By Rabbi Yair Hoffman
The American legal system is an adversarial system – where opposing sides fight vigorously before an impartial judge or jury in order to best discover truth. From a Torah perspective, since it is very hard to find qualified people with a high moral compass, this is probably good for the country and also an effective means to get to the truth.
The problem is that there is another area that also has an adversarial system, and this is probably not good for the country and not an effective means of improving quality.
What is that other area? It could be that I do not know what I am talking about, but I would like to share a story that could give us some insight into the tragic murder of the United Healthcare CEO.
Someone woke up in the middle of the night with an extremely rapid heartbeat that would not go away until more than three hours later. That person made an appointment with a cardiologist as soon as he could. The cardiologist ordered an angiogram as soon as possible. The insurance company sat on it for a number of weeks before they approved the test. The problem was that just one day after the approval finally came in – that person suffered a widow-maker heart attack and although miraculously survived, sustained permanent damage to the heart with an injection fraction of twenty-five percent.
The other area now that has developed an adversarial system is, in this author’s view, is medicine. Yes, there are now two types of doctors. There are the doctors, who we will call the “Group A doctors,” that try to help and cure patients And there are doctors who we will call “Group B doctors” that deny or delay insurance coverage to save money for the insurance companies for whom they work.
Group A doctors spend an extraordinary amount of time dealing with insurance companies. They could be using this time to help other people. I do not know this for a fact, but I am not sure how many doctors went to medical school because they so much look forward to spend time on the telephone in conversations with Talmudic-level depth as to why one particular test is so much more effective and appropriate than a cheaper alternative test. Now don’t get me wrong, I enjoy conversations of Talmudic-level depth, but only in regard to the Talmud. Here, however, I doubt that this was a motivating factor in doctors attending medical school.
Group B doctors are hired by insurance companies to come up with arguments why the second level or third level test is warranted, and also to incorporate denials and delays. Why is this so? Because the more time that the insurance companies are holding on to the pre-paid money of insurance premiums the more interest they make.
In short, the adversarial system is good for the legal system, but absolutely horrific for the nation’s health system.
When I first heard about the horrific murder I was retrurning from a nuclear test that I had just gotten approval for after many weeks of my cardiologist fighting for. I imagined that if I was an FBI profiler, I would assume that the murderer was probably someone who lost a loved one because of a delayed or denied test.
This morning I heard that the bullet casings found near the victim had some writing on it. They said, “Deny”, “Delay”, “Depose.”
Of course murder is evil and very wrong. A point should never be made in this manner. Whoever has any information or suspicion about this eveil did should come forward. Is there another Ted Kaczynski, Unabomber killer here? Perhaps. In that case his brother came over and turned him in.
Here, however, this adversarial system in the medical field is wrong. I do not know of statistics, but I imagine people die or are permamently compromised because of the adversarial system in America’s healthcare. It also puts enormoous strain on our doctors and their staff, with no compensation for them.
Hopefully, the new adminsitration coming in will try to address this problem and resolve it. May the murderer be caught and may the country move forward in finding a better system. Some people erroneously read this as justifying a murder. Heaven Forbid! Even putting forward this suggestion is highly disturbing.
It is rather giving a different theory as to who could be behind such a horrific murder. Some people have suggested that the CEO was murdered because others were afraid that he would reveal incriminating evidence against them. I am suggesting that there is the idea of a possible Unabomber copycat. The writing on the shell casings point more to this theory than to the other one. If the unabomber theory is correct then there are other people at risk as well, heaven forbid. May Hashem protect us all.
The author of this op-ed can be reached at [email protected]
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8 Responses
That is a terrible story. Hashem should give you a Refuah Shleimah b’soch she’ar cholei Yisroel. I continue to daven for יאיר ניסן בן שרה.
When Rav Isser Zalman Meltzer was engaged to his future wife, he contracted tuberculosis. The Kallah’s family wanted here to break the engagement, but she still wanted to marry her chosson.
She traveled to the Chofetz Chaim who told her that some people are healthy, and some people have אריכות ימים, and that she should go ahead with the שידוך. Rav Isser Zalman lived a full life, I think into his 80s.
Hashem should grant you too אריכות ימים!!
I was just yesterday calling our insurance agent bemoaning my issues with untied healthcare being so difficult to deal with. Spending 30k a year to be ignored and denied is not fun.
My coworkers were glad i had an alibi…
Murder is terrible.
I also hope the insurance companies wake up.
We have a friend who is addicted to pain medication cos her insurance pushed off surgery for a yr. They won a huge settlement from Healthnet. But thats being used up for in and out high end residential drug rehabs.
I would agree with R Hoffman’s own statement that he doesn’t know what he is taking about.
I see your point, Rabbi Hoffman, but I disagree with the theory you presented. Based on news reports, a more likely explanation is that this tragedy was tied to insider trading. It seems he may have been ready to expose data on high-profile individuals, and they eliminated him to protect themselves. While the issues with the healthcare system are real and urgent, I think this case might have a different, darker context with high-level individuals.
Rabbi Hoffman is 1000% correct
No matter what the motive of this particular incident were, the behavior of the insurance companies are disgraceful and dangerous. People who deal with them have a right to be upset. And we know there are people who have a hard time dealing with other people or institutions who bully them until they feel they have nothing to lose and become maniacs
The unabomber’s name was Ted Kaczynski not Koznianski.
No need to make him Jewish sounding.
People are upset at insurance companies, but no one ever complains at the billing staff at the doctors and hospitals who are rarely competent and frequently bill incorrectly (to the tune of 90% incorrect billings in some hospitals). Why should I be billed, or my insurance be billed and deny a bad bill? Let’s start at the top.
Everything you say about the medical system might be true, but its still not necessarily so bad, for the following reason.
Abot 30 years ago, there was an extended doctors’ strike in Israel. The mortality rate during that time DROPPED by 30%. This means that the modern healthcare sysytem is practising dangerous medicine. Approximately one third of hospital beds are taken up by people who are suffering iatrogenic disease, or in simple English, have had a reaction to their prescribed medications. So if your insurance company refuses to give you a certain treatment, they may actually be saving your life, or keeping you healthier.
And by the way, the vast majority of standard tests result in no change in the treatment protocol, so there’s often no point in doing them.