HCN 44
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Rick: Welcome to the Healthcare Nation Podcast, your host Rick Janata, here with our producer, Joe Woolworth.

Today we're gonna talk about the assassination of the United Healthcare CEO, Brian Thompson, which happened last week, and I think we can all agree this unfolded like a grim crime story, A mask gunman, armed with a ghost gun ended Thompson's life outside the Hilton and Midtown in Manhattan, leaving the city and the nation in a state of very uneasy reflection.

What we know as of today, the recording of this podcast is that 26-year-old Luigi Mangione, a software developer from Maryland, was apprehended in Altoona, Pennsylvania. He had what many describe as a manifesto, although it has not been released yet, and what we know is it appears to be an indictment of the US healthcare [00:01:00] system, painting a picture of someone who is disillusioned by what he perceived as corporate greed, trumping patient care.

And the bullets or the bullet casings that they found said, deny, depose and delay. These are synonymous with some of the tactics that are used to perhaps for stall care used by insurance companies and was the headline of a, of a book that was published. Clearly they, or a connection. With respect to, um, this person's sentiments.

But at the time of the murder, initially, as news of it spread, social media became a cauldron of conflicting emotions, and we really wanna talk about that today. Some users embittered by personal battles, with insurance denials and exorbitant medical bills, expressed what I would call a very dark satisfaction.

Conversely, many including us here at the podcast, see this as, total act of Mac carb celebration, any kind of violence is not to be tolerated. As we say in healthcare, first do no harm and [00:02:00] harm takes many forms, but in this case, violence should never be the end, um, outcome of it. But the polarized reactions do underscore a nation grappling with ongoing frustration.

Over a system that often seems to prioritize profits over people. Now, I'm very familiar with this. I've been a CEO of many healthcare systems across the country. I've served at the bedside as a clinician and worked my way up to the boardroom. There are many miracles and there is also madness, triumphs, and tragedies.

And here at the Healthcare Nation Podcast, we try to cover every angle. We wanna meet the players, literally, sometimes metaphorically. And some of them are visionaries and many are villains. And the bureaucrats and benefactors are necessary if we're gonna tell the complete story and expose. The underbelly of an industry that, despite its noble mission, often stumbles under its own weight.

The ride isn't always comfortable, but understanding the [00:03:00] challenges, the first step in mastering it. And today what we're gonna do is try to explore why this event is triggering such strong reactions across the spectrum from outrage of the crime, to reflection on the state of healthcare, and examine the broader implications for industry and the society.

At large and where we go as we move forward. But I do hope that we can all agree as we navigate this, that one truth remains meaningful. Change cannot be born from the barrel of a gun or violence. Now I wanna just give some background here some points of reflection, and I wanna aim this to folks who are in the healthcare sector, healthcare delivery, and healthcare leaders.

Some of the questions that I've had when I think about myself in, in those roles, in, in my past history, but also now what I do advising folks within the sector kind of writ large. Why did this event trigger so many? Well, I would say this healthcare as a shared pain point is pretty easy to understand.

Everyone has experienced some frustration with the system, [00:04:00] whether that's through the high cost denied claims or just navigating the bureaucracy and certainly the killing of a high profile leader. Has tapped into the shared discontent. It's turned, what I would say are, are grievances that are understandable into what we see on social media.

This kind of concerted, almost collective outrage. There are certainly human narratives here, and this has put a spotlight on the tension between healthcare as a business and healthcare as a human right. We know this, it affects so many people in the United States. Medical debt is the leading cause of bankruptcy in the us.

Significant implications for individuals and families, right? Approximately 62% of all bankruptcies, bankruptcies in the US are attributed to medical expenses. This also seems, at least from my perspective, as a statement of desperation when you look at some of the public reactions. Now clearly that while few condone the act, many share a sense of disillusionment with healthcare [00:05:00] access costs, everything that is put out there.

And it resonates because so many people understand that denied care, these bankruptcies I talked about, profit driven decisions, turn what I would say, this heinous crime into something that is a larger symbol. Now there's no. Good story here. There's no, I'm sure when we learn, learn more about, um, the perpetrator.

You know, this isn't, seems like someone who is without healthcare, insurance, without means, but there's gonna be more to come on that. And it's been a lightning rule. Rod across the board. Criticism is certainly mounting against the prioritization of profits. Just today I read where Anthem Health in New York is changing their policies that were to go infect in February regarding timed anesthesia and opening that up.

Now, was that in direct response to this? Probably. So I, I'm sure we're gonna see much more of this as this trial unfolds as well. But at the end of the day, I also wanna talk about the role of media and social media in this. There [00:06:00] has been amplification. News outlets are seizing on this story to highlight systemic issues.

The coverage has ranged from personal stories to healthcare struggles, to critiques of corporate practices, and even security. The echo chamber on platforms like X and Reddit, or rife with debates, some called Thompson, a symbol of greed. Others pointed to systemic reforms as the, as a root solution to this.

Now, the crime has divided public opinion a. Public opinion across the board and reflects a deeper cultural divide. And as Charlie Munger said, if you want to know the outcome, show me the incentives. And I think we could apply that to so much of what is going to unfold as we get deeper into the health sector and how healthcare insurance really unfolds and touches individuals lives that are gonna be part and parcel to everything we see in the legal proceedings that are gonna move forward with, as I said, the perpetrator.

As this crime is further investigated. So a lot more to come on [00:07:00] that. But right now I'm gonna go to Joe and Joe, we're here in the studio. I know that you've got a lot of feedback on this from folks. When we, when we cast a kind of a survey for folks to throw in their questions, what do you have for me?

And let's, let's dig in.

Joe: Yeah. I think there's a lot to unpack. I think start with the idea of just unpacking the crime and the immediate reaction. So just actually what happened, so. Walk us through what we know about the killing of Brian Thompson, the suspect, the details that have emerged about his alleged motives and, and you were actually in New York.

Rick: I was. I was in New York. I was traveling in from Jersey on the train. You know, in a crazy twist. The train hit a pedestrian. It was a suicide. The train was delayed for two and a half hours. I got into Penn Station and there was a flurry of activity there. Because of the shooting, and it, to me, it juxtaposed two things, just the issues with mental health and someone killing themselves.

Obviously creating a, a situation [00:08:00] for so many in transit, but the tragedy of that and then arriving and having you know the, you know, see the, the buzz in the city, which was really, really dialed up. It, it is a tale of a lot, a lot of it. I want to talk about a second with respect to mental illness, but for what we know now, obviously, Brian Thompson, CEO of UnitedHealthcare, shot in in Midtown.

The authorities quickly got the suspect. 26-year-old Luigi Mangione. As I said, he's from Maryland, a software engineer. They found a ghost gun with him. What I would say is a manifesto that critiqued or criticized the US healthcare system. Mangione was a University of Pennsylvania graduate of valedictorian from the Gilman School, which is a Presti, very prestigious institution in Maryland.

He comes from what some have described, a prominent family with significant ties to. Maryland real estate and even the healthcare sector. His classmates have described him as a well-educated, popular guy and make this clearly makes the [00:09:00] allegations against him really kind of shocking when you think about, I hate to put it this way, as a, as a profile.

Joe: Yeah. I think you would automatically assume that this would be a person who couldn't afford healthcare or had a story like that, but it doesn't sound like that is. This guy's situation. Yeah.

Rick: I, I doubt if he, um, had an issue with having healthcare coverage, although there has been some reports that, that he had some issues with his, with some healthcare problem and members of his family.

I don't think he was, he was ever in a situation not to be covered. And one of the thing I would say is the choice of a gun, you know, an untraceable firearm, it just adds another dimension to this that I'm sure is going to be out there.

Joe: Yeah. Like he planned to get away with it. Oh,

Rick: he, he planned on. To get away.

I think that he, he, the elaborate, I think maneuvers that he took to, to evade cops initially, and, and, you know, leave the city was one thing. The other strange piece was you know, that, that when he was caught, he did have the [00:10:00] manifesto and the gun on him, so he didn't get rid of it. So this is, this is another, another point that I'm sure folks are gonna be talking about and, and looking deeper into, yeah.

Joe: Well, you talked in the intro about the reactions from social media. What do we know about the reactions from leaders in the healthcare industry and, and just the health. Even just workers, how have they been reacting to the issues? Yeah,

Rick: yeah. I think that reactions have been swift. I think most folks have, have, you know, in high profile positions have said something or indicated something.

Business leaders, policy makers, certainly healthcare professionals, they've, you know, acknowledged and we're hearing this in a lot of podcasts out there. And obviously in the media kind of across the board that healthcare. You know, as a delivery system has flaws, but violence is not the solution. Many call for constructive dialogue, I think we're gonna see this.

And, um, you know, some venting of the frustration that folks that were, you know, just referenced in, in on social media. I. You know, or expressing, I think it's [00:11:00] just the beginning of the narrative and there's gonna be a lot more to follow on this jump.

Joe: Yeah. So this crime, it, it involved a young male suspect, Luigi Mangione.

Are there trends linking this demographic to similar acts of violence or expressions of societal discontent?

Rick: Yeah. You know, um, I, I wanted to touch on the mental health component of this, and we're gonna be hearing a lot more than this. Certainly if you characterize it as a political assassination. Um, that would be one thing and look could very well be that that's the only motivation here.

But I dunno, there's always something more than that. It's certainly troubling to your point, that young men, particularly those in their twenties, are disproportionately represented in acts of violence. Studies suggest that it could be societal pressures, economic changes, sense of alienation, all contributing to that kind of outcome.

In this case, we got a highly educated guy. A professional trajectory on his own makes it even more perplexing. You know, not [00:12:00] someone who was without means, but it does perhaps align with a broader narrative of young individuals feeling disenfranchised in systems that seem to prioritize some kind of profit or bureau bureaucracy.

Over fairness, accessibility, again, I think there could be a theme there. Yeah.

Joe: Another kind of category here is just the outrage in the reflection that that has caused people. So I think everybody wants to make sense of it. And, you know, social media took it and there was like you mentioned this kind of macabre reaction of people and like a very inappropriate, almost like good kind of a, a thing.

Do you think that this reflects like just the negative side of social media or does this reflect. Desperation that other people, that's why this sentiment is resounding with people, or is it both or?

Rick: Yeah. You know, I thought about, you know, airline execs and situations where you have a CEO of a, say a big [00:13:00] airline, a door flies off or a plane has trouble or even crashes.

What you don't see is acts of violence or assassination. You see? Either from a regulatory perspective of the board removing the individual right now. Look, no one condones this act and many understand, you know, like us, that there's lots of frustration, stories of claims, all the issues that that we brought up earlier.

The bottom line is that so many. Don't trust the system, and I think you could trace this back to obviously what we just spoke about, but also even the pandemic, everything that's gone into issues with healthcare and healthcare delivery across the board. I think there is outrage. Absolutely it's justified, but we can't forget that there was some absolute broad.

Brutality with respect to the act and it, and it does represent a breakdown in our ability to arbitrate through nonviolent means folks grievances. But as I said earlier, listen. 30% of [00:14:00] adults with employer-sponsored insurance are paying off medical and dental bills. That's a big number, right? In 2024, the average healthcare premium was around $25,000.

A 7% increase over the previous years. 73% of healthcare providers report an increase in claims denials. 70% experience long payment delays, right? This is a reality. Pre-authorizations, individuals frequently encounter obstacles with prior authorizations. This delays care and necessary treatments. This is a bubbling level of, as I said, frustration that we're seeing express itself.

How you reconcile that with the act. It can't happen.

Joe: Yeah.

Rick: But I do think that there is going to be more denial. I, I gave the example of Anthem changing, you know soon to be enacted. Policy on time, anesthesia. Oh my gosh. What if you exceeded the time under surgery, you wouldn't wanna wake up. Now, was that in response to this?

Probably. So. [00:15:00] I think there's gonna be a lot more of folks, you know, in healthcare insurance and, and that side of it looking at. Their claims data, their pre-authorization with more scrutiny, whether it sustains and maintains and creates lasting change, we shall see.

Joe: Yeah. So Thompson, he was, he was a prominent CEO for a for-profit healthcare company.

And, you know, there's a, there's a large amount of people that, like you mentioned, just have a healthy level of distrust for any large American corporation. And this is a big one. Um, how do you think his role influenced the public perception of the tragedy?

Rick: Yeah. Look just let me frame something up.

I've said it many times on our podcast that I think so much innovation in, in healthcare, in the health sector is being driven broad by the private sector, right? By private companies. Mm-hmm. Certainly not by government. Government sponsored, you know areas. It's been really in the private [00:16:00] sector.

UnitedHealthcare is a publicly traded private company. This is a, I mean, a publicly traded company, right? It it is, it is. Beholding to its shareholders. And as a CEO, as I said earlier, that was his incentive, but it doesn't matter. His position as a head of a major insurer made him a symbol of healthcare industry's corporate side.

So for critics this, he represented rising costs. And executive bonuses. We heard about how much his pay was fair or not. It's a role that evokes strong emotions, especially in a, in a landscape where millions feel that their healthcare needs are not met. This is just a reality. So you hate to see an individual targeted like that.

At the same time, this is a structure that was born out of the way our healthcare system was put together. Mm-hmm. That's, that's just a reality. I

Joe: I mean, you're not really excited that this is the way that it's happening, but I think [00:17:00] the, the amount of coverage and the way that the country's talking about and engaging with it is gonna put the healthcare system under scrutiny for a while.

Yeah. So what systematic issues do you think that Maggio's Manifesto might most likely? Bring to light.

Rick: Yeah, I think, yeah, I, I've already jumped all the way to the defense, imagining him in a courtroom. And folks are going to focus on high cost of healthcare, limited access denials, perception of healthcare as a profit driven enterprise.

You know, call out. Probably United Healthcare and others specifically, these aren't new criticisms, but they're gonna resonate even more because of this act. And this is, this is just a reality. So again, I think it's gonna be, you know, bring a lot of scrutiny up there. And as things again, unfold in the legal process, it's gonna be something that's in front of folks, not only in the social media side, but probably on the, on the general news cycle.

Yeah. For a

Joe: while. Yeah. You mentioned [00:18:00] just airlines as a, as another example. Mm-hmm. I mean. We've all had problems with airlines and you know, most of our gut reaction is like, I wanna write an angry letter, and I'm not flying for a while. But why do you think that healthcare elicits such an emotional response compared to other industries?

Rick: You know, I, I, I often had said in, in some of my previous roles that, look, the difference between healthcare and healthcare delivery is we're not baking bread, right? You, you, you're making a loaf of bread, you burn it, you're a baker, you can throw it away. You start again. In healthcare, you're dealing with people's lives, right?

Their, their physical wellbeing, you know, mortality, in many cases, their ongoing issues with chronic illnesses, it touches people at their most vulnerable moments. And when the system fails. It's not just a a inconvenience, it can fail big. You know, as I said, everything from life altering or life threatening situations and these stories are out there.

Yeah, when affordability, and affordability and cost for treatments is part of that calculus, [00:19:00] it just makes this proposition so much more highly loaded, and that is why I think. This touch point is, is just so volatile.

Joe: Yeah. It makes it easy. Yeah. It makes it easy to empathize. Putting yourself in the position of somebody who was denied care or was.

Like you said, mistakes happen in any industry. There's no recourse that feels like make it right. Like I miss a flight. They can gimme vouchers in a free flight and there's something that feels like they can make it right. But I think like you hit the nail on the head there when it's the loss of a loved one, there's nothing that an organization or company can do to make it right in that situation.

That's right. Yeah. Um, but I think one of the things you were touching on before is, and I think this is gonna play a huge part of this, you're talking about the role of the media and social media, and I think. If you're on the media and the cynical side of Joe is like, you really want to push this as a politically motivated thing because the election's over and there's, there's really not a lot of political stuff to talk about right now.

Yeah. And they're driving ratings and it's sensational. And then social [00:20:00] media crazy. Um, the reaction to this, so how do you think that the media shaped the public discourse on this specific tragedy?

Rick: Yeah. Listen, I think it has amplified the systemic issues. Um. That have been in the press, you know, nonstop everything we, that we've, we've mentioned so far, some traditional outlets have focused on facts and implications, social media perhaps I've seen, this is my own personal experience, a much more polarized approach.

Um, you know, even to the point of vilifying the CEO and others. Now look we understand that there's a lot to change here, but I think some of these reactions, and I'm not gonna. Rehash them here, but they were clearly over the top. I mean, we can't forget. This is a man, family person. Kids, you know, he was murdered in the streets of New York.

This is terrible. Um this is just a reality that we, we don't wanna get lost in the bigger picture as well, which [00:21:00] is, look, there needs to be some systemic reforms, and this is clearly highlighting it right or wrong.

Joe: Yeah. You talk about jumping, like the thoughts of the trial. I feel like it's gonna be unfair for him.

'cause I think people are gonna wanna put the victim on trial in this case and be like, well, was it justified? Which isn't the point. I mean, you don't get to act as judge and jury. We have judges and juries. Um, and that's what makes part of this like such a sad thing. Yeah. But, and also we were mentioning before, just like the fact that we're even talking about it, there's good to that, like let's talk about reform, but then you feel bad even talking about it because you're like, are we highlighting?

It's like, um, the way a lot of people feel about talking about school shooters, giving them exactly what they want by giving them infamy. It's a tricky one. Yeah. Well

Rick: we mentioned the airline industry, you know you know, see reforms after, after bad events or near misses or crashes, but you don't want it to come to that.

Right. I mean, I said earlier, first do no harm. That is clearly the [00:22:00] ethos and I've always thought of it in, in healthcare delivery, but what kind of harm, administrative harm is a real thing. Yeah. There's no doubt about it. Murder is absolutely a real thing as well. Yeah.

Joe: I mean, kind of point of the show Healthcare Nation, right?

We're talking about what's going on in the industry. What do you think is the way forward for the people that set policy? We've already heard some decisions. Maybe they're linked to, maybe they're not. But given the, the widespread frustration with healthcare before this, even this tragic event, like what steps are the right first steps

for the industry to take to rebuild trust.

Rick: Yeah. And you probably, you could think and wonder, what's the United Healthcare Board doing right now? What are they thinking about? And as well as Aetna and Cigna and everyone else is out there. Look, there's so much we can cover, but I would say this transparency is absolutely key, right?

Healthcare companies, they've gotta. Clearly communicate everything with why they're doing something, why there's a denial, what the pricing is. Simplify [00:23:00] processes, demonstrate some genuine commitment to making the, the experience of healthcare not only more pleasant, but. More empathetic. We've heard a lot about that across the board.

Obviously at the end of the day, making sure you have good clinical outcomes, good patient outcomes. Right. I think this is a place to start, but the dialogue's gotta be listened to the, to the people. You know, we, we, we've said it before, the net promoter scores for healthcare are the worst in the country.

Sure. You gotta sit back and wonder why, what does banking do better than healthcare delivery? Right. It's, it's kind of crazy. Or, or other areas. When we're dealing with people's lives, and I think this is gonna be the start of a lot of dialogue that's out there, whether it's sustained and maintain, we shall see.

But I think what's sure to be a trial coming up, we'll keep it in the headlines.

Joe: Yeah, I think you're right. I think you imagine there's a lot of boardrooms at healthcare companies talking about this. Right now and trying to make decisions and what they should do, but, and maybe they're not the best people to influence that.

Maybe they're [00:24:00] missing some voices. What do you think the role of the public and policy makers play in addressing these issues?

Rick: Yeah, well, I think a lot of it goes, but just think about the lobbyists in, in DC right? I think demanding some level of accountability with your policy makers, with your elected officials.

We all want meaningful reforms. What does it mean for the average everyday person when you think about, you know, capping out of pocket costs or the role of regulatory oversight? So there, there's still this place for innovation and private sector, you know, breakthroughs to be in the hands of the average person.

Yeah. At the same time not create a situation where anyone is in danger. So there's a balance between that. I think there's gonna be a lot of conversation. Let's hope there's also collaboration between all the stakeholders across the board. If we really want to, as we said earlier, um, you know, prioritize health over profits.

Right.

Joe: I think this is one of those things where we could see a couple like tweaks and [00:25:00] changes, but when we think about like systemic shifts and what it would take to make that happen, I think there's another significant development worth exploring. It's the increasing privatization of Medicare through Medicare Advantage plans with companies like UnitedHealthcare.

They're playing a essential role in, in administrating these plans. What are the implications for the influence of private. Insurers over public healthcare programs.

Rick: Yeah. So let's put this in some perspective if you want to. And look. Incoming President Trump, clear focus on efficiency through Doge with Elon Musk and Vivek Mon, and we'll see how much they will get into the healthcare delivery system.

Certainly RFK Jr. We know he is going to have his hands in that and how that will manifest itself with respect to. Efficiencies and how that impacts an individual is yet to be seen. But we do know one thing, the push for privatization of Medicare has been a, something that's been in [00:26:00] discussions for, for many years.

Going back to you know, 2006 on up, there's, there's just been a big push for that right now we have. Probably 60%, a little more than 60% of individuals in Medicare Advantage plans. These are plans that are administered by UnitedHealthcare, Aetna, others, or the big insurers, right? This is such an important question.

The growth of this, right? It's more than just the dramatic shift. The reality is. That for companies like UnitedHealthcare, this means expanded influence over one of the largest public programs in the country. Right? And I think their charge is to do it economically and efficiently. And when you think about doing that in a cost effective way, you gotta be very, very wary of the potential downsides.

Restrictive networks, increased prior authorization hurdles, focus on profits so that they can wake up tomorrow and do it all over again. Right? Their [00:27:00] for-profit companies and taking these savings over what we'd say is, you know, comprehensive patient care. That's just a, a reality that I think should be top of mind for individuals as we go through this discussion.

Right.

Joe: UnitedHealthcare big, big player in this space. Well, I think you mentioned, we talk about this a lot, about the privatization and I think people get excited about that if like, great, maybe the big clumsy government won't be so involved and maybe, but that doesn't necessarily spark a lot of confidence for people that don't trust big corporations either.

Right. I think. We're just, are we just transferring trust from one organization? We don't trust to another one? And is there another answer? Is there some safeguards or policies that.

Rick: Yeah. You know that's a great question. I think, I don't want to use the pandemic and as, as kind of the, the touch point for all of this, but for me it is, it was an inflection.

I think it, it just opened up a lot of [00:28:00] doubt and trusting the. Established medical system policy issues came out of that. You know, so much that we could, we could really get deep into. But I think that for the. Individual, the average family that's out there. We talked about the cost of healthcare.

We thought about the implications of what that means for bankruptcies, this is impacting folks' lives. We know that pre-authorizations create delays. We know that there's clear inequities. There are individuals who are out there, you know who are covered by insurance or who have means that have no idea of how difficult it can be for a family.

And if you take into account, you know, how. The system generates from an economic perspective money, so that it keeps going. It, there are a lot of incentives there that need to be looked at and reformed. I would say if we're going to have a system that is better, that [00:29:00] is better in every way, better outcomes, better with respect to the inequities that are out there, better.

With respect to the economics of it being a viable system for the next generation. Right. There's a lot there to unpack.

Joe: Yeah, I think so. We spent a lot of time talking about the, the systematic issues in healthcare, but. Talking about like, oh, are we just transferring trust from a big government to a big organization?

And who might be the missing voices? And I think one of those obviously could be the people on the front lines. You got your nurses, your physicians, and other providers that have been navigating a perfect storm of financial pressures. The lingering impact of the covid, like we were talking about, a rise in workplace violence.

And now that's gotta be like a whole new fear. Yeah. For people with this tragedy that's going on in the news. So maybe we can just kind of unpack how those factors are influencing this.

Rick: Yeah. Let me, you know, you, you mentioned the violence piece. I've, let me just bring that up [00:30:00] for a second. All the professionals, you, you mentioned.

They are facing and have faced. Look in my, in my career, well over 30 years, there's always been an element of, you know, situations with patients for a variety of different reasons, um, that have created challenging environments. And I've seen tragedies myself. There's, there's no doubt about that. Um, but I do think now it's a different type of situation and these professionals are facing what I would say is an increased level of violence in that.

Respect today, fi you know healthcare workers are five times more likely to experience workplace violence than employees in other industry. Over 75% Wow. Of ed Docs have been victims of violent in incidents, often perpetrated by patients or their families. Right. Disgruntled, disgruntled folks with respect to the.

Potentially the care they received. Now you add to this there's a big issue of underreporting, right? Many healthcare workers view violence as an unfortunate, [00:31:00] but you know, it goes with the territory, inevitable part of the job. And that also. Prevents, I think a kind of change that we need across the board.

Yeah. And at the end of the day, because so much of this has gone into inequities, even in, let's just say Thompson's pay, um, and how that comports with, you know, folks who are struggling to pay their healthcare insurance. I would say this, while executives in healthcare systems do record, you know, in many cases record compensation increases.

Certainly in the insurance side, many nurses and frontline workers struggle with stagnated wages and obviously, you know, issues with compensation increases year over year that just have not kept up with the cost of Of living. Yeah. And at the end of the day, the compound effect is burnout, moral injury, and what we're seeing is an exodus of the profession.

And the attrition isn't just a staffing issue. Right. [00:32:00] It's a patient care crisis that we know is gonna come to a head in, in the very near future. And if the workforce on the front lines isn't supported, the system collapses from the inside out. So we need new models of care. We need new ways to recognize these frontline workers at every level, including compensation for the incredible job that they do each and every day.

Joe: Why do you think that there's an underreporting of violence? Do you think it's hospitals don't want. Incidents in their hospital to make other patients feel safer. Do you think it's like an empathetic ER nurse that got punched because somebody was upset and just thought, you know, whatever, it's the worst day of this guy's life.

I don't need to call the cops. Like, is it a combination of a bunch of stuff, but Yeah.

Rick: Yeah, I think it is a combination. And as I said a second ago, I, I do think a lot of it is under-reported because folks just see it as this goes with the territory. I've got someone who's unstable, violent, patient, et cetera.

And it's just, it's part of the job, but it, but it shouldn't be. And if it is because of [00:33:00] some situation, let's just say with a psychotic patient, then let's make sure we have the means necessary to create a safe environment for everyone. Obviously the caregivers, but also the patient because we don't want any harm to go just in restraining or anything like that.

This is an important problem. As I said, it leads to a lot of different issues across the board, and there are, you know, there's technologies that are out there that are, that hopefully can be deployed in that forward thinking, um, health systems will embrace to keep people safe. Sure. And that's the, that's the most important thing.

Joe: So, closing thoughts, the, what do you think the final takeaways are from? This incident in the, the broader conversation that it sparked?

Rick: Yeah. Yeah. I'll tell you, I do think that as we see the case that is made to defend, um, the perpetrator, you know, come to light. And how that opens up a lot [00:34:00] of the conversation.

It will all come back to the point that this tragedy is going to be a reminder of the human cost of systemic failure, right? While the act is absolutely inexcusable. This is a murder. It does force us to confront the cracks in a system that leaves so many individuals feeling very, very helpless and they cannot have the kind of agency over their own healthcare that they, that they deserve.

Right? Yeah. So I don't think the way forward is any kind of, you know, cookie cutter menu. It's probably a combination of everything from reforming policies, transparency, privacy, how we address grievances. The time process between getting back to someone who has a critical, you know, condition and of course the application of, of healthcare in an equitable manner across the board.

But you said it earlier, we gotta rebuild trust. We got to ensure that healthcare really [00:35:00] goes back to its true purpose and that's gotta be to heal and not to harm.

Joe: Yeah.

Rick: So I think that wraps it up. Very different kind of podcast. I think we'll probably build on this in the future and have some guests on to unpack this in more detail.

Joe: Sounds

Rick: good. So thanks to our listeners for listening to the Healthcare Nation podcast. Stay tuned for more and thank you All