As you’ve doubtless heard, Brian Thompson, the CEO of insurance giant UnitedHealthcare, was assassinated this month. Thompson was gunned down in broad daylight outside a shareholders’ meeting in midtown Manhattan in a premeditated attack. The most Hollywood-esque twist is that the fatal bullets had words engraved on them: “delay”, “deny” and “depose”. After a massive manhunt, police claim to have caught the shooter in Pennsylvania.
Most gun violence in America is an occasion for grief, despair, and the rote offering of “thoughts and prayers”. But this shooting has given rise to celebration. If you’ve been on social media, you’ve probably seen people praising the shooter and hailing him as a folk hero. There was even a lookalike contest.
In case it needs to be said, I don’t endorse assassination as a means of change. I’m not an accelerationist. I don’t cheer for anyone’s murder or encourage others to do violence.
Even so, Thompson’s killing should be the least surprising thing imaginable. It’s an eruption of the rage that’s long been building against a cruel and broken system that’s thwarted every effort at reform.
Every American has experience with the infuriating illogic and inhumanity of our for-profit healthcare industry. Insurance companies throw up one hurdle after another: stalling, denying vital care, burying patients and doctors in a landslide of paperwork.
UnitedHealthcare in particular has been a rich vein of horror stories. Even in an industry that’s so widely despised, they stand out, and not in a good way.
They deny claims at more than twice the industry average. In 2021, they announced that they wouldn’t pay for emergency room visits if, in their opinion, the visit wasn’t a true emergency (as if people are supposed to diagnose themselves and figure out whether their complaint is serious enough to justify the ER). They scheme to deny care to people with expensive conditions. In 2023, they were sued for using an AI model to auto-reject claims, kicking elderly, sick and disabled people out of nursing homes. The plaintiffs claim the AI has a 90% error rate – but of course that’s not an error, it’s the intended result.
My family has personal experience with UnitedHealthcare. My wife Elizabeth has insurance through them. I’ve written about the time when, after a routine operation, they tried to charge us $32,000 for an “out-of-network” technician in the operating room. They only relented when she quoted New York’s surprise-billing law to them. Obviously, they knew what the law was; they were just playing dumb and hoping that we didn’t know our rights.
All this byzantine bureaucracy might be a worthwhile tradeoff if it guaranteed high-quality care at an acceptable price… but it doesn’t even do that. Americans pay twice as much for health care as other developed countries, and yet we have the worst outcomes.
For-profit insurance companies are the reason. In the name of profit, they’ve murdered tens of thousands of people: coldly, slowly, a little bit at a time, shaving off a few years of their lives with each denial. An estimated 68,000 Americans die each year because they can’t afford medical care. Those deaths may not be as sensationalized as this one, but they’re no less real and no less meaningful.
Brian Thompson didn’t have sole responsibility for this inhumane system. But in any list of who benefits from the status quo, his name would be near the top. We don’t know what specific grievance his killer had, but it’s not even a little surprising that someone eventually snapped. The only surprising thing is that it hasn’t happened before now.
The expectation of fairness is the thread that knits society together. The only reason anyone would want a society is because it protects their rights and treats them fairly, as opposed to an anarchy where the powerful can abuse others as they please. If people perceive that society isn’t keeping that promise, they’ll grow angry and aggrieved, and they’ll be more willing to take the law into their own hands.
In opinion polls, supermajorities of Americans express a preference for universal public health care. But the American political system has frustrated that wish for decades, thanks to rivers of lobbyist money and an antiquated, anti-democratic structure that permits minority rule. Obamacare reined in some of the worst abuses, but people feel with justice that it didn’t go nearly far enough, and soon even those modest gains could be wiped away.
When pledges of justice and fair treatment ring hollow, when people feel they have no recourse and their voices go unheard… then their sense of frustration transmutes into rage. They rightfully conclude that if the law doesn’t protect them, then the law is a sham that doesn’t deserve their allegiance. They want to avenge wrongs done to them by any means necessary. Again, what right do we have to be even a little surprised?
Whether this is going to bring about any real or lasting reform… I doubt it. More likely, insurance executives will just use their vast wealth to surround themselves with bodyguards, and carry on as before. However, if this story sticks in their mind – if they start looking over their shoulders more often; if they feel nervous and frightened, even just a little, the next time they propose a new way to get between human beings and the medical care they need – it’s not inconceivable that it will have some positive effects.
There’s some evidence of this. Another insurer, Anthem, recently put forth a horrible proposal to not pay for anesthesia if an operation takes longer than an arbitrary time limit. Anthem was already under fire from doctors and politicians over this… and, right after the shooting, they backed down. It’s not a leap to imagine that someone at Anthem didn’t want the next target to be on their back. Even if Thompson’s killing was only a small grain of extra weight, it might have been the grain that tipped the scale.
Again, this isn’t a question of right or wrong, justified or unjustified. It’s a question of cause and effect. You can only push people so far, you can only take so much from them, before they rise up against you. That’s the lesson from every revolution in history. It’s a lesson that America’s ruling class seems determined not to learn, and there will be more bloodshed because of it.
In a country as well armed and appallingly unequal as the US, the only surprising thing about this was that it doesn’t happen every week.
Maybe if it does start happening every week, in a little while you might find one of those factors might get stepped on. I wonder how many murders of CEOs it would take to make the rich people burn the NRA to the ground and remove the 2nd amendment? (Note I’m obviously not expecting them to do anything about the “appallingly unequal” factor – I’m not an idiot). Tell me you think they couldn’t/wouldn’t…
This comment makes me think of the pre-Civil War southern states that made it illegal for free black people to own guns – Second Amendment be damned. The rich and powerful will always alter or just ignore the law in any way necessary to protect themselves from threats to their power.
I am just so conflicted about the whole topic. Obviously I don’t condone murder–just as you did, I want to get that out there.
We’re still getting all the facts so what I say next may turn out to be true and may not: one thing I’ve heard is that the shooter had numerous serious problems with his back and was not being given care. Seeing as how he comes from a wealthy family, he might have had an expectation that the system would work for him. But, as we’ve all found out, the same people who swilled paint thinner and made meth in their bathtubs also abused prescription painkillers, therefore nobody can have them. Who knows how many times he was told, “You’re in excruciating pain? Take a Tylenol. Don’t take 2 or it will ruin your liver.”
So it may be true that this guy was just pushed until he snapped. Based on the interviews I’ve seen on tv, anyone who ever met him said he was a gentle, nice kid with a bright future ahead of him. Will anything be learned by this? Who knows.
Just one of many stories in my family about sub-par medical care: upon graduating college, my son went with some friends to a big tourist area. On the last day, while cleaning up, he dropped a glass in the kitchen sink and foolishly tried to grab the broken glass, and cut himself badly. Unable to stop the bleeding, they first tried to go to a walk-in after-hours place…only to find that none existed in the huge tourist area that sees 100,000 people a week. So they went to the local hospital. An ER doc cauterized the wound with a hot metal strip and bandaged it with an over-the-counter quality bandaid. Total time spent there: less than an hour. Then I got the bills–the hospital, the ER that was in the hospital, the doctor, the nurse, the “medical supplies”…to the tune of $10,000. My son said he kept handing over his medical insurance card and his friend kept writing it down on paperwork, but when I called, there was mysteriously no record of it. I spent a month fighting with all the different moving pieces, ending up finally getting the bill knocked down to $600. We joke that he could have held his hand over the stove burner for free.
On Youtube, Dr. Glaucomflecken (a real US doctor, name isn’t really Glaucomflecken) has a great talk today. So does Trae Crowder.
“In opinion polls, supermajorities of Americans express a preference for universal public health care. But the American political system has frustrated that wish for decades, thanks to rivers of lobbyist money and an antiquated, anti-democratic structure that permits minority rule.”
Which I think is the result of regulatory capture, lobbying being but a fig leaf.
The obvious question arises: if it’s thus in healthcare, might it also be thus in other areas?
I do enjoy the sight of all the people commenting on this story who preface what they’re saying with a variation of “I don’t condone murder, obviously. But…”
@John, back in the early 1990s, during the first attempt to bring universal healthcare to the USA, the right created a series of stupid commercials with actors badly mouthing platitudes against universal healthcare. The proto-MAGA lapped that stuff up and bleated it nonstop. I was active duty military at the time, and the US military had a single-payer plan that boiled down to, “if you need health care, go to a military health facility and get it at no cost to you.”. Nonetheless I heard military people–who had universal health care–complaining that they didn’t want universal healthcare. If you pointed out to them that’s exactly what they had, they’d deny it.
“Get your government hands off my Medicare!”
It’s less of a leap to think this is confirmation bias from people trying to rationalize making a woman a widow and leaving two sons without a father for no reason whatsoever (Unitedhealthcare will, of course, continue on under other leadership – they were hardly dedendent on this generic corporate drone to be their CEO.)
I don’t think anyone believes that the loss of a single executive disrupts a company to such an extent that it’s unable to function.
I do think it’s likely that insurance executives are worrying about their own personal safety. Especially while this story is fresh in the public mind, they might well decide that this isn’t the time to push an ostentatiously cruel policy, like the Anthem anesthesia story, for fear of provoking a copycat killer and becoming the next target.