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The murder of UnitedHealthcare CEO Brian Thompson is a profoundly revealing moment in American politics. Not only has it opened the floodgates of public anger at health insurance companies, but it has also demonstrated just how avoidant most U.S. politicians are when it comes to acknowledging that anger or doing anything about it.
The surge of online excitement surrounding the man accused of murdering Thompson, 26-year-old Luigi Mangione, is a symptom of a much larger problem: an oligarchic U.S. political system that repeatedly fails to respond to the needs of the people. In the absence of effective government, vigilante violence becomes much more likely.
Mangione has found popularity precisely because the man he is accused of killing ran a company that routinely boosted profits by pushing its customers closer to illness and death. Earlier this year, a U.S. Senate committee investigated UnitedHealthcare and determined that the insurance company frequently denied nursing care to patients who were recovering from falls and strokes in order to boost its profits. Health news platform Stat reported that a UnitedHealthcare subsidiary called NaviHealth systematically denied care for seriously ill seniors. Thompson himself was facing a class-action lawsuit for insider trading amid a Department of Justice investigation.
Of course, it is easy to treat UnitedHealthcare’s abuses as the actions of just one evil company run by a handful of bad men. But these companies are owned by Wall Street. Institutional investors and shareholders reward and punish corporate executives based on the profits they generate and the share prices they produce. In causing harm to so many Americans, Thompson was meeting the demands of his corporate board members and the even wealthier interests that they serve.
These profits generated by denying Americans medical care are in turn converted into campaign contributions and lobbying dollars that block our political system from doing anything about it. In 2023 and 2024, UnitedHealth Group’s political action committee reported donating $2.95 million to federal campaigns and spending $16.62 million on lobbying expenses. Meanwhile, the top federal recipient of campaign contributions from UnitedHealth Group executives and employees was Kamala Harris. Perhaps this is why Harris flip-flopped on abolishing private health insurance during her first of two failed runs for president: she knew just how much money was on the table.
Harris, of course, isn’t the only major recipient of campaign contributions from UnitedHealth Group employees in 2024. The Democratic National Committee received $103,022; the Republican National Committee received $207,125; and the Trump campaign took in $144,297. And UnitedHealth Group is not alone. A quick review of other major health insurance companies demonstrates that each of them has spent heavily in recent campaign cycles to maintain a political system that responds to their corporate interests, while undermining the health of the American people.
Perhaps this is why prominent Democratic politicians like Pennsylvania’s Sen. John Fetterman and Gov. Josh Shapiro were so quick to condemn the murder of Thompson, while saying little or nothing about the thousands of people who have been denied coverage for their medical care by UnitedHealthcare under Thompson’s management. And perhaps this has something to do with why New York Gov. Kathy Hochul issued a statement regarding the murder of Thompson and personally joined a virtual convening of some 175 corporate representatives who were concerned about their safety, but has said nothing regarding the insurance abuses of UnitedHealthcare.
With Republicans about to control all three branches of the U.S. government, any real accountability for health insurance companies, including criminalization of their abuses, is highly unlikely. But even under the best of circumstances, we shouldn’t expect much from our status quo political system. The high-water mark of health care reform in recent American history was the Affordable Care Act, or “Obamacare.” Obama’s signature achievement was originally a conservative Heritage Foundation plan previously implemented by former private equity executive Mitt Romney when he was the governor of Massachusetts. And even this market-friendly approach was later disavowed and attacked by Republicans.
But despite these tremendous hurdles — or because of them — a clear public rage exists that would be foolish to ignore. For progressives seeking to reboot the Democratic Party, this is the time to turn public outrage at UnitedHealthcare into tangible pressure that breaks the back of business-as-usual.
It is worth remembering just how often Republicans leverage false crises to capture the national debate.
In evaluating the present moment, it is worth remembering just how often Republicans leverage false crises to capture the national debate. The hysterias over the so-called war on Christmas, transgender access to bathrooms, critical race theory, “all lives matter,” and “they’re eating the cats” are all examples of moments when conservatives have created controversies or flipped the script on real-world events to shift headlines and distract the public from the actual problems of concentrated power and wealth in America.
Republicans have long been better at this than Democrats, because Republicans use their meme wars to punch down and target the powerless, while Democrats are usually too fearful to punch up and target the corporate elites who fund their campaigns while driving many of America’s ills.
But unlike many Republican attacks, the problems with health insurance are real, and public concern is quite broad. A recent Economist/YouGov poll revealed that 62 percent of those polled blamed health insurance companies for problems with the health care system, and the same percentage blame corporate executives. Democrats would be foolish to let the public’s focus on UnitedHealthcare dissipate, but as the 2024 elections revealed, Democratic Party leaders have a long track record of such foolishness.
Given that Republicans will soon hold a trifecta in Washington, and that many Democrats are too fearful of their paymasters to bluntly criticize the corporate classes, how can we push our political system to hold health insurers and Wall Street accountable? One answer might be found in abandoning any hope of seeking immediate redress through our legislative process. Instead we should treat health insurance companies, their dominant shareholders, and the politicians who serve them in the same way that one would treat a repressive government that one is trying to reform — or overthrow. In this context, our tools of battle become cultural delegitimization, demand radicalization, economic pressure, and (nonviolent) political war.
Cultural Delegitimization
Our goal should be to build an American political culture in which health insurance executives and their companies are viewed and treated the same way that child molesters and drug cartels are. They should be ostracized, stigmatized, and demonized. By doing so, we will shift American politics and create a more hospitable environment for pursuing the long-term accountability that health care reformers seek.
This cultural delegitimization can be accomplished through a series of campaigns that target health insurance executives, demonize employment in their businesses, and create a broader negative environment in which no one wants to be associated with them. When it comes to finding opportunities to stigmatize these individuals and corporations, there are likely to be many opportunities to choose from.
One recent example? Even as Thompson and UnitedHealthcare were denying sectors of the public access to valuable medical coverage, they were allowed to “sportswash” their reputations by serving as sponsors of the 2026 Special Olympics USA Games. The next time a philanthropic or community initiative unrolls a red carpet for a health insurance executive, there should be a dramatic public backlash.
Radicalize the Demands
We must shift the Overton window far enough that legislative reforms and accountability become the moderate position in American politics. This means speaking bluntly and directly about what should happen to predatory health insurance executives, their corporations, and their enablers.
Health insurance CEOs who implement denial of coverage practices to boost profits should go to jail. Health insurance companies that enable this behavior should face revocation of their corporate charters. And shareholders and investors who financially benefit from these ugly profits should be made directly and criminally liable.
Finally, the thousands upon thousands of people who have been unjustly denied coverage for their medical services should be introduced to a new concept: reparations.
Economic Pressure
Every entity that profits from predatory health insurance practices should be made to face economic costs. Corporate accountability campaigners and health insurance exchange experts should put their heads together to determine the best ways to undermine abusive health insurance companies’ access to new customers and policy holders.
In addition, investors in UnitedHealth Group and other abusive health insurers should face direct pressure to divest from these companies. Investment funds, retirement funds, university endowments, and other major investment players should all be pushed to take their money elsewhere.
As documented by Derek Seidman in Truthout, the top two shareholders of UnitedHealthcare parent company UnitedHealth Group “are the world’s two biggest asset managers, BlackRock and Vanguard,” which oversee a combined total of over $20 trillion in assets. Not only that, but BlackRock and Vanguard are also the top two shareholders of each of the top four U.S. health insurers. Both investment firms should face public demands to stop building their wealth off of the suffering of the thousands of people denied coverage for their medical needs.
Political War
Finally, the days of prominent politicians taking money from UnitedHealth Group must come to an end. It’s not hard to imagine a large number of senior citizens signing on to a demand that politicians should not take money from health insurance companies that are denying older Americans health care coverage.
With elections for the next Democratic National Committee chair coming up in February 2025, now is the time to push the DNC to stop taking money from UnitedHealth Group and other major health insurers. Politicians who stay silent on these demands and who refuse to bluntly criticize health insurance executives and companies should face electoral boycotts in which voters commit to voting against them.
Moving From Anger to Action
In a fairer world, Brian Thompson wouldn’t have been murdered. He would already have been put behind bars.
Health insurance executives profiting off of human suffering should live in fear. But what they should fear is jail, not murder. We don’t want to live in a society where private individuals become judges, juries, and street executioners based simply on their own determinations of morality or crime. That is the world in which anti-abortion activists kill doctors and nurses. It is the world where white supremacist gunmen assume Black community members are “criminals” to be executed. In the space between illegal vigilante violence and deference to a broken political system is a vast opportunity for constructive and sustained political disruption that eliminates the “safe space” for business executives who profit from the destruction of human life.
One can easily condemn the murder of Thompson while simultaneously condemning who Thompson was and what UnitedHealthcare is known to have done. Denying countless people access to the medical coverage they needed has caused significant pain and suffering, and may have even caused many unnecessary and early deaths. That it took a murder of a health insurance CEO for us to be talking about this reveals just how broken our political, legal, and media systems are.
Health insurance executives, investors, and the politicians who they purchase should all fear social ostracism, financial collapse, and political defeat. This is entirely possible if the political rage of the American public is combined with a strategic road map that turns that anger into action. The fundamental question is whether or not progressive leaders and health care reformers have the courage to turn this moment into something of lasting significance.