Over the course of my career in journalism, I have certainly seen news stories take surprising turns. But the murder of a health insurance executive on the streets of New York is something different. The killing by a coward, ambushing from behind, collectively shocked and disgusted many of us. As it should have.
But what has suddenly grabbed much of the country by the lapels is the support shown not for the victim, but for the man accused of committing the crime. With that support, we are witnessing an undercurrent of anger, even rage, come to the surface. It is directed squarely at an American business model that is, according to many policyholders, screwing us over every single day.
Violence cannot and should not be condoned, especially cold-blooded murder. It should be condemned, and the person who did it made to pay the maximum penalty under law. Period. Full stop. Beyond that, we as a nation, as a society, as a people are forced to recognize this: The lack of sympathy for murdered UnitedHealthcare CEO Brian Thompson and the glorification of his alleged killer has opened a window into the frustrated psyche of the American health insurance consumer. It is a window that we ignore at our peril.
If you haven’t been following this closely, here’s the quick backstory: On the morning of Wednesday, December 4, Thompson was shot in the back and killed in midtown Manhattan on his way to an investor meeting. The shooter inscribed the words “delay,” “deny,” and “depose” on the shell casings found at the scene.
Some of those words appear in the title of Jay Feinman’s book about the health insurance industry, “Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It.” The killer’s etched words have become a rallying cry for many Americans who are hurting — physically, emotionally, and financially — under the current system. In these days after the murder, you can buy online merchandise like mugs and sweatshirts adorned with “delay, deny, depose.”
The man now charged with Thompson’s murder is 26-year-old Luigi Mangione, an Ivy League graduate who allegedly dropped a backpack full of Monopoly money in Central Park as he fled the scene on a rented electric bike, according to police. He was able to escape the city on a bus. Authorities arrested him on Monday at a McDonald’s in Altoona, Pennsylvania, after a patron recognized him.
In the ensuing five days, Mangione was vaunted as a modern-day folk hero and a 21st century Robin Hood.
What gives? Americans are good-hearted people. With that having been said, we are now witnessing a groundswell that knows no boundaries. It is red and blue, men and women, coast to coast — folks who have collectively had it with corporate health care.
Much of the online reaction to Thompson’s murder was morbid glee. The UnitedHealthcare Facebook page had to be taken down after a post about the CEO’s death received more than 36,000 laughing reactions, according to The New Yorker.
Things weren’t better on X, where 6 of 10 posts about the crime were in support of the shooter. “Thoughts and deductibles to the family. Unfortunately my condolences are out-of-network,” one person posted. “My only question is did the CEO of UnitedHealthcare die quickly or over several months waiting to find out if his insurance would cover his treatment for the fatal gunshot wound?” posted another.
Author Joyce Carol Oates put it well with her social media post. The outpouring of negativity “is better described as cries from the heart of a deeply wounded & betrayed country; hundreds of thousands of Americans shamelessly exploited by health-care insurers reacting to a single act of violence against just one of their multimillionaire executives,” she wrote.
The phenomenon of a person operating outside of the law to deliver justice in what is perceived as an unjust world has been called social banditry. “When people lose faith in the state’s ability to address their concerns and grievances, they sometimes look to outlaws who offer themselves as an alternative,” Joshua Zeitz wrote in Politico Magazine.
In the eyes of many, Luigi Mangione has become that alternative.
This unnerving reaction to Thompson’s murder and murderer was born of unbridled frustration with a failing system. The American health insurance “system” is a misnomer. It implies that it was intentionally designed. In truth, coverage in the United States entails a messy patchwork of private insurance companies covering 65% of those insured and government-funded insurance (Medicare and Medicaid) covering the other 35%.
Senator Bernie Sanders is a proponent of health care for all provided by the federal government. What we have “is a system not designed to provide health care to all people in a cost-effective way,” Sanders said of the current setup. “It is a system designed to make huge profits for the insurance companies, the drug companies, and many other industries within the system.”
Most of those private insurance companies are publicly traded entities whose primary goal is to make money. And boy, do they.
Last year, UnitedHealthcare, the largest private insurance company in the country, made $16 billion in profit. To boost profits even further a company must reduce costs. The easiest way for insurance companies to do so is to deny coverage. UnitedHealthcare, which has one of the highest denial rates in the industry, turns down about a third of all claims.
Shockingly to me, many health insurance companies — UnitedHealthcare among them — outsource the decision-making of approving or denying coverage to third parties that use AI-generated algorithms to make life-and-death judgements. According to reporting by ProPublica, this hidden cottage industry works by a “denials for dollars” model. The more they deny, the more they get paid.
It is no wonder people are infuriated and some are praising a self-styled vigilante who claimed he was trying to do something about it.
A 2023 Gallup poll found that just 31% of Americans trust the U.S. health care system. One in 4 report delaying or foregoing medical treatment because of cost. While the Affordable Care Act has improved things, adding 45 million people to the insurance rolls, an estimated 23% of these are still underinsured, meaning they don’t have enough coverage.
Wouldn’t it be great if we had politicians who had the guts to do something about this mess? Health care lobbyists have spent more than $150 million to keep Congress in line.
And now we have Donald Trump and his bevy of billionaires, including the world’s richest man, looking to cut costs. Elon Musk says he may consider Social Security and Medicare as possible places to find savings.
The system can be fixed, but it would take elected officials willing to have the government do more, not less, at least when it comes to health care. Anybody think that sounds like Trump, et al.?
If you need a place to vent your frustrations, our comments section is always open. You will find a lot of support here, not from trained medical professionals, but from fellow citizens who have suffered from a health care system that seems designed to deny. You will be heard.
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Dan
