The Grand Illusion
So often in my life, I’ve heard, or overheard, phrases along the lines of, “It’s not personal; we need to make a change…” Or it’s not personal because corporate headquarters, or the state legislature, or someone else cut the funding. It might not be “personal” because the business is failing.
But whatever the cause, to the person or people affected, it’s personal; it’s very personal.
And for large corporations, such as United Healthcare, it’s definitely never personal. It’s just about the need to maintain profit, and whether the so-called “impersonal” axe falls on employees being let go or policyholders not getting the benefits they paid for, the corporation seldom, if ever, considers the personal costs.
Yet, in a way, many of the “personal decisions” are in fact personal, just not in the way most people would consider personal. Corporate profit increases tend to boost the price of the stock, and, in the case of most CEOs, increasing profits and stock prices increase their compensation. According to the latest publicly reported information, Brian Thompson was paid slightly more than $10 million annually. But his salary was only one million dollars. The rest, 90%, came from stock, stock options, and bonuses.
So those decisions on how to raise profits had a decidedly personal effect on Mr. Thompson. He may not have considered the algorithms “personal,” but they not only increased the negative effects of healthcare denials and delays on policy holders in order to increase profits., but also significantly increased his personal compensation.
Not personal… really?
Most CEOs suffer from a lack of empathy. Unfortunately, it rarely bothers them. For most people if they haven’t met a person, they don’t count as real. They are just a number. I have watched companies let people go by the hundreds and not care but if at that same company they let someone in the inner circle go there a lot of anxiety and often extra expressions of regret and significant compensation.
Comments at times like you mention are usually said to themselves and not to the person suffering. Most people have some level of empathy and use coping mechanisms to ease their discomfort in difficult situations. To deconstruct it, “it’s not personal” means I am doing you wrong, but I don’t want to think about it or let it make me feel bad.
Part of any dehumanizing activity is to make it easier to do horrible things because the victims aren’t real people. At any company especially large insurance companies, people are accounts or case numbers, and they don’t have a name. Therefore, what is done to them doesn’t count.
Dan Davies talks about “accountability sinks” in his book The Unaccountability Machine, when managers set up institutional policies and procedures specifically to make it so that no one has to take personal responsibility.
The managers all get their bonuses from these same policies.
The last time a manager told me, “Don’t take it personally,” my instant reply (I’d had years to work it up) was, “I’m a person. How am I supposed to take it?”
Retirement is so much better, and not just because I don’t have to commute.
Cory Doctorow covers the health insurance story in more depth.
The link got stripped out:
https://pluralistic.net/2024/12/09/radicalized/#deny-defend-depose
Joe, thanks for that link. I think Doctorow says it all and does so elegantly. I have wondered the same regarding politicians – especially in recent years.
Saying it’s just business is the worst kind of copout. I can’t put it better than Michael Corleone did just before he went to go kill Sollozzo…
“…Tom, don’t let anybody kid you. It’s all personal, every bit of business…. They call it business, OK. But it’s personal as hell. You know where I learned that from? The Don. My old man. The Godfather.”
Billy Crystal put it even more succinctly in “Analyze This” when the mafia don played by Robert DeNiro assigned one of his henchmen to kill Crystal’s psychoanalyst character and the mobster insisted it wasn’t personal. Crystal responded simply, “Oh, don’t kid yourself, Jelly. This is as personal as it gets.”
United Health seems to have lost 100 million Americans’ identities:
https://techcrunch.com/2024/10/24/unitedhealth-change-healthcare-hacked-millions-health-records-ransomware/
Nebraska is suing:
https://techcrunch.com/2024/12/18/nebraska-sues-change-healthcare-over-security-failings-that-led-to-medical-data-breach-of-over-100-million-americans/
The fact that Mangione got sympathy for his action pretty well shows how CEOs of Healthcare, esp are seen by many as ghouls. Having had issues with getting approvals myself, I know how I felt when I read about it. I doubt anything will change the policy of delay, deny, defend, however.