The targeted killing of UnitedHealthcare CEO Brian Thompson has become a defining moment in the zeitgeist of American health care.
The attack was a tragedy that adds to the country’s grim tally of gun deaths. But instead of eliciting sympathy, it opened the floodgates for an outpouring of rage, captured across social media and online forums, over the health care system — one that charges people the highest prices in the world, erects financial and bureaucratic barriers to getting care, and has plunged millions of people into debt.
Social media posts have ranged from mournful to apathetic to joyful, including morbid celebrations of Thompson’s death. That deluge has forced people across the country to grapple with two heavy subjects at once: the callousness of a slaying, and an undercurrent of deep-seated anger at a health care industry that makes a lot of money by exploiting Americans.
Much of this came before there were any hints about the shooter’s motive. People assumed someone was driven to kill Thompson because of his job, which is telling, said Yolonda Wilson, an associate professor of health care ethics at Saint Louis University. Wilson added that she was speaking for herself and not her employer.
“I think that says something really important about how people are experiencing health care in this country,” Wilson said. “I don’t think it’s just anger. I think it’s pain. I think a lot of people have pent-up pain, and they haven’t had a place to put it.”
The public’s dissatisfaction has never been higher. Recent polling data show the health care system is as unpopular now as it was before the Affordable Care Act went into effect 15 years ago — a time when insurers could decline to cover people if they had any number of pre-existing health conditions and nearly 49 million people lacked insurance. A survey from Gallup released Friday reveals that “Americans’ positive rating of the quality of health care in the U.S. is now at its lowest point” since 2001.
Several factors have contributed to that resentment. Roughly 25 million Americans remain uninsured. Tens of millions of others have health insurance but can’t afford their deductibles, coinsurance, or copays due to the high prices of tests, surgeries, and prescription drugs. Insurers have tried to root out unnecessary procedures, but that sometimes results in inappropriate care delays or denials and excessive paperwork. These barriers aren’t just a nuisance — they can have real effects on patients’ health.
After care is provided, patients are inundated with medical bills they don’t understand — perplexed why their insurer isn’t advocating on their behalf, and fearful that hospitals and other providers will send them to collections or sue them. Things like surprise bills from ambulances, a problem nearly all agree should be fixed, remain as common as ever.
It’s all part of a health care system that is projected to spend $5 trillion this year, eating further into workers’ wages.
“That’s more than enough money to take care of everybody,” said Mark Fendrick, an internal medicine doctor and professor at the University of Michigan who has studied ways to improve health insurance. “And that’s more than enough money to avoid this significant number of Americans who have felt wronged by their insurance company.”
Police have not caught the person who killed Thompson. New reporting shows the shooter’s bullet casings were inscribed with “deny” and “defend,” words associated with how insurance companies handle medical claims. But they don’t confirm a motive.
UnitedHealthcare, an insurer whose parent company also owns physician groups and a major claims processor, has caught a large amount of animosity over the years. Its techniques have advanced with technology. STAT previously reported that UnitedHealthcare and a sister company, NaviHealth, have used algorithms and artificial intelligence to limit and deny rehab care for vulnerable older adults.
In a statement posted to its website on Thursday, UnitedHealth said “we have been touched by the huge outpouring of kindness and support in the hours since this horrific crime took place.”
“We, at UnitedHealth Group, will continue to be there for those who depend upon us for their health care,” the company said.
The public’s disdain for insurance companies isn’t new, and it extends far beyond health plans.
“In doing my research, it shocked me to learn the extent to which people have always hated insurance companies — from the very earliest days of the business,” said Katherine Hempstead, a senior health care policy officer at the Robert Wood Johnson Foundation, who wrote a book on the history of America’s insurance industry. “People need insurance, but they generally do not trust insurance companies and assume the worst motives.”
What’s new: increasingly consolidated providers and insurers, and a political climate that has fomented and tolerated violence, amplified by the speed at which an online post can go viral.
Mary Haddad, the head of the Catholic Health Association, a trade group of Catholic hospitals and long-term-care facilities, said violence should not be condoned.
“People have to separate out the person from the institution. This is a husband. This is a father. This is someone who lost their life,” Haddad said. “We have to take a step back and say, ‘What’s our compassionate response to the loss of a life?’ I think we’ve become numb to that.”
However, she said the suffering within today’s health care system is real.
“I think people are feeling a sense of helplessness in trying to address this mammoth commercial insurance industry that we have in this country that’s putting restraints on people’s ability to get care,” Haddad said. “I think when you feel that sense of helplessness is when you end up having situations like this where people don’t know what else to do.”
Those who feel most aggrieved often are the sickest. Most people are generally satisfied with their health insurance. However, people who have more health conditions and therefore need to get care more frequently don’t like their coverage nearly as much as healthier people, according to polling from research firm KFF.
“I always say it’s like auto insurance — I want to know the people who had an accident,” said Bob Blendon, a health policy professor at Harvard University who has tracked public sentiment on health care for more than four decades.
“I don’t want to just know people who paid for 10 years and never used it,” Blendon said. “The people in fair and poor health are regular users, and they are less satisfied.”
Ty Beringer is among those forced to regularly interact with the system. The 30-year-old Arkansas resident has type 1 diabetes. Beringer has a full-time job with health insurance, so he’s currently able to get the insulin he needs with no major problems. But there were points during and after college where he said he had to ration insulin to avoid the large out-of-pocket costs.
Beringer posted on X that the denials and protocols of companies like UnitedHealthcare could make people feel desperate. And he said in an interview that he views the responses to Thompson’s killing as people “collectively airing out their grief toward an industry.”
“I feel for the family of Brian Thompson, but I also feel for the millions of families who have been torn apart because of UnitedHealthcare and the health care system at large,” Beringer said.
For Wilson, of Saint Louis University, the frustration with UnitedHealthcare is personal, too. She was scheduled to undergo surgery a year ago when the insurer withdrew approval just two days in advance. Wilson recalls crying when she learned the procedure would cost tens of thousands of dollars without insurance. Fortunately, UnitedHealthcare was just missing necessary test results, and she was able to have the surgery after all.
Wilson recognizes that her education level and a team of advocates helped her manage the hurdle, but not everyone has the same privileges. After Thompson’s death, she decided to share her experience on social media to help people understand the harm she says UnitedHealthcare inflicts on people.
“While I’m not rejoicing about the UHC CEO being shot dead in the street, I’m not sad about it, either,” Wilson wrote on X. “People deserve better.” She added in an interview that her canceled surgery made it seem as if the company is not “terribly interested in how that comes off from a patient standpoint,” which she said is “really troubling.”
The anger that’s erupted since Thompson’s murder is something Monica Bryant sees every day in her work as chief operating officer at Triage Cancer, a nonprofit that provides free education and legal advice to cancer patients.
“People feel there is an inherent unfairness in the way that the system works,” Bryant said. “That someone who has health insurance gets sick and then it’s a company, a business, that can be the barrier to them accessing the care they need to sometimes save their lives.”
