Why Many Americans Are Celebrating the UnitedHealthcare CEO’s Murder

The murder of UnitedHealthcare CEO Brian Thompson in New York City on Wednesday appears to be the first successful assassination of a national political figure in the United States in the twenty-first century. Thompson was not an elected official, of course, but he wielded more power than most of them as head of the nation’s largest health insurance provider.

The New York City Police Department has not yet arrested the suspect in the shooting, so the precise motive of the gunman is not yet known. But we can make a pretty good guess about it from the current evidence. Thompson’s wife told the New York Post that her husband regularly received death threats over claim denials. At the scene of the shooting, investigators found shell casings with the words “deny,” “defend,” and “depose” on them—an apparent reference to “delay, deny, defend,” a phrase describing tactics by health insurance companies to refuse coverage for their customers.

Thompson’s death appears to stem from simmering public discontent over how the U.S. health insurance industry operates. But the killing—and especially the public response to it—says less about the state of American health care than it does about the state of our democracy. As Americans have fewer and fewer lawful means to peacefully address social and economic issues or resolve disputes among themselves, targeted killings like this may only become more common.

One murder is not a trend on its own, of course. It is the reaction to Thompson’s murder that is more telling. The gunman’s presumed motive appears to have garnered sympathy, if not outright support, from a broad cross section of American society. UnitedHealthcare posted a statement announcing Thompson’s death on Facebook, which described him as “a highly respected colleague and friend to all who worked with him” and said that the company was “deeply saddened and shocked” by his death. “Our hearts go out to Brian’s family and all who were close to him,” it concluded.

At least 76,000 people have responded to that post with laughing emojis as of Friday morning. Beyond it, social media is aflame with reactions about Thompson’s death that range from apathy to satisfaction and even celebration of his killing. Such reactions happen from time to time whenever a public figure dies, but the usual response—“That person had a family and children, you know”—is often met with this retort: So did those who died because his company denied them access to health care.

The lack of sympathy is unsurprising. Few institutions in American life are as ubiquitously autocratic as a health insurance company. Anyone who has had even a passing brush with a health insurer knows how humiliating it can be to interact with them, begging for coverage of major health events for which you have theoretically paid thousands of dollars. The majority of adults in this country are legally required to pay health insurers each month under the theory that their payments will help defray future medical expenses. As publicly traded companies that are accountable to their shareholders, however, health insurers are incentivized to avoid making those payments whenever possible.

UnitedHealthcare appears to be particularly cruel and arbitrary. Some reports suggest that the company is among the most aggressive in the industry at denying claims. Last year, the survivors of two former beneficiaries sued UnitedHealthcare over allegations that it had used a flawed AI algorithm to cut off coverage for older patients. “The elderly are prematurely kicked out of care facilities nationwide or forced to deplete family savings to continue receiving necessary medical care, all because [UnitedHealth’s] AI model ‘disagrees’ with their real live doctors’ determinations,” the complaint alleged.

A Senate investigation found similar problems with the company’s opaque methods to deny access to care. “According to documents obtained from PSI’s investigation, UnitedHealthcare’s prior authorization denial rate surged from 10.9 percent in 2020, to 16.3 percent in 2021, to 22.7 percent in 2022,” Connecticut Senator Richard Blumenthal said in an October release. “During this time, multiple initiatives were implemented to automate the process. The company continues to implement initiatives to automate the process. In December of 2022, a UnitedHealthcare working group met to explore how to use AI and ‘machine learning’ to predict which denials of post-acute care cases were likely to be appealed.”

What can anyone do to address this? The entire premise of government is that it can resolve disagreements and correct abuses without interpersonal violence, either through law or might. Crimes are investigated by police and prosecutors instead of the victims or their families. Wills and estates are settled in court instead of among feuding heirs. Contract disputes are resolved by courts instead of brute force.

Most Americans today, however, do not have the resources to challenge a health insurer in court. Appealing to lawmakers for reforms is even harder. The health insurance industry spent more than $60 million on campaign contributions to Democratic and Republican candidates alike in the last election cycle, giving them access and influence to stop potential changes. Health insurance lobbyists also spend millions on pressure campaigns and advocacy efforts in D.C., including one recent push on Medicare Advantage reforms that featured a pricey Super Bowl commercial and wall-to-wall advertising in the nation’s capital.

This problem is hardly limited to health care. One-party control of state governments is the norm, either because of cultural self-sorting or because some legislatures have gerrymandered themselves into permanent majorities. Congress is a broken institution where lawmakers struggle to pass budgets, let alone major legislation, in between their constant fundraising sessions. The federal courts are thoroughly captured by the conservative legal movement and its wealthy bankrollers.

A Pew Research Center survey in 2023 found that roughly two-thirds of Americans don’t think the nation’s political system is doing well, with similar numbers expressing little to no confidence in its future. Only about 16 percent of Americans said the federal government does the right thing all or most of the time. While local leaders like governors or mayors fare better in public esteem, confidence in national institutions is at historic lows. Only 26 percent of Americans had any confidence in Congress, with Democratic and Republican respondents showing near-equal losses of faith in the legislature.

Much of this anxiety has been channeled through the nation’s presidential elections. In some of the early exit polls in 2024, American voters listed “democracy” as their top concern on Election Day. The initial assumption from many analysts was that this was good news for Vice President Kamala Harris’s campaign, as they thought it reflected concerns about Trump and the dangers that he would pose if reelected. But the actual election results suggest that a significant number of respondents were Trump supporters who read the question much differently from supporters of Vice President Kamala Harris.

It’s not hard to imagine how a Trump supporter could have expressed concern for “democracy.” There are undoubtedly dyed-in-the-wool fascists in Trump’s coalition, but a portion of it also includes Americans who are opposed to what they see as congressional gridlock and bureaucratic intransigence on issues like immigration, trade, and crime. They see Trump, though autocratic in nature and hostile to the American civic tradition, as a populist representative who can smash through those institutions and ensure that the people’s will is truly done. (I describe here only the existence of these beliefs, regardless of their validity.)

Trump’s early campaigns harnessed this discontent well. He painted Hillary Clinton as the consummate insider in 2016 and himself as a billionaire who couldn’t be bought. He denounced his Republican primary rival Jeb Bush for his massive campaign war chest and criticized Citizens United and super PACs for their corrupting influence. “I don’t need anybody’s money,” Trump told voters when he launched his campaign in 2015. “I’m using my own money. I’m not using the lobbyists. I’m not using donors. I don’t care. I’m really rich.”

It is now clear that Trump didn’t actually mean any of that. He eagerly courted billionaire donors in 2020 and 2024, including Tesla CEO Elon Musk, who spent nearly a quarter-billion dollars to reelect Trump in the latest cycle. During his first term, Trump presided over one of the most corrupt administrations in modern American history. His second-term appointments (at least 11 Cabinet nominees are billionaires), as well as his hostility toward ethics laws and other legal constraints, suggest the next round will be even worse. Nonetheless, that outsider status remains part of his political mythology, reflecting a genuine urge for more lower-case-d democratic reforms across the political spectrum.

Thompson’s assassination also reflects both a continuation and an expansion of the ongoing resurgence of violence in political life. As I’ve noted before, it was something of a miracle that the United States did not have a major assassination this century before now. A gunman who opened fire on a congressional baseball practice in 2017 seriously wounded some lawmakers but failed to kill them. President-elect Donald Trump survived an assassination attempt in July by mere inches. The FBI foiled multiple plots to assassinate Trump’s opponents in recent years, including one by a Coast Guard member who had been gathering guns and ammunition in hopes of starting a “civil war” and another by a Trump supporter who mailed pipe bombs to top Democrats and media figures. God knows what would have happened if any of the January 6 rioters, some of whom had shouted about hanging the vice president, had actually found lawmakers in Capitol Hill that day.

American culture teaches its citizens that democracy is the ideal method for resolving disputes, but that political violence can be acceptable in the face of tyranny or to preserve that democracy. There is a broad consensus about certain tyrannies that have justified it: the British redcoat in 1776, the slaver’s whip in 1860, the swastika in 1939, and so on. But tyranny is an inherently subjective idea. It is unsurprising that the few Americans who are inclined to use violence may have different standards and targets for doing so.

I do not mean to suggest that Americans are generally prone to political violence. If anything, I think the opposite is true. This is one of the most heavily armed societies in human history. Thirty-two percent of the nation’s adults own a gun. According to the National Shooting Sports Foundation, a gun industry trade group, there are nearly five million lawfully registered silencers owned by Americans. In the modern era there have been far bloodier conflicts in wealthy industrialized countries with much more limited access to firearms, like the Troubles in Northern Ireland or Italy’s Years of Lead. Americans’ cultural respect for the rule of law and the Constitution may have kept rivers of blood at bay so far.

How much longer that respect will last, however, is unclear. Reversing the nation’s democratic decline will be even harder if enough Americans come to believe that violence is a more effective means to solving the nation’s problems than participating in democratic institutions. Anthem Blue Cross Blue Shield’s climbdown from a controversial and ill-timed billing policy change on anesthesia may convince people that political violence, even indirectly applied, can produce positive outcomes.

At the same time, it should also be noted that political violence is often more effective at delivering corpses than results. After Thompson’s death, UnitedHealthcare removed its leadership page from its website but apparently did nothing else. The shareholder meeting at the Manhattan hotel that Thompson was scheduled to attend that morning was canceled, but the company released its 2025 outlook on schedule. Claim denials presumably continued as planned. The stock’s price closed up 1 percent on Wednesday afternoon. Nothing actually changed, except for Thompson and his family.