Illustration by Michael DiMilo
By Geoff Carter
The world was shocked when Brian Thompson, the CEO of United Health Insurance, was recently murdered in broad daylight on a busy street in Manhattan. Reports confirmed a gunman clad in a gray hoodie who fled on a bicycle and then escaped on a bus and that shell casings from the assassination were inscribed with the words “deny”, “delay”, and “depose” were found at the scene, a clue which seemed to provide a motive for this crime.
The three D’s, deny, delay, and depose are defining strategies for rejecting claims in the health insurance industry. It seemed the assassin had a bone to pick with his health insurance provider. And, gauging for the response on social media, it would seem that he is not alone. Videos on TikTok featured the CEO Assassin Walking Tour. Spotify playlists dedicated to the assassin began to appear. After Luigi Mangione was arrested for the crime, donors contributed thousands of dollars to his legal defense, and the police that arrested him have been subjected to death threats.
Luigi Mangione is the most unlikely of assassins. He comes from a wealthy and prominent Baltimore family, was valedictorian at an exclusive private school, and graduated from the University of Pennsylvania. What drove a young man of such privilege and promise to murder someone in cold blood? And why is he being hailed as sort of a local folk hero? Why is Etsy being flooded with orders for gray hoodies?
Part of the answer to this has to do with Mr. Mangione himself. Since his arrest, elements of social media have been gushing over his good looks and chiseled body. Apparently, to some Americans, he embodies some sort of heroic ideal, sort of a Marvel superhero vigilante type. But aside from this juvenile fascination with the killer, there is a deeper—and darker—reason for valorizing this killer.
The American health insurance industry is making all-time high profits. Since United Health Care started implementing AI, rejections of claims have risen to 31%. Customer frustration and anger is at an all-time high. Imagine having a treatment claim for a child, spouse, or parent summarily denied—by AI. According to Truthout, the country’s five largest insurers’ profits have topped $371 billion; United’s profits have topped 400%, mostly because it denies almost one-third of client claims. The salaries of the CEOs of these five largest insurers top $75 million in annual compensation.
Truthout also reports that family premiums for employer-based compensation has topped $27,000 per year—in addition of out-of-pocket, deductible, or denied claims. One in twelve Americans carries medical debt. Three million people owe more than $12,000, creating a downward spiral in their credit report and overall economic well-being. Deny, delay, and depose are policies that kill. How many lives has United Health sacrificed in order to increase their bottom line? According to Physicians for a National Health Program, nearly 45,000 deaths can be attributed to lack of health insurance annually. Who is ultimately responsible for these deaths? The companies? The stockholders? The CEOs?
Any corporate officer will tell you that their primary responsibility is to their shareholders, that their sacred duty is to make money no matter what the human cost. This is the same mentality which outsourced manufacturing jobs offshore because of cheaper labor costs. This is the same mentality that ignores environmental regulations concerning dumping of hazardous materials and the mitigation of climate change, all of which are destructive to humanity and the planet.
Are the corporate leaders who allow—and encourage—this sort of thinking liable? Or, like the war criminals at Nuremberg, do they meekly say they are only fulfilling their duties to their stockholders—following orders as it will.
As a country, with our laws, and as a people, with our collective conscience, we have allowed this corporate mentality of greed and mendacity to destroy the lives of our people. Why is withholding health care to any of our citizens not a crime? Why are those who make obscene profits from the blood and tears of American families not held liable for mayhem—or murder? Perhaps they should be, but they are not—not here.
And murder is a crime. While some may maintain (with some justification) that Mangione had reason to do what he did, murder is still a capital crime. Luigi Mangione suffered intense pain. He recognized a gross injustice and tried to remedy it, grossly misguided as that attempt was. He killed a citizen, a husband, and a father of two in cold blood. But how many fathers, husbands, and citizens were his company responsible for killing?
Responsible is the word. Luigi Mangione is responsible for the murder of Brian Thompson. He will stand trial by jury be punished accordingly. That is the law. But there are no laws punishing those who pass and facilitate the malignant policies of United Health and other companies. Those who run the companies, those who own stock in these companies, and those who work for them have to answer to their own respective consciences—if they have any. Their companies do nothing for the general welfare. They don’t provide or pay for healthcare. They simply charge for it.
In short, the health insurance industry is an evil and malignant entity. It should at the very least, be drastically reformed, or—at the very best—abolished in favor of a nationalized Medicare program. Luigi Mangione wanted to make a statement, to change the world, but an eye for an eye is not the answer. Not this time.
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