Healthcare on Trial After Shooting of UnitedHealthcare CEO

The attack on UnitedHealthcare CEO Brian Thompson reflects public anger over U.S. insurance

Jeenah Moon/ABC News

The tragic shooting of UnitedHealthcare CEO Brian Thompson in Midtown Manhattan sparked controversy across the nation. On December 4, 2024, Thompson was fatally shot outside a hotel in Midtown Manhattan, where United Healthcare was hosting its annual Investor Day. Witnesses reported that Thompson was approached by the gunman near the hotel’s entrance before multiple shots were fired. Thompson first joined UnitedHealth Group in 2004, where he obtained many leadership roles that oversaw Medicare & Retirement and Community & State divisions. The incident, labeled by authorities as a “targeted attack,” raised questions about both the safety of corporate leaders and larger societal issues triggering such an extreme act. Investigators identified Luigi Mangione as the suspect who reportedly held a strong anti-healthcare perspective. While this act serves as a reminder of the violence that can stem from societal objections, it also reflects the growing public frustration with the U.S. healthcare system. Many Americans see this system as a profit-driven structure devoid of the “care” in healthcare.

A Targeted Attack

It has been made clear that the attack on Thompson was not a random act of violence, but rather a deliberate response to societal grievances. Investigations revealed that Mangione suffered a back injury in 2023, leading him to seek emergency medical care. Although he was not under UnitedHealthcare insurance, some individuals believe he held anti-healthcare sentiments due to a bad experience during his treatment.

While this could be one answer, it is undeniable that it went beyond just personal experience and extended into ideological beliefs. He publicly admires Ted Kaczynski, the “Unabomber,” referring to him as a “political revolutionary” and drawing inspiration from his attack on institutions seen as exploitative. In a manifesto seized by law enforcement, Mangione labeled the U.S. healthcare system as a “parasitic industry” and referred to the shooting as a “symbolic takedown”. The bullets used in the attack had the words “delay,” “deny,” and “defend” engraved into them; a clear remark against the current insurance industry practices.

While Mangione’s motivations included personal frustrations, his actions were meant to symbolize public anger against the exploitative side of healthcare. The U.S. ranks poorly among other high-income nations in terms of affordability and access to healthcare, with a 2023 poll revealing that only 19% of Americans are satisfied with the costs of care. The attack on Thompson was fueled by the frustration of this system.

Public Response

In the aftermath of the attack, many members of the public expressed sympathy for Mangione’s frustrations, if not his actions. On social media platforms like Tiktok, Twitter, and Reddit, individuals framed the shooting as an expression of resistance against this system, one that they believe has failed them. Posts highlighted the struggles of Americans dealing with extreme medical debt, denied insurance, or unaffordable medications.

For example, comedian Bill Burr’s commentary on Jimmy Kimmel Live went viral after criticizing health insurance companies for making patients “fight tooth and nail” to receive coverage they already pay for. Burr’s comments, while not necessarily condoning violence, supported Mangione and the feeling of disillusionment from the system.

Not only was support noticed online, but public demonstrations were made too. In December of 2024, supporters were seen assembled outside courthouses during Mangione’s hearings. For instance, about two dozen individuals gathered together in freezing temperatures to attend a session in Manhattan. Not only did they express their support, but also used this as an opportunity to voice their reasoning.

These reactions were not seen as support for violence but rather a growing frustration among individuals that suffered due to the system. Sympathy for Mangione’s motives signals this feeling of being unheard.

Corporate Practices

At the center of the public’s dissatisfaction is the perception of corporate greed in the healthcare industry. UnitedHealthcare reported $324 billion in revenue in 2023 making it one of the most profitable companies in the industry. At the same time, millions of Americans are struggling with medical debt or lack of access to affordable care.

Executive compensation has also drawn criticism. In 2023 alone, Thompson received a compensation package of 10.2 million, including stock options and bonuses, ranking him one of the highest-paid executives. In stark contrast, patients are facing the other end of the stick, unable to afford life-saving treatments. According to the Kaiser Family Foundation, nearly 40% of Americans delay or avoid medical care due to cost concerns.

Insurance companies are frequently criticized for practices that prioritize profit margins over patient care. Take the “delay, deny, defend” slogan, for example. It is a term used to describe how insurers sometimes delay claims processing, deny coverage, or challenge the need of treatments to minimize payouts. These practices fuel public anger and add on to the stereotype that the system is only serving corporate interests.

Global Comparison

The U.S. is not alone in facing public dissatisfaction with healthcare systems, but its challenges are different in scale. In the United Kingdom, the National Health Service (NHS) maintains high levels of public trust. This is largely due to its universal healthcare system that prioritizes need over ability to pay. However, they too face criticism over long wait times and underfunding. This led to public protests over attempts to privatize parts of the NHS that prioritize equity.

Germany, can be seen as a more compelling example. Its healthcare system operates on a dual model that combines public and private insurance. Most citizens are covered through statutory health insurance system funded by income-based contributions. Higher income individuals also have the opportunity to opt for private coverage. Their system attempts to provide care for everyone but also additional options for those that are able to afford it. Due to shorter wait times combined with universal healthcare, they have high levels of public satisfaction. In 2023, they were ranked among the top nations for healthcare outcomes and equity.

In contrast, the U.S. healthcare system is highly dependent on employer-based or private insurance. Millions of Americans remain uninsured or underinsured, and medical debt is a leading cause of bankruptcy. While none of these healthcare systems are without their flaws, the disparities in the U.S. system are incomparable to those of other nations.

Conclusion

The attack on Brian Thompson may have been an extreme act of violence, but the public reaction highlights a deeper issue within the U.S. healthcare system. While the act itself is indefensible, the widespread frustration can’t and shouldn’t be ignored.

Medical debt continues to be one of the most pressing issues, with nearly 100 million Americans struggling with healthcare-related bills. Long-term care and maternity care, in particular, remain inaccessible for many, as insurers frequently deny coverage for essential treatments. The “delay, deny, defend” approach has real consequences, leaving families burdened with financial hardship. Without a change, these issues will continue to push more Americans into economic instability and distrust in the system.