The murder on Dec. 4, 2024, of Brian Thompson, CEO of UnitedHealth Group’s insurance division, sparked an unprecedented wave of vitriol from members of the public not at the alleged murderer, but instead at Thompson, UnitedHealth Group, and the healthcare insurance industry. While the accused killer has not to date revealed his motivation for the shooting, shell casings retrieved in the area had the words “deny,” “defend,” and “depose” on them. Investigators on the case apparently believe those words potentially refer to terms that insurance companies employ to avoid paying insurance claims.
Luigi Mangione, 26, of Towson, MD, was charged with killing Thompson after stalking him when he left a Manhattan hotel early on the morning of Dec. 4. Police believe he fled the state following the attack and he was arrested five days later in Altoona, PA. He has been charged with federal crimes of using a firearm to commit murder, interstate stalking resulting in death, and discharging a firearm that was equipped with a silencer in furtherance of a crime of violence, in addition to numerous state crimes including multiple counts of murder, terrorism, and criminal possession of a weapon.
In a poll conducted after the shooting, more than two-thirds of those who responded believed that the killing was motivated by health insurance company denials of care and profiteering. In comments on social media platforms and Reddit chat rooms, thousands of patients, family members, and healthcare providers described their experiences with health insurers who denied what they believed was necessary care.
The anger around the shooting, came out in the form of jokes, commentary on claims denials, and critics who actually celebrated the murder and expressed no sympathy for Thompson or his family. “Animosity was expressed from avowed socialists to right-wing activists suspicious of the so-call ‘deep state’ and corporate power. It also came from ordinary people sharing stories about insurance firms denying their claims for medical treatments,” according to the BBC.
Experts noted that these reactions were due to the public’s lack of trust in the US insurance industry’s perceived erection of barriers to healthcare in the form of prior authorizations, denials of healthcare, and more.
The State of Public Sentiment
While many were surprised by the anger that emerged in the wake of Thompson’s murder, negative public sentiment about the healthcare system and health insurance isn’t new. A recent Gallup poll revealed that the percentage of Americans who report a positive view of the healthcare system declined to 31% in 2024 from 51% in 2020.
The results of this Gallup poll represented a low in terms of public opinion of healthcare since the poll first began in 2001. More than half of those surveyed in 2024 agreed that the US healthcare system today has major problems. A Forrester Healthcare Division poll of US consumers in 2024 revealed that just over half of those surveyed believed that health insurers will do what’s best for their customers.
People’s Action Institute, an activist organization, held protests at a variety of UnitedHealthcare facilities and events in 2024, including one in July, where 11 out of 150 protestors were arrested. The protests were organized to call attention to UnitedHealthcare’s alleged practices of wrongly denying care through prior authorizations and outright denials of care.
What Underlies Negative Public Sentiment
Negative public sentiment hasn’t arisen in a vacuum. High costs, a scarcity of providers, healthcare and pharmacy deserts, and more have created the conditions for an increasingly unfavorable view of health insurers and the healthcare industry. Two in five working adults report delaying visits to the doctor and filling prescriptions as a result of high costs associated with healthcare, including high deductibles and copays, according to a Commonwealth Fund report. In addition, half of all adults report difficulty in affording healthcare, especially those in historically marginalized communities and those with lower incomes.
More than half of those surveyed by the Kaiser Family Foundation have experienced problems with health insurance including denied claims, provider network problems, and preauthorization issues. More than half of those surveyed with Affordable Healthcare Act Marketplace plans rate their health insurance negatively in terms of the cost of premiums, while 40% of those surveyed delayed or skipped care due to costs.
Coordinating healthcare is also becoming increasingly burdensome, with US adults surveyed by Harris Poll reporting that they spend the equivalent of an eight-hour day a month coordinating healthcare for themselves, their families, or their loved ones. An increasing scarcity of primary care providers has negatively impacted what used to be a foundational relationship within healthcare—the relationship between primary care providers and their patients. Today, patients must wait weeks or even months to see their providers and many patients rely instead on telehealth-only primary care, retail clinics, and urgent care facilities, fragmenting relationships.
How Anger Might Impact MPL Claims
At the same time that negative public sentiment exploded after the Thompson murder, the legal environment in regard to medical professional liability (MPL) lawsuits continues to be mixed at best. Over time, while the overall number of MPL claims that progress to lawsuits where the plaintiff prevails has declined, the number of large verdicts has risen. Known as mega or nuclear verdicts, these extremely large judgments have, according to one analysis, risen by 27% each year between 2009 and 2023.
Experts identify social inflation, the tendency of claims cost to rise faster than inflation, which many believe is a significant factor in the rise of mega verdicts. The precise costs and measurement of social inflation are hotly debated issues, as are its causes, although some attribute it to several factors including changes in societal norms and third-party investment in litigation, with hedge funds and other third parties willing to risk a small amount of capital for the potential benefit of reaping a portion of a massive legal settlement or jury verdict.
It appears social inflation may be a substantial factor in the rise of mega or nuclear verdicts. How much the current negative sentiment against health insurance companies will contribute to that social inflation is hard to say, but it seems likely that the widespread anger that surfaced around the time of Thompson’s murder won’t dissipate quickly.
A Final Word
The continuing rise of higher and higher nuclear or mega verdicts doesn’t look likely to diminish anytime soon. Negative public sentiment towards insurers and the healthcare industry doesn’t bode well for the future.