America’s anger at healthcare shows no sign of abating

Two very ugly, typically American things happened yesterday: a health care executive was shot, and because he was a health care executive, people cheered.

Brian Thompson, CEO of UnitedHealthcare, was murdered by an unknown assailant outside his midtown Manhattan hotel yesterday. In response, a post on X wishing the killer would never be caught received 95,000 likes. Social media was littered with jokes about Thompson’s outstanding hospital bills and the tragedy of not being able to return to his McMansion. The sentiment was summed up by journalist Ken Klippenstein, who wrote on “Today we remember the legacy of Brian Thompson, CEO of UnitedHealthcare.”

There is no excuse for celebrating murder. But Americans’ excitement over the death of an insurance executive shows both the brutalization of public discourse and the extent of anger Americans feel about the shortcomings of the U.S. health care system. Gallup polls show that only 31 percent of Americans have a positive view of the healthcare industry. Of the 25 industries Gallup includes in its survey, only the oil and gas industry, the federal government and pharmaceutical companies are more vilified.

The entire American healthcare system is designed so that some level of anger is inevitable. Although the governments of most wealthy industrialized countries provide some level of insurance to all of their citizens, the majority of Americans rely solely on the whims of private health insurers. The system is designed to keep costs low enough to make a profit. The insurance industry’s eagerness to save money by denying people care is a feature, not a defect, of this country’s system. In their anger at Thompson and other health care CEOs, Americans are expressing their frustration with a system that is causing real and preventable harm. Those cheering Thompson’s death argue that taking pills away from sick Americans or denying them necessary surgeries is immoral and should be punishable by death.

This logic is indefensible, but people have a reason to be angry: About half of Americans report having difficulty paying their health care costs. A single denied insurance claim can plunge a patient into financial ruin, and health insurers have become more adept at finding ways to deny claims. Until Congress intervened in 2020, patients were often hit with unexpected medical bills for hospital visits because the rotating doctor in question was outside their insurance network without them knowing. And even less serious maneuvers, such as step therapy, which requires patients to try cheaper drugs before insurers pay for more expensive therapies, can delay the treatment needed to relieve suffering.

UnitedHealthcare is particularly notorious for its aggressive use of these tactics. Health publication reporter Stat (where I worked until September) has spent the past year documenting the countless ways UnitedHealthcare has made profits at the expense of patients’ lives. For example, they found that the company used AI algorithms to justify kicking out elderly patients from nursing homes, despite evidence that some of those patients still needed around-the-clock care. Doctors who worked for United (which also bought medical practices) told it Stat that the company was pressuring to treat more patients and diagnose them with additional conditions, presumably to increase the company’s profits. United has also faced lawsuits from patients and the federal government over its aggressive business tactics. (United has denied the claim that it relied solely on AI to deny care, saying in response: Statreports that it trusts its physicians to “make independent clinical decisions.”)

But the problem is the health insurance system, not the CEOs. As long as the majority of health insurance in America is private, it will operate according to this logic. UnitedHealthcare’s aggressiveness is exactly why its parent company is now the largest health insurer in America. It is undeniably successful in its primary business objective of generating profits for its shareholders.

Compassion and capitalism can coexist, and this country assumes that the role of government is to mediate between the profit motive of corporations and the inviolable needs of citizens. Insuring people with costly medical conditions would not be compatible with a pure profit motive, which is why companies like UnitedHealthcare were only required to insure people with pre-existing conditions with the Affordable Care Act. The way out for dissatisfied Americans is to either change insurers or elect politicians who will reform the current system. The ugly reaction to Thompson’s death shows how many people clearly feel that none of these options serve the country’s true needs.

The identity and motivation of Thompson’s killer are still unknown. His death is believed to have nothing to do with the US healthcare system. (However, bullet casings were reportedly found at the crime scene and labeled with the words deny, defendAnd put downseem to suggest otherwise.) Even if the killer had targeted Thompson for a reason that had nothing to do with his job, the act exposed that Americans are so angry about their health care that they would kill a man would celebrate publicly. Cheering on a vigilante may be liberating for those fed up with the decay of America’s current healthcare system, but it won’t change anything.