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Comment by imiric | Hacker News Reader

The people in these industries are collectively responsible for millions of preventable deaths, and they, their families, and generations of their offspring are and will be living the best lives money can buy.

And yet one person kills a CEO, and they're a terrorist.

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Large and complex systems are fundamentally unpredictable and have tradeoffs and consequences that can't be foreseen by anybody. Error rates are never zero. So basically anything large enough is going to kill people in one way or another. There are intelligent ways to deal with this, and then there is shooting the CEO, which will change nothing because the next CEO faces the exact same set of choices and incentives as the last one.

Well, given what you said, one obvious mechanism is to cap the sizes of these organizations so that any errors are less impactful. Break up every single company into little pieces.

That doesn't really help because the complexity isn't just internal to the companies, but also exists in the network between entities that make up the industry. I may well even make it worse because it is much harder to coordinate. e.g. If I run into a bug cause by another team at work, it's massively easier to get that fixed than if the bug is in vendor software.

In terms of health insurance, which is the industry where the CEO got shot, we can pretty definitively say that it's worse. More centralized systems in Europe tend to perform better. If you double the number of insurance companies, then you double the number of different systems every hospital has to integrate with.

We see this on the internet too. It's massively more centralized than 20 years ago, and when Cloudflare goes down it's major news. But from a user's perspective the internet is more reliable than ever. It's just that when 1% of users face an outage once a day it gets no attention, but when 100% of users face an outage once a year everyone hears about it even though it is more reliable than the former scenario.

Pretty predictable what happens when you deny coverage for a treatment someone needs

But do they need it? How do you know? And don't say because the doctor said so, because doctors disagree all the time. When my grandfather was dying in his late 80s, the doctor said there was nothing he could do. So his children took him to another doctor, who said the same. And then another doctor, who agreed with the first two. But then they took him to a 4th doctor, who agreed to do open heart surgery, which didn't work, and if anything hastened his inevitable death due to the massive stress. The surgery cost something like 70 grand and they eventually got the insurance company to pay for it. But the insurance company should not have paid for it because it was a completely unnecessary waste of money. And of course there will be mistakes in the other direction because this just isn't an exact science.

At that point, why cover anything at all if the doctor could always be wrong?

Stupid question. If you have a better way to make decisions on insurance coverage then state it.

Why is it on me to come up with a new model for healthcare? I can acknowledge shortcomings of the present system without having to come up with solutions for them.

> Pretty predictable what happens when you deny coverage for a treatment someone needs

Other poster demonstrated that you have no idea what "need" is. So you also have no idea what a "shortcoming of the present system" is either, because how the hell would you even know?

People being denied treatment they need seems like a shortcoming of the present system.

It would be a clean and compelling narrative, if Luigi or someone he loved was denied coverage for a necessary treatment!

But that doesn't seem to be true at all. He just had a whole lot of righteous anger, I guess. Gotta be careful with that stuff.

Why does it matter if it personally occurred to him or someone related to him? It happens to plenty of people. You can have empathy for people not bound by blood.

Of course you can. But where does it stop?

There is a great deal of injustice in the world. Psychologically healthy adults have learned to add a reflection step between anger and action.

By all evidence, Luigi is a smart guy. So one can only speculate on his psychological health, or whether he believed that there was an effective response to the problem which included murdering an abstract impersonal enemy.

I'm stumped, honestly. The simplest explanations are mental illness, or a hero complex (but I repeat myself). Maybe we'll learn someday.

He could die quietly making no impact on the issue. Or he could sacrifice the rest of his free life to put a spotlight on the issue. That is what he chose to do. Not an easy decision I'm sure.

I'm not talking about unpredictable tradeoffs and consequences.

I'm talking about intentional actions that lead to deaths. E.g. [1] and [2], but there are numerous such examples. There is no plausible defense for this. It is pure evil.

[1]: https://en.wikipedia.org/wiki/Tobacco_Institute

[2]: https://en.wikipedia.org/wiki/Purdue_Pharma

Well those get handled. Perdue was sued into bankruptcy and the Tobacco Institute was shut down when the industry was forced to settle for $200 billion in damages.

So human lives have a price tag, and companies can kill millions for decades as long as they pay for it. Gotcha.

You say “a CEO” like it’s just a fungible human unit. In reality, a CEO is much much more valuable than a median human. Think of how many shareholders are impacted, many little old grey haired grannies, dependent on their investments for food, shelter and medical expenses. When you think of the fuller context, surely you see how sociopathic it is to shrug at the killing of a CEO, let alone a CEO of a major corporation. Or maybe sociopathy is the norm these days, for the heavily online guys.

The CEO literally is a fungible human unit. Any job can be learned.

In that case it also accomplishes nothing to kill him because another will just take his place. So either way you lose.

A message is certainly sent in the process that previously was going unheard.

"Former UnitedHealth CEO Andrew Witty published an op-ed in The New York Times shortly after the killing, expressing sympathy with public frustrations over the “flawed” healthcare system. The CEO of another insurer called on the industry to rebuild trust with the wider public, writing: “We are sorry, and we can and will be better.”

Mr. Thompson’s death also forced a public reckoning over prior authorization. In June, nearly 50 insurers, including UnitedHealthcare, Aetna, Cigna and Humana, signed a voluntary pledge to streamline prior authorization processes, reduce the number of procedures requiring authorization and ensure all clinical denials are reviewed by medical professionals. "

https://www.beckerspayer.com/payer/one-year-after-ceo-killin...

CEOs are not special humans. They know lots of people, but that's not an unusual trait.

When one gets fired, quits, retires, or dies, you get a new one. Pretty fungible, honestly.

But yeah, shooting people is a bad decision in almost all cases.

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