In a three-page note, Luigi Mangione wrote: “I do apologize for any strife or traumas, but it had to be done. Frankly, these parasites simply had it coming. Health insurers are too powerful, and they continue to abuse our country for immense profit.”
This statement came to light following Mangione’s alleged assassination of Brian Thompson, the former CEO of UnitedHealthcare’s insurance division, in early December. In a reaction that surprised many, waves of online support went not to Thompson or his family, but to the affluent young man charged with his murder.
UnitedHealthcare, the company Thompson led, is the largest global health-care company by revenue, generating over $350 billion annually.
Some reports estimate the company denies one in three insurance claims. This rate is in line with other large companies, such as Molina and Anthem, which deny 26% and 23%, respectively. These insurance companies garner massive profits while close to one in two Americans struggle to pay their insurance premiums. At the time of his murder, Thompson earned an annual $10.2 million compensation package.
In recent years, America’s health-care system has fallen behind in affordability compared to other countries with similar GDPs per capita, cementing it as the country with the most expensive health care.
A recent Senate report by the Permanent Subcommittee on Investigations (PSI) provides insights into the role of insurers in exacerbating these inequities. Between 2019 and 2022, UnitedHealthcare’s denial rates for post-acute care — when one is stable enough to not be in a hospital but not enough for discharge — more than doubled, from 10.9% to 22.7%. CVS and Humana exhibited similar patterns, with denial rates for post-acute care standing higher than for other services.
Many patients who require post-acute care, such as rehabilitation, skilled nursing, or home health services, may experience worsened health outcomes due to a lack of proper follow-up care. Additionally, many patients who are denied post-acute care coverage are forced to either pay out of pocket or rely on family members for care, leading to financial strain and increased caregiver burden.
UnitedHealthcare’s “Machine-Assisted Prior Authorization” and CVS’s “Post-Acute Analytics” prioritize cost-cutting over medical necessity, placing profits over lives. These practices not only delay essential treatments but also shift the financial burden onto patients and their families.
One healthcare professional told The Falcon that UnitedHealthcare and other health insurance companies often seem to purposely delay payments to hospitals — sometimes for months — increasing their profits while forcing these institutions into financial strain.
The source further explained that insurance company delays exacerbate already-inefficient processes in the industry, which spill over to the quality of patient care. As part of the system, providers must compile lab work and identify problems without any compensation before even referring a patient to a large medical institution like UCSF.
The health-care professional described how delays in care are an everyday detriment to patients’ wellness, saying: “There aren’t enough providers in specialties. Some patients are lucky to get an appointment within a week, while others wait months — or even years. Chronic illnesses escalate because everything is delayed.”
Without substantial reform, the health-care industry’s trajectory will lead to increased public backlash. Regulators should address these exploitative and damaging practices by requiring further transparency and setting random audits for companies with high denial rates.
Yet, instead of focusing on these systemic issues, much of the public discourse has been overshadowed by the assassination’s internet presence. While Mangione remains a hot topic in memes and on the internet, focusing on the killer diverts attention from the root problem: a health-care system prioritizing earnings over human well-being. To drive meaningful change, the public must instead push for tangible reforms that will fundamentally improve a broken system.
