Detained suspect in the killing of UnitedHealthcare CEO Brian Thompson seemed to have a grudge against the healthcare industry

The capture of a suspect in the homicide of UnitedHealthcare CEO Brian Thompson appeared to confirm the notion that anger at the healthcare industry motivated the perpetrator.

A man named Luigi Mangione, 26, was apprehended at a McDonald’s in Altoona, Pa., on Monday, five days after Thompson was gunned down outside the site of parent company UnitedHealth Group’s annual investor conference in Midtown Manhattan.

Among Mangione’s possessions at the time of his arrest was a two-page handwritten document described as “railing against the healthcare industry,” according to a CNN report. In the document, he reportedly questioned the cost of U.S. healthcare relative to the country’s health outcomes.

The document indicated that violence was an acceptable recourse and stated that Mangione was acting alone and had self-funded the attack.

The motive has been a leading theory of investigators since authorities at the murder scene found bullet-shell casings with handwritten words that at least partially mirrored the title of the 2010 book Delay. Deny. Defend, which was about the health insurance industry.

UnitedHealth Group’s CEO responds

In some corners of social media, discussion of Thompson’s killing included anger toward health insurers and, more generally, the state of healthcare affordability and accessibility.

As part of a message to UnitedHealth Group employees two days after Thompson was killed, CEO Andrew Witty reflected on those sentiments and emphasized that the company’s efforts to serve as a healthcare gatekeeper are vital. The video was obtained and posted by a journalist named Ken Klippenstein.

“We make sure that care is safe, appropriate and is delivered when people need it, and we guard against the pressures that exist for unsafe or for unnecessary care to be delivered in a way that makes the whole system too complex and ultimately unsustainable,” Witty said in the posted video.

“The mission of this company is truly to make sure we help the system improve by helping the experience for individuals get better and better,” Witty also said. “There was nobody who did more to try advance that mission than Brian Thompson.”

In a 2023 consumer survey by KFF, 81% had positive feedback about their own health insurance, describing it as excellent or good. Still, 58% said they had a problem using their insurance during the previous 12 months, stemming from issues such as denials, preauthorization and network composition. The share rose to 67% among people in fair or poor health and roughly 75% among those with more than 10 provider visits per year.

A separate KFF report found that in 2022, Medicare Advantage insurers at least partially denied 3.4 million prior authorization requests, a 7.4% share. That was up from 5.8% in 2021.