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ALPERN AT LARGE - Brian Thompson, [who was fatally shot], was the man that Luigi Mangione should have grown up to be. Luigi Mangione was the man Brian Thompson once was.
Half Thompson's age, Mangione actually followed in Thompson's footsteps...all the way until Mangione literally followed Thompson's footsteps and killed that good guy, with Mangione becoming a bad guy in the process.
They were both good-looking, handsome, honor school athletes. Both well-rounded individuals who boasted extraordinary academic achievements and boasted above-average physical prowess that made them both respected and admired by all who knew them...and probably both the kind of man a woman would want to marry some day.
Heck, they in many ways look alike—Luigi Mangione could have easily passed as Brian Thompson's son.
And both Thompson and Mangione wanted to extend health care to the ordinary Joe/Jane American who we all know as friends, family members, and neighbors.
But that's where the similarity ends—Brian Thompson was a class president, valedictorian, homecoming king, college scholar, all-state trombonist, active in supporting children-focused charities such as the Special Olympics, and a fierce fighter to extend health care to disadvantaged, Medicaid, and Medicare populations.
Luigi Mangione was a valedictorian, athlete, a head counselor at a pre-college program at Stanford, and he came from a wealthy and philanthropic family who was no stranger to doing good.
Then Mangione chose, not just in a fit of passion but in a planned attack, to hunt the more accessible (and probably trusting) Thompson, and then shoot him dead without warning from behind.
The farm boy who did good was cruelly (and stupidly) killed by the frat boy gone bad.
This angry young man who could have lived his life better, fighting for what the older man's life was all about (helping spread health care to underserved populations and provide benefits not heretofore available to them), has effectively ended not only one but both lives.
Let me explain something really quick—some of you will get it, and some of you will never get it—but both medicine and the business behind it is knowing when to say “no” to some with unrealistic and inappropriate demands in order for the majority to hear “yes” to medical demands which actually are realistic and appropriate.
I work with Optum Medical Group (speaking only for myself), which is owned indirectly by United Health Care, with indirect ownership allowing most individuals who see me for dermatology/skin cancer/eczema/acne/psoriasis/infections and the like can still see me and my team if they switch insurances so they need not change doctors.
I call out the group when I see bad operations, but on this one I don't know of ANYONE who felt the slaying was in any way justified, moral, smart, or with good outcomes.
Whether you reading this or not, the government (coupled with health plans) in a bipartisan fashion just cut and slashed physician payments for a few years, so that the “donut hole” faced by seniors can be managed to ~$2000 a year, and allow they both get medicine, afford a home, and eat.
The government (coupled with health plans) fought for very safe medications (such as the nonsedating antihistamines and acne medications) can be more cheaply purchased by a person over the counter without having to see a doctor and pay ten times more.
The government (coupled with health plans) fight to limit the costs of both old and new medications so that more can access them without healthcare premiums becoming unaffordable to us all.
My most well-read CityWatch article, referencing the “Doxycycline Debacle”, address price-gouging by generic drug manufacturers for medications that cost pennies to make. I always have and still despise inappropriate profiteering to the suffering of the greater population.
But there are gazoodles of doctors and patients who knowingly ask for medications costing $45,000 or more per year when a $2000 per year drug will take care of the problem with equal results. Patients need to be triaged to best figure out who needs a surgery or procedure now...all during a historical lack of doctors and nurses.
My dermatology team and I both fight for better care, better subspecialists, and better access (often elbow-swinging in ways our bosses don't always like) but also fight to get to the most ill, miserable, and endangered first (overbooking skin cancer surgeries, keeping people out of the emergency room, etc.).
Our sentiments are shared by many, and even those we spar and debate with. As much as I imagine my medical group tires of my bloviating and finger-wagging it does, overall, respect and appreciate and support our efforts—we all know that one cannot teach a person to genuinely care about others.
And Thompson definitely and genuinely cared about others. In some way, shape, or form, he was one of my higher-ups/bosses, and perhaps he would have appreciated my ongoing efforts, and/or he would have been annoyed by my “gadfly” crusades.
But Thompson had his own selfless crusades, and if it's makes anyone reading this feel better, he like everyone in his pay grade probably got half or less after taxes (ever wonder why athletes and celebrities want to be paid so damn much so they can actually keep half their official salary?).
And does Thompson's wife and children have ANY say in THEIR “denial of coverage” of a wife and father at Mangione's hands?
I don't know if Mangione thought he could get away with Thompson's murder, or if he was willing to sacrifice himself for what he thought was the good of America's health, but I can relate to Thompson because I fight within our screwed-up system to get RESULTS!
But Mangione's results? This handsome scholar/athlete/crusader just cowardly and ignorantly slew a man who led United Health Care's efforts to assume coverage of Medicaid and Medicare populations. These populations comprise groups that many if not most other health plans won't touch with a ten-foot pole.
So to witness Saturday Night Live Weekend Update host Colin Jost mention Luigi Mangione's name, with many in the audience responding with a high-pitch cheer for Mangione the likely murderer, it's no wonder that:
Independent talk host Piers Morgan (LINK: https://www.yahoo.com/entertainment/piers-morgan-calls-snl-audience-195259068.html) decries this cheer, which by the sound of it probably comes primarily same demographics as the roughly 40% of 18-to-29 year-olds who support Mangione and his coldhearted murder.
And for the hordes of teenage girls and women who looooooooooove Mangione because of his beautiful hair and ripped abs...well, someday Mangione could have, and should have, been a Thompson-like figure you'd want to want to marry and have children with when YOU are 50 or so years of age.
We should all think about that when some one raises the history of why we allowed the minimum voting age to drop to 18 years of age (“if you're old enough to die in Vietnam, you're old enough to vote).
Maybe we SHOULD consider returning to the 21-year-old threshold for those not serving in the military.
Because many of our youth, as tech-savvy as they are, need to recognize the difference between good and evil, between smart and stupid, and between fighting the difficult fight versus surrendering to self-immolation and defeat.
We could have, and should have, had both gifted men—Thompson and Mangione—fighting for the health and well-being of all Americans.
And now we will have neither.
(Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father. He was active for 20 years on the Mar Vista Community Council (MVCC) as a Board Member focused on Planning and Transportation, and helped lead the grassroots efforts of the Expo Line as well as connecting LAX to MetroRail. His latest project is his fictional online book entitled The Unforgotten Tales of Middle-Earth, and can be reached at [email protected]. The views expressed in this article are solely those of Dr. Alpern.)
