On the dawn of December the 4th, Brian Thompson, CEO of UnitedHealthcare (America’s #1 healthcare insurer) was killed in a targeted shooting in midtown Manhattan whilst on his way to an investor meeting. A manhunt for the assassin began quickly. Just five days later, Luigi Mangione was arrested in Pennsylvania.
On Manigone, at the time of his arrest, were a few notable items: a silencer, a gun, a notebook, and a manifesto. Police quickly put Mangione in custody, from acquiring the weapon to planning his arrest – Mangione detailed it in his spiral notebook. Although the assassin’s notebook provided an abundance of evidence for investigators, it was the manifesto that was the focus of the public.
While major media outlets withheld releasing the manifesto, on December 10th, independent journalist Ken Klippenstein released Mangione’s alleged damning letter. He criticized the ineffectiveness of American medical aid stating how it is the “#1 most expensive healthcare system in the world,” but somehow the U.S. is “[ranked] roughly #42 in life expectancy.”
The letter cites the corporations in charge of healthcare for this imbalance, writing “[UnitedHealthcare] has grown and grown, but our life expectancy? No the reality is, these [indecipherable] have simply gotten too powerful, and they continue to abuse our country for immense profit.” The killer’s words sent shockwaves through the public, igniting already inflammatory debates on the flaws of the U.S. healthcare system.
Shortly after the note’s release, director Micheal Moore of the healthcare exposé documentary “Sicko” – which was referenced in the manifesto – questioned why “Each year nearly 50,000 Americans are killed by gun violence” while annually “over 100,000 Americans die from infections they pick up when they visit or check into [U.S.] healthcare facilities.” But what causes this shocking disparity between life and price?
Healthcare insurance in America comes in two forms: public, meaning government provided, and voluntary, meaning insurance purchased from a corporate entity. Universal healthcare sponsored by the federal government is not offered in America. As recorded by the Organisation for Economic Co-operation and Development (OECD) in 2023, only 92% of Americans had any healthcare coverage, while countries such as the UK, Canada, and Australia had 100% coverage.
As mentioned by the assassin, voluntary healthcare is an issue for many. A majority of Americans rely on voluntary healthcare, 61% do so as of 2023 according to the OECD. Although obtaining insurance is one thing, keeping it is a separate concern. According to KFF health news polling, as of July of 2025 nearly 50% of American adults stated they struggled with keeping up with healthcare insurance payments. Additionally, a quarter stated they had a household member struggling to meet healthcare insurance payments. Based on these statistics, a majority of people on voluntary healthcare struggle to afford it.
Even when insurance is secured, having medical care actually paid for is an entirely different issue. Some healthcare plans might not be partnered with medical professionals making said places “out-of-network” or which means any care that occurs there would not be paid for with help from insurance. Alternatively, healthcare insurers might only allow limited coverage for certain treatments that are in-network. In these situations patients would need to request or “claim”.
In 2023, KFF reported that healthcare plans from insurers sold on HealthCare.gov – such as UnitedHealthcare and Blue Cross – denied 19% of in-network and 37% of out-of-network ones. The fear of not being able to pay for care looms over the heads of many Americans, and such concerns are so crushing, many end up avoiding seeking care as a whole. As of July of 2025, KFF reported that one out of three adults postponed or completely skipped getting essential healthcare due to the cost.
Although healthcare is an issue most students overlook in their daily lives, the flawed system still finds a way to frustrate people of all ages. One student at Wilcox, who wished to remain anonymous, stated they had the issues obtaining healthcare. Currently, they are suffering from persistent chronic migraines either due to a neurological condition – which is unknown to them at this time – or stress.
When asked how their condition affects their daily life, they stated “I usually skip at least two days of school a month just because either I can’t get out of bed because my head hurts and I can’t look at anything bright, or I will get dizzy and nauseous.” However, despite the concerning state of their condition, they have been unable to seek proper treatment.
The student elaborated that they are under their parents healthcare plan with UnitedHealthcare. When asked about dealing with their insurer when seeking treatment, the student stated, “I struggle with approving claims with my insurer – as I need a brain scan.” As for the reasoning for their denied claims, UnitedHealthcare stated that they are “healthy” as they passed their athlete’s clearance.
The student added that this wasn’t the only time they attempted this claim, “Twice. Once it was denied due to me passing the athlete’s thing and not having serious systematics when I was younger… My second claim was denied with minimal reason.” As with many Americans, they feel frustrated, “I am both [ambivalent] and deeply resentful. On one hand this is the system that I do know and have unfortunately worked for. I can understand it to a degree, and I am very unhappy with how the system works itself.”
Patients aren’t alone in feeling the pressures of the healthcare system, healthcare workers themselves are forced to face the consequences of the system daily. It is an understatement to say the healthcare institution – and its ability to care for patients – was heavily impacted by the pandemic. Post-2020, across 133 countries, the number of healthcare worker protests per week rocketed up by 47% according to “Health worker protests and the COVID-19 pandemic: an interrupted time-series analysis”
Jennifer Kelly, spokesperson for SEIU-UHW (Service Employees International Union – United Healthcare Workers West), cites understaffing as one of the biggest issues facing the workers. When asked about the union’s recent pickets, she states “When I talk to some of these frontline healthcare workers, they mention all the time how people don’t last more than a few months. They come in, they start the job, they realize the workload is unsustainable.” As healthcare workers are the ones who directly provide care, this data paints a grim future for US healthcare.
During the pandemic, short staffing was accelerated. According to a study done by the National Council of State Board Nurses, 100,000 left the field of healthcare during the pandemic with an additional 610,000 – which is nearly 13% of the nurse workforce according to the American Association of College Nurses – planning to quit by 2027. With there not being enough workers to fill jobs, a loop is created with workers quitting due to the workload which further increases the pressure put on the remaining workers.
Highlighting the already unfavorable issue of staffing, Kelly states, “Some of the hospitals [SEIU-UHW] works with have the latest and greatest technologies” however, she adds that “all of them struggle with the amount of frontline healthcare workers they need to operate all of that [equipment], to interpret all of that, and to take care of patients” It seems although management is providing the necessary tools to provide care, they forget that the people are at the heart of the system.
On top of the increasing workload, medical staff feel they are being underpaid, giving them less incentive to stay in the profession. According to Everee’s 2024 Healthcare Staffing Report, 66% of U.S. healthcare workers stated that they are living paycheck-to-paycheck. Management’s lack of worker care has been a major topic for many healthcare pickets nationwide. When it came to the SEIU-UHW’s recent pickets, Kelly explains, “[Picketers were] in the middle of trying to negotiate a new union contract and they’re big – top priorities – include resolving the short staffing crisis that they’re all seeing throughout their facilities. They’re trying to raise the pay rates because it’s been years of under paying these workers that has led to really high turnover.”
Due to the low pay and the short staffing, patient care has been on a decline. Patients are unable to receive care as healthcare staff are missing when their presence is needed the most. Kelly describes one of the anecdotes she heard from a recent picket at Sutter, a healthcare company in charge of facilities in California, “I was talking to a worker who also works at Sutter and she supports the operating room in her hospital. Routinely the surgeon will come into the operating room, look around to make sure that everything is there, and the equipment that he needs might not be there… They were so short staffed on the support staff, they weren’t able to get the supplies to the operating room.”
Medical facilities play a crucial part in sustaining the health of a community. However, access to healthcare infrastructure has been inconsistent, combined with unaffordable prices for treatments, America’s livelihood is at stake – especially for those already struggling. Kelly identifies corporate greed as the reason behind poor medical infrastructure, “Sutter has made the decision to move away and close services in some of these poor communities of color, especially in the Bay Area to open up facilities in wealthier locations… this is going to create more profit for their system.”
These closures heighten existing disparities in healthcare access, putting communities who rely on these centers the most at risk. As of 2023, over 50% of the populations in nearly ⅓ of US counties have to drive over 5 miles to get to the closest medical facility, with Black residents being more likely to be a part of this demographic in 56 counties according to “Racial disparities in access to health care infrastructure across US counties: A geographic information systems analysis”
Amador County in California – which requires over 50% of its population to drive over 5 miles to seek medical assistance – recently experienced a closure of a Sutter surgery center. Residents have expressed concerns as many rely on the center for care as alternatives are few and far in between. Patricia Tara, one patient at the center, shared with KCRA 3 the difficulties for residents who would need to make the over 35 mile trip to the next center stating that “on roads that are very windy… seniors who have a hard time seeing or anything like that, they cannot make that drive”
While healthcare workers struggle to make ends meet and patients are forced to go through herculean tasks to get care, many feel that the executives in charge are not doing enough to help. Kelly states, “Executives who don’t take care of patients, who don’t go into the hospitals on a daily basis, who weren’t going in and out of COVID rooms throughout the pandemic – and still today – making sure disease is not being spread… they’re making millions and millions of dollars in executive pay.” An example of what Kelly mentioned is Sutter Health, the non-profit organization who paid their CEO a total of $11.5 million during 2023 according to ProPublica.
Currently, Luigi Mangione’s trial is still ongoing. He is facing the death penalty, however, the charges of terrorism he once faced have been dropped. With such a high-profile case, arguments questioning the validity of the death penalty in this case have come from Mangione’s lawyers, denials along with accusations of the assassin influencing copycat killers have been thrown around, and conflict over decisions of public comment regarding the trial have all arisen. Regardless of Mangione’s verdict, one thing has cemented itself in the minds of the American people, something must be wrong with the institutions implemented to take care of them to cause such bloody violence.
