As you know, the CEO of UnitedHealthcare, fifty-year-old Brian Thompson, was murdered on the street in midtown Manhattan on Wednesday morning, twenty minutes before sunrise. He was in town for an investor conference and had worked for UnitedHealthcare—a company that is part of UnitedHealth Group, a $560 billion health insurance conglomerate—for more than two decades. UnitedHealthcare had 2023 revenue of two hundred and eighty-one billion dollars, and Thompson, who became CEO in 2021, had increased annual profits from $12 billion to $16 billion during his tenure. He received more than $10 million in compensation last year. UnitedHealth Group CEO Andrew Witty, in a video message to employees, remembered Thompson as a “truly extraordinary person who touched the lives of countless people across our company and far beyond.” Thompson lived in a suburb of Minneapolis, where UnitedHealthcare is based, and is survived by his wife and two sons.

The details of this murder are strange and remarkable: it occurred in public; the suspected shooter previously went to Starbucks; he fled the scene on his bicycle; he hasn’t been found yet. But the public reaction was even wilder and even more lawless. The jokes poured into the comments under every news article across social media platforms. “I’m sorry, thoughts and prayers require prior approval,” someone commented on TikTok, a response that received more than fifteen thousand likes. “Does he have a history of shootings? Denied coverage,” another person wrote under a CNN Instagram post. On The whiff of populist anarchy in the air is briny, unprecedented, and especially on the other side of the aisle. new York post The comment sections are full of criticism of capitalism and self-enriching executives and politicians (like “Biden and his crime family”). On LinkedIn, where users post using their real names and professional backgrounds, UnitedHealth Group had to disable comments on its post about Thompson’s death – thousands of people liked it and loved it, some even responded with “claps.” The company also disabled comments on Facebook, where a post about Thompson had received more than 36,000 “laugh” reactions as of midday Thursday.

What on earth, some people wonder, is happening to our country? Are we really so divided, so used to dehumanizing one another, that people are out here openly celebrating the cold-blooded murder of a hard-working family man? That people joke about how the assassin could have won the Timothée Chalamet Lookalike Contest in Washington Square Park? That, as a journalist at the American view When I called an 88-year-old woman upset about her poor Medicare Advantage insurance to comment, she joked that she wasn’t the murderer – she couldn’t even ride a bike?

There have already been threats against Thompson, his wife told NBC News, motivated by “I don’t know, lack of reporting?” . . All I know is that he said there were some people who threatened him.” There were protests at UnitedHealthcare headquarters in Minnesota in April and July; Eleven people were arrested. The group responsible for the protests, People’s Action, also confronted Witty, the CEO of UnitedHealth Group, at a Senate hearing in May. In a statement, People’s Action leaders cited endless hours on the phone trying to secure medical care and the denial of coverage for life-saving medications and surgical procedures. A recent statement from the group in response to Thompson’s death said: “We know there is a gun violence crisis in America. “There is also a crisis of denial of health care by private health insurance companies, including UnitedHealth.” They called on political leaders to “act on both measures.” UnitedHealthcare has the highest claim denial rate of any private insurance company: At 32 percent, it is twice the industry average. And although the shooter’s motive remains unknown, the words “deny,” “delay,” and possibly “depose” were written on the shell casings found at the scene, reminiscent of the title of a 2010 book by Jay M. Feinman Title “Delay” recalls “, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It,” which climbed one of Amazon’s best-seller charts on Thursday.

For most Americans, a company like UnitedHealth represents less the provision of health care than an active barrier to receiving it. UnitedHealthcare insures nearly a third of patients enrolled in Medicare Advantage, a government-funded program sponsored by private insurance companies who receive a flat fee for each patient they insure and then generate their own profits by minimizing the cost of care for each patient. reporting in Wall Street Journal has found that these private insurance companies, which cover more than a third of America’s seniors with Medicare benefits, collect hundreds of billions of dollars annually from the government and overstate Medicare by approximately $10 billion annually; UnitedHealthcare has filed a lawsuit to challenge its obligation to repay overpayments. In 2020, UnitedHealth acquired a company called NaviHealth, whose software provides algorithmic care recommendations for sick patients and is now used to manage its Medicare Advantage program. A 2023 class action lawsuit claims that the NaviHealth algorithm has a “known error rate” of ninety percent and cites horrific patient stories: A man in Tennessee broke his back, was hospitalized for six days, and was hospitalized for eleven days a nursing home transferred days and was then informed by UnitedHealth that his care would be discontinued in two days. (UnitedHealth says the lawsuit has no merit.) After a few rounds of appeals and reversals, the man left the nursing home and died four days later. The company declined requests to share the analyzes underlying NaviHealth’s conclusions with patients and physicians, saying the information was proprietary.

At the same time that news of the NaviHealth algorithm broke, the company was fighting – ultimately unsuccessfully – against a court ruling that it had acted “arbitrarily and arbitrarily” by repeatedly denying coverage for long-term inpatient treatment to middle school-aged girls. who has repeatedly attempted suicide and has since died by suicide. A few years ago, government investigators found that UnitedHealth had used algorithms to identify mental health providers they believed were overtreating patients; These identified therapists typically received a call from a corporate “care advocate,” who interviewed them and then stopped reimbursements. Although some states have made this practice illegal, it persists throughout the country. There is no single regulator of private health insurance, even if it is found to be in violation of the law. To curb United’s practices, every single jurisdiction in which the company operates would have to successfully file a lawsuit against the company, mental health advocates told ProPublica.

Thompson’s murder is a symptom of America’s propensity for violence; his field of work is different. Denied health insurance claims are by and large not understood this way, in part because people in important positions at health insurance companies and people in their social circles are likely to have perceived denied claims primarily as a matter of extreme annoyance at worst: hours on the phone, perhaps; a lot of additional paperwork; Maybe the money spent could have gone towards next year’s vacation. For people who don’t have the money, social contacts in hospitals, or the ability to spend weeks on the phone, a denied health insurance claim can instantly steer their lives toward bankruptcy, misery, and death. Maybe everyone knows that anyway, and structural violence—another term for it is “social injustice”—is simply the fabric of American life at this point, and is treated as normal whether we give it that particular name or not.

Norwegian sociologist Johan Galtung coined the term “structural violence” in a 1969 paper that offers a taxonomy of violence—ways to distinguish between the forms violence can take. It can be physical or psychological. It can be positive, implemented through active reward, or negative, implemented through punishment. It may or may not hurt an object; This object may or may not be human. There is either – Galtung points out that this is the most important distinction – a person who acts to inflict the violence or not. Violence can be intentional or unintentional. It can be manifest or latent. Traditionally, our society has been fixated on only one version of this: direct physical violence perpetrated by a person intent on causing harm. The pretty girl was killed by a boyfriend, the CEO was shot in the street, the subway dancer was strangled by the ex-Marine. You don’t even need a human object – people are generally more concerned about Zoomers throwing soup at paintings in a strange attempt to draw attention to climate change than they are about the more than ten thousand farmers in India who are going to Some people die by suicide every year because the unpredictable and extreme weather makes their debts insurmountable. Hypothetically, if one were to blow up an unoccupied private jet to protest the fact that the richest one percent of the world’s population produces more carbon emissions than the poorest 66 percent, many people would see it – like Thompson’s murder and in contrast to the tens of thousands of human ones deaths per year that are already caused by climate change – a sign of deeply worrying societal decline.