If you ever wanted an encapsulation of healthcare in the USA, you need to look no further than Luigi Mangione’s courtroom statement about why he murdered UnitedHealthcare CEO Brian Thompson.

“After years of enduring severe pain from a broken back, navigating the obstacles of the health insurance system and witnessing similar experiences of countless others, I learned that UnitedHealthcare would be holding its annual investor conference in New York City on December 4, 2024, although the specific location was not publicly disclosed.

I then researched the event online. I observed that the annual conference of America’s largest health care organization with the stated mission to make health — excuse me — with the stated mission to make the health system work better for everyone, would be attended by company executives, the board of directors, and hundreds of investors, not doctors, nurses, and patients

In November of 2025, I traveled from outside of New York State to Manhattan. I then emailed UnitedHealthcare leadership posing as an investor at a firm managing over $50 billion in assets and requesting information about the conference. Unlike my previous interactions with insurers, I received an immediate response within an hour.”

I’m certainly not condoning this act of violence because it clearly hasn’t led to any meaningful change, but it’s not hard to understand why Mangione was frustrated enough to do it. UnitedHealthcare was unresponsive to his needs as a patient, but they were incredibly responsive when he falsely claimed he had billions of dollars to invest.

If there is anything to be gained from this, there is some comfort in knowing every health insurance executive in the USA sleeps with one eye open from now on.