Assassination of top executive reveals just how broken America is

US healthcare system is rigged but gleeful response to shooting is shameful

[Brian Thompson was shot twice from behind by a gunman who waited for him. Image: Courtesy Wikimedia Commons]

It has been several days since a 50-year-old healthcare executive was shot and killed close to his New York hotel, and yet police are still working to catch the killer.

In what was a major breakthrough, CNN said on Monday police in Pennsylvania had charged a suspect, Luigi Mangione, 26, who had been detained with a gun with a suppressor similar to the one used in the New York murder.

Some of people who might otherwise have phoned in tips, one fears, might have declined to do so as they viewed the assassin as some sort of folk hero, taking a stand for the millions of Americans who every week are denied coverage, or forced to pay of pocket, to get the treatment they need.

If UnitedHealthcare CEO Brian Thompson sat atop a system prepared to make profits from people’s hardships, many have said, why does he deserve our sympathy?

If this is where we’re at, what a dark world we have entered, where the hooded jacket and backpack used by the shooter are praised for their style, and the agony felt by Thompson’s wife, Paulette, and two young sons, is conveniently ignored, or chalked up as collateral damage.

If you doubt this, consider a recent article by New York Magazine that suggested the murder was “inevitable”.

First, a little background for non-American readers. Lone among the major nations in the developed world, the US does not have a system of universal healthcare.

There is nothing like Britain’s National Health Service - itself struggling through various crises - but where a person’s access to treatment is not linked to their ability to pay.

Here, rather, there is a patchwork where various private for-profit health companies sell insurance to cover treatment costs. People lucky enough to have a full-time job, often receive coverage from their employer.

[Brian Thompson’s period as CEO coincided with a doubling of the number of claim denials by United. Image: Courtesy Business Wire]

But the coverage varies greatly. If you have a good plan, you can go and see a doctor, and receive the care you need, and in many cases your coverage will pick up the bulk of the cost.

Even with the best plans there is a so-called “co-pay” requirement where the person has to make some contribution, and there are very often caps to the total covered.

Healthcare is America is not cheap. While the system spends vast sums - $4.5 trillion, or $13,493 per person in 2022, according to official government figures - its results in terms of life expectancy, infant mortality, diabetes and other measures, are often worse than counties that spend less. As much as 30 per cent goes on administration.

There have been efforts over the years to expand healthcare and make it more affordable, notably a push by Barack Obama, whose landmark Affordable Care Act, passed in 2010 and often referred to as “Obamacare”, saw the number of uninsured Americans fall from 16 per cent of the population in 2010, to 9 per cent in 2016.

Because Obamacare was the work of a Democratic Party president, a lot of Republicans heaped scorn on it, and Donald Trump tried several times to overturn it.

Today, data suggests in 2023, 26 million people - or 8 per cent of the population - are uninsured. Asked during a presidential debate with Kamala Harris to outline his ideas to replace Obamacare, Trump said he had the “concepts of a plan”.

[Senator Bernie Sanders has been among outspoken critics of US’s healthcare system. Image: Courtesy Wikicommons]

Senator Bernie Sanders of Vermont has long been among those most critical of the status quo.

He has proposed creating universal coverage by making all Americans eligible for Medicare - the federal programme currently available for people over the age of 65. Notably, Medicare is available to elected members of the Senate and House of Representatives.

Sanders, 83, ran for president in 2016 and 2020, campaigning on his “Medicare for All” plan, and told audiences they should not have to struggle to pay for medical care.

“Healthcare is a human right not a privilege,” he said in one speech in 2019.

Fast forward to last week, when video cameras captured a young man approaching UnitedHealthcare’s Thompson from behind as he prepared to make his way into the New York Hilton Midtown hotel at around 6.45am last Wednesday morning.

In the hotel, United had been holding its investors conference and Thompson had been due to speak at around 8am. The footage caught a man with a cap and a jacket who had previously been seen in a Starbucks, waiting for Thompson and then shooting him twice.

Without bothering to deliver a kill shot, the shooter then left the scene, and headed north into Central Park. Over the weekend, officers from the New York Police Department said they’d recovered the backpack the suspected gunman had been carrying, and suggested he may have left New York.

Often in the case of unsolved murders, members of the public rush to try and help solve the case. Oftentimes the information they pass on is wrong, but sometimes it can be crucial.

In this case, there does not seem to such enthusiasm. Rather, social media has been full of people, celebrating the killing, or at the very least trying to justify it.

[Many on social media have described the suspect as a hero. Image: Courtesy Wikicommons]

The shooter had written on three shell casings he left behind, the words “depose,” “deny” and “delay”. These could have several explanations, but many have suggested they refer to language that insurance companies use when denying a customer treatment they need.

It has been pointed out UnitedHealthcare, the largest private healthcare provider, has one of the the highest rates of denial claims.

A recent Senate report found its rate had reached 23 per cent by 2022, almost double that of just two years earlier - a period that coincided with Thompson’s term as CEO, a position for which he was paid an annual salary of  $10.2 million.

Fortune magazine reported his tenure began April 2021 and marked a period of growth. Profits for UnitedHealthcare surged from $12 billion in 2021, to $16 billion in 2023.

CNN said in May 2024, Thompson was sued for alleged fraud and illegal insider trading by the Hollywood Firefighters’ Pension Fund.

It filed a lawsuit against UnitedHealth Group, CEO Andrew Witty, Executive Chairman Stephen Hemsley and Thompson, alleging the executives worked to inflate the stock by failing to disclose a US Justice Department antitrust investigation.

It said Thompson knew about the investigation as early as October 2023 and sold 31 per cent of his company shares, making a $15 million profit,

Perhaps we should not be surprised many have claimed Thompson in some way brought his fate upon himself.

When United posted news of Thompson’s death on its Facebook page, more than 37,000 people posted a laughing emoji.

Senator John Fetterman of Pennsylvania was among those who saw the lack of empathy for what it was.

“The public execution of an innocent man and father of two is indefensible, not ‘inevitable’,” he tweeted. “Condoning and cheering this on says more about YOU than the situation of health insurance.”

This is surely correct.

It can both be true that America’s healthcare system is in need of complete overhaul, and that people have utterly lost sight of any moral compass when they try to effect change in such a violent manner.

America is awash with guns. We already have so many people picking them up to scores, or attack people they don’t like, or whose views they do not approve of. (As with its absence of universal healthcare, America is an utter outlier when it comes to the number of people who lose their lives to gun violence, as many as 48,2041 in 2022, according to official figures.)

One can demand Americans get the kind of healthcare available to those who have universal coverage, without making heroes of people who shoot dead people in the street and then flee.