Crime or resistance? CEO’s murder spotlights US health system flaws

The fatal shooting of UnitedHealthcare CEO Brian Thompson has ignited a national debate over the flaws of the U.S. healthcare system, dividing public opinion on whether the act was a senseless crime or a symbol of resistance against systemic inequities.

Luigi Mangione, 26, has been charged with second-degree murder in Thompson’s death. The 50-year-old executive, who led the nation’s largest health insurer, was gunned down outside a Manhattan hotel on Dec. 4.

Thompson had worked at UnitedHealth Group for 20 years, overseeing decisions that directly impacted 49 million Americans enrolled in the company’s insurance plans.

Mangione, an Ivy League graduate from an affluent Maryland family, pleaded not guilty to weapons charges in Pennsylvania, where he was arrested at a McDonald’s after a five-day manhunt.

Luigi Mangione, 26, a suspect in the New York City killing of UnitedHealth executive Brian Thompson, is photographed shortly after being discovered by police at a McDonald's restaurant in Altoona, Pennsylvania, U.S. December 9, 2024.Reuters

The case has become a flashpoint for discussions about the state of healthcare in the U.S., a first-world nation frequently criticized for its expensive and inefficient system.

Critics argue that the system leaves vulnerable Americans reliant on limited government aid through programs like Medicare and Medicaid under the Affordable Care Act. Americans pay the most on average for healthcare of all countries in the world, but their life expectancy doesn't even rank among the top 50.

In a dilemma

Americans like Sarah Jane, a resident of Arizona, say “there is a dilemma to wrestle”.

“Many of us find ourselves agreeing with his (Mangione’s) opinions on the obvious corruption of private health insurers. We have all suffered different degrees of their conspicuous greed,” she told Nukta.

But, she said, one cannot ignore the law of the land for personal or moral reasons.

Referring to a handwritten note by the suspect, she said: “Mangione’s choice to commit a homicide like this and call it ‘facing the issue with brutal honesty’ shows narcissism.”

Search for motive

In the note found in Mangione's possession, he expressed "ill will" toward corporate America and included passages such as "frankly, these parasites had it coming," according to police.

Mangione comes from a prominent wealthy family in Baltimore that is invested in many businesses including country clubs, nursing homes, and a radio station, according to local media reports.

Luigi Mangione, 26, a suspect in the New York City killing of UnitedHealth executive Brian Thompson, is escorted after an extradition hearing at Blair County Court House in Hollidaysburg, Pennsylvania, U.S. December 10, 2024.Reuters

Shortly after Mangione was charged, his cousin, Republican state lawmaker Nino Mangione, issued a statement saying the family was "shocked and devastated".

"We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved," the statement read.

Vigilante justice?

Linda Wesson, a Californian, told Nukta how she wished to be “appalled by the vigilante justice” but for her, like millions of others, it has come down to be a hard choice.

“When a soul-less insurance company has the say whether it will pay for our treatment or have us lose all our worldly possessions and put our family on the street, there is a sad satisfaction in what Luigi (Mangione) has done,” she said.

For many the glorification of violence is unsettling. On social media platform X, Mangione has been painted as a saint, with posts calling him Robin Hood. In the streets of New York posters of individuals, whose health claims were rejected by United Health and who died eventually, have been plastered.

The NYPD believes Thompson's killing was intended as a "symbolic takedown" that could inspire other extremists to target business leaders.

A view of the exterior of SCI Huntingdon where Luigi Mangione, 26, is being held after being apprehended in Huntingdon, Pennsylvania, U.S. December 10, 2024.Reuters

It has warned healthcare executives about an online "hitlist" that emerged after Thompson's death, which included names and salaries of health insurance executives. Multiple wanted signs featuring corporate executives have appeared throughout Manhattan, prompting companies to increase security measures.

Some security experts are drawing parallels between this incident and school shootings, warning that the chance of copycat events could rise dramatically like they did after Columbine. Security firms are now advising executives to delete their digital footprints, including removing floorplans of their homes and information about where their children attend school.

A “manifesto” is also circulating where Mangione has referred to two other individuals: documentary filmmaker Michael Moore and former New York Times reporter Elisabeth Rosenthal, who he thought had “illuminated the corruption and greed” of the health care industry.

‘Rotten’ health care

Ashfaq Khwaja, another American resident, called the health care system of the US “rotten” that reduces human beings to digits and profits.

“It cannot go on like this forever, the state has to make sure the security and health care of its residents remains its top priority otherwise I fear there will be more similar violent incidents in the future.”

A person holds a sign while standing on the roadside near the McDonald's restaurant where a suspect in the killing of the CEO of UnitedHealthcare, Brian Thompson, identified as Luigi Mangione, 26, was arrested, in Altoona, Pennsylvania, U.S. December 9, 2024.Reuters

Also in the spotlight is Mangione’s total disappearance from social circles.

He was reported missing by his family on November 18 in San Francisco. It is not clear if he actually was there during that time or if his mother only assumed it. His permanent residence on the dates was Hawaii, where his existing spinal cord injury worsened, after a surfing accident that left him in debilitating pain.

Mentally ill?

But Emmett Irwin, a Social Security disability lawyer, thinks that Mangione was likely mentally ill.

“I’ve represented many people with bipolar and schizophrenia. His actions are pretty typical (except the murder) of someone in a psychotic break or a hypermania episode,” he said.

Turned into a cult leader-like figure overnight, thousands have posted the book reviews he wrote on Reddit and Goodreads in the last few months, connecting dots to unfold his ideology and motive. Others have taken another extreme by comparing his “good looks and involvement in crime” with Ted Bundy, a notorious serial killer from the 70s.

Qindeel A, a resident of Massachusetts, told Nukta: “I hope we can seize this moment to reform our healthcare system. Healthcare is a fundamental human right, and everyone deserves to live with good health and dignity.”