Gun violence isn't a solution to the healthcare crisis- but we're fools if we pretend it can't be understood.

Or, how much can we expect people to bear before they break?

I was interviewed by the LA Times about my family’s experience with UHC while Carolyn was sick. You can read Robin Abcarian’s Opinion piece here, and a fuller view of my thoughts below.

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Feeding tube, round 1: $900 a month.

No one deserves to be gunned down on a New York City street. This much I believe we should all agree on. Yet after years spent in my own battle with United Healthcare trying to keep my ailing daughter alive, I understand why an anonymous David would be moved to aim his stones at a modern-day Goliath. If you are shocked by my admission, you are likely part of the problem.

When my 8-year-old daughter was diagnosed with leukemia during the pandemic, I braced myself for the years ahead. I was told the treatments would be brutal, sometimes life-threatening. Some kids die of cancer, her doctor told me, and some kids die of cancer treatment. What I didn’t expect was the uphill battle we’d face with the American Healthcare System, and specifically our insurance provider, the United Healthcare group.

Arguing with our insurance company over partially or wholly-denied claims was often more relentless and unforgiving than the actual disease we were fighting. Claims submitted for medications and treatments essential to my daughter’s care were repeatedly denied. These were not experimental treatments, but basic components of a standard leukemia treatment plan. Specifically, UHC denied any coverage for the feeding tube supplies my daughter needed to supplement her nutrition to prevent her body from wasting away from several devastating rounds of chemotherapy.

Their reasoning was as cold as it was cruel: UHC would only cover the cost of my daughter’s feeding supplies if the tube was her sole source of nutrition. To qualify for coverage, I would have to starve her of anything she could chew, taste, or savor—anything that resembled the comfort of normal childhood. I could not provide her comforting meals on the days she felt up to eating. She would rely solely on a steady drip of sticky, vanilla-smelling formula delivered by the case to our door.

The alternative, the UHC representative explained, was to pay $900 out of pocket every month to a private company who would supply the supplies. There were no payment plans available and no partial reimbursement. If I didn’t pay, my daughter wouldn’t receive the supplemental nutrition she needed to stay alive. The voice on the other end of the phone was apologetic but clear: I could let my child live and tether her food intake to a feeding tube, or I could bankrupt myself.

Of course I paid. I worked full-time while my daughter underwent treatment, because as a single parent in Pennsylvania, I had no access to paid family leave. Her feeding supplies bills were another line on my credit card statement, one more way people far-removed from the day to day of my family’s life would profit off of my daughter’s illness.

I continued to field denials from our insurance company as my daughter’s treatment progressed. She was eventually relieved of the feeding tube, and I the associated expenses, but then she developed a sensitivity to a sedative used during her monthly lumbar punctures. Her doctors switched her to an alternative, which was quickly denied by UHC. The cost of the sedative replaced the cost of the feeding supplies.

Exhaustion became my constant companion, and the stress drove me to drink. A few glasses of wine each evening became a box. My body eventually failed under the strain—I developed a heart condition that required ablation surgery to correct. I worked myself to the edge of collapse because the system left me no other choice.

Behind the scenes of my family’s fight to save my daughter’s life, executives at UnitedHealthcare continued to bring home multimillion-dollar salaries, undisturbed by the ruin their policies inflicted on families like mine.

UnitedHealthcare has faced significant criticism in recent years for its high denial rates and low reimbursement levels, which have led many healthcare providers to sever ties with the insurer. A Senate report revealed that between 2020 and 2022, UnitedHealthcare’s denial rate for post-acute care requests more than doubled. The report highlighted the use of algorithms in decision-making as a critical factor in these rising denial rates, which prompted regulatory scrutiny.

Moreover, UnitedHealthcare's reputation for slow payments and administrative difficulties has driven several major health systems to drop its Medicare Advantage plans. The University of Florida Health System and Trinity Health of New England have both recently ended their contracts, citing the insurer’s burdensome processes and low reimbursement as primary reasons.

62% of health system CFOs surveyed in 2023 indicated that collecting from Medicare Advantage plans, including those managed by UnitedHealthcare, has become significantly more challenging than in previous years.

We often think of violence as something sharp, sudden, and spectacular—a bullet, a punch, a riot. But there is another kind of violence, quieter but no less brutal: the violence of denial. Denial of care. Denial of rest. Denial of dignity. It’s the violence I lived with when I had to make impossible choices between my daughter’s comfort and my own financial ruin. It’s the violence many of us endure every day, in a system where life itself has become a privilege, not a right.

I have to ask: what is more violent? A man shot on the street, or a system that denies a child the care she needs to survive? What’s more brutal—violence we see in public, or the slow, grinding violence that forces parents to choose between their child’s life and their own solvency?

Each year, millions of Americans fall through the cracks of a healthcare system designed not around healing, but around profit. My daughter’s feeding supplies weren’t luxuries. They were essential to her survival, as essential as air or water. The denial of coverage for her supplies was an absurd technicality with real, devastating consequences.

Condemning the physical violence of a single act is easy. Reckoning with the structural violence that leads to such acts is more difficult. How long can we remain surprised when people break after spending every moment of their lives fighting to survive? It is violence to deny life-saving care. It is violence to design a system that strips people of dignity, forces them into impossible choices, and then demands their quiet compliance.

The shooting of Brian Thompson has been met with a kind of cold indifference by the public. The reaction on social media was swift and harsh, with many openly admitting they felt little sympathy for the death of a healthcare executive. This lack of care is not because people are inherently violent, but because they recognize the cost of the violence inflicted on them by the American Healthcare system every day.

If we want to prevent more violence on our streets, we need to address the violence baked into our institutions. This shooting is a curl of steam let off by the simmering rage of a society stretched to its breaking point. It is the inevitable result of a society that asks too much of its most vulnerable and rewards those who exploit them.

We must stop pretending that survival is a privilege reserved for the wealthy. Until we do, these tragic, explosive moments will keep happening. And each time, they’ll remind us that this system isn’t designed to care for people– it’s designed to break them.