The Anger Stage of Grief, Algorithms, and America’s Healthcare Horror Show
An uncanny personal take (7 min read)
I recently lost a friend, Ryan, to cancer. I know, we’re starting off on a depressing bang here but the more things become not real, the more I want to share real stories. Ryan was a real one. I hate saying Ryan was. We met in college–art school lol–and bonded quickly after he unwittingly taught me how to draw, which was really teaching me how to see. We moved to opposite sides of the US after graduation, then briefly reconnected in Seattle ten years later. That was the last time I saw him. It’s surreal to scroll through our messaging history, or see his Instagram stories posthumously appear on my feed, tributes posted and reposted by a slew of people who knew Ryan, if only for a brief moment.
Ryan cared for the Earth and the people in it with remarkable sincerity and creativity, despite the horrible health crisis he faced for years, diagnosed at 30. For the living, death provokes a potent reflection of our own lives: how we spend our time, how we relate to one another, and, for Americans, whether we’ll be able to take care of our health and the health of the people we care about amid a violent and rapacious healthcare system, one that could leave us bankrupt because an algorithm denied our claims, or leaving us waiting too long for insurance approvals to get the care we need.
I’m also writing this while texting mom as we wait to see how much dad’s six-figure surgery bills will be covered by the algorithms and AI of his insurance company, after his hands and arms went completely numb this year. Last August, doctors urgently informed him that he needed major spinal fusion surgery or else he would face paralysis of all four limbs in his body. The diagnosis came after dedicating nearly forty years of his life to working in factories for various American corporations. Thank you for your spine, our country says. Here’s a six-figure bill for a new one, addressed to you and your descendants.
I’m begging for more states to follow California’s newly passed Physicians Make Decisions Act, ensuring that decisions about medical treatments are made by licensed health care providers, not solely determined by AI or algorithms used by health insurers. Humana, Cigna, and UnitedHealth are all facing lawsuits alleging that they made flawed algorithms that guided AI to deny health care. Last year, STAT released an investigative series, revealing secret rules and more flawed algorithms to deny care, leading to class action suits against UnitedHealth and Humana. Then, ProPublica reported a story of “how Cigna doctors reject patients’ claims without opening their files.” Now, tech startups are trying to combat all this by redirecting the use of AI towards fighting insurance denials by analyzing coverage requirements and drafting appeal letters for doctors and patients. The fact that there aren’t stronger protections against AI abuse in a country with a privatized healthcare system is a premise straight out of a horror film.
Thank god for the surgeons, doctors, nurses, modern medicine, and technology for reconstructing my dad’s spine, and, for performing multiple surgeries on Ryan’s spine too, to treat Chordoma, a rare form of bone cancer, helping him stay alive for as long as he could.
Coincidentally, dad had the same spinal fusion procedure that the alleged UnitedHealthcare CEO killer/ex-data scientist had done. But the US privatized healthcare problem is, of course, not one that a 3D-printed gun can solve. And while it is redirecting our attention to one of the most monstrous crises of our time, the online discourse is more interested in how hot the murder suspect is than the lives of the people, across generations, affected by this failed system.
In my more frustrating spells of grief, I’m enraged that Ryan, with all his exquisite care and generosity for this planet, is no longer living, particularly as we approach a new year with power swinging, hard, to those with obscene wealth and access, bewitched by their own self-interests above the health of this planet and its inhabitants, or tied to the golden handcuffs of delivering shareholder value, in perpetuity. It’s times like these that I wish I could reach out to Ryan–that I wish I had reached out to him more–for solidarity and art and friendship. We’re going to need a lot of that, now and forever.
Backed by a swath of Silicon Valley billionaires, and nearly 78 million voters, Trump returns as US president next month, with Amazon, Meta, and OpenAI CEOs donating $1 million each to his inauguration, kissing the ring and hoping Trump won’t regulate them. Trump is eager to make America the “crypto capital of the planet,” and enact substantial tariffs that could spike costs and slump the development of cleantech projects. These tariffs pose a serious threat to Europe’s export-focused economy at a time of political paralysis, as Germany and France face government collapse and Romania cancels their presidential elections after alleged Russian interference on TikTok.
After becoming Trump’s quarter-billion-bribing-bonehead, and with a skyrocketing net worth of $400 billion, Elon Musk has been strutting around Capitol Hill like he owns the place, because, well, we’ve let him. He is currently one of the Pentagon’s largest contractors, and last year, two of Musk’s companies–Tesla and SpaceX–received $15 billion in federal contracts. Then there’s the Starlink network of mobile internet terminals and satellites, controlling nearly two-thirds of all active satellites orbiting Earth. Starlink has been Ukraine’s primary battlefield communication tool, and in 2022, Pentagon officials had to plead with Musk after some Ukrainian units lost access to Starlink. They eventually stuck a deal, with one Pentagon official chillingly recalling, “We are living off his good graces. That sucks.”
Musk is now the co-lead of the new “Department of Government Efficiency,” aka fucking DOGE, aiming for $2 trillion in cuts which economic experts say is not mathematically possible, but will give him power to cut federal programs that vulnerable families need, close departments, slash regulations, and layoff government workers. He even went so far as to post on X the names of federal employees in climate-related government positions he wants out.
Disrupting bureaucracy with brute efficiency has always been the tech sector’s modus operandi, one that Musk and his followers assume could easily be applied to government. Even the alleged UH CEO killer reshared a post on X of another user praising Musk for his “commitment to long-term civilization success.” But with a man at the helm who has a $400 billion net worth and a self-interest to destroy the ‘woke mind virus,’ who will benefit from this efficiency, and who won’t? At what point does efficiency become weaponized? Certainly, with algorithms and AI making decisions about who gets insurance coverage or determining the order in which patients are seen, the possibility for efficiency to get weaponized is ever-present.
How efficient it would be, to take that whopping ass $400 billion and redistribute it towards expanding Medicare so my 63-year-old dad can get coverage, or debt relief programs for grieving families, or advancing medical research and innovation for rare cancers, or investing in burnout prevention and better working conditions for healthcare workers, or funding community clinics in underserved areas, or, or, or? We are drowning; we don’t have time for the schemes of wannabe dictators dressed in tech bro’s clothing.
But how do we reclaim agency when our humanity is trapped inside systems designed to feed our greed, tyranny, and indifference? The fact that the alleged UH CEO killer, according to the frustrations written in his manifesto, decided to face these broken systems by enacting murder is not only a sign of our profoundly alarming social decay, but a sign of profound desperation to answer this very question. (Murder, not the answer, and I’m also writing this to the healthcare industry.)
I don’t have the answers, but I think about writer Lidia Yuknavitch, who often says, “make art in the face of fuck,” and I imagine Ryan encouraging a similar sentiment. (He had created a lot of art throughout his life, spanning the American comics publishing and music industries, and before his death, he was a book designer at Fantagraphics, designing numerous cover designs, including a few horror stories.) If you’re reading this, you’re alive and living in these times for a reason, carrying a distinct, non-AI-made creativity and generosity that, when applied and organized, can lead us towards a reclamation of agency. Some days it’s easy to trust this, and some days it’s not; that’s okay.
As I’ve been sifting through old photos of Ryan on his Instagram, I found one from October 2022, while he was in the throes of battling cancer. Those close to him might say this photo is “classic Ryan,” cradling tiny pumpkins he grew in his garden, while wearing a sweatshirt inspired by a mashup of two horror films–the 1974 version of the The Texas Chain Saw Massacre, and the 1989 cult comedy-horror, The Burbs. His shirt, my god, it says, “Who will survive and what will be left of them?” ◆
