Green Mario is the brother of Mario Mario (who is also sometimes called Red Mario). Green Mario stands accused of shooting and killing a private healthcare insurance executive earlier this month, becoming a kind of hero for doing so. His arrest in the Mushroom Kingdom aka Pennsylvania happened at a McDonalds of all places and he’s now awaiting trial.

The killing of Brian Thompson has sparked conversations about healthcare and health insurance with some of my friends. Every American has had a time where their insurance company dragged their feet or denied coverage or put up hoops to parkour through in order to receive care or the care was given and the company later rejected to pay the amount they previously promised.

In the latter half of this year, I’ve been trapezing through hoops such as these because I have a health condition: insomnia. My insurance is slowing my care. If the United States had universal healthcare like other developed nations, I would be farther along a treatment path than I am now.

Private insurance companies are among the most vile organizations that exist, making evil amounts of profit by denying to cover necessary care. “How,” you may ask, “could that be the case?” Well…

Healthcare is necessary, for everyone. Rich or poor, you deserve to be looked after by doctors who specialize in different parts of the body to prolong your life and make you happy. Their labor needs to be compensated, but you shouldn’t have to pay for procedures whose costs are proportional to how unexpected a medical event is—that is, you shouldn’t need to lose tens of thousands of dollars for a surprise shoulder surgery.

But, with collective resources, we can pay in one day for promised care in the future. That is insurance. One might one year have no big health issues, but someone else may need it, so our money goes to their care. The next year we might need more care than we pay in, so others pay for our care.

However, if you are managing the collection and distribution of care while a for-profit public company, your mission—nay, your obligation—is to maximize profits for shareholders and the board (including yourself). So what can a poor health insurance CEO do to pay off his second or third McMansion?

First, pay employees less than their worth, for one. (You are likely underpaid if the company you work for makes any profit.) The other is to take more money in and deny money going out. Ideally, all money going in would be routed to serving care, and none would be made as ‘profit’.

Second, you pay a complicated equation to get healthcare, with some things being paid by your insurance, some out-of-pocket, and some a mix of you and your insurer. It’s a ridiculous thing, but it’s there so that the companies can maximize the amount you pay and minimize the amount they pay.

Third, the insurance can deny to pay for your care, or make it more difficult in hopes you give up. Denied care that you paid your insurer in hopes that said care would be covered is, in the eyes of the company, profit.

This last point is the crux of it all: the insurance companies can make a profit by charging you a fixed upfront price for some coverage, and not pay the healthcare provider (your doctors). That insurance companies mark down profits while people do not receive care is the problem. All the money that people pay in should go to paying out.

Denying to cover the expenses of medically-necessary care to people is unconscionable. It’s evil. And there are people making these decisions at the top level, who see the profit but not the casualties.

Better things are possible. Universal healthcare would do away with this, making everyone part of the same system that both the wealthy and the homeless can use.

We all have a stake in this, and all Americans have stories of our insurance companies interfering with their care, whether they remember it or not. I remember, and I am also actively fighting my insurance company over small potatoes.

I suffer from insomnia. I’m not sure what type—there are a few—but I do know my body takes hours being in bed to actually fall asleep. In the fall, I started weekly meetings with a sleep psychologist recommended by my psychiatrist. This was not covered by my insurance; my family had to pay out-of-pocket for treatment that didn’t end up working after three months of trial and error.

I did not have a primary care doctor here in New York; my old one is back by my parents. Because of the quirks of my insurance plan, finding a doctor that was in-network was insufferable, postponing treatment and checkups. I finally found a doctor who saw me and made some recommendations. A follow-up Zoom visit was scheduled, until the day of, where the office suddenly realized that my insurance has my old doctor’s info on it and I can’t get the next appointment after all.

A few phone calls later and I was able to get the appointment back. If it weren’t for the middleman of an insurance company, I would have been able to see someone sooner and start treatment. But I have to deal with private insurance whose goals are not aligned with mine.

And I’m not an extreme case. This is a system of denying care. An industry of rent-seeking, trying to extract sums of money out of an interaction that could better be managed by the state. You have to understand the rage directed at insurance companies for their actions. And you should be angry too. I’m honestly surprised someone angry enough and crazy enough to assassinate a CEO in that industry hadn’t already done so, considering *gestures broadly at everything*.

Did Thompson deserve it? Or was he ontologically evil for his active involvement in a suffering machine? Did people under his care not suffer for his wealth? The answer is that neither Green Mario nor Thompson should have the levers to inflict suffering onto other people. But such as the society we live in where the one is possible, you are not allowed to criticize the other.