Dispatches from the Empire


How UnitedHealth Grew Larger Than The Biggest U.S. Bank

Denying Your Health Care Is Big Business in America

The Hidden Autopilot Data That Reveals Why Teslas Crash

What the Murder of the UnitedHealthcare C.E.O. Means to America

Of course, the solution, in the end, can’t be indifference—not indifference to the death of the C.E.O., and not the celebration of it, either. But who’s going to drop their indifference first? At this point, it’s not going to be the people, who have a lifetime of evidence that health-insurance C.E.O.s do not care about their well-being. Can the C.E.O. class drop its indifference to the suffering and death of ordinary people? Is it possible to do so while achieving record quarterly profits for your stakeholders, in perpetuity?

Thompson’s death resurfaced some unsavory details about his industry. We learned, for instance, that Thompson was one of several UnitedHealth executives under investigation by the D.O.J. for accusations of insider trading. (He had sold more than fifteen million dollars’ worth of company stock in February, shortly before it became public that the Department of Justice was investigating the company for antitrust violations, which caused the stock price to drop.) A new policy from Anthem Blue Cross Blue Shield also went viral: the company had announced that, in certain states, starting in 2025, it would no longer pay for anesthesia if a surgery passed a pre-allotted time limit. The cost of the “extra” anesthesia would be passed from Anthem—whose year-over-year net income was reported, in June, to have increased by more than twenty-four per cent, to $2.3 billion—to the patient. On Thursday, the company withdrew the change in response to the public outrage, if only in Connecticut, for now. It’s hard not to be curious about what, if anything, might happen to UnitedHealthcare’s claim-denial rates. I was at a show in midtown Manhattan on Thursday night, and when the comedians onstage cracked a joke about the shooter the entire place erupted in cheers.

Brian Thompson Was Never Content With the Status Quo

Andrew Witty, CEO of UnitedHealth, parent company of UnitedHealthcare:

We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better. We are willing to partner with anyone, as we always have — health care providers, employers, patients, pharmaceutical companies, governments and others — to find ways to deliver high-quality care and lower costs.

(Emphasis mine.) Bullshit. Your one and only mandate is to extract as much value for your stakeholders as possible, health and human life be damned.

Health care is both intensely personal and very complicated, and the reasons behind coverage decisions are not well understood. We share some of the responsibility for that. Together with employers, governments and others who pay for care, we need to improve how we explain what insurance covers and how decisions are made. Behind each decision lies a comprehensive and continually updated body of clinical evidence focused on achieving the best health outcomes and ensuring patient safety.

You've conveniently left out the mandate for profit generation, Andrew.

While the health system is not perfect, every corner of it is filled with people who try to do their best for those they serve.

Brian was one of those people. He was raised in the same Iowa farmhouse as his mom. His dad spent more than 40 years unloading trucks at grain elevators. B.T., as we knew him, worked farm jobs as a kid and fished at a gravel pit with his brother. He never forgot where he came from, because it was the needs of people who live in places like Jewell, Iowa, that he considered first in finding ways to improve care.

Pandering to middle America, ✔ 

The ideas he advocated were aimed at making health care more affordable, more transparent, more intuitive, more compassionate — and more human.

Fuck you, Andrew Witty.

I've said this before, but corporations are money-making machines. That's the sole reason for their existence: to generate profit for the stakeholders and shareholders. That's it. Dont ever fool yourself into thinking that any corporation has your best interest at heart — ever

Suspect in UnitedHealthcare CEO’s Killing Went Silent for Months. Where Was He?

Friends and family members have been left bewildered by the jarring transformation of a young man who had seemed destined for a life of achievement. He was the valedictorian at his elite prep school in Maryland and a computer science graduate of the University of Pennsylvania’s acclaimed engineering program, with wide-ranging social connections and significant ambition.

How could a person “destined for a life of achievement” possibly come to the conclusion that health insurance companies are immoral, unjust, and beyond the reach of the law?

Google’s AI-powered smart glasses are a little closer to being real

Google is working on a lot of AI stuff — like, a lot of AI stuff — but if you want to really understand the company’s vision for virtual assistants, take a look at Project Astra. Google first showed a demo of its all-encompassing, multimodal virtual assistant at Google I/O this spring and clearly imagines Astra as an always-on helper in your life. In reality, the tech is somewhere between “neat concept video” and “early prototype,” but it represents the most ambitious version of Google’s AI work.

Watch this video and enjoy being mildly horrified, both by how thoughtless this technology will make us if we needn't be bothered to remember our friends' taste in books and also by just how much data Google will be hoovering up about every single thing we do.

These types of interactions with AI will become anodyne in short order, especially in younger generations, but imagine the implications of a network outage on an entire generation of people who will have have needed to remember or learn anything. (I say this as a stan of the Reminders app. I use it all the time, for everything, adding reminders via Siri on every connected device I own, but yes, it's been somewhat detrimental to my ability to remember certain things. And yeah, I'd be rightly fucked if every Apple device I had went dark all at once. But boy, is it useful.)

Have you ever wondered how many people asked AI which candidate to vote for in the last election? Do you think that number isn't going to grow dramatically over time? 

Luigi Mangione Is Everywhere

Indeed, “Deny, Defend, Depose,” which is widely viewed as a pointed critique of the health insurance industry in America, has become a rallying cry online in recent days as the focus moved away from the shooting itself and onto the shooter and his motives.

However, the fictionalized version of the shooter that was created online does not match reality. Mangione, who allegedly had a handwritten manifesto admitting to the killing in his possession when arrested, is a software engineer from a privileged background. He also follows popular right-wing influencers, such as Tucker Carlson, Joe Rogan, and Jordan Peterson—though he has also criticized some of the arguments put forward by these figures.

During a brief court appearance on Monday night, the police did not outline a motive for the shooting, but based on Mangione’s online posts and reading lists, it appears that the pain from an injury suffered while surfing could have played a significant part in his motivation.

I don't understand the pearl-clutching in the wake of the shooting. The CEO of a healthcare company known for some really shady shit is not a moral person, no matter how respectable (read: wealthy, clean-cut, dresses like he's on a golf course) he appears. Brian Thompson decided profit was more important to him than the health of fellow human beings… So what are we mourning the loss of, exactly?

What about the justice system, you might ask? Well, fellow American, do you genuinely believe that the justice system holds people like Brian Thompson to task for their misdeeds? Does the justice system even consider what he did illegal?

Spare me the moralizing.

I'm not happy my culture has been so corrupted that I've come to accept violence as a way to hold some people to account, but what do we expect? To all things come balance, and with wealth (and health) inequality at current rates, balance will find a way. I'm not saying it will be pretty or pleasant or palatable, but it will find a way, which should only incentivize us to usher in some progressive legislation on wealth distribution sooner rather than later. (But be honest with me — do you think that'll happen?)

May we all aspire to be kind, loving, moral people who don't prioritize money over the health and well-being of other humans. Unlike Brian Thompson.

Trying to scold the entire internet

Thompson’s death been a real shock to the system for America’s ruling class, who seem to be realizing for the first time that the majority of the country will not mourn their deaths. As podcaster and reporter Michael Hobbes wrote a few years ago, “I think we'll look back on the last decade as a time when social media gave previously marginalized groups the ability to speak directly to elites and, as a result, elites lost their minds.” Which is why a whole bunch of tedious hall monitors are suddenly tut-tutting about all the memes in every major newspaper. I, personally, am not going super hard on the pro-assassination memes — as funny as they are — because we just don’t know what the motive was. We live in a time of mass accelerationist violence and I don’t feel like publicly cheerleading a guy who might have a compound full of deranged far-right ramblings. But I’m also not stupid enough to think that scolding the entire internet for how they’re acting is a meaningful use of my time on planet Earth. Maybe if I had a paid column somewhere — or proper health insurance — I’d feel different.

The UnitedHealthcare CEO shooting

Even if you believe Thompson was all the evil things so many people online say he was — a corrupt corporate CEO guilty of insider trading and working as the face of a company that denies life-saving coverage to tens of thousands of Americans a year in the name of profit — he was a corporate cog. He was responsible to a board and to shareholders. And, in short order, he'll be replaced by another CEO. Nothing will change, except that killing someone in the middle of Manhattan whom you deem evil could now become more normal.

I know how a lot of people might react to me writing this, because I've already encountered the refrains. "It's good these people are scared," is one common throughline of the response. In other words: "No, I don't necessarily support killing corporate CEOs in cold blood on the streets, but if CEOs scale back their predatory behavior because they’re scared of reprisal, that’s a net good.” Or, of course, people might react by saying that I am more worried about the killing of one CEO than a system that kills tens or hundreds of thousands of people a year.

I suppose there's something appealing about these kinds of arguments. They are not entirely unlike arguments I've made in the past — like that we should be prosecuting more corrupt presidents and members of Congress, not fewer, stability of the system be damned. The obvious difference, though, is that when I made those arguments they came from a place of demanding accountability — insisting that the system do a better job of rooting out corruption and evil, not cheering extrajudicial violence on the streets.

To put it differently: If you are hoping for our rich corporate overlords to live in fear of expedited, unanswerable and unexpected punishment, then you are necessarily hoping for us common folk to start delivering that punishment. Which requires us to be the arbiters of who is good and who is evil. The left might consider how long it'll be until abortion-providing doctors or trans activists or Democratic politicians start regularly being mowed down in the street in the name of striking fear into evildoers. If that's the world you want to live in, I strongly suggest signing off the internet and going to spend some time outside.

An Assassin Showed Just How Angry America Really Is

While I really dislike a lot of these people, none of us should want to live in a country where assassination becomes a method of political expression. It’s hard to see democracy surviving if elected leaders and corporate leaders feel they might be shot at any point. And that’s why we have to actually get our laws working again. I hope that men like Carl Nichols and Fortune 500 CEOs start to wake up, and see that there is deep rage outside their clubby environs that can’t be fixed with security measures but must be addressed by some measure of social obligation to the people who live here.

After all, societies that give citizens no way to control their own lives, but put the fate of their people in the hands of distant masters with no concern at all for their wellbeing, invite disaster. We’ve always known that. It’s one of the main reasons for the passage of our antitrust laws. So I hope we can get some control over our society again, before we truly do spin out of control.

Torrent of Hate for Health Insurance Industry Follows C.E.O.’s Killing

The fatal shooting on Wednesday of a top UnitedHealthcare executive, Brian Thompson, on a Manhattan sidewalk has unleashed a torrent of morbid glee from patients and others who say they have had negative experiences with health insurance companies at some of the hardest times of their lives.

”Thoughts and deductibles to the family,” read one comment underneath a video of the shooting posted online by CNN. “Unfortunately my condolences are out-of-network.”

On TikTok, one user wrote, “I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick. I just can’t feel sympathy for him because of all of those patients and their families.”

🍿🍿

Citi Bikes leave ‘digital exhaust’ that could help track a killer

An electric Citi Bike like the one reportedly used as a getaway vehicle after the murder of United HealthCare C.E.O. Brian Thompson creates “digital exhaust,” streams of data that can be used to track the rider, said David Shmoys, a computer scientist at Cornell University who helped design the system.

Between the creation of a Citi Bike account, connecting it to a credit card, undocking it, riding it around the city and docking it at a new location, every user creates many “streams of digital breadcrumbs” that can help Lyft, the company that operates Citi Bike, track the user’s location, and possibly their identity, Mr. Shmoys said.

Combined with the user’s phone data and location shared with cell towers, “It is amazing how much information is conveyed,” Mr. Shmoys said.

Never ride one of these.

UnitedHealthcare CEO Brian Thompson Is Fatally Shot in New York City

We know it’s not antifa because they’ve never been this effective.

When our cities are no longer safe for extraordinarily wealthy insurance CEOs, what’s our country coming to?

Health care industry executives, like those in the insurance and defense industries, face increased risks “because of the services that are being provided and the emotion that comes along with some of those services,” Mr. Komendat said.

That’s an actual quote in the New York Times.

“Because of the services that are being provided and the emotion that comes along with those services.”

Wow.

What an obtuse way to say “these industries kill a lot of people.”

U.S. officials urge Americans to use encrypted apps amid cyberattack

Amid an unprecedented cyberattack on telecommunications companies such as AT&T and Verizon, U.S. officials have recommended that Americans use encrypted messaging apps to ensure their communications stay hidden from foreign hackers.

The hacking campaign, nicknamed Salt Typhoon by Microsoft, is one of the largest intelligence compromises in U.S. history, and it has not yet been fully remediated. Officials on a news call Tuesday refused to set a timetable for declaring the country’s telecommunications systems free of interlopers. Officials had told NBC News that China hacked AT&T, Verizon and Lumen Technologies to spy on customers.

iMessage and FaceTime Audio, always. If you need to communicate with an Android user, Signal.

John Gruber on this developing story.

The Land That Allowed Ken Burns to ‘Raise the Dead’

In a move that seemed rash then and remains unconventional now, he rented the white colonial, then heated by a wood-burning stove, and bought it a few years later for $94,000.

The decampment to the small town — a pinprick of a village a 3½-hour drive from Manhattan that then had a population just over 3,000 — allowed Mr. Burns to explore, gave him peace and shut him out from the rest of world so he could see it more clearly.

Ohh.

Yeah, maybe it’s exactly this.

Food Lobbyists Plot to Have It Their Way With RFK Jr.

Although much of the early criticism of Kennedy’s nomination has focused on his skepticism regarding some vaccines, the nominee is a longtime critic of the food industry, which he says is a leading contributor to America’s obesity epidemic. In recent months, he has called for a crackdown on food additives, limits on certain crop protection chemicals, stronger guidelines regarding what he says are conflicts of interest among regulators and business, and a review of any substance causing, what he argues, Americans to be “mass poisoned by big pharma and big food.”

What a kook.

In videos that have gone viral this year, Kennedy has singled out ultra-processed food as a priority for what Kennedy has called his “Make America Healthy Again” (MAHA) agenda. In one video devoted to the potential dangers of Yellow 5 food dye, Kennedy stands before a table with Doritos chips and Cap’n Crunch cereal and claims the ingredients used in such products are one reason more than 40% of American adults are classified as obese by the Centers for Disease Control and Prevention. The dye, also known as tartrazine, has been linked to behavioral problems in children and other health risks. The European Union requires child warning labels for products with tartrazine. 

Kennedy has made similar arguments about the widespread use of seed oils – including those from corn, soybeans, sunflowers, and peanuts – especially in highly processed foods. Research suggests that high levels of seed oils, rich in polyunsaturated fat, can cause inflammation. America's overreliance on seed oils in fast food and snack products, Kennedy claims, is a major overlooked factor in the health crisis. 

He's crazy.

"Increasing number of voices on the right target the food industry," an October memo stated, which went out to clients that include McDonald’s and America’s largest candy makers. The lobbyists warned that Kennedy’s MAHA movement “had gained increasing momentum among conservative figures who have taken a more vocal interest in the way food is produced and regulated.”

Herein lies the problem with both sides of our bipolar political spectrum: the American public no longer possesses (and if they do, they're reticent to demonstrate their use of) discernment and critical thought. 

Trump bad. Biden bad. Go team.

It's all incredibly unintelligent, and it's been disappointing to watch the Left tumble off that same cliff the Tumpets did years ago. But I've watched if first-hand among friends, neighbors, colleagues. If you so much as question the current state of immigration, in the eyes of many Democrats, you may as well be MAGA. If you agree with RFK's positions on food safety and public health, you're a vaccine denier. If you posit that the American economy rebounded fairly well from covid, you're a libturd (if you're talking to a Trumpet) or a neoliberal (if you're talking to a Leftist).

China’s Hacking Reached Deep Into U.S. Telecoms

China’s recent breach of the innermost workings of the U.S. telecommunications system reached far deeper than the Biden administration has described, the chairman of the Senate Intelligence Committee said on Thursday, with hackers able to listen in on telephone conversations and read text messages.

“The barn door is still wide open, or mostly open,” the Democratic chairman, Senator Mark Warner of Virginia, a former telecommunications executive, said in an interview on Thursday.

U.S. officials said that since the hack was exposed, the Chinese intruders had seemingly disappeared, suspending their intrusion so their full activity could not be discovered. But Mr. Warner said it would be wrong to conclude that the Chinese had been ousted from the nation’s telecommunications system, or that investigators even understood how deeply they were embedded.

IMG_0416

I love the internet.

Forty-Three Monkeys Escape From US Research Lab

The rhesus macaque fugitives broke out of Alpha Genesis, a company that breeds primates for medical testing and research, and are on the loose in a part of the state known as the Lowcountry. Authorities have urged residents to keep their doors and windows securely closed and to report any sightings immediately. The escaped monkeys are young females, weighing about 7lbs (3.2kg) each, according to the Yemassee Police Department. Police said on Thursday that the company had located the “skittish” group, and “are working to entice them with food.”

“Please do not attempt to approach these animals under any circumstances,” police said.

A real heart-warmer of a story.

Makes you wonder what they’ve been infected with that makes the police so nervous.

Daring Fireball: I Wonder

I wonder how much it stings to be reminded that all the money in the world cannot buy dignity. I wonder too, what taste Cheetos-dusted 78-year-old testicles leave in one’s mouth. Whatever the flavor, I hope it lingers.

Police Freak Out at iPhones Mysteriously Rebooting Themselves, Locking Cops Out

The exact reason for the reboots is unclear, but the document authors, who appear to be law enforcement officials in Detroit, Michigan, hypothesize that Apple may have introduced a new security feature in iOS 18 that tells nearby iPhones to reboot if they have been disconnected from a cellular network for some time. After being rebooted, iPhones are generally more secure against tools that aim to crack the password of and take data from the phone.

If this is true, I owe Apple a drink.

Some post-election thoughts:

- Boy, did the Democrats blow it. Right now, I would love to have a sit-down with Jaime Harrison (DNC chair), Gretchen Whitmer (DNC vice-chair), and for good measure, Debbie Wasserman Schultz.

• I am furious with every liberal expressing shock at Trump's re-election. I know many, and they are the ones I can hardly bring myself to speak to right now, not the Trumpets.

• I'm far less anxious than I was in 2016 or 2020. We saw this election coming. I went into it clear-eyed. Trump is a known entity. I'm nervous for the future, but I can't say I'm unprepared.

• For every aghast liberal scold exclaiming, "how could you vote for a rapist?!," shut the fuck up. Democrats didn't have a primary, Democrats kept telling us Biden was fit for office when it was obvious he was not, and Democrats had zero plan to deal with immigation or the economy. (Instead, they decided gaslighting the public on those issues was the right tack.) Trump didn't win, Democrats lost. 

• Telling voters they shouldn't trust their feelings is a losing tactic. Duh. Told you so.

• Maybe if liberals want to win, they should spend more time around conservatives. Move out of your cities and into a small town — I dare you.

• Democrats are obnoxious. The open condescension with which they speak about rural people, white people, heterosexuals, men, and Christians is astounding. I say this as someone who used to do that very thing. (But you can't move to rural America and maintain that condescension and hope to make any friends.) That condescension is hateful — knock it the fuck off. 

• To my shocked liberal friends: what work did you do between 2020 and 2024 to change the outcome of the election? And don't say "vote," because that is the bare minimum required of an American citizen. Seriously. Being a citizen is work — tell me, what work did you do? Do you live somewhere surrounded by people that think like you? How many Trumpets do you talk with on a regular basis? How many do you count as friends?

• Any person claiming Harris lost the presidency because she's a woman or black is in denial. Full stop.

• I'm upset, yeah, but more than anything I'm sad. I'm trying — expending real mental effort — not to be angry. Not at the results of this election, but at this cycle, this endless stream of bullshit, these false choices. Let's be real: a vote for Kamala or a vote for Trump is pretty much the same. Sure, Kamala gave lip service to an inheritance tax — a tax that would've affected me personally — but do you think it was ever gonna pass? Do you really think the Democrats are any less in-the-pocket of big corporations than the Republicans? C'mon. They're two sides of the same coin, and capitalism as we know it is rigged against you. I'm sorry you don't want to admit it Democrats, but it's true.

• And yet a vote for Trump is a Faustian bargain, no matter what you think of him. We are all now at the mercy of his ego.

• We Americans got the president we deserve. The over-educated wealthy that live (though not exclusively) on the coasts and in the cities parade their liberal platitudes — "science is real," "black lives matter," "we believe women," etc. — and do they give away any of their money? Of course not. That should say everything. Real liberal values would compel them to help the poor, not condescend to them. History tells us that it's really this simple: societies crumble when wealth accumulates at the top. Class unrest consumes the population, as it will and should, and everything we cherish — democracy, civility, safety, all our creature comforts… it all goes out the window. This election is a verdict that damns the elite, the wealthy, those at the top. They — we — should've known better. That's what all that education was for… Instead, we treated education as a way to climb the corporate ladder, to make ever-more money, to make ourselves richer and fatter and safer… the next iPhone, a new car, another home. We lost sight of the social contract: an education is meant to better ourselves in service of helping others, not to buy more shit and surround ourselves with people that think exactly as we do. We failed. Trump is our retribution.