Murdering health insurance CEOs will get us nowhere

The brazen murder of a health insurance company CEO has shocked the public consciousness — but for some, it seems to be a relatively mild, pleasurable shock. Brian Thompson, the 50-year-old CEO of UnitedHealthcare, was shot and killed on the sidewalk outside a hotel in midtown Manhattan hotel early on Wednesday morning. Much of the internet response to this news has been ambivalent, bordering on enthusiastic, rather than horrified. Thompson’s killing was like something out of an Ian Fleming novel: the killer used a silenced 9mm pistol and left messages (the words "deny," "defend" and "depose") written on the shell casings like a version of Ted Kaczynski who avoids the post office. At this writing, the shooter remains at large, although video images showing his uncovered face are now in wide circulation.

Violence is a strategy that never warrants celebration because it is crude, brutal and ineffective, not to mention immoral. There’s always a better way, even if it’s not as easy or as dramatic. Nonetheless, it’s not bizarre or surprising to see that Reddit is being flooded with memes mocking the murder, or that many on social media are seemingly trying (or failing) to suppress their glee. There’s now even a rush to cash in with merch, such as a ballcap using the company’s logo next to crosshairs and the phrase “We aim to please.” A chart from valuepenguin.com displaying the percentage of claim denial rates by insurance companies, with UnitedHealthcare topping the list, has gone super viral, with one user on Threads captioning it, “To paraphrase Chris Rock ‘... but I understand.’”

The overall justification for this celebration — the New York Times described it as a “torrent of hate” — lies in the widely understood the fact that health care companies inflict violence on thousands of people in this country, if not millions, every single day. Take the announcement this week from Anthem Blue Cross Blue Shield, which couldn’t have had better or worse timing, depending on one’s perspective. That company proposed that its health insurance plans in Connecticut, New York and Missouri would no longer cover anesthesia care if a surgery or operation extends beyond an arbitrary time limit. That seems to have outraged the American Society of Anesthesiologists, which has called on Anthem to immediately reverse this proposal.

On Thursday, Anthem did just that, but the shock remains. If that’s not violence, what is? Whether you’re in an alley or on an operating table, if someone has a knife to you and demands your money, it’s violence. Or consider the innumerable examples that aren’t just proposals but routine policy: the tidal wave of denied or delayed claims, the noose of restrictive networks, costly deductibles, prescription refusals and on and on. There is also convincing evidence this walled garden especially excludes and discriminates against people of color, queer people and women, making this systemic violence not just prevalent, but also disproportionate.

For this reason, it seems not everyone is shy about their delight or perceived moral vindication in Thompson’s death. Independent journalist Taylor Lorenz, formerly of the Washington Post and New York Times, citing the Anthem proposal, posted “And people wonder why we want these executives dead.” In a now-deleted post, Lorenz shared the name and headshot of Blue Cross Blue Shield’s CEO, later clarifying that she only intended for people to “learn the names of all of these insurance company CEOs and engage in very peaceful letter writing campaigns so that they stop ruthlessly murdering thousands of innocent Americans by denying coverage.” She added, “Healthcare is a human right. We need universal healthcare now.”

It’s time to take a breath and acknowledge an important complication: At this moment, we have no idea what the motives of the killer are. The presumption that he’s some sort of Robin Hood-esque vigilante out to right the wrongs of the for-profit health care industry isn’t yet borne out by facts. For all we know, this killing was the result of a personal grudge, or Thompson owed millions of dollars to organized crime. Admittedly, those are unlikely possibilities, but until we know more, it’s all speculation. In the meantime, it’s worth exploring why so many people are willing to project their own motives onto this situation.

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We also don’t know much about Brian Thompson. The AP reports that he kept a “low profile,” which is perhaps prudent when you’re at the helm of a human-smushing machine that brings in billions in profits while letting untold numbers of people languish, suffer and die. In fact, the day before Thompson was killed, Reuters reported that UnitedHealth Group, the parent company of UnitedHealthcare, projected its revenue for 2025 to be between $450 billion and $455 billion. Earlier this year, Thompson was a defendant in a high-profile lawsuit alleging fraud and insider trading. As CNN reported, he and other executives at UnitedHealthcare were accused of conspiring “to inflate the company’s stock by failing to disclose a US Justice Department antitrust investigation into the company.”

Over at Wikipedia, there is internal debate over whether Thompson is even notable enough to have his own page (he didn’t before this week) or if such an entry page should be strictly focused on his death, as sometimes occurs for victims of violence who don’t merit the site’s “notability” criteria.

We do know that Thompson leaves behind a wife and two sons. However despicable his role in health care, he was still a human being and for those people, his death will be a private tragedy. The rejoinder is, of course, that everyone who has died and will die because of institutions like UnitedHealthcare were people mourned by their loved ones as well.

I’m reminded of my former neighbor in Yucca Valley, California, a bubbly, friendly old woman who lived with her elderly son. Every day she would greet the mailman with a “Hi! How’s it going!” so loud that I could hear it across the street in my home office. They would often talk for quite a while and she was always amicable to me when we caught each other on the street. One hot summer day in 2021, her son invited me in to share some extra produce they’d gotten from a food bank. I enjoyed some fresh strawberries and a loaf of bread.

She wasn’t so bubbly then. She was sitting in a chair, breathing heavily with her eyes closed, with a large tumor on her face that I pretended not to notice. She died a few weeks later. I helped her son move out shortly afterward, which was when I learned that she’d been bounced around from facility to facility without finding doctors willing to treat her, until her entirely treatable cancer destroyed her face and killed her.

There is no other or better word for what happened to her than violence. Rural health care access is especially abysmal, with mortality rates in remote areas far exceeding those in more urban contexts. My mother died in 2023 in very much the same way as my neighbor, both of them statistics of this disparity. My mom’s cancer was diagnosed late and she was bounced from one provider to another, ultimately allowing her disease to metastasize past the point of no return.

What about the indirect victims of the health care death machine? In 2017, my father was diagnosed with Stage IV myelofibrosis, a rare and deadly form of blood cancer. He made a miraculous but uncomfortable recovery, becoming so wrung out from the whole process of being nothing but a number to the health care system, that he said he would rather die than fight if his cancer returned. His experience with the systems run by people like Thompson bred so much distrust in health care that he refused to be vaccinated for COVID-19, and died in late 2021 from a preventable disease.

I can’t say with any certainty that I never had dark fantasies about inflicting violence on the doctors who neglected my mother’s health and let her die. But if I did, I rationalized those thoughts away with the understanding that such violence would accomplish nothing. Killing more CEOs will do nothing but promote new ones — with bigger and better-armed security details. That wouldn’t stop the health care machine from crushing more people because that cruelty and violence is systemic, not individual — and that problem can’t be fixed by a lone avenger with a gun. To say otherwise is the same warped logic of gun-lovers who say spree shooters can be stopped with a “good guy with a gun.”

If Thompson hasn’t been replaced already, he soon will be. And there is no reason to believe that UnitedHealthcare will change its tactics or practices. Right now, there’s no meaningful incentive to do so. Our entire health care system squeezes profit from people because that’s what it’s designed to do. Those in the executive suites at insurance companies do exactly as they’re supposed to, not because they woke up one day and decided to inflict as much suffering as possible. It’s fair to observe the other side of the coin, however: Brian Thompson and others like him have seemingly no regrets or reservations about the damage they do. It’s like a massive version of the trolley problem: Pull the lever and save some lives or keep the train on track to mangle millions while pocketing billions. Most people would make the exact same decisions if put in such a position, and it’s unrealistic to believe that any individual has the power to dismantle the system. 

I personally believe in the concept called karma, but not in the sense that the universe is a giant calculator that doles out ultimate judgment for good and bad behavior. The word simply means “action,” which I believe follows Newton’s Laws of Motion, specifically the third: “Whenever one object exerts a force on another object, the second object exerts an equal and opposite on the first.” Inflicting massive violence on innocent people has a way of rebounding on its originator, perhaps better summarized by the concept of “blowback” in foreign policy or by Jesus’ famous maxim that those who live by the sword die by the sword.

Violence does accomplish something: It makes people feel pain, perhaps similar to the pain inflicted in the first instance. But if I shoot dead the doctors and health care executives who neglected my mother, that won’t bring her back. Nor will it do anything to change or dismantle the American health care system, which all too closely resembles the apparatus of death from Kafka’s “In the Penal Colony,” which embeds punishment into the flesh of its victims. Remaking our health care policies will take much more than individual acts of lethal violence. That will require a shared collective consciousness of how and why this system is so badly broken, and a collective decision to build something better.