury and prove in court. Sure, we can look at his actions and reasonably interpret them as terroristic in nature, and even terroristic under the law. But I can understand if a prosecutor doesn't want to risk having the jury get hung up arguing over whether it was really truly terroristic.

I think the prosecutor would want a clear factual basis of a terrorist plot, if he were to bring that charge.

There seems to be a clear factual basis for alleging a murder. I don't think making inferences about the killer's state of mind or intended outcomes is good enough to bring a charge of murder one.
 
The penalties are 20-life for first, and 15-life for second. Yeah, it makes sense on the conviction likelihood to go for second degree and the max sentence. Same outcome, easier burden.
 
theprestige said:
I'm pretty sure prosecutors like to bring charges they think they can explain to a jury and prove in court. Sure, we can look at his actions and reasonably interpret them as terroristic in nature, and even terroristic under the law. But I can understand if a prosecutor doesn't want to risk having the jury get hung up arguing over whether it was really truly terroristic.

I think the prosecutor would want a clear factual basis of a terrorist plot, if he were to bring that charge.

There seems to be a clear factual basis for alleging a murder. I don't think making inferences about the killer's state of mind or intended outcomes is good enough to bring a charge of murder one.
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And it doesn't really boil down to a huge difference. The penalties can basically be the same:

First:
A defendant under the age of 18 cannot be charged with first-degree murder. First-degree murder is punishable by 20 years to life in prison and thus must serve at least 20 years in prison before being eligible for parole, or life imprisonment without the possibility of parole. The death penalty was struck down in New York in 2004
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Second:
Second-degree murder is punishable by 15 years to 40 years or life-with-parole after 25 years, or life-without-parole if the victim was under 14
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Either way it'll end with Life in Prison in NYC, unless the feds want to throw their hat in the ring and try him afterwards too. Which I wouldn't put past Trump to do. He does have a soft spot for CEOs.

ETA: Ninja'd be Thermal
 
I Am The Scum said:
Clear beyond a reasonable doubt? I can easily see a jury perceiving this as a personal grievance.
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And no one else was really terrorized. The city functioned as normal, people went on with their daily lives. Sure a couple of CEO's ◊◊◊◊ their pants but that's not really terrorism. Luigi never said he was going after other CEOs or anything. Unless it's in his papers, but I'd bet the police and prosecutors have read those by now.
 
I Am The Scum said:
Clear beyond a reasonable doubt? I can easily see a jury perceiving this as a personal grievance.
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Only in the sense that an Al-Queda bomber has a personal grievance. I mean, Luigi-boy already acknowledges in his manifesto that it was for the societal objective, not a personal one.

But as discussed already, easier burden for the prosecutors.
 
I mean, if he were to testify that this was intended as a terrorist act aimed at CEOs and policymakers. Or if he had written it down somewhere and it could be introduced as evidence. Or if co-conspirators came forward to testify to such a plot. That would be different.
 
Thermal said:
Only in the sense that an Al-Queda bomber has a personal grievance. I mean, Luigi-boy already acknowledges in his manifesto that it was for the societal objective, not a personal one.
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The manifesto would definitely be the best bet for prosecutors. I haven't been focusing super closely on the case, but do we know for sure that the "leak" is legit?
 
3point14 said:
I was recommending relying on market forces. Which I'm reliably informed is the only way to achieve the correct result. I'm shocked to find out the invisible hand of the market is not the perfect and reliable process I've been told it is.
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This is gonna ramble....

Part of the problem with the "market" in regard to US healthcare is that the system is pretty adulterated to the point that the market doesn't really work the way we think it should. I think I read somewhere that when insurance was first introduced, the AMA opposed it for this reason, saying it would drive costs up. I think it's worth noting, however, that medicine was more primitive at that time. Hospitals mostly consisted of room and bed space. There were not expensive pieces of equipment like MRIs or the types of lab and imaging services we have today. Or the surgical equipment.

Insurance, by its nature, separates the demand for the product from the supplier. How many in the US even know what the fee is for a doctor's appointment. (One time, I asked at the front desk how much the appointment would cost without my insurance. Nobody in the office knew.)

Also, generally speaking, cost is not a topic during the appointment. The doctor says: "We need to do these tests." or "It looks like you have X condition. We can try these treatment options." There may be discussion of the advantages and disadvantages of the options, but it usually doesn't involve laying out the prices. (Your doctor may say something like "This is the best option, but the insurance company will make us try these options first."

Price negotiation happens between the providers and the insurance companies. the insurance companies can pass the price through to patients in the form of premiums. Patients (or employers) shop insurance based on the premiums they can afford more than the fine print of coverage limits.

Whenever there's a story about unaffordable healthcare, it always seems to be about insurance premiums or inability to afford insurance. (Evil insurance companies.) Then there are the stories about how Medicare doesn't pay enough so doctor's offices are limiting the number of Medicare patients or declining Medicare patients entirely so the elderly can't find a provider. (Evil Medicare: Reimbursement rates are too low.) Stories about salaries for Healthcare providers are almost always: "Nurses are underpaid and overworked!" (Evil Hospital administrators.) It's never about how much doctors make. The salary of the CEO may be questioned, but not that of the doctors (even the administrative ones).

We want cheap affordable healthcare where the healthcare providers are well paid and the provider to client ratio is high. (You can substitute "childcare" in that sentence as well. Either one is a bit of a paradox.)

I'm lucky. I've had a "Cadillac" plan pretty much the whole time since I graduated college. It's an HMO. My part of the premium (Family plan) is like $250/month. My employer pays about $1000/month, I think. No deductible. Copay for Doctor's visits $30 Copay for hospital/ER $300 per admission. After reaching the out-of-pocket maximum (It's happened) the copays go to $0.

I kept my daughter on my plan until she was 26. (Thanks Obama!) Even after she was married. When she was pregnant, the insurance would pay for her, but not my grandson was not eligible as he is not my dependent. Her husbands insurance had lapsed due to a period of seasonal unemployment six months earlier and there was a two month gap before it would kick back in. (He's in the trades...the union insurance coverage is tied to on the number of days you work in the previous quarter or something. It's complicated.) So I bought the same plan for my grandson for two months at $500/month. (Left the hospital with no bills, though.) The person at the insurance company, by the way, was very helpful, and the process was very smooth even though I was up front that I was only keeping the insurance until my son-in-law's kicked in and charges would likely exceed the premiums by $15,000. (Not everyone is evil.)

My wife was in the hospital for a couple weeks last summer. Our copay was $300. (Well, actually $0 because she also has Medicare as a secondary payer.) The charges were around $150,000. I think that one incident accounts for about ten years of premiums. Just to give an idea of the math here.

The interesting thing is that the insurance company, the main hospital in the area and the "physicians' group" are all part of the same overall company. The Hospital portion is "non-profit" but the other parts are not. (Not sure exactly how that works.) (Our plan, by the way, is better than the one the employees of the company get.)

Health insurance (private or single payer government) depends on healthy people's premiums subsidizing the expenses of the people who are less healthy. If the young and healthy opt out, then premiums go up. If providers waive charges for those who can't pay (or are never able to collect...same result) prices go up and premiums go up.

My impression that in many of the countries with universal healthcare the doctors are employees of a national provider service. So taxes go to provide the facilities and staff. If taxes (premiums) are too low, patients have to wait for care, newer treatments are not available and/or doctors/nurses leave for more lucrative opportunities (private or overseas). If you raise them...well, no voter like higher taxes. But these systems have an advantage in that the expenses can be centrally managed and there is 100% participation. (Of course, low-income people still don't pull their weight.)
 
I am more and more convinced that this fella just had a psychotic break a few months ago, about the time he stopped communicating with his family and friends.
 
I Am The Scum said:
The manifesto would definitely be the best bet for prosecutors. I haven't been focusing super closely on the case, but do we know for sure that the "leak" is legit?
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I've heard several quotes from reputable investigative sources which are consistent with the leaked contents. It's possible that someone took the quotes and reverse-engineered them to fit a manifesto, of course. It's a pretty bland manifesto, come to that. Like, borderline boring.

It should also be noted that there are at least two entirely different ones floating around. The one that is 'credible' reads like an unimaginitive summation of the healthcare situation. Pretty dry. Another has a more personal backstory of a suffering mother, with lots of details about relatively low healthcare costs (the author is crying about a $180,000 treatment, as if that would be a blip on the multi-millionaire mother's radar).
 
Thermal said:
(...) The one that is 'credible' reads like an unimaginitive summation of the healthcare situation. Pretty dry. (...)
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Probably because it's more like a 'users manual' to the investigators of his crime rather than a manifesto to inspire followers or copycats.
Kind of, 'In case you're wondering about my motive this is it!'
It reminds me of suicide notes from from people who want to make it easy for whoever finds the body and has to deal with the mess left behind.
He appears to have had the realistic assumption that he might get killed by the police instead of arrested.
 
Thermal said:
Serious question: how many Americans in the north of a quarter million a year income bracket will be on board with their massive salary cut to make this work?
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The kind of healthcare providers who are genuinely interested in improving the health and well-being of their fellow human beings. Many doctors are. Consider people like the guys at Science-Based Medicine, for instance.
To me they come across as people who are much more interested in that aspect of their profession than in the yachts and other material benefits they can get out of being doctors.
 
dann said:
The kind of healthcare providers who are genuinely interested in improving the health and well-being of their fellow human beings. Many doctors are. Consider people like the guys at Science-Based Medicine, for instance.
To me they come across as people who are much more interested in that aspect of their profession than in the yachts and other material benefits they can get out of being doctors.
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You will always have good people in any system, however fractally broken, of course. We have damn good cops over here in the States, too.
 
dann said:
Probably because it's more like a 'users manual' to the investigators of his crime rather than a manifesto to inspire followers or copycats.
Kind of, 'In case you're wondering about my motive this is it!'
It reminds me of suicide notes from from people who want to make it easy for whoever finds the body and has to deal with the mess left behind.
He appears to have had the realistic assumption that he might get killed by the police instead of arrested.
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He still pisses me off. With a teeny tiny bit of thinking, He would never have been caught, I am sure.

It was interesting that he said that his back injury stopped him from both surfing and... let's say his romantic life. First off, I totally get that. But I'm wondering if that's why he totally let his guard down and flirted with the hostel woman? When ya ain't getting none, a brother will act in ways that aren't conducive to survival.
 
I don't think we are. Flat tax is flat tax.

The poor generally don't pay tax. When you are struggling to eat, the government has this gig where they don't tax what pittance of income you manage to scrape up. A, say, 15% tax is taking much needed food off their table.

The rich pay up to 36% (I think is the top bracket nowadays, although it should be much higher). A 15% flat tax is a freaking 50% tax break.

ETA: or did you mean like a national sales tax? Different, but similar problems.
 
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3point14 said:
Are you telling me the market doesn't work??!?!?
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I'm telling you that the market doesn't work.

The major components that makes markets work are freedom, the availability to choose, informed consumers and competition. The Healthcare market doesn't offer any of them. Patients at best are only marginally informed. Even if they fully understand their condition, the treatment they have no idea of prices for treatment. The insurance companies and Healthcare providers make it absolutely impossible to understand so a patient can choose between competitors.

For all the free market capitalist arguments, the industry has done everything in their power to eliminate anything remotely resembling actual free markets.
 
San Francisco PD says they IDed Luigi four days before he was caught, recognizing him from the missing person report that his mom filed.

I'd seriously like to know if mamasan is going to claim she hadn't seen the pics of her son, or didn't recognize him (when complete strangers did).
 
Thermal said:
San Francisco PD says they IDed Luigi four days before he was caught, recognizing him from the missing person report that his mom filed.

I'd seriously like to know if mamasan is going to claim she hadn't seen the pics of her son, or didn't recognize him (when complete strangers did).
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I think this all went down fast enough and there would be a powerful urge to be in denial about your son killing someone that I won't be too hard on that score. I never saw a picture of hem prior to his getting caught, so its not even that crazy an idea that she hadn't. I get all my news from podcasts and this forum rather than TV or newspapers.
 
acbytesla said:
My guess it was simply me with too many windows open and not paying attention

But back to the ramifications of the murder of the Healthcare Insurance executive. Health Insurance is about collecting as much as possible in premiums and paying out as little as possible in claims and expenses. We are paying them to shuffle paper and little else. Oh and provide dividends to shareholders.
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I keep seeing people make comments like this... and it's just not true. Health Insurance in the US is the only industry that has it's profitability capped by law. Insurers are required to pay a minimum of 80% of their premiums out as direct medical costs. That leaves 20% to pay premium taxes, usage fees, and ALL administrative costs including salaries and compensation for their employees. It the rolling 3-year average ends up being less than 80%, insurers are required to pay that money back to their policyholders.

It may be hard to believe (especially with some publicly traded companies doing some dastardly things) but most of the prior authorization requirements, denials, etc. are in place to prevent abuse by doctors and hospitals, and to control costs so that the premiums can remain as low as can be reasonably done.

The reality is that the underlying costs being charged by providers when combined with increases in how often people use care have been steadily rising at around 7% per year since I entered this field over 25 years ago. That premiums do NOT rise quite as fast is due to insurers constantly trying to negotiate lower prices on behalf of their policy holders, and putting in place programs to minimize fraud, waste, and abuse.
 
ahhell said:
I think this all went down fast enough and there would be a powerful urge to be in denial about your son killing someone that I won't be too hard on that score. I never saw a picture of hem prior to his getting caught, so its not even that crazy an idea that she hadn't. I get all my news from podcasts and this forum rather than TV or newspapers.
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Possible. But if you just filed a missing person report on your own son, seems like you might be paying attention to the news a bit more than casual forum posters?

I'm still stunned that like 40 people wouldn't have quickly said "hey that looks just like Luigi" on day 1, or someone said to his mother "hey, doesn't this look like your missing son?" Admittedly, I'm not good with faces (people thing) but others seem to have little problem equating the NYPD pics with the Altoona guy.
 
Thermal said:
San Francisco PD says they IDed Luigi four days before he was caught, recognizing him from the missing person report that his mom filed.

I'd seriously like to know if mamasan is going to claim she hadn't seen the pics of her son, or didn't recognize him (when complete strangers did).
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The moment the photo from the hostel it became a 95%+ probability that he would be identified and caught quickly.

As for the question of the mother. What does that matter? What mother would want to believe their son is a wanted assassin? Even if she saw it, the probability of her being in denial is high.
 
dudalb said:
I just have to repeat, approve violence just be prepared for the consquences.
Start this kind of thing, you can't stop it easily.
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One of the consequences of the social-media approval of this assassination is that health insurance workers throughout the US have been subjected to threats and harassment. Some of you might be just fine with health insurance executives getting death threats because you believe they're all evil... but it's not limited to just executives. Customer service representatives have been threatened too, and seriously, they're just people with a job.
 
dirtywick said:
any particular reason why insurance companies aren't spending more time and energy on negotiating prices with doctors, hospitals, equipment, and pharma companies to keep costs down instead of simply shrugging their shoulders instead of simply passing along the costs to their customers? shouldn't somebody be on patients sides here? then what the hell are we paying them for? they seem to be adding a layer of extra cost and doing nothing for you.
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They DO spend a whole lot of time trying to negotiate prices.

There are some serious barriers. One of them is the consolidation of provider groups. In my area, we've got three large hospital groups that have been buying up the independent hospitals over the past several years. Once they've been bought, those large groups then ask for double-digit increases from insurance companies. In a lot of cases, insurers do their damnedest but cannot actually say no because there aren't any other hospitals in that area.

My company had a situation last year where the only hospital in a more rural area got bought by a large hospital group, then they asked for a 30%+ increase. Our network negotiators spend six months arguing them down... and ended up settling at 23%. The hospital group put out a press release trying to make it sound like the insurer was trying to gouge the customers, and didn't want to pay for necessary care... but the quality ratings for the hospital were pretty low, and their rate hike would have necessitated a massive increase in premiums for customers. But simply saying no and walking away wasn't an option - they're the only hospital in that region. Without some kind of contract with them, my company would have been unable to provide insurance to anyone in that entire county, because we would fail to meet adequacy requirements put in place by the federal government.
 
Thermal said:
They're in a game of freaking multiple trillions though, man. Their profit range, from what I've read, is in the single percents. If they dropped premium prices by 5%, they be bankrupt immediately. Yes, the raw numbers seem huge, but as I understand it, there's really not a whole lot of wiggle room.
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Average profit margin on insurance companies in the US is around 3%. It varies year to year, but if an insurer makes more than 5% that's a serious exception.

It's also important to understand that insurers are required by law to carry a high amount of capital as reserves - and the margin is substantially used to contribute to that capital. Capital gets used to upgrade technology, facilities, etc. But we're also required to hold a substantial reserve so that if we have a bad year (pandemic, for example, or major environmental event that puts a high concentration of people in the hospital with traumatic injuries, or just plain things going wrong) we can cover our contractual obligations to our policyholders.

Contrast that with Pharma and Device manufacturers who routinely make 20% to 30% margin year over year. And NO that's not being eaten up by R&D. Most of the R&D costs are administrative expenses deducted prior to profits being reported.

Some hospitals have had a rough couple of years - Covid had some definite impacts on doctors, nurses, etc. But prior to that, most hospitals (not all) ran at double the margin that insurers make.
 
acbytesla said:
The moment the photo from the hostel it became a 95%+ probability that he would be identified and caught quickly.
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Like I was saying earlier, I don't see much resemblance between the hostel pics and Luigi. Even the AI rendition was literally not even close.
acbytesla said:
As for the question of the mother. What does that matter? What mother would want to believe their son is a wanted assassin? Even if she saw it, the probability of her being in denial is high.
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She was literally searching for her missing son. I don't think she'd have any denial radar working.

And seriously: not one family member or acquaintance recognized him? That's a tough sell, if complete strangers had success.
 
alfaniner said:
Going back to the dentist today for a broken crown I thought -- great we got all that worked out earlier in the year for another issue, I've paid my deductible already, and I should be covered well.

They'd already taken the tooth impression and the insurance coordinator comes in and says "They say you don't have an account." Same ◊◊◊◊◊◊◊ thing they tried earlier this year, and I god damn well have an account. Now I have to wait maybe a few more weeks for the paperwork to go through, again, and it will probably go into next year when I have to start with the deductible again. So I can understand ire with insurance companies.
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Talk to your insurer now. If the service occured this year, it should absolutely NOT fall under your 2025 deductible. Costs should always be allocated to the date of service, and the coverage in place at that time.
 
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