How the shooting of a medical insurance CEO (briefly) united America

Brian Thompson sounds like he was an okay guy. An obituary of the 50-year-old UnitedHealthcare CEO by The New York Times manfully cobbled together some nice comments about him from other CEOs, even if some of them read more like workplace performance assessments:

“When asked to develop a long-term plan for the company, he solicited input from top executives and then synthesized their views. ‘That speaks to how inherently sharp he was and how well he knew the business,’ [fellow United executive] Mr. Burns said.”

The same obituary recorded that Thompson, who was gunned down outside the New York Hilton Midtown at 6.45am on 4 December, had presided over the health insurance company during “a period of substantial profits”. His division’s profits topped $16-billion, with Thompson taking home a pay package of $10.2-million.

Brian Thompson may have been a nice enough dude, as far as CEOs of billion-dollar companies go, but he went to his grave knowing how much people reviled his industry.

“We work every day to find ways to make healthcare more affordable, including reducing the cost of life-saving prescription drugs,” read Thompson’s last LinkedIn post.

The comments in response were deeply revealing, alternating between plain abuse and desperate pleas for assistance from United customers.

“United Health Group is failing my mother by not providing her the basic care to get better and back [into] her life. You continue to delay any decision making and authorizations,” wrote one.

“Hey Brian, I just spent an hour on the phone battling to get general information for my wife with stage 4 cancer. She’s a 45 year old mother of 4,” wrote another, who supplied his phone number and begged Thompson to call him.

The experiences described in these comments were tame in the extreme compared with the stories that would be shared on social media by Americans in the days following Thompson’s murder: tale after tale of unnecessary pain, suffering and needless deaths as a result of US medical aid companies – or as they call them, health insurers – refusing to cover vital treatment.

In 2021 alone, US health insurers denied 49 million claims. Investigative journalists from ProPublica have revealed how these life-and-death decisions are often made in bulk by an algorithm. It is not uncommon in the US for people to suddenly fall ill or have an accident and end up saddled with medical debt for the rest of their lives.

The system is so ingrained that many Americans seemingly cannot comprehend even the concept of free government-supplied healthcare.

One sneering tweet which went viral after the shooting read: “So basically people think there’s an unlimited supply of free, quality healthcare that we’re all being prevented from accessing by evil corporations?”

Literally correct, responded people from countries with a functioning social welfare net.

Little sympathy

But that tweet was unusual. What became very clear almost immediately after Thompson’s shooting is that Americans were struggling to muster any sympathy for his death. Comments on news articles and social media posts about the shooting saw people making the same dark jokes over and over:

My requests for thoughts and prayers have been denied. My tears are out of network.

It is, in fact, hard to recall any death of a public figure – beyond those of hated dictators or polarising politicians, like Margaret Thatcher – which has occasioned such an outpouring of contempt. It is impossible to recall a murder which prompted this kind of response.

The public reaction intensified once it became clear that the shooting had a very targeted motive, with the discovery of three bullet casings at the scene marked with the words “deny”, “defend”, and “depose”.

These plausibly referred to strategies used by the insurance industry to avoid paying out claims; a 2010 book slamming these practices was titled Delay, Deny, Defend. 

Folk hero

The aura of mystique around the shooter bloomed further when police discovered a backpack discarded by him in Central Park filled with Monopoly money, as a possible critique of capitalism. To top matters off, CCTV footage of the shooter checking out of a hotel near the shooting showed a distinctly attractive young man.

Just like that, a folk hero was born. Suggested name: The Claims Adjustor. 

The intensity of public response in favour of the shooter clearly discomfited many in authority, including legacy media outlets, who continued to report on the assassination in sombre tones. “Lol they keep trying to make us feel sad about this,” was a common response on social media.

Most shaken of all was the health insurance industry. At least three health insurers deleted their website pages containing information about their top executives, while at least two others removed their photographs. A day after the murder, one company reversed a decision which would have denied coverage for anaesthesia in certain contexts. It was a move almost certainly unrelated to the Thompson killing, as the company had already received widespread criticism, but the shooter got the credit nonetheless.

The most striking aspect of the public reaction, however, was how it transcended political boundaries in a country which increasingly seems irredeemably polarised between red and blue.

Alt-right podcast bros who failed to realise this and attempted to make some political mileage from the happenings found this out the hard way. When podcaster Ben Shapiro released an episode condemning the public response titled “The EVIL Revolutionary Left Cheers Murder!”, his ordinarily devoted fans were quick to correct him: It’s not just the left. It’s all of us.

With every day that the shooter was at large, his legend grew.

Police appeals for help, along the lines of “Have you seen this man?”, were met with thousands of comments like: “Insurance denied my claims for eye surgery so I can’t see him”. Internet sleuths flat-out refused to use their tech skills to assist.

Even the ordinarily staid The New York Times, finally sniffing the zeitgeist on this one, published a revealing piece of advice on their live-blog on the manhunt.

“If someone you know is the subject of a nationwide manhunt and the authorities are desperately trying to learn the person’s name, are you under any legal obligation to come forward with it? The answer is, in a word, no,” the NYT posted.

When the alleged shooter was eventually apprehended at a McDonald’s in Pennsylvania on Monday, the McDonald’s staff received death threats from a public livid that he had been turned in. Initial reports stated that he was found in possession of the gun used in the shooting and a two-page manifesto.

Luigi Mangione

The discovery of his (alleged) identity sent the internet into overdrive. Twenty-six-year-old Luigi Mangione is from a wealthy Baltimore family and attended the same Ivy League university as Donald Trump, the University of Pennsylvania, from which he earned a Master’s degree in computer science. He in no way appeared to fit the profile of an embittered loner: social media posts suggested a life filled with travel, friends and family.

Mangione’s extensive Gen Z digital footprint has now been meticulously picked through online, and possibly the only criminally revealing detail is found in a Goodreads review he left of the Unabomber’s manifesto.

In support of Ted Kaczynski, Mangione wrote: “When all other forms of communication fail, violence is necessary to survive… These companies don’t care about you, or your kids, or your grandkids. They have zero qualms about burning down the planet for a buck, so why should we have any qualms about burning them down to survive?”

Yet a trawl through Mangione’s X feed reveals that he is far from the radical leftist his Kaczynski review might suggest. In fact, he is almost impossible to classify in political terms.

Mangione was consistent in expressing his dislike for big corporates – an unusual stance for a tech bro, which is effectively what he is. He is also clearly preoccupied with climate change as a concern. Simultaneously, he is very religious and despises atheism, is a fan of the libertarian icon Ayn Rand, and repeatedly echoed an alt-right talking point about how badly young men are treated by contemporary society.

This unusual hodgepodge of ideologies soon led people online to suggest: is this the world’s first recorded act of centrist terrorism?

Motivation unknown

The exact motivation for Mangione’s attack is still unknown, and the details of his “manifesto” had, at time of writing, yet to be published. But evidence online suggested that he had been struggling with chronic back pain for which he had received spinal surgery, prompting the belief that this experience could have been his villain origin story.

With his arrest being widely lamented, internet users are speculating about the potential jury for his trial. Boomers are perceived as the generation most likely to disapprove of his murdering ways, but are simultaneously also likely to have some experience with chronic pain and denied healthcare claims, which could engender sympathy.

Some have expressed the hope that the trial will effectively put health insurers in the dock, forced to open up under oath about their profiteering techniques.

Others are spreading awareness of a very low-possibility Hail Mary for the shooter: the concept of “jury nullification” in US law, which holds that a jury may still decide to find a defendant not guilty even if the evidence is overwhelming – but the decision must be unanimous.

New York, where Mangione will be tried, is not a death penalty state, so that is not on the cards. Whatever his fate, however, the Claims Adjustor has already won immortality. DM