In defence of the ‘Moral Economy’.
As published in the Western People, 17 December 2024
Luigi Mangione, a suspect in the killing of UnitedHealthcare CEO Brian Thompson, is escorted by police from an NYPD helicopter on Thursday, in New York, where he faces four counts of federal charges including murder (NPR, Amela Smith-AP)
The assassination of Brian Thompson, the powerful CEO of UnitedHealthcare has shocked corporate America. Thompson was gunned down in broad daylight on December 4 outside the Midtown Hilton Hotel, in Manhattan, where he was set to later address investors. In a premeditated attack, the killer, wearing a mask and wielding a silenced pistol, fired three shots at Thompson from behind, before cycling off into Central Park to escape. Five days later, police arrested 26-year-old Luigi Mangione in Pennsylvania for the murder. Mangione suffered debilitating back pain for many years but the media’s suggestion that his motive was borne out of a frustration with healthcare providers over his own condition is unlikely, as he was from a wealthy family.
Mainstream America has roundly condemned the murder with both sides of the political divide claiming the other’s rhetoric radicalised Thompson’s killer. Yet, Democrat and Republican politicians both criticised the outpouring of barely-concealed glee and anger directed against Thompson in his position at the helm of one of America's largest health insurers. A significant amount of ‘ordinary people’ on the right and left clearly empathise with the assumed motives of Thompson’s killer, signalled by the words “deny, defend, depose” written on shell casings left at the scene. This would seem to refer to the tactics of healthcare providers to avoid paying claims, echoing the phrase “delay, deny, defend” — the way some attorneys describe how insurers deny services and payment and the title of a 2010 book that was highly critical of the industry. Police also said Mangione’s notebook laid out a rationale which was ‘targeted, precise and doesn’t risk innocents’, focussing his retribution solely on Thompson.[1]
The USA is the only wealthy, industrialised country without universal health care, giving private health insurers an outsized role (and outsized profits). Instead, the country relies on a combination of private insurance, employer-provided plans, and government programs like Medicaid and Medicare. In 2022, only 36.1% of Americans were covered by public health insurance. Yet, compared to high-income tier nations, the U.S. has the highest healthcare spending per capita in the world, but ranks with the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, and the highest maternal and infant mortality.[2] Despite the reforms of Barack Obama’s Affordable Care Act, exorbitant medical bills still play a leading part in personal bankruptcies. Around 530,000 people report falling into bankruptcy annually, due partly to medical bills and time off work, according to a 2019 study.[3] It also has a chilling effect on Americans seeing their physicians, resulting in fewer doctors’ visits than in most other countries.
The whole aspect of the assassination of the CEO of the world's ninth-largest company by revenue, finds an eerie echo in the violent advocates defending the ‘moral economy’ of early nineteenth-century Ireland, against the advances of unfettered capitalism benefiting from the misfortune of ordinary people. This term was first coined by British social historian and political activist, E.P. Thompson (no relation) who argued that the many peasant riots in eighteenth-century England were not simply spontaneous reactions to hunger, but rather actions informed by a shared belief in defending traditional rights and customs. It extended beyond class boundaries and emphasised the defence of established economic practices and social obligations that were perceived as fair and just by the community. Thompson viewed the ‘moral economy’ as a system that was being ‘swept away by market forces’, highlighting the tension between traditional economic practices and the emerging capitalist economy which resulted in often-violent peasant protests.
Coinciding with an economic depression, 1816 was known as the ‘year without a summer’, when extreme weather caused by the 1815 Tambora volcano eruption in Indonesia resulted in famine conditions in Europe and up to sixty thousand people dying in Ireland during 1816-8. In February 1817, while Castlebar prison was full with debtors, 500 protesters from the ‘working and lower classes’, prevented the export of corn by Ballina merchants — by seizing grain-laden carts and presenting them at Colonel King’s residence. They demanded that this senior magistrate-landlord take action on the reneging on the social contract by local merchants, who were bound to the reciprocal obligations of long customary standing that corn should be consumed where it was grown, especially in times of scarcity.
Magistrates resorted to calling out the military who felt ‘compelled’ to fire on the rioting mob at Ballina Quay and James Gallagher, one of the leaders, was shot. Gallagher was of a higher social status from the neighbourhood of Crossmolina and thus would seem to advocating for the ‘moral economy’. Yet he was also known to authorities as a troublemaker and five years later, Gallagher was convicted for stabbing a man during an argument in Killala, with a butcher’s knife. His well-crafted petition of complaint addressed to the Chief Secretary seeking release from temporary imprisonment in Ballina, caused consternation for the local establishment who attempted to move him to Castlebar prison. However, the military refused to escort him fearing a rescue by his supporters as he had significant local backing. Without a regular confinement facility in Ballina and with his victim somehow recovering, Gallagher was judiciously set free.
The North Mayo elites were both dismayed and confused by the fervent support in the community for such a ‘notoriously turbulent character' as Gallagher, not understanding that his actions at Ballina Quay in defence of the ‘moral economy’, trumped whatever else he did. Just over 200 years and 3000 miles later, Luigi Mangione is being seen in somewhat similar light by many who regard his actions as advocating for a modern ‘moral economy’. To them, Mangione is acting against the legal but immoral excesses of capitalism, irrespective of the cold-blooded murder of Brian Thompson and that it will likely do nothing to fix the broken social contract between the government and ordinary Americans. Thompson’s killing and the subsequent public reaction to it reveals a deep resentment over the systemic grievances in the US healthcare industry and is to be ignored by the establishment at its peril.
[1] https://www.nytimes.com/2024/12/11/nyregion/luigi-mangione-assassination-plan-notebook.html ; https://apnews.com/article/unitedhealthcare-ceo-shooting-delay-deny-defend-depose-ee73ceb19f361835c654f04a3b88c50c
[2] https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022
[3] https://apnews.com/article/medical-debt-legislation-2a4f2fab7e2c58a68ac4541b8309c7aa