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The killing of a top UnitedHealth Group executive on Wednesday sparked an outpouring of sympathy but also jubilation, underscoring the frustration among Americans who see the health care system as broken.

According to research from Rutgers University in New Jersey, the most popular posts on the social media site expressed many users of other social media apps such as TikTok posting similar messages.

The barrage of criticism of UnitedHealth, a health and insurance company that serves tens of millions of Americans, and Thompson highlights how the industry is grappling with controversy over everything from the cost of care and medications to the prevalence of medical debt.

“Today we mourn . . . Brian Thompson, shot. . . Wait, I’m sorry – today we mourn the deaths of 68,000 Americans who needlessly die each year so that insurance company executives like Brian Thompson can become multimillionaires,” Anthony Zenkus, a lecturer at Columbia University in New York, said in a post viewed millions of times on X.

Zenkus’ post referenced a 2020 study published in the Lancet that estimated that universal health care for Americans — replacing the current system in which most consumers rely on public and private insurance — would save 68,000 lives annually would. Zenkus told the Financial Times he would “never celebrate the death of anyone.”

Another sign that UnitedHealth was being harshly criticized was the statement posted on the Minnesota-based group’s Facebook page about Thompson’s killing, which drew 53,000 laughing “emojis.”

While the social media posts represent an extreme fringe, they underscore widespread unease in the country about the health care system. A Gallup poll this summer found that less than a third of Americans view the health care industry favorably, with nearly a quarter giving it a “very negative” rating.

Social media users also mourned Thompson’s death, with Minnesota Senator Amy Klobuchar saying in a post on X that the incident was “a terrible and shocking act of violence.”

Another post, which has been read thousands of times, said: “It is a tragedy that a life was lost in such a violent manner. “While the healthcare system is undeniably flawed, it does not justify the callous joy at his death.”

The shooting of Thompson, 50, outside a large hotel in midtown Manhattan, which authorities described as a “premeditated, targeted attack,” sent shockwaves through the health care industry. The bullet casings found at the scene were labeled with the words “deny,” “defend,” and “depose,” possibly in reference to a book about insurers denying claims.

A former Cigna executive recalled how the US health insurer used to face frequent threats when claims were denied. “There were times when proton laser therapy was denied to a child with seizures and the parents freaked out,” said the former executive director.

Another industry executive said: “What’s most disturbing is people’s ability to hide behind their keyboards and lose their humanity.”

Matt Eyles, a health care industry veteran who previously led America’s Health Insurance Plans, an industry organization that does not include UnitedHealth, said most health insurance executives are deeply aware of the challenges patients face.

He said: “We have all had friends or family members who have had terrible health problems and sometimes navigating the healthcare system and dealing with health insurance can be frustrating.”

About 77 percent of respondents to a 2024 survey of 200 U.S. health care providers said claim denials were increasing, nearly double the 42 percent figure in 2022, according to Experian. The survey found that the time to reimburse a claim is increasing: 67 percent of respondents reported an increase in payment deadlines in 2024, compared to 51 percent in 2022.

UnitedHealthcare, a UnitedHealth unit led by Thompson, is the largest U.S. health insurer, covering 26.6 million patients under its employer and individual insurance systems. Thompson had a compensation package of $10.2 million in 2023, including his $1 million base salary and bonuses.

Eyles called the people who used Thompson’s death as an opportunity to criticize the U.S. health care system “disgusting.”

He said: “I don’t think most people get into a health-related field unless they hope to actually make things better. It doesn’t always work perfectly, even when the best motives are behind the measures aimed at improving our system.”