Assassinations are the perfect fuel for conspiracy theories. So you might think Wednesday’s (4 December) fatal shooting in New York of Brian Thompson, CEO of the huge US firm UnitedHealthcare, would prompt exactly that reaction. And sure enough, dark mutterings soon appeared about whether it was a professional “hit”, and who was behind it. Did it relate to allegations that Thompson had been involved in insider trading? Or was he about to reveal something about vaccines?
But on social media in the hours after the story broke, the overwhelming response was not convoluted theories, but something simpler: rage. On X and BlueSky, the immediate assumption was that the murder was revenge for the suffering of a relative denied adequate healthcare. The bullet casings were reportedly marked with words like “defend” and “deny”, associated in the US with health insurance companies’ sometimes obstructive response to claims. We simply do not know the motive yet – but the outburst of pain and fury tells a story of its own.
UnitedHealthcare is one of America’s biggest public companies, the country’s biggest provider of private insurance, including of “Medicare Advantage” plans. It also manages insurance for federally funded programmes. A bar chart soon appeared claiming its rate of denial, at 32 per cent, was double the industry average, indicating a reputation for rejecting claims rather readily. A lawsuit filed last year alleges that the company knowingly used a poorly functioning AI system to assess one category of claims, with many being wrongly rejected. The company insists this is simply not true. But the anger towards companies like UnitedHealthcare is real enough.
As the news spread, it prompted a torrent of bitterly ironic comments, drawing on the arcane jargon of US healthcare. Thompson wouldn’t be able to claim for the costs of his treatment, some suggested, because bullet wounds are a “pre-existing condition”. One wrote that offering “thoughts and prayers” required “prior authorization and 2 appeals”. Another observed that given Thompson’s annual income was in the millions of dollars, he made more money dying in an ambulance than the tweeter made in a month. The investigations editor of the left-wing magazine the American Prospect suggested Thompson’s death at 50 was “a lot more tragic when you know that his life expectancy as a member of the Top 1% was 88, or 15 years longer than the life expectancy of the average American male”. Others suggested that, if all Americans were provided with decent medical treatment, Thompson would still be alive. One tweet alleged that: “Brian Thompson made his money by denying people care and pricing them to death,” and added, “What goes around comes around.”
Reading this in the UK, barely hours after Thompson, a married father of two, had suffered a sudden, horrible early death, was startling enough. But were these comments just the rantings of a hard-line minority? The many stories that appeared of the suffering caused by rejected insurance claims suggested this was a glimpse of something more substantive. As did the matter-of-fact context provided by outlets like the New York Times. Thompson’s grieving widow told reporters he had received threats. But then, wrote the NY Times’s Chelsia Rose Marcius, “Chief executive officers of health care companies often receive threats because of the nature of their work.” A risk management consultant noted that healthcare executives are at greater risk because of “the emotion that comes along with some of [the] services” they provide. Which is one way to put it.
This chimes with the vengeful tenor of American politics at the moment. Thompson lived in Minnesota, where UnitedHealthcare has its headquarters; the state’s Democratic senator, Amy Klobuchar, duly tweeted that this was “a horrifying and shocking act of violence”, and that her thoughts were “with Brian Thompson’s family and loved ones and all those working at United Healthcare in Minnesota”. The outraged stream of comments this provoked sounded a lot like the rhetoric, audible during the election, about powerful elites who cared nothing for the struggling public. One quote-tweeted Klobuchar, writing: “It is no mystery who democrats [sic] actually work for, and it isn’t you.” Some of those replying to the senator noted that she had received donations from UnitedHealthcare. Others demanded to know where her “thoughts” had been for those on the sharp end of denied insurance claims. Several simply tweeted: “Read the room.”
The most striking response to the tragedy, however, was a post that appeared early on, on BlueSky, by a national opinion columnist on the Philadelphia Inquirer, Will Bunch, who wrote, “In a nation ruled by its oligarchs, the oligarchs become targets for assassination.” He hoped Thompson would rest in peace but added that this was “in a weird way, a kind of a reality check”. Several others said the same, or that they were surprised such attacks didn’t happen more often.
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The word “oligarch” seems to have been cropping up more frequently in the US lately, in contexts like this, and it points both to the long history of such power imbalances, and to a more constructive, less bloody way of responding to complaints of bad treatment. It is redolent of the reaction against the concentrations of power in the “Gilded Age” of the late-19th century. Meanwhile it’s becoming increasingly common to refer to present-day America as undergoing a “Second Gilded Age”, and there are signs of a similar reaction. Indeed, UnitedHealth Group, the parent company, has been the subject of peaceful protests, and an investigation by the Department of Justice over potential antitrust violations – a move that sits in the tradition of Progressive-era attempts to constrain corporate power.
The ideological tangle of the impending Trump administration contains a strand that speaks to all this, with its promises to break up Big Tech and “Make America healthy again” – even as Trump’s ally Elon Musk seems eager to gut Medicare. We will have to wait and see which tendency wins out. Nothing can justify shooting a person dead in the street. But whatever the motive turns out to have been, the reaction suggests that some of America’s aggressive populist anger might be directed at the existing model of healthcare.
[See also: The counter-elite gambled on Trump and won]