Choices, mistakes, soup, and murder

Last week, someone was murdered. In reality, many people were murdered last week but someone leapt to mind the moment you read it. On social media, people argue about the validity of who you think about and why you should have thought of someone else. I have never seen these arguments at a funeral.

I have been an executive at a health insurance company. I neither approved nor denied claims directly, but was responsible for the call center that handled both talking to customers and providers. Claims are denied on the presence and absence of evidence; my team was part of the evidence-gathering process.

Every claim is a research project. As with science, you start with the default that the claim should be denied and then gather evidence to reject that null hypothesis. Over time, heuristics form and then become laws, as immutable as gravity, because you cannot afford to revalidate them every time. So every flu shot claim, even if you’ve already had one this year, gets approved.

During my time as an executive, I am absolutely certain we denied claims that we should have approved. I am also certain that we approved claims that should have been denied. These mistakes happen in insurance for the same reasons they happen in science: our sources of information are imperfect and our judgement fallible.

Mistakes were made. I have made many mistakes. Many mistakes are mine.

(I pause here to make dinner for my son, who has a father that is still alive and has not yet been murdered.)

(Sometimes, my son drops his bowl, scattering soup across the kitchen. I am angry. He protests that it was an accident. I point out that it was an avoidable accident, that he made choices that made the accident more likely, that the accident was a matter of policy. We settle there, hug, clean up the food. I do not murder my son.)

(What if he dropped the bowl on purpose, because he is not a fan of soup? What if the dog gave him a big-eyed look in the certain knowledge that spilled soup increases Rover Oral Integration, also known as doggy dinner? What if, in spilling the soup, he burns my leg, does me harm, forces me to take out a loan to pay for more food and burn cream?)

(Should I kill him then?)

Science does best when free from outside influence. I have been a health insurance executive and I believe that people are best served by a single payer system run by the government. I believe this because evidence exists from the study of our own system and from the practical experience of other countries.

I enact this belief by voting. Sometimes my candidates win; sometimes they do not. Sometimes the candidate that wins says publicly that they will turn more of our healthcare system over to companies. I believe he will.

I also enact this belief by being visible. Sometimes, being visible gets you a nasty note. Sometimes, it gets you a death threat. Sometimes, you ask the police to do an extra pass by your house at night and they do it. Not to shoot you but to shoot those who would shoot you, because you are white and male and affluent and because someone cares if you die.

I would work in health insurance again. I would try to make it better. I would be glad when we got a single payer system. I would find new problems to solve. Because it is core to my beliefs that no one deserves to die. Not the murdered. Not the murderer. Not the murdered murderer.

(My son will spill the soup again. He will be a grown man some day. Aggravator and aggrieved, please do not kill him, through action or inaction. There are already enough ways to die.)