Two years before Brian Thompson was shot dead on the streets of New York, a post from health insurance executives sparked a series of fearful and angry responses.

“Making health care more affordable means more money in people’s pockets,” Thompson, chief executive of UnitedHealth Group’s insurance division, wrote on LinkedIn. “This is more important now than ever. Reducing drug prices and improving price transparency are two ways we are working to reduce costs for UnitedHealthcare members.”

Underneath the post, there were only a few who praised the sentiment. “I’m curious, whose pockets is the money in?” wrote one user. “It appears that members are not the primary recipients when the CEO to average employee salary ratio is 30:1 and sales are increasing by more than 10 percent per year.”

Another spoke about her 86-year-old mother’s health insurance being canceled without notice.

“Do better,” said a woman who said she was diagnosed with stage four cancer but was forced to drop her insurance coverage after UnitedHealth denied her medication. “Every month there is a different reason for rejection. We have now significantly exceeded our annual maximum at well over $20,000 (£16,000). Since we’re in our 60s, we don’t have time to make up for it.”

Now Thompson’s murder by a masked assassin in the US has sparked another flood of public anger over the state of the country’s healthcare system.

For some, sympathy seems to be in short supply. Within hours of the murder, videos surfaced online of nurses and patients posting horror stories about dealing with health insurance. Below a video of the shooting on CNN, one commenter said: “Thoughts and condolences to the family. Unfortunately, my condolences are outside the network.

The manhunt for the attacker in Thompson’s attack is still ongoing and his motive is unknown. However, there is growing speculation that he was targeted because of his work in the health insurance industry. Speaking to reporters this week, Thompson’s estranged wife suggested that he had been the victim of threats in the past. She said these may be above health care “insurance.”

The evidence discovered Thursday only strengthened the theory that Thompson’s job played a role in the attack. Police officials said bullet casings were found at the scene emblazoned with the words “deny,” “defend” and “cancel.”

Some suggested this could be a reference to the tactics insurers use to avoid paying out claims to patients in a 2010 book called “Delay, Deny, Defend: Why Insurance Companies Don’t.” Pay Claims and What You Can Do About It”.

In the book, author Jay Feinman writes, “All insurance companies have an incentive to poach their customers to increase their profits.”

Frustration with the state of the US healthcare system has been growing for years. Democratic Sen. Bernie Sanders said in April, “It’s a system that’s not designed to provide affordable health care to everyone.” It’s a system that’s designed to generate huge profits for the insurance companies, the drug companies and many other industries within the system.” He claimed that this system was “totally broken.”

Insurers argue that it is the drugmakers who reap the profits, not them. However, there are obvious problems at play. Across America, 85 million people are either uninsured or underinsured. For those who pay for insurance, it is a significant portion of their salary.

In 2022, health insurance was the second largest portion of workers’ compensation after wages, accounting for 7.9 percent of their pay package. The cost of family health insurance offered by employers has only increased since then, up 7 percent this year to $25,572.

Many insured people say they are overcharged for services they believe should be covered by their insurance.

Research by the Commonwealth Fund earlier this year found that more than two in five working-age adults had received a bill or co-payment – a fixed amount that patients must pay before insurers offer cover – for what they thought was a health service that if they had not done this they should have been covered by insurance.

This has led to growing resentment towards health insurers. According to a Gallup poll, less than a third of Americans have a positive view of the healthcare industry. Only oil and gas, the federal government and pharmaceutical companies fared worse.

A particular point of criticism from those who deal with insurers is the “rejection rates”. Although companies are not required to publish how often they deny claims, official studies have found the problem is significant.

A Senate committee investigation earlier this year found that the three largest companies in the field – UnitedHealthcare, Humana and CVS – denied all care to people who had suffered falls and strokes. She accused UnitedHealthcare of denying nursing care requests three times more often than other services. The companies refuted the report.

For now, UnitedHealthcare executives can only mourn their colleague. Andrew Witty, chief executive of parent company UnitedHealth Group, said the case was a “terrible tragedy.”

“Our thoughts are with his family, especially his mother, his wife Paulie, his brother and his two sons who lost a father today,” he said.

But not everyone can understand the human tragedy of this case. As one nurse said on TikTok, “I just can’t feel any compassion for him because of all these patients and their families.”

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