On top of that, mass media controls the narratives way too hard - just look how fast Luigi Mangione got out of the news.
What news would there be? He was arrested and locked up, his court case hasn’t started. Should we have “Luigi still in jail” headlines?
"Awareness" is almost never the limiting factor to policy change.
This is why awareness based movements such as occupy, BLM, and climate protests go nowhere. Everyone is aware of climate change, police brutality, or inequality.
Organized opposition with leverage and a compelling alternative is the bottleneck. Awareness isn't a policy position and doesn't advance debate.
Luigi did not have a thesis capable of changing minds. I dont know and haven't seen a single example of someone having their mind changed. Just people more fired up on their priors.
No, it wasn't; if the momentum was there, the debate would have been self-sustaining and not dependent on new news events relating to Mangione to sustain it.
> but the day he got caught, the debate got suppressed and no one is talking about it anymore.
The debate didn't get suppressed and didn't need to be; the “debate” in the major media wasn't a real debate, it was just a way to stretch attention to Mangione news for a few more commercial breaks, and once there were no more news events for it to leverage for that purpose, it was abandoned by the same people who had been driving it. And, to the extent that there were people engaging in social media and elsewhere who saw the debate as genuine, they didn't need to be suppressed, as they never had momentum, they just mistook cynical commercial manipulation for opportunity.
It was all show no thought. The big questions remain unanswered. Where are costs inflated between pharmaceuticals, providers, hospital administrators, insurance administrators and patients seeking unnecessary care? How do we reform insurance when most people hate our healthcare system while simultaneously liking their own coverage?
Luigi didn't add anything substantive to the debate. Instead, his role was in facilitating venting. Someone still has to come up with an idea beyond "I hate this."
> there was a debate beginning to form what drives someone to execute a healthcare executive on the street
On Twitter, maybe. For most people, it was another Manhattan mental-health case murder. The chase and his good looks provided salacious intrigue, but only for so long as he was on the run.
Pharma costs are inflated by R&D costs and promotion. Insurance overhead is actually relatively lean, but base cost is primarily driven by cost of goods, and to a lesser extent admin. Provider costs are inflated by high legal and regulatory liability, shortage of qualified staff to offset liability, and high admin.
At a the highest level, cost is driven by an inability to discover and set prices at market clearing rates.
Manufacturer dont sell fixed price product into a market, but negotiate complex bulk deals with PBMs, pushing some prices up and others down. Similarly, hospitals/providers dont set prices at clearing rates, but negotiate 1:1 pricing, with some products above and below cost.
Last, and I suspect most significantly, health plans cant meaningfully vary in provided care, only cost sharing. That is to say, a bronze plan must include the same medications and procedures at a gold plan, differing only in copay. This breaks the price feedback on COGs. (e.g. a generic only insurance plan is illegal, so name brands face reduced competition).
If I were Medical Czar, I would look at banning preferential pricing/institutional rebates for goods and services.
I would allow more heterogeneity in policies (e.g. generics only, no implants, limited oncology, ect). This would crush innovation, but also greatly reduce pricing as it moves from cutting edge, to 10 year old technology.
Provider shortage is a tougher nut to crack, but I think it would require radically altering the residency program as it exists today and loosening requirements for other healthcare professionals.
Republicans might make big changes but this has been the situation since Obama.
People say this a lot, but it seems just as likely to me that the media is simply reflecting what we care about. Coverage fades because, broadly speaking, people have moved on from the story. Even more "intellectual media" like the Atlantic has moved on from it. I get that it’s uncomfortable to acknowledge, but an equally plausible explanation is that the public is far more interested in Blake Lively’s lawsuit than in Mangione or the state of healthcare in the U.S.
Yes, it’s a symbiotic relationship, but I think people are often too eager to blame a shadowy cabal rather than recognizing that it’s often just a reflection of what society actually values. Probably because, as stated, dismantling mass media seems like something that could possibly happen while changing the entirety of a nation is essentially impossible.
