No surprise Americans are ‘rooting for’ the UnitedHealthcare CEO’s killer

Belén Fernández

Al Jazeera columnist

On the morning of December 4, Brian Thompson, the CEO of UnitedHealthcare – the largest health insurer in the United States – was fatally shot in New York City. At the time of writing the suspect had yet to be apprehended and a motive not established, although the words “depose”, “deny”, and “delay” were found written in permanent marker on bullet casings at the crime scene – a potential allusion to manoeuvres by health insurance companies to avoid paying for the things they are supposed to pay for.

In the social media world, the tears for Thompson were few and far between, with Fox News lamenting on December 7 that a commemorative Facebook post by UnitedHealth Group – the parent company of UnitedHealthcare – had already racked up more than 77,000 laughing emoji reactions. Other social media users scattered witty counter-condolences across various online platforms, such as “My empathy is out of network” and “I’m sorry, prior authorisation is required for thoughts and prayers” – a reference to another common tactic employed by UnitedHealthcare and similar firms to decline coverage and increase profit margins.

Meanwhile, The New York Times notes that, while authorities are pleading for help from the public in tracking down the suspected perpetrator, “some seem more interested in rooting for the gunman,” who is being “venerated as something approaching a folk hero”.

And yet it’s not difficult to understand why many Americans would fail to mourn the death of a man who symbolised a willfully dysfunctional, for-profit US healthcare system that is literally deadly in itself. Back in 2009, a Harvard Medical School study found that 45,000 Americans were dying every year for lack of health insurance. This, of course, does not include the countless insured Americans who die every year because their insurance companies opt to deny them life-saving treatment.

But that, after all, is how capitalism works: healthcare is a business, not a right, and human lives are expendable in the interest of ensuring that obscene wealth remains concentrated in the hands of an elite minority. Americans spend far more money per capita on healthcare than their counterparts in other developed nations – but it’s not like you get what you pay for. Often, the US healthcare experience consists of jumping through hellish bureaucratic hoops, spending a good portion of your life on hold on the telephone, and battling insurance claims denials – if you have the energy and time to do so.

Indeed, there’s no denying this claim: that it’s downright sick that people who are seeking medical treatment precisely because they are ill should be put through such mental and physical agony simply to obtain care. Public anger at the system is, therefore, absolutely logical – you might even call it a preexisting condition.

Of all the predatory firms that comprise the multitrillion-dollar US healthcare industry, UnitedHealthcare has a particularly vampiric reputation for charging huge premiums while pathologically denying claims left and right. As per The Associated Press news agency, UnitedHealthcare raked in $281bn in 2023, while Thompson himself enjoyed a $10.2m annual pay package.

This financial context is key when considering, for example, the recent case of a chronically ill college student in the US who was reportedly slammed with $800,000 in medical bills when UnitedHealthcare denied him coverage for the drugs his doctors had prescribed. Or consider the untold number of folks whose claims denials have ultimately constituted death sentences – and all to sustain those billions in revenue and Thompson’s annual pay package.

I personally have no health insurance policy, which is part of the reason I avoid the US like the plague despite it being my birthplace. I do, however, have some personal experience with UnitedHealthcare, which was my father’s insurer at the time of his death last year of prostate cancer in Washington, DC.

My dad was enrolled in the government-funded Medicare Advantage programme for seniors, which allows private firms like UnitedHealthcare to overbill the government for its services while skimping on providing needed care to the country’s elderly. Denied insurance coverage for the prostate cancer drug Xtandi – which, to add insult to injury, was developed with US taxpayer money – my father was forced to seek foundational financial support in order to acquire the medication. Had he not succeeded, he would have been billed no less than $14,579.01 for a one-month supply, ie, more than the average annual income in some countries.

Obviously, Brian Thompson is not personally responsible for the terminally ill state of society in the US – a country that managed to spend $916bn on its military in 2023 alone and that continues to fund Israel’s genocide in the Gaza Strip to the tune of tens of billions of dollars, all while poverty remains a leading cause of death among Americans.

But the man was in fact emblematic of the lethal inequality that underpins US corporatocracy, where the health insurance racket does its part to keep people so sick and debt-ridden that they can’t pose a challenge to the system. And that, at the end of the day, is why the gunman is being “venerated as something approaching a folk hero”.

The New York Times quotes Alex Goldenberg, a senior adviser at a research institute that tracks online threats, on the perceived “lionization of the shooter” and the implications of Thompson’s killing: “It’s being framed as some opening blow in a broader class war, which is very concerning as it heightens the threat environment for similar actors to engage in similar acts of violence.”

But there is already a class war raging in the US, and the healthcare system is one of its most violent fronts.

The views expressed in this article are the author’s own and do not necessarily reflect Labour Heartlands’ editorial stance.

Belén Fernández

Belén Fernández is the author of Inside Siglo XXI: Locked Up in Mexico’s Largest Immigration Detention Center (OR Books, 2022), Checkpoint Zipolite: Quarantine in a Small Place (OR Books, 2021), Exile: Rejecting America and Finding the World (OR Books, 2019), Martyrs Never Die: Travels through South Lebanon (Warscapes, 2016), and The Imperial Messenger: Thomas Friedman at Work (Verso, 2011). She is a contributing editor at Jacobin Magazine, and has written for the New York Times, the London Review of Books blog, Current Affairs, and Middle East Eye, among numerous other publications.

---

Update

On Monday 9 December 2024, a person of interest was taken into custody in Altoona, about 275 miles (440km) west of New York City. The alleged shooter is Luigi Mangione.

It has not been confirmed whether that person is the suspect in Thompson’s killing. Police have not named them.

A source close to the investigation told CBS that the person was taken into custody on an unrelated matter, but was then questioned about the killing.

The source said the person was carrying a firearm similar to the one used in the shooting in New York last Wednesday.

The source also said the physical description matched that of the person of interest being sought by the New York Police Department (NYPD).

Health struggles

In recent years, Mangione suffered from troubling back pain and underwent surgery to treat it, according to a friend and online postings.

Mangione posted a similar photo as the backdrop for his X page, which was taken offline after he was identified by police Monday.

And on the book review website, Goodreads, Mangione reported reading or wanting to read a number of books about coping with chronic back pain. He also linked to handwritten notes laying out his workout routine, which state that he was suffering from spondylolisthesis, the slippage of a vertebrae in the spine.

Posts from a now-deleted Reddit account that does not list Mangione’s name but closely matches many of his biographical details – including his university, age, major and health condition – say that the user had suffered from back aches related to spondylolisthesis since childhood but aggravated the condition after a surfing incident.

“My back and hips locked up after the accident,” the user wrote in July 2023, adding that “intermittent numbness has become constant” and “I’m terrified of the implications.”

A few weeks later, the user wrote that he had undergone spinal surgery, which improved his symptoms. The user did not appear to post about health insurance related to the surgery, or connect the treatment to UnitedHealthcare.

The user also detailed past struggles with health issues including Lyme disease and severe brain fog, which he said started after losing sleep during his fraternity’s “hell week” and caused his college grades to start “tanking.” He expressed frustration about how little was understood by the medical community about brain fog, writing that “it’s absolutely brutal to have such a life-halting issue… The people around you probably won’t understand your symptoms – they certainly don’t for me.”

---