What is it about the American health care system that deranges so many people? I'm not just talking about the man who allegedly murdered UnitedHealthcare CEO Brian Thompson. I'm also concerned about the performative sociopaths who unleashed a tide of glee on social media, abetted by what you might call the "yes, but ..." brigade: Yes, violence is bad, but so are insurance companies who deny claims.
The latter's ranks included academics, journalists, television personalities and Sen. Elizabeth Warren, D-Massachusetts, who told HuffPost that "violence is never the answer" before adding "this is a warning that if you push people hard enough, they ... start to take matters into their own hands."
Warren later said she "should have been much clearer" that murder is never justified. But what was she thinking in the first place? The attempt to use a murder to start a national conversation on health care was madness on every level: to treat assassination as a policy choice, to identify with the actions of someone who seems to be having some sort of mental health crisis and to suggest that these actions reflected the popular will.
The U.S. health care system is in many ways frustrating, and many of its failings are unique to our complex and fragmented system. Americans frequently ping-pong between a bewildering array of public and private insurers, none of whom are good at talking to each other, or our providers.
People are annoyed that they can't find doctors who take their insurance, mad that none of their physicians seem to know what the other doctors are doing, mad about "surprise billing" from specialists they didn't know were out-of-network. They are mad about insurance companies refusing to cover treatments their doctors recommend, and aghast at the monstrous expense of it all: In 2022, the United States spent 17% of its gross domestic product on health care.
However wrong those in the online left were to celebrate Thompson's death, they were right that these frictions make people unhappy, and some of them would go away in a more centralized single-payer system. (Though we pause to note that surprise billing was already mostly outlawed in 2022.)
They're still wrong, however, to assume that Americans are overwhelmingly miserable with what we have now, and would be happier if only the government took over.
Single-payer systems have their own frustrations. Starting with the taxes to pay for them: Denmark's top marginal rate of 55.9% kicks in for incomes roughly the U.S. equivalent of $82,000 a year. Nor do those systems give you all the care you need, at little or no cost to you, as many leftists seem to believe. An Organization for Economic Co-operation and Development report in 2019 found that Americans actually pay an unusually low share of their health care costs out of pocket, and data from the Commonwealth Fund show that we are less likely than people in Britain or Canada to wait more than two months for surgery or specialty care. While some of our extra spending pays for administrative bloat, our higher bills often also pay for higher quality.
Oh, sure, Americans tell Gallup pollsters that the system is terrible -- only 31% have a positive view of our health care industry. But 92% of people in this country have insurance (and of the remaining uninsured, about one-third are noncitizens). Insured Americans are quite satisfied with their own coverage, with 81% telling KFF it is "excellent" or "good."
In an Ipsos survey of 28 countries in 2023, Americans ranked near the top in calling the quality of their health care "good" or "very good," and were in the middle of the pack when asked whether they were satisfied with their government's health-care policies -- ahead of France, Sweden and Britain.
None of this points to a groundswell of suppressed rage. Ahead of last month's election, just 3% of Americans told Gallup that health care was the most important issue facing the country, well behind poor government leadership (21%), immigration (20%), the economy in general (17%) or inflation (11%). If someone had decided to shoot the Fed chair, the treasury secretary or the head of Immigration and Customs Enforcement, how many senators, or online leftists, would have explained that this was only to be expected, given how frustrated everyone is?
To return to the question of "Why does the health-care system derange so many people?" -- the answer is that it doesn't. It deranges a handful of folks who have mistaken social media for the real world. It would be better if all of them, and especially any U.S. senators, put down their phones and had more contact with reality.
Megan McArdle is a columnist with the Washington Post Writers Group.