Ghosts of the Gilded Age
Holding the healthcare industry politically accountable can create a safer world for all Americans, including CEOs.
About a week ago, when my father-in-law was in town for a Thanksgiving visit, my wife took him to the Home for the Holidays tour at the Clayton Mansion on Pittsburgh’s Eastside. Built by industrialist and financier Henry Clay Frick in the late 1800s, the Clayton provides a window into the life of American elites at the peak of the Gilded Age. In the industrial history of Pittsburgh, Frick is often cast in the role of bad cop to good cop Andrew Carnegie, whose name graces our city’s most beloved libraries and museums. A notorious enemy of organized labor, Frick called in the Pinkerton guards to break the Homestead Strike of 1892, a show of force that would leave at least ten dead. The mansion tour had left my wife and father-in-law with mixed feelings, both awed by the splendor of the Clayton but disturbed by the ruthless wealth extraction that made such splendor possible. “Did they mention the assassination attempt?” I asked, referencing the failed attempt by Russian anarchist Alexander Berkman to take Frick’s life in retaliation for the Homestead Strike. My wife didn’t recall the tour guide mentioning the incident on the tour, which is understandable. Political violence against rapacious capitalists was the stuff of another era, quite a downer when people just wanted to look at garland-draped chandeliers and ornate parlor organs. But as we discussed the outsized role Elon Musk was playing in the incoming Donald Trump administration and the fact that wealth inequality in the United States was once again approaching Gilded Age levels, we wondered how long until the violence Alexander Berkman unleashed on Henry Clay Frick would return with a vengeance on our 21st century Robber Barons.
We only had to wait a few days until we got our answer. Last Wednesday morning, UnitedHealthcare CEO Brian Thompson was shot on the streets of Manhattan by a gunman that police have identified as Luigi Mangione. Thompson would not be as lucky as Henry Clay Frick. He would die from the wounds inflicted by his assassin’s bullets. Shock and horror at the brazenness of the attack would soon be eclipsed by shock and horror at the callous and even giddy responses written online in the aftermath of Thompson’s death. Clickbait legacy media stories about outrageous social media reactions are often little more than annoying cultural background noise like an ear-piercing feedback loop caused when a microphone is placed too close to a speaker. News outlets run stories aghast at social media celebrations of a tragedy, causing social media to mock the pearl-clutching news outlets who then run more stories about the lack of civility on social media, and on and on it goes. All decent human beings know that Thompson’s death was an unqualified tragedy, but no one should have been surprised that there would be edgy 15-year-old Maoists on X dancing on his grave or making nauseatingly cutesy tributes to the dreamy smile of his supposed assassin.
But there was more to this story than just the typical legacy media and social media feedback loop. Americans from all sides of the political spectrum were chiming in, recounting the suffering inflicted on their families by the health insurance industry. While not sadistically celebrating Thompson’s death, these reactions were not somber celebrations of the life Thompson lived or grateful memories of the impact he had on the lives of others.
A torrent of anger against the American “Healthcare Industry” had been unleashed, and justifiably so. Healthcare in the United States is an absolute disgrace. We pay almost double per capita for healthcare compared to any other country yet American health outcomes are worse than nearly any country in the developed world. To even call this a “Healthcare System” is a farce. The “health” of the American people is poor despite over 20% of our GDP getting sucked into healthcare. UnitedHealthcare Group, the parent company of Thompson’s UnitedHealthcare, became one of the top ten revenue producers in the world by aggressively denying the “care” Americans desperately need. Not only does this perverse economic arrangement promote neither “health” nor “care” it is also not a “system.” There is no rational structure of organizations ensuring Americans’ medical needs are provided for, just a patchwork of competing and colluding private interests extracting every dollar they can from the American people. It is not an “industry.” Unlike Henry Clay Frick’s U.S. Steel, healthcare insurance companies do not build anything like railroad ties, bridges, or beams that enable civilization to progress, they only suck up our monthly premiums and then tell us whether they will or will not give us anything in return during the most desperate and stressful moments of our lives. They are gatekeepers, tollbooth operators, basically legally sanctioned highwaymen who demand our tribute before we can proceed on our journey to healing. The only reason private health insurers exist at all is because they funnel their parasitic profits back into campaign donations and lobbying fees that they use to buy the favor of politicians from both parties. UnitedHealthcareGroup’s top five recipients of campaign donations in 2024 were Kamala Harris, the Republican National Committee, the National Republican Congressional Committee, Donald Trump, and the Democratic National Committee’s Service Corporation. UnitedHealthGroup has bought the complicity of both political parties so they can conduct their business with the most ruthless claim denial rate of any private health insurer. Brian Thompson certainly did not deserve to die, but the company he ran deserves every bit of the outrage that it is facing at this moment.
Outage is inevitable in any human society. In a properly functioning democracy, those who are outraged have nonviolent channels to seek redress for their injuries and promote reforms to prevent others from suffering their unfortunate fate. But when it comes to the question of healthcare in America, we do not have a properly functioning democracy. Despite every other developed country providing comprehensive healthcare to its citizens, Medicare For All is not a political question up for debate in 2024 America. Democrats who back universal healthcare programs that would put them in the mainstream of any other developed democracy are relegated to the lunatic fringe of their party, a level of marginalization on par with the QAnon wing of the GOP. When Democrats attempt “health care reform” it is uninspired, incremental changes that entrench rather than extrude the for-profit parasite from the American body politic. Barack Obama’s explanation of why he did not pursue a more cost-effective universal single-payer option for the Affordable Care Act shows just how weak-willed the Democrats are in their attempts at healthcare reform:
Everybody who supports single-payer healthcare says, “Look at all this money we would be saving from insurance and paperwork.’ That represents one million, two million, three million jobs [filled by] people who are working at Blue Cross, Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?
The hopelessness of seeking a political resolution to healthcare outrage is perfectly summed up in Obama’s admission that the Democratic Party lacks the courage and creativity to find other jobs for the millions employed in private healthcare, even if their current jobs are primarily dedicated to preventing other Americans from getting the care they desperately need. In Obama’s defense, he was facing a highly mobilized, richly-funded Republican opposition spreading lies that the corporate-friendly Affordable Care Act would lead to “death panels” run by the practitioners of “socialized medicine.” Considering the boom of private sector start-ups specializing in denying Americans life-saving care, it is obvious that the Republicans have no objection at all to death panels, as long as their friends and donors are making a profit while sending patients off to an early death. With Democrats serving as impotent apologists and Republicans as deranged defenders of for-profit healthcare, Americans currently have no viable political channels to voice their outrage at the predatory practices of corporations like UnitedHealthGroup.
“War is a continuation of politics by other means,” Prussian general Carl Von Clausewitz famously stated in On War, a classic work of military strategy. Looking at the development of human society, we can justifiably assert a corollary to Clausewitz’s famous quote, “Politics is a continuation of war by other means.” We become a civilized society when disputes between human beings are resolved through rational political dialogue rather than acts of violence. Thomas Hobbes justified the existence of government as a way to extinguish the “war of all against all” in our state of nature. Governments that do not provide peaceful political channels to ease outrage and resolve injustice invite civil war and acts of political violence. Henry Clay Frick’s failed assassin, Alexander Berkman, grew up in the Russian Empire where the Okhrana, the czar’s secret police, ruthlessly stifled all meaningful dissent. Berkman’s act of political violence against Frick was a spillover effect of his upbringing in a society where peaceful political resolution to issues like labor rights had been closed off by a vicious cycle of violence between government agents and factions of the radical fringe, acts of terror that would claim the lives of both Czar Alexander II and Aleksandr Ilyich Ulyanov, the publicly executed brother of Vladimir Lenin. As a cult of personality forms online around Brian Thompson’s killer and raises the risk of copycat violence against other CEOs, we should be wary of the parallels to the late 19th-century Russian radicals who justified assassinations on the doctrine of “The Propaganda of the Deed,” the notion that acts of violence prove the mortal vulnerability of elites and inspire common people to join in revolution. The way to avoid further violence against our 21st-century elites is to bring policies like universal healthcare and wealth taxes into our mainstream political discussion, not shame those who have aired their legitimate grievances against UnitedHealthcareGroup in the aftermath of Brian Thompson’s death.
Unfortunately, there has been no shortage of stories by mainstream media painting criticisms of our healthcare system as excuses for the murder of Brian Thompson. Explanations of the social conditions leading to killings are not the same as excuses for murder. When conservatives explained the Pandemic Era increase in murder rates on criminal justice reforms and “woke” DAs were they excusing those who pulled the trigger in those killings? When liberals explain the murder of transwomen by pointing to the stigma created by trans-exclusionary state legislation are they making excuses for those who take the life of another human being during a fit of transphobic sexual panic? I doubt the media would answer yes to either of these questions. Yet when Americans across the political spectrum voice their outrage at a for-profit healthcare system that has killed their relatives or left them bankrupt, we are told that those explanations of social conditions leading to the Thompson murder amount to excusing the cruelty of his killer. Disgusting online content celebrating Mangione or mocking Thompson’s tragic death should be condemned, but suppressing the brushfire of populist rage at our for-profit healthcare system will only increase rather than decrease the potential for further violence against CEOs. If Americans cannot voice their outrage toward for-profit healthcare at the ballot box, at least let them speak out against it online without the insinuation that they are excusing the murder of a man who did not deserve to die.
Whether our elected representatives and the legacy media decide to listen or not, the fires of discontent against for-profit healthcare and CEOs will continue to burn. We shouldn’t be shocked that some Americans are angry enough at the healthcare system to cheer the murder of a CEO. We should be disappointed that the Democrats didn’t channel that anger toward more humane and productive purposes, like winning the 2024 election on a Medicare for All platform. In 2016, the Democrat Party made a fateful decision, turning away from Bernie Sanders’ assertion that billionaires in general pose a threat to democracy to focus instead on the threat posed by just one billionaire in particular, Donald Trump. Failing to channel the American’s rage toward the billionaire class, Democrats only left independents more vulnerable to the phony populism of Trump’s MAGA movement and his false promise that only he was rich enough to be above the influence of campaign donations. There is no clearer proof that Trump is a fraudulent populist than his assembly of an administration that already includes 13 fellow billionaires.
Trump turning the federal government into a playground and cash machine for the billionaire class is both a threat and an opportunity for the Democrats, depending on whether they are willing to learn from the mistakes of 2016. Their decision to coddle corporate elites in a short-term strategy to boost campaign donations has led to them being driven out of power from all three branches of government while creating an increasingly destabilized American society where violence can seem like the only recourse for those whose loved ones have perished or whose finances have been obliterated by a politically unaccountable healthcare industry. Democrats must embrace the legacy of their late 19th-century Populist and early 20th-century Progressive forebears, who channeled the rage of those like Alexander Berkman toward more productive and peaceful ends like the establishment of the 8-hour work week, abolition of child labor, a federal income tax, and the breaking up of trusts and monopolies. The Populist and Progressive reforms made the world safer not just for industrial laborers but also for industrial capitalists like Henry Clay Frick. 21st-century reforms like Medicare For All and a Wealth Tax promise to create a world that is safer not just for healthcare patients but also for CEOs. A better world is possible where Americans can seek medical treatment without worrying about bankruptcy or dying prematurely from a claim denial, the kind of world where Americans can pin their hopes for justice on the courage of their elected representatives rather than the cruelty of an assassin.