Chief executive of the insurance company UnitedHealthcare Brian Thompson was shot outside a Midtown Manhattan hotel on December 4th, 2024.
The bullet casings left behind were found inscribed with the words “deny, defend, and depose”, a slightly modified version of the title “Delay Deny Defend” by Jay Feinman. These three words, a rallying cry for insurance critics, decidedly allude to tactics insurance companies are accused of using to avoid paying claims (official requests for insurance companies to pay for covered incidents). His death has since been used to fuel a sweeping public and online outcry against healthcare insurers.
Pre–existing and murder–incited frustrations have led to a jarring celebratory acceptance of Thompson’s death. Reactions on social media and on the streets of New York City demonstrate an onset of “morbid glee” from patients and others who have been swept under the rug by insurance companies at some of the hardest financial, medical, and emotional times of their lives. One comment on Instagram reads: “I would be happy to help look for the shooter but vision isn’t covered under my healthcare plan”.
How could the situation become so dire that Thompson’s death becomes a rallying point for many—eliciting such cold reactions? And how can we possibly address the health institutions that have perpetuated such negative feelings onto us?
Alarmingly, financialized (profit-oriented) healthcare systems such as Unitedhealthcare are distinctly an American problem. The United States reportedly spends twice as much as other developed nations for health care with even worse results. In fact, most Americans agree that healthcare is unaffordable and that the need for care would drive them to bankruptcy. Despite these ongoing and readily accepted conversations, it genuinely seemed like nothing could significantly disturb the ongoing rift between the need for insurance and the systemic debt it gives in return.
UnitedHealthcare handles coverage for over 49 million Americans, raking in more than $281 billion in revenue in 2023. The company has been widely criticized by medical professionals and patients alike for rejecting claims and making access to care extremely difficult. Derrick Crowe, spokesman for nonprofit People’s Action Institute, attests to the fact that 250 million health claims are denied annually by health insurance companies, with UnitedHealthcare leading significantly in the statistics.
As a previous employee at a rheumatology clinic, current volunteer at Mount Sinai Morningside, and fellow cog in the machine battling for insurance coverage, I have seen firsthand both the inability to receive treatment and the financial pressure that results from coverage denial. The plight of healthcare insurance is universally felt—an all-consuming anxiety and dread that comes with desperately begging for, rather than confidently relying on, treatment coverage. We are inundated with enforced high copayments, low approval rates for coverages, and meandering requirements to scrape up benefits that should be guaranteed. Instead of the financial fallback you would expect, health insurance has perpetually caused the very economic problems it should solve. This deepening frustration and bitterness is what led to the overwhelmingly callous or even disdainful responses to Thompson’s murder.
While the deathof Brian Thompson has indeed evolved into an ominous exhibit to both insurance members and insurers, his death should not be celebrated as an “unfortunate but stark reminder” to push for an improved healthcare system. Tragically, Thompson himself spoke about the necessity of transforming the healthcare system in the country—a topic most high-ranking officials avoid or ignore.
In actuality, the hardship we all feel from expensive and unreliable healthcare is not a result of a single company official but the symptom of a greater problem in healthcare.
Competition between health insurers should effectively push down prices and force health companies to produce better products and services—but there are few competitors.
In particular, market control and enterprise consolidation by select gargantuan companies leave little room for any significant economic competitiveness. As a result, for-profit health companies such as UnitedHealthcare have the capacity to focus on stock values rather than quality of service. Our incompetent healthcare system won’t automatically resolve itself.
Change starts with us!
The vast majority of healthcare consumers do not have a working understanding of healthcare plans and policies—meaning we are unable to make informed decisions to save money for the best benefits. Health insurers exploit our lack of (usually inaccessible) information with price gouging (the unreasonably exponential increase in costs). We can fight back—armed with knowledge that can be made attainable through governmental social services, public health advocacy groups, and the sharing of information within our communities.
Wilson G. Zhang is a premedical undergraduate student at Columbia University studying Computational Biology.