By JOHN KIRKLAND
Following the Dec. 4 murder of health insurance CEO Brian Thompson, social media was overwhelmed by a tidal wave of anger against corporate power, and particularly against the health insurance industry. Thompson, CEO of UnitedHealthCare (UHC) was on his way to speak to investors when a person walked up and shot him from behind. The words “deny,” “defend” and “depose” inscribed on bullet casings recovered by police at the scene sparked speculation that the killing was motivated by anger over a denied claim. The words may be an allusion to the 2010 book on the insurance industry titled “Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It.”
The shooter achieved a sort of folk hero status over the following days, at least in some quarters. Many social media posts celebrated the death of someone whom people see as responsible for heading a company that puts profits above human lives. The announcement of Thompson’s death on the corporate Facebook page was inundated with comments like “My empathy is out of network” and “I’m sorry, prior authorization is required for thoughts and prayers” from people who have suffered at the hands of the insurance giant. Comments were quickly shut down but, according to al-Jazeera, people “continued to post more than 77,000 laughing emoji reactions.” Wanted posters appeared in Manhattan featuring the faces of health insurance executives.
The ruling-class reaction to the murder of Thompson was swift. Pennsylvania Governor Josh Shapiro stated: “In America, we do not kill people in cold blood to resolve policy differences or express a viewpoint” while condemning the online comments celebrating Mangione. Online posters quickly replied with pictures of Shapiro signing bombs in Ukraine. The New York Times columnist Bret Stevens published an essay titled “Brian Thompson, not Luigi Mangione, is the real working-class hero,” in which he highlighted Thompson’s origins in the Midwest with a beautician mother and a father who worked in a grain storage facility. What Stevens misses is that Thompson’s career has been built on denying health care to people like his parents so that investors can line their pockets. Shapiro, Stevens, and The Times have all spent the last 15 months cheerleading Israel’s genocidal war in Gaza.
On Dec. 9, the alleged shooter, Luigi Mangione, was arrested in Altoona, Pa. He allegedly had the gun and fake IDs in his possession. On Dec. 19, the suspect was extradited to New York, where he faces numerous charges, including first-degree murder and “terrorism.” He also faces federal murder and firearms charges, as well as state charges in Pennsylvania.
Mangione, 26, the son of a wealthy Maryland family, graduated from a private high school and attended the University of Pennsylvania, an Ivy League school. According to the Crooks and Liars site, “Mangione has retweeted Tucker Carlson and was an Elon Musk and Peter Thiel stan, but also had an ‘ill will toward corporate America.’”
Of course, some right-wing commentators have quoted from the eclectic musings in Mangione’s papers and online posts in order to try to show that they reflect a “far-left” orientation. The right is eager to twist the available evidence in order to portray Mangione as a “left-wing terrorist.” Fox News contributor Joe Concha wrote that “I think this encapsulates the far left’s worldview: If you run a company that isn’t to their liking, you deserve to die.”
Mangione’s hand-written “manifesto”, published by Ken Klippenstein, lays out his alleged motivations: “Frankly, these parasites simply had it coming. A reminder: the U.S. has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy. United is the [indecipherable] largest company in the U.S. by market cap, behind only Apple, Google, Walmart. It has grown and grown, but as our life expectancy? No the reality is, these [indecipherable] have simply gotten too powerful, and they continue to abuse our country for immense profit because the American public has allowed them to get away with it. Obviously, the problem is more complex, but I do not have space, and frankly I do not pretend to be the most qualified person to lay out the full argument.”
The truth is that these insurance companies hold the power of life and death over working-class people. Yes, the United States has the most expensive health-care system in the world. The U.S. spent $12,555 per capita on health care. Health-care costs were 17% of GDP in 2022, up from 5% in 1962. Life expectancy in the US was 49th out of 204 countries and is expected to fall to 66th by 2050. According to CNN, “Life expectancy in the US is expected to increase from 78.3 years in 2022 to 80.4 years in 2050.”
The CEO of UHC’s parent company, Andrew Witty, stated that “we guard against the pressures that exist for unsafe care or for unnecessary care to be delivered in a way which makes the whole system too complex and ultimately unsustainable. So, we’re going to continue to make that case.” In other words, the company will continue to prioritize stockholders over patients.
In denial
Health insurance profits have soared as denial rates have gone up. UHC, which is the largest health insurance company in the country, raked in $6 billion in profits during the last quarter alone. At the same time, it has the highest denial rate of any health insurance company at 32%. PBS reported in 2023 that “companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims—sometimes bundles at a time—without reviewing the patient’s medical chart. A job title at one company was ‘denial nurse.’”
PBS continues, “Companies in 2021 nonetheless denied, on average, 17% of claims. One insurer denied 49% of claims in 2021; another’s turndowns hit an astonishing 80% in 2020. Despite the potentially dire impact that denials have on patients’ health or finances, data shows that people appeal only once in every 500 cases” (https://www.pbs.org/newshour/health/analysis-health-insurance-claim-denials-are-on-the-rise-to-the-detriment-of-patients). While this practice increases profits substantially, denied or delayed treatment results in tens of thousands of deaths annually.
One insurance giant, Anthem Blue Cross Blue Shield, had announced its intent to “deny any claims for anesthesia services that exceeded specific time limits set for surgeries and procedures.” In the wake of the assassination of Brian Thompson, the company reversed course and tried to claim there had been no such policy.
And in debt
Medical debt is the leading cause of bankruptcy in the U.S.. Sixty percent of personal bankruptcies, more than 650,000 annually, are attributed to medical debt. More than 3 million people in the U.S. have medical debt of more than $10,000 and 25% have medical debt of $5000 or more. Some 100 million people in the U.S. have medical debt.
About one-third of GoFundMe campaigns, more than 250,000 annually, are for medical expenses and raise roughly $650 million. The Affordable Care Act (ACA) enacted under Obama was supposed to help alleviate medical debt and bankruptcy, but one study found that “despite gains in coverage and access to care from the ACA, our findings suggest that it did not change the proportion of bankruptcies with medical causes. That’s not surprising because the chronically poor—the group most affected by the ACA’s coverage expansion—have reduced access to credit, have few assets (such as a home) to protect, and face particular difficulty in securing the legal help needed to navigate formal bankruptcy proceedings” (https://pmc.ncbi.nlm.nih.gov/articles/PMC6366487/).
The murder of Brian Thompson is the “chickens come home to roost” for our ruling class’s failure to enact real health-care reform. Before the ACA, there was a robust movement for single-payer health care. Obamacare was a tepid half measure designed to short circuit that movement and preserve the money and power of the health insurance companies. During the recent presidential campaign, neither Trump nor Harris highlighted health-care system reform. During his previous term, Trump tried and failed to repeal the ACA. In the 2024 campaign, Trump claimed that he had saved the program while in office.
Is shooting a CEO a strategy for social change?
In some respects, Luigi Mangione’s action is reminiscent of Herschel Grynszpan’s assassination of Nazi diplomat Ernst vom Rath in November 1938 in Paris. Grynszpan, a Jewish expat who had been raised in Weimar Germany, was in France with an expired Polish passport and German travel papers. He is alleged to have told French police on his arrest, “Being a Jew is not a crime. I am not a dog. I have a right to live, and the Jewish people have a right to exist on this earth. Wherever I have been, I have been chased like an animal.” The Nazis used Grynszpan’s action as a pretext for Kristallnacht, a pogrom aimed at Germany’s Jewish community. More than 30,000 Jews were arrested and put in concentration camps.
In 1939, Trotsky expressed understanding of Grynszpan’s motivations, but pointed out, “We Marxists consider the tactic of individual terror inexpedient in the tasks of the liberating struggle of the proletariat as well as oppressed nationalities. A single isolated hero cannot replace the masses. But we understand only too clearly the inevitability of such convulsive acts of despair and vengeance. All our emotions, all our sympathies are with the self-sacrificing avengers even though they have been unable to discover the correct road.”
Trotsky concluded by calling on “all those capable of self-sacrifice in the struggle against despotism and bestiality: Seek another road! Not the lone avenger but only a great revolutionary mass movement can free the oppressed, a movement that will leave no remnant of the entire structure of class exploitation, national oppression, and racial persecution” (https://www.marxists.org/archive/trotsky/1939/xx/grnszpan.htm).
The U.S. health-care system is badly broken and needs to be completely changed to serve the needs of the majority. We need a mass working-class-led movement for nationalization of the health-care industry under workers’ and community control. The infrastructure already exists in hospitals, clinics, and urgent-care facilities. There should also be a free program to train thousands of health-care professionals, from nurses to PAs to doctors.
Neither of the capitalist political parties can resolve this crisis. They only serve the interests of the rich, and not those of the oppressed and exploited. Working people need a party of our own that will fight every day for our interests.
- Health care is a human right! It should be free for all.
- Nationalize the health-care system and the pharmaceutical corporations; place them under workers’ and community control and run them as a public service. Health care must include dental, vision, and mental care.
- Fully fund women’s reproductive health care and care for LGBTQ and trans people.
- Slash the military budget to pay for these items.
