Dec 9, 2024

The UnitedHealthcare CEO shooting.

An image released of the suspected shooter, who remains at large. Photo: NYPD
An image released of the suspected shooter, who remains at large. Photo: NYPD

A look at the responses to the shooting and our healthcare system's problems.

I’m Isaac Saul, and this is Tangle: an independent, nonpartisan, subscriber-supported politics newsletter that summarizes the best arguments from across the political spectrum on the news of the day — then “my take.”

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Today's read: 15 minutes.

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We cover the shooting of UnitedHealthcare CEO Brian Thompson, and the online reaction to the news.

Coverage note.

The fall of Bashar al-Assad’s government in Syria is the biggest global news story right now, but with the situation on the ground changing rapidly, we decided to give the story an additional day to breathe. We’ll cover the topic in full in tomorrow’s edition.

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Quick hits.

  1. Syrian President Bashar al-Assad and his family fled to Russia after Syrian rebel forces seized control of the capital of Damascus. The fall of Assad’s government comes after a 13-year civil war and widespread reports of human rights violations overseen by Assad. (The fall) On Sunday, Israel said it had taken control of territory on the Syrian side of the border in the Golan Heights, its first captured Syrian territory since 1973. (The operation)
  2. South Korean lawmakers failed to hold a planned vote on impeaching President Yoon Suk Yeol after members of Yoon’s People Power Party party boycotted the vote, which followed his decision to declare martial law last week. However, party leader Han Dong-hoon said Yoon would no longer be involved in state affairs for the remainder of his term. (The latest) Separately, the Romanian Constitutional Court canceled the results of the country’s first-round presidential elections in November, citing an alleged Russian interference campaign to boost their preferred candidate. Romania now must restart the electoral process. (The ruling)
  3. In his first broadcast interview since winning the election, President-elect Donald Trump laid out his plans for his first months in office, telling Meet the Press’s Kristen Welker that he would pursue an extension of the tax cuts passed in his first term, not raise the age for government programs like Social Security and Medicare, not seek to restrict access to abortion pills, issue pardons for those convicted in the January 6 Capitol riot, and seek to end birthright citizenship. (The interview)
  4. The judge in Daniel Penny’s trial dismissed the manslaughter charge against him after the jury failed to reach a unanimous decision on the count. The jury will continue to debate a lesser charge of criminally negligent homicide on Monday. (The dismissal)
  5. A federal appeals court ruled that a law requiring the social media app TikTok to sell its U.S. operations or be banned in the United States is constitutional, rejecting the challengers’ argument that the ban infringes on free speech. (The decision)

Today's topic.

The healthcare CEO shooting. On Wednesday, a gunman shot and killed UnitedHealthcare CEO Brian Thompson outside a hotel in New York City. Police have yet to publicly identify the shooter or determine a motive, though they believe the attack was targeted. Despite these limited details, the incident has reignited debates about the United States’s healthcare system and incited controversy on social media, where many have expressed support for the shooter. 

Thompson became chief executive of UnitedHealthcare in 2021 after more than two decades at the company. UnitedHealthcare offers health insurance to individuals and employers and generated approximately $281 billion in revenue in 2023; that year, Thompson received a total compensation package of $10.2 million. Earlier this year, Bloomberg reported that Thompson was one of several UnitedHealth executives who sold millions of dollars worth of company stock prior to the announcement of a federal antitrust investigation. 

The shooting took place at approximately 6:45 am ET in Midtown Manhattan. Surveillance footage shows the assailant firing multiple shots at Thompson from close range before fleeing toward Central Park on a bicycle. Thompson was transported in critical condition to Mount Sinai West Hospital, where he was pronounced dead. Police shared photos of the suspect — who appeared to be a young white man — from the hostel where he had been staying prior to the attack, but they have yet to release further details about his identity. On Saturday, New York City Mayor Eric Adams said law enforcement was making progress toward making an arrest, though police also believe the suspect is no longer in New York City. 

On Friday, New York City Chief of Detectives Joseph Kenny said investigators were exploring whether the shooter could have been an employee or client of UnitedHealthcare. Additionally, police are investigating several pieces of evidence from the immediate aftermath of the attack, including a backpack found in Central Park believed to have been worn by the shooter. They have also tested a discarded water bottle and protein-bar wrapper for DNA and obtained a warrant to search a cellphone found along the gunman’s escape route. 

While the attack caused shock over the nature of the shooting and the gunman’s ability to evade capture so far, it has also generated intense debate about the motive. In particular, the discovery of shell casings at the crime scene with the words “delay,” “deny,” and “depose” written on them suggested that the shooting could have been motivated by insurance company policies. Delay, Deny, Defend is the title of a 2010 book on tactics used by insurance companies to avoid reimbursing patient claims. 

On social media, scores of users have linked the incident to broader complaints about purported exploitative practices of insurers like UnitedHealthcare, with some even praising the shooter. The Network Contagion Research Institute released a report that found that six of the top-10 most engaged posts on X about the shooting on Wednesday “either expressed explicit or implicit support for the killing or denigrated the victim.” Furthermore, public acts of solidarity with the shooter have taken place around New York City, many of which referenced the “delay, deny, depose” messaging. 

In the days since the attack, large corporations have adopted heightened security measures for their executives, particularly those in the pharmaceutical and insurance industries. 

Today, we’ll explore reactions to the shooting from the left and right. Then, my take.


What the left is saying.

  • The left is concerned by the celebratory response by some to Thompson’s death, arguing the attack won’t encourage necessary reforms. 
  • Some say the anger that followed the shooting is a sign of societal fraying. 
  • Others say the response shouldn’t come as a surprise against the backdrop of the U.S. healthcare system.

In Bloomberg, Lisa Jarvis said “the health insurance industry is broken. Don’t let it break us.”

“I found myself wincing at the tone of the messages rolling in on my various group threads and social media sites — including from people whose opinions I usually deeply respect. My compass on these things is always how I’d want my daughter to hear me react in such a moment. Would I want her to think it’s okay to dance on the grave of someone whose sons are now fatherless,” Jarvis wrote. “And yet, we can’t ignore the ferocity of the response — or the fact that no one’s gut told them to check it. It lays bare a ground truth: If there’s anything our fractured country seems to agree on, it’s that the health care system is tragically broken, and the companies profiting from it are morally bankrupt.”

“I desperately want this rage to be channeled into something productive. My worry is that it will not and, by design, cannot under the US’ current health care infrastructure. That instead of prompting health care companies to introspection about their most egregious, profit-driven behaviors, they will simply go quiet and hope we move on,” Jarvis said. “I also worry that the rage is causing more people to gravitate toward ideas that ultimately are dangerous. There seems to be a growing attitude that real change can only come by burning it all down. Or that we need to be open to extreme approaches to fixing our system.” 

In The New York Times, Zeynep Tufekci suggested “the rage and glee that followed a C.E.O.’s killing should ring all alarms.”

“Even before any details were available, the internet was awash in speculation that the company had refused to cover the alleged killer’s medical bills — and in debates about whether murder would be a reasonable response,” Tufekci wrote. “It’s true that any news with shock value would get some of this response online — after all, trolling, engagement bait and performative provocation are part of everyday life on digital platforms. But this was something different. The rage that people felt at the health insurance industry, and the elation that they expressed at seeing it injured, was widespread and organic.”

“The conditions that gave rise to this outpouring of anger are in some ways specific to this moment. Today’s business culture enshrines the maximization of executive wealth and shareholder fortunes, and has succeeded in leveraging personal riches into untold political influence. But the currents we are seeing are expressions of something more fundamental,” Tufekci said. “The fraying of the social contract is getting worse. Americans express less and less trust in many institutions. Substantial majorities of people say that government, business leaders and the media are purposely misleading them. In striking contrast to older generations, majorities of younger people say they do not believe that ‘the American dream’ is achievable anymore.”

In The Guardian, Arwa Mahdawi wrote about why “Brian Thompson’s death has elicited little sympathy.” 

“I don’t need to spell out why Thompson’s death has elicited so little sympathy. It doesn’t matter how great a guy he might have been to his friends and family; he was a top executive at a company that has treated millions of people very poorly. Health insurance in the US is a racket that is more focused on increasing profits than providing care. And UnitedHealthcare is particularly egregious when it comes to getting its customers to pay enormous premiums, then turning around and denying them care when they desperately need it.”

“In short: Thompson was the face of an unfair system that has screwed millions of people over… Whatever the motive, many people seem to think Thompson got what he deserved. The glee we’re seeing doesn’t just stem from animosity towards insurance companies, but anger towards an unfair system in which the elite rarely seem to face any consequences for their actions,” Mahdawi said. “Murdering anyone is quite clearly wrong. But please spare me the pearl-clutching from people (mainly politicians and billionaires) who are shocked by the satisfaction Thompson’s murder has inspired.”


What the right is saying.

  • The right is dismayed by the shooting and the response that followed.
  • Some suggest the progressive left’s response had laid bare the hypocrisy of their politics.
  • Others worry that American society is embracing violence as a solution for anger.

In National Review, Dominic Pino said “murdering CEOs is evil.”

“The natural human reaction to all of this is to first be horrified that a husband and father of two children was murdered. The second reaction is to wonder who planned this and whether they have also planned more hits, against other UnitedHealth executives or leaders of other companies,” Pino wrote. “This is not the time to offer your criticisms of the health-insurance industry. And there is never a time to believe that corporate executives are, by their very nature, evil people who deserve to be killed. Yet, that is what you’ll see if you go on social media right now and look at comments on news stories about this assassination.

“I had never heard of Brian Thompson before today, and it’s entirely possible that he made some bad decisions. It is not possible that he deserved to be murdered, because nobody deserves to be murdered. And the level of seething resentment some people seem to have of wealthy people is deeply unhealthy,” Pino said. “Socialism is always motivated by envy and often brought about by violence. If there is some kind of organized effort to target CEOs with violence to win applause from the public, that ought to fail because the American public would be repulsed by it. All of us need to be repulsed by this murder. Basic human decency and a commitment to a free society demand it.”

In The Free Press, Kat Rosenfield wrote “a CEO was shot dead. These people cheered.”

“The shooting was captured on video: The killer, masked and dressed in black, steps out from behind a parked car as Thompson passes. A moment later, Thompson stumbles, falls, and doesn’t get up. It is terrible to watch—and yet, even this literal snuff film is less disturbing than the various critics and commentators, many of them self-described progressive empaths who preach compassion for the marginalized and hashtag their posts with ‘#BeKind,’ who are treating this real murder of a real person as though it were the emotionally cathartic climax of a John Wick movie.”

“This practice of celebrating the destruction of one individual person as a scapegoat for whatever systemic injustice—racism, or sexism, or in this case, corporate greed—has been a recurring cultural phenomenon since roughly the first Trump administration,” Rosenfield said. “It has always been human nature to hunt for witches, particularly in moments when everything seems to be either broken or falling apart. When people feel scared and out of control (as anyone who has ever had the displeasure of tangling with a health insurance conglomerate in the midst of a medical crisis surely has), it’s strangely soothing to imagine that every harm, every injustice, can be traced back to the depravity of a single, mustache-twirling villain who feasts while decent people starve. The only problem is, it’s not true.”

In The Deseret News, Cliff Smith argued “the decoupling of ends and means is leading to disaster.”

“Something has taken hold in America that is particularly toxic. Namely, too many people seem to believe that any grievance justifies any response to rectify it. And this past week, we’ve seen a particularly dangerous example of this playing out on the internet and in the media,” Smith wrote. “The people that were justifying a premeditated killing need to have a good, hard think and undertake an examination of their own consciences, and of reality. Their usual take amounted to this: Since the health care industry is flawed, it leads to people dying, ostensibly due to corporate greed. It is therefore OK to justify, and even celebrate, Thompson’s cold-blooded murder.”

“You can see similar flawed logic playing out, in big or small ways, in those who justify Hamas attacks on innocent Israelis, justify the pardon of the plainly guilty Hunter Biden because his dad is president and account for delegitimizing elections and attacking the Capitol,” Smith said. “Anger itself is not wrong, but it can lead us to do wrong things. There has to be a direct, comparable connection between the means and ends, and whatever means taken cannot be more destructive than the ends gained. No amount of anger, justified or not, changes that.”


My take.

Reminder: "My take" is a section where I give myself space to share my own personal opinion. If you have feedback, criticism or compliments, don't unsubscribe. Write in by replying to this email, or leave a comment.

  • I’m stunned by how much apparent glee I’ve seen on social media responding to Thompson’s death.
  • Our health insurance system is deeply broken, which I understand and have personally experienced.
  • The best way to enact change, though, is through slow and steady reform — definitely not through public violence.

Before Brian Thompson was killed last week, I had never heard of him. I'm a politics reporter who pays pretty close attention to the general societal upset over the state of health insurance in America, so I suspect that if I had never heard Thompson’s name then 99% of other Americans (at least) also hadn't heard of him — until he was murdered in cold blood.

That reality makes the general tenor of the reaction to his death all the more startling. When Donald Trump was nearly assassinated and many on the left joked about how they wished the shooter hadn’t missed, I was morally shocked — I thought it was disgusting but predictable. Americans live in a deeply polarized world where they are effectively being brainwashed to hate people whose politics they don't agree with, a reality that informs the very work we do here at Tangle. So the reaction to an attempt to kill our most famous politician didn't take me by surprise. But this? This is a little different.

On Tuesday night, nobody knew who Brian Thompson was. By Wednesday at lunch, people were celebrating his death — with little regard for the wife or kids he left behind, and little care about what he actually did as a CEO. The fact that he led UnitedHealthcare was enough for him to be deserving of death or unworthy of sympathy.

Even if you believe Thompson was all the evil things so many people online say he was — a corrupt corporate CEO guilty of insider trading and working as the face of a company that denies life-saving coverage to tens of thousands of Americans a year in the name of profit — he was a corporate cog. He was responsible to a board and to shareholders. And, in short order, he'll be replaced by another CEO. Nothing will change, except that killing someone in the middle of Manhattan whom you deem evil could now become more normal.

I know how a lot of people might react to me writing this, because I've already encountered the refrains. "It's good these people are scared," is one common throughline of the response. In other words: "No, I don't necessarily support killing corporate CEOs in cold blood on the streets, but if CEOs scale back their predatory behavior because they’re scared of reprisal, that’s a net good.” Or, of course, people might react by saying that I am more worried about the killing of one CEO than a system that kills tens or hundreds of thousands of people a year.

I suppose there's something appealing about these kinds of arguments. They are not entirely unlike arguments I've made in the past — like that we should be prosecuting more corrupt presidents and members of Congress, not fewer, stability of the system be damned. The obvious difference, though, is that when I made those arguments they came from a place of demanding accountability — insisting that the system do a better job of rooting out corruption and evil, not cheering extrajudicial violence on the streets.

To put it differently: If you are hoping for our rich corporate overlords to live in fear of expedited, unanswerable and unexpected punishment, then you are necessarily hoping for us common folk to start delivering that punishment. Which requires us to be the arbiters of who is good and who is evil. The left might consider how long it'll be until abortion-providing doctors or trans activists or Democratic politicians start regularly being mowed down in the street in the name of striking fear into evildoers. If that's the world you want to live in, I strongly suggest signing off the internet and going to spend some time outside.

I want to be clear that I am consciously not joining the chorus celebrating the purported message sent to major corporate health insurers (I say “purported” here because, crucially, we still don’t know the motive of the shooter), even though I’d have plenty of reason to do so. My own frustrating health issues have, in the past, sent me down the rabbit hole of insanity that is our healthcare infrastructure, full of denials and never-ending phone calls and exorbitant prices and inexplicably inhumane treatment from insurers. I've seen it happen to the people I love, too.

During my mother's second bout of breast cancer, her doctors informed her that her body was likely to reject the chemotherapy treatment. She had gotten a similar treatment two decades before, and it was common for patients' bodies to reject the treatment the second time. The oncologists had a backup plan, but my mom's insurance wouldn't cover it unless they tried the chemotherapy first. This process, we were told, might be unpleasant.

I was with her at the appointment, playing cards while the chemo began. A few minutes into the treatment things seemed to be going well, and for a brief moment we thought she might be one of the lucky ones. Then I noticed her chest turning bright red with a flush running up toward her throat. Suddenly her mouth was open, but she couldn't speak, only choking out an "I can't breathe." I yelled for help and stood back out of my chair as she was swarmed by nurses like in some kind of horror movie — they pulled out her IVs, started injecting her with steroids, and held her head back so she didn't choke to death.

It took minutes for the situation to resolve, and my mom (and I) were fully traumatized by the whole experience. Thankfully, the attentive medical staff was able to save her, but she easily could have had a blood pressure spike or stroked out right there in the chair. Our system, in effect, had to torture her before she could get coverage for the right treatment.

And we were lucky. My mom is in good health (even after beating breast cancer a third time) and has, thank God, gotten incredible care throughout her life despite the sometimes exorbitant and infuriating costs. Many other people aren't so lucky. I can only imagine the pain, frustration, or anger I might have felt if my mom's story had ended differently. I try to hold that perspective as I watch the alarming response to Thompson's death last week.

Shockingly, we still don't know a lot about this story. While a scary number of people seem to be celebrating or gleefully cheering on the shooter's escape, we know next to nothing about who he is or his motivation. Was he or a family member a patient with UnitedHealthcare insurance? Did he work at UnitedHealthcare? Did he know Thompson personally? Did he target Thompson intentionally, or even kill the right person? (He was, after all, waiting outside a healthcare conference). Could there be another explanation altogether? None of this is known to us, yet we’re all seemingly comfortable jumping to conclusions.

Whatever details emerge, one thing will remain true: Improving our healthcare system, and our society more broadly, is not going to start by shooting corporate leaders in the back. It's going to take fastidious work from consumer advocates, legislators, and corporations. It'll require grassroots movements and political pressure. It will happen slowly, deliberately, with a checkered history of wins and losses. That is always how this goes, and anyone trying to convince you otherwise is selling snake oil.

Even less discussed these days is that a majority of Americans are actually satisfied with their own personal health care’s quality and coverage, which majorities rate positively. In other words, people seem to simultaneously hate the system — perhaps in part due to the narrative building around things like Thompson’s death — while being satisfied with their own care. I’m not sure how to connect those dots, but I do know it’s a sign there are plenty of things working well that we can build off of, so long as we choose a path better than the one we appear to be on now.

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Under the radar.

Last week, North Carolina’s Republican-controlled state Senate voted to override Democratic Gov. Roy Cooper’s veto of a bill that would strip power from several prominent Democrats who will take statewide office in 2025. The bill, passed during a lame-duck session after the election, was marketed primarily as an aid package for Hurricane Helene victims, but Gov. Cooper accused lawmakers of disguising its true intent. The bill includes provisions that would shift appointment power for the State Board of Elections from the governor, who will be a Democrat in 2025, to the state auditor, who will be a Republican. Additionally, it would bar the attorney general (who will be a Democrat) from taking legal positions opposed to the General Assembly in litigation challenging a given law’s validity. The state’s incoming Democratic superintendent of public instruction would also lose the power to appeal decisions by a state board that reviews charter school applications. The bill now returns to the state House, where Republicans have a slim veto-proof majority. The Associated Press has the story.


Numbers.

  • 52 million. The approximate number of UnitedHealthcare customers in 2023. 
  • $281 billion. UnitedHealthcare’s revenues in 2023.
  • 84%. The percentage of insured U.S. adults who describe themselves as in good health who rate their insurance provider positively, according to a 2023 KFF survey. 
  • 68%. The percentage of insured U.S. adults who describe themselves as in fair or poor health who rate their insurance provider positively.
  • 58%. The percentage of all insured adults who reported a problem using their health insurance in the past 12 months. 
  • 16%. The percentage of insured adults who say their health insurance denied or delayed prior approval for needed care in the past 12 months. 
  • 48.3 million. The total number of in-network claims denied by Affordable Care Act marketplace insurers in 2021. 
  • 0.2%. The percentage of those denied claims that consumers appealed through their issuer’s internal appeals process.

The extras.

  • One year ago today we had just published a special edition on the final Republican debate.
  • The most clicked link in Thursday’s newsletter was the California school shooting
  • Nothing to do with politics: A website or a fever dream? Welcome to zombo-com.
  • Thursday’s survey: 2,617 readers responded to our survey on the Tennessee healthcare bill for trans minors with 49% opposing the law and its legal standing. “I still think parents of the teens should have a say in the decision. Being supported for any teen goes a long way to becoming a responsible adult,” one respondent said.

Have a nice day.

Lyn Story’s car frequently broke down, but that didn’t prevent her from using it to serve others. The neighborhood app “Nextdoor” connected Story to community members who needed rides — like April Goodwin, who needed help getting to medical appointments, and Kevin Horrigan, who needed assistance getting to work. After hearing about the service Story had been rendering in her community, car dealer David Kelleher stepped in, arranging for Story to receive a new car. CBS News has the story.


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Isaac Saul
I'm a politics reporter who grew up in Bucks County, PA — one of the most politically divided counties in America. I'm trying to fix the way we consume political news.