In the United States, where gun controls are far too few and unchecked guns are generally okay, even celebrated, such political determinants of health have constantly terrible impacts. Guns have one purpose: to kill. Such political determinants of health have determined that anyone can be shot dead or injured with a gun at any point and because no Medicare for All program exist, the political determinants of health have also determined that any of us could be stuck with an impossibly large stack of medical or funeral bills.
Because our society allows guns, children regularly die at school, as happened again on Monday, December 16, 2024, in Madison, Wisconsin. This tragic event left three dead, including the teenage shooter, and at least six were injured. And Brian Thompson, the infamous CEO of United Healthcare who died on December 4, 2024, also died because our society allows guns.
Gun deaths prompt grief—almost all gun deaths are “stupid deaths,” unnecessary deaths using Paul Farmer’s language—but grief has different manifestations. Grief looks different depending on the context. When children are among the victims, people are often collectively outranged and upset (for about five minutes before forgetting and moving on to the next breaking news story). When a friend or family member is the target, people may be devastated and depressed. And as we are seeing with the death of Thompson, when the person left dead has caused suffering and further represents and stands-in for all the other CEOs and politicians who contribute to inequality and much that is harmful to the nation, people are almost glad in a sense and see it as a form of karma, understandably.
Anyone who is “very online” knows that social media has recently been full of comments about guns, Thompson, and all things healthcare. Many fantastically heart-felt articulations of the injustices caused by the for-profit healthcare insurance industrial complex continue to fill my newsfeeds.
In more ordinary circumstances, the ones that utilize rhetorics of mocking and that are even celebrating Thompson’s death would probably be shocking and deserve condemnation. However, after Thompson—an individual in charge of creating and enforcing detrimental political determinants of health—was killed, we have all been reminded that people can only be disregarded for so long until their raw feelings manifest in new and surprising ways. (To be clear, I am not advocating for violence. And Thompson certainly has friends and family who are traumatized by his untimely death.) People want their stories to be heard. As a colleague put it long ago, “feelings are neither right, nor wrong, but how you act on them can be.” People’s reactions are valid and just that. People sometimes have parasocial relationships—intense, one-sided relationships—with actors, not with CEOs, so naturally they are unlikely to experience much personal sadness. And people aren’t likely to mourn in conventional ways when someone who has caused so much hurt is then also hurt.
Healthcare insurance CEOs add to their pocket by charging unnecessarily high monthly premiums (as evidenced by their salary and their companies having record-breaking profits), by refusing to pay healthcare providers fair rates, by bankrupting families, and by denying just coverage. One social media post put it: “‘Your claim is denied’ is the new ‘let them eat cake.’” Healthcare insurance CEOs effectively murder unsuspecting, often defenseless people at their mercy the same as shooters murder the unsuspecting and defenseless with a bullet. These CEOs don’t directly murder people needing healthcare, but they come close. They perpetuate passive murder and go unpunished. They also cause people to worry and suffer while profiting from the misery when they could easily create positive political determinants of health by helping to provide every avenue possible to promote health, wellness, and access.
Andrew Joseph Pegoda, PhD, MA, MA, (@AJP_PhD) is a Lecturer of Women’s, Gender, and Sexuality Studies at the University of Houston and a Bioethics and Health Policy graduate student at Loyola University Chicago.
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