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Something I've pointed out in other discussions that may also not be coincidental to Luigi's decision to act: he's 26. Since Obamacare, 26 is when you get kicked off your parents' health insurance.

I'm acutely aware of this because my son will be kicked off of ours next August. He's trans and literally needs medical care to authentically be himself, so to say he's extremely anxious about navigating the system alone for the first time in his life is an understatement. I can only imagine what it must be like to be dealing with Luigi's level of chronic pain and the shitshow that is health insurance for the very first time.

As always, Robert, thanks for your eloquent (usually) insightful (always) analysis of our modern dystopian dumpster fire.

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Not sure if it helps your situation any, but my oldest kid is disabled (and incidentally nonbinary) and so is able to stay on their dad's insurance forever, basically (unless they were to suddenly become abled, which won't happen). I think their dad just has to tell the insurance company at enrollment that his dependent is disabled. All this could change, of course, as the Trump administration wreaks further havoc on the healthcare system, but if it helps for now, maybe worth considering, because if your trans kiddo doesn't get the care they need, if they aren't already disabled, that is likely to become disabling.

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When you are 26 you can sign up for Obamacare which is available across the country. Without Obamacare if not employed there is Medicaid, and if not for Obamacare which raised the age limit a dependent child loses coverage under a parent’s plan your son as was mine at that age would have no safety net even earlier. Luigi’s family likely has a personal doctor, and their health plan is what the very wealthy even the fairly comfortable all have today and that is concierge medical care. Doctors on calls. No wait for referrals and the best that money can buy navigated by personal (concierge) doctors. Mangione is mentally ill. I see all the hallmarks of adult-onset schizophrenia which strikes many young adults in their 20’s. It steals their personality, their potential, their lives. Most are not violent certainly, but Mangione pulled that card as well. He is rich in material goods and money to afford anything he wants to pursue, and likely powerful connections, but he is impoverished when it comes to his health. I predict his lawyer will plead not guilty by reason of insanity.

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Is your kid working? My own daughter is 28 and switched to Medicaid at 26, because she is autistic and has several health issues. I mean, Medicaid isn't perfect, but she has been able to keep her GP and go to specialists. They suck, but that's because we live in West bumfuck.

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I have worked in a support role in both behavioral health and medical pediatric care. I observe parents with commercial insurance thru employment adding Medicaid for their child when they are diagnosed with a medical and/or behavioral health condition, which is then secondary to the commercial plan; then when child reaches the age where they are no longer eligible for parent's commercial plan they continue on Medicaid. Also, not many people I find know there is another resource. There are HEALTH CARE NAVIGATORS available across the country. And typically, health clinics have them available on staff within the practice. I recommend using one very much. Their services are free. Again, little known but Obamacare opened up government funding for this position to be there and help us navigate selecting insurance no matter what stage of life the patient may be. Google "health care navigator" and you "state" in a search. Or go to any clinic locally which are truly excellent and provide specialties from medical to ob-gyn to pharmacy to behavioral health and more, or a hospital where you can also find these professionals on staff and their services are "free." HEALTH CARE NAVIGATORS.

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I am going to say im. If killing CEOs replaces school shootings then we will finally get gun reform.

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Sadly, you're probably right.

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Yeah, I'm kind of excited for the potential shift in victims.

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Nah we'll just get more 3D printers

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great idea — kill people so people will stop being killed — brilliant

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hm yeah because there's not like a million ways to kill ppl. When guns are not available people default to bombs. Yall should make those illegal.. oh wait

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Merica

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This is so very good. How on earth did you knock this out so fast?

The repercussions of this young man's actions will last a long time and spread further than most people will predict. But I suspect you won't be surprised by what happens next.

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He writes ok.

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I find it interesting how we categorize radicalization.

The training that psychologically conditions army cadets to kill without emotional affectation is considered fine. If soldiers are killing people the state sanctions, then it is morally supported and not considered radical. Regardless, I’m aware of the hundreds of thousands of civilians murdered in the Iraq wars.

Or you consider the American revolution and war of independence, which was wholly illegal under British law, is now enshrined and celebrated as a wholesome moral act. The second amendment exists in part to uphold the ability to enact violence against the state in the advent of corruption or moral decay.

And then we get a young man like Luigi, who was clearly intellectual and had a lot going for him, and we classify his actions as the result of radicalization instead of being a considered act of sound mind. I’m not saying this to condone vigilante justice, but to point out how our categorizations are incongruent.

Will Brian Thompson be considered radicalized for knowingly signing off on business practices that lead to the deaths of thousands of UHC customers? No. That’s just business as normal.

I think part of the reason the public has responded with so much support for Thompson’s murder is believing CEO’s who exploit others to death for profits should be punished in kind is not such a radical idea. Really, the legislative and judicial body should never allow such abuses to go unpunished. But when they do, it’s predictable that someone else will eventually pick up the slack. It may be illegal and repulsive, sure, but I don’t actually think the concept is that radical. It’s certainly not unpopular.

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On Luigi's Goodreads account you could see that he liked this quote from Industrial Society and Its Future:

"The concept of 'mental health' in our society is defined largely by the extent to which an individual behaves in accord with the needs of the system and does so without showing signs of stress."

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You may be onto to something here. Today's armed forces are fairly certain to experience some sort of psychologic trauma, as every generation previously did, but we are finally coming to a realization that it fundamentally alters that person. It's treated, probably not as well as it should be, but as a nation we thinking about it at least.

That leads me to my real point: the generations before now, the ones that served and saw and were just given their DD214's and a pat on the head, are the ones in charge. We are ruled by damaged men....

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I would argue (strongly) that your interpretation of 2a is incorrect, although it is a popular one, and one that SCOTUS twisted itself in pretzels to arrive at. The 2a derives from English common law, where it was required that ordinary citizens be trained in the weapons of the day, so as to be useful to the state in the event of war (and an inevitable call up). In the time of Henry the 8th, it was illegal for a yeoman (non serf, non noble) to practice with the longbow at a range of less than two hundred yards.

This gave the government an army of highly trained bowmen (see Agincourt). Similarly In the time of the 2fa, the US did not want or have a large standing army. It wanted a small (and cheap, controllable) professional army, with the ability to scale rapidly if need arose.

I invite you read the 2nd amendment again, in the light of the historical facts above, and see if that is not the most logical interpretation.

I would argue that no government, not the most enlightened, and certainly not the US government would ever encourage the ownership and training in small arms with the express purpose of being able to exterminate the government should the need arise. The reason for the current interpretation of 2a is entirely parochial politics - the right needed another group to add to their coalition in order to secure election victories.

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Turns out Luigi was a founder subscriber of @gurwinder on Substack, who I also read. Maybe reading heterodox rationalists makes you a radical? 😂

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Exactly!! Eloquently said.

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You hit the nail on the head. The factors that drive an act like this are complex and deeply personal and subjective. The act has a utilitarian meaning to the masses, but his own pathology isn’t going to be congruent the way the left or the right would prefer. Even for someone who has the appearance of being in the upper echelons, having upward mobility, it seems evident that no one is being spared by the visceral dystopian reality we exist in as a collective. I’ve seen so many folks trying to reduce him to a party or side without considering the totality of context or his background. This kid was in pain and was just trying to figure it the hell out and was understandably deeply disillusioned by his own experience and I’m sure working in tech was a factor. It’s actually more remarkable that he’s a Maryland prep school, Ivy League kid—yet in his manifesto he details his own mother’s struggle with pain, countless denials and gaslighting by doctors, his own pain and a burgeoning class consciousness. The seeds that were sewn in him were deeply rooted in his lived experience with healthcare, and it’s truly a uniquely American tragedy. We can’t expect a 26 year old from the suburbs to have a fully fleshed out perspective on everything or a perfect political ideology. Considering his age and given he completely isolated from his support network, mental health is likely a factor as well, but chronic pain will do that to a person.

Algorithms attempt to pacify but also inflame the public in a way tech companies and their benefactors thought they could control or weaponize but we’re now seeing the results of the experiment. My generation is jumbled up, confused, frustrated, in constant struggle to find truth, reduced to a joke in a failed system. We’ve watched horrors beyond comprehension unfold day after day with no change and the homeostasis has been being lit on fire 24/7 by the simple conditions of existence, let alone any personal traumas that amplify. Who couldn’t have predicted the hydra effect, albeit from an unlikely suspect?

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Excellent stuff, and powerful point about the kindergarten shooting. I was aware of both shootings but hadn't thought about how the CEO shooting getting vastly more attention might influence the school shooter types.

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It hadn't occurred to me until I read your comment but I personally gave this shooting vastly more attention than I do to school shootings. I think for several reasons: (1)As a parent, school shootings are incomprehensibly horrific for me. It is painful to read about them so mostly I don't. The loss of a 50 something CEO doesn't generate the despair a school shooting does. (2)Nearly everybody has a screwed over by health insurance story. People don't have to approve to understand the sentiment. (3)His escape from NY and its omnipresent cameras was fascinating to me anyway.

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I look forward to reading Kyle Rittenhouse'opinion...

(for the avoidance of doubt, that's sarcasm...)

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The need to pigeonhole the shooter into a political ideology speaks to a broader need to clench cheeks and whisper "please don't be..." every time there is a mass shooting or act of terrorism. This shooting feels a way in how many people could've done this. Left, right, rich, poor, religious, atheist: navigating the American healthcare system has a radicalizing effect, hampered luckily for many who contemplate outward harm. The butt clench didn’t happen because it could've been anyone and plenty from all walks are between giddy and benignly intrigued.

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This is a story that I really don’t know how I feel about. I’m not from the U.S., but we all get your news and many of my good friends are emigrants. The two issues I struggle most to wrap my head around are probably guns and healthcare.

I think there’s a typo in “That does suggest *it* may be his own x-ray.” And I “bare” > “bear no relation”.

I found this a really valuable insight. There’s a theory that I came across when studying Franco’s Spain that people tend only to resist actively when most of their basic needs are fulfilled. You’re less likely to mount an organised rebellion when you’re surviving on boiled dandelions, that kind of thing. I suppose guns level the playing field slightly, but the other thing that strikes me here is the profound lack of any wider solidarity. Or, I suppose, that the only solidarity is to be found in shooting someone, not in the experience of pain.

All of this is probably influenced, as I say, by being brought up down the road from where the forerunner to the NHS was dreamt up. It took the pain of World War 2 to make affordable healthcare a national reality. Not saying war is my recommendation, though.

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I have read that leaders of revolutions are generally economically secure to some degree. Most are also educated, formally or self-educated. Those in truly desperate straits rarely have time and energy to design revolutionary strategies.

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The ‘radicalised by pain’ line is getting quoted far and wide, with Robert’s name removed

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Curious as to what you're seeing?

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Memes and quotes and Facebook and insta, I’ll screenshot if it comes up again

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Thanks. I consider that a positive sign on the whole.

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I've seen a couple other unattributed quotes from this on quora. I imagine they stole them from Facebook. :P

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I’m seeing this too, but had my share of this actual original article removed for “attempting to gain likes in a misleading way.” I shared it without any commentary, so I’m not sure how that’s misleading. I suspect anything semi-sympathetic to the alleged shooter is just getting buried.

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I just want to say I want to thank you for noticing the role disability has in this. When this first happened I immediately knew it had to be a disabled person. I have suffered with chronic pain for more than half my life, since I was 11 years old. It changes you.

I am frustrated by the amount of people who are so quick to dismiss that. That he must be part of some great conspiracy with lots of players, that his disability had nothing to do with this.

Disability has everything to do with everything. We will all either become disabled or we will die young. This country has done nothing for disabled people.

The pain from watching society return to “business as usual” from the ongoing pandemic has darkened a lot of our hearts (as someone who is disabled).

I think we as a society need to seriously get our shit together, and as left leaning individuals you need to start including disabled people in your community.

anyways long rant, lots of feelings. Thanks Robert

((Edited for grammar cause spelling roll instead of role is haunting me))

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I like to refer to folks as temporarily able bodied. Sometimes gets their attention.

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Iconic behavior. Stealing that energy

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He has all the hallmarks of adult-onset schizophrenia that effects young adults in their twenties. Violence is an anomaly. But they lose absolutely everything. The stress of much feared surgery may have been the trigger. He has lived with pain all his life per his friend interviewed by Morgan and Morgan. His condition is a curved spine and how that causes nerves to compress. According to his friend his life in Hawaii consisted of long stretches of good days interrupted by great pain and literally unable to get out of bed. He must have consulted with his doctor in NY. It appears surgery could no longer be put off. He freaked out and was not only in pain but very fearful of the surgery according to his friends. Maybe it triggered schizophrenia which can be triggered by a powerful stress. My friend’s sister suffered a trauma giving birth and the baby was still born. She was never the same after the birth after which rather quickly as if overnight her personality and behavior changed. Today she is in middle life still battling schizophrenia. She is brilliant with a double major out of school and a master’s in finance. I wish people would at least look at this as a possibility Mangione is mentally ill. The country has gone mad with this “mob” calling for more blood. Hard to watch.

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Wow. This makes a tremendous amount of sense. And in these post-opioid days of doctors being very stingy with pain meds, I could see how this could drive someone to extremes. Will be interesting to see how this plays out, because it will no doubt be a huge factor in his defense.

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Thanks for the serious write-up. Unfortunately most people who were happy to scour Thompson are equally flippant about Luigi.

It's hard to say whether any real good will come from this assassination. It was justified and necessary IF AND ONLY IF it accomplishes something.

It's too bad that the kid is so thoughtful that he has no natural tribe (as you mention). If he did he would already have his cheerleaders (as I scathingly predicted when the news of the killing first broke https://ydydy.substack.com/p/brazen-manhattan-murder-of-a-monster ).

As a thoughtful, intelligent, open-minded fellow he's got fewer advocates than he'd have if he were some red or blue tribe nut.

Hopefully that changes. And the rest of our man vs man system too.

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Why on earth would anyone believe anything good will come from vigilante assassination? The only possible result of this will be more vigilantes kill more people, and those people may or may not be the kind of victim you like.

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The hope is obvious, isn't it? That CEOs will be afraid of violence, and since their life is probably the only thing they value more than maximising profit, they might hesitate before signing off on price-gouging.

I'm not saying this is going to happen. I have no idea what's going to happen. But your "why on earth" and "the only possible result" made it sound like you couldn't see what good people are hoping might come out of it. And I think it's not completely impossible.

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I think the New Deal only happened because the Russian revolution have our rich a clear understanding of what would happen if they didn't do something to make things better for people. It's clear that our rich have forgotten, with a few exceptions like Nick Hanauer. Government by assassination isn't good, but reelecting Trump probably means we aren't going to have the good options.

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wow not to derail, but McKinley I've got your latest newsletter open in another tab that I am reading while* reading this and it's exceedingly delightful to see two of my favorite communicators interacting!

(This post itself was very good and is making me think and I simply have nothing interesting to say about it at this time.)

*this isn't possible, but ADHD makes all things seem possible

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Aw hey ❤️

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It's completely impossible. Vigilante murder doesn't change laws and it certainly doesn't persuade anyone to come to your side. The most it will do is inspire more vigilante murder.

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Revolutionaries have always instilled fear into the hearts of the elite who have overplayed their hands. Defecting on defectors is a legitimate game theoretic group survival strategy. Don’t act ignorant towards it.

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You can @me when one positive thing happens because it gets normalized that shooting people you don't like is okay. 40% of the country would cheer the vigilante murder of AOC or Rashida Talib. The issue is that it's a dumb strategy, not that it's illegitimate. Not even to mention the reactionary crackdowns that might occur or the fact that the other side has most of the guns!

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It’s like you forget that the founding of America was made possible by vigilantes taking a moral stand and killing people they didn’t like during the War of Independence. Perhaps you are right though, they should have laid down their arms and turned the other cheek like good Christians.

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So at least one good thing has happened: an insurance company was planning to introduce draconian charging schedule for anaesthesia (where, if complications arose during your surgery, you could lose coverage while unconscious and wake up to find you're paying out of pocket)

It has been reversed. Of course they don't say it's because of the shooting, but then you wouldn't expect them to. And the timing is certainly perfect

https://thehill.com/policy/healthcare/5025236-anthem-reverses-anesthesia-payment/

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It's odd to find a positive, but I've been thinking about the author's final paragraphs. The shooting of this CEO got vastly more attention than a shooting at a kindergarten, perhaps the school shooter types will take a lesson from that and change targets. CEOs can defend themselves, children can't.

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Absolutely not justified. Please do a little bit of introspection here and you will agree. If you say it's justified, you're part of this same radicalization that the author is rightfully concerned with.

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The author is talking about “radicalization by pain”. How do you expect someone to be “unradicalized” under pain? Do you think pain is something that can be managed or avoided with mental strength?

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A 262 word “manifesto”? What’s a better word for a nefarious paragraph?

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So, I tried to share a link to this article on Facebook, and it got removed for violating “Community standards on spam.” The funny thing is, it didn’t violate ANY of the examples they showed. I wonder what the problem could be.

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Facebook has auto-banned links to Substack in status updates. You can post them in comments. Some Sstack creators and readers will include a passage with pertinent information and direct those interested to see the link in the comments

My largely unsupported believe is that FB is desperate to keep users' eyes glued, particularly in the app. They don't want users to read material that could divert them to this kind of site. I suppose the concern is that if you read an essay on Substack that draws you in, you will browse the offerings here, rather than return to FB upon finishing a piece. Every click away from FB is money they can't make.

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I didn’t realize it was removing all Substack links in status updates. That’s still shitty but doesn’t scare me quite as much as outright suppression of the concept of empathy for the shooter.

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Me too and I appealed to no avail. Not understanding why.

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Thanks for the post. Good stuff. One typo, I think: Not a series of bombings that killed and *mailed* innocent people...

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Uuh....maim is definitely a word that fits the sentence

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He updated it to maimed. Guess Robert does keep weird hours.

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