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You should never have a health system where accountants decide which treatments are essential, leaving doctors to second guess the accountants, says Peter Kelly…

On the morning of December 4, 2024, Brian Thompson casually strolled to the New York Hilton Midtown to attend an annual investors meeting for UnitedHealth Group, the parent group of an American health insurance company called UnitedHealthcare.

Mr Thompson was the CEO. Suddenly, he was assassinated in a way you might expect a mafia boss or a defector from a military dictatorship to be assassinated, not a CEO of a successful American corporation.

Thompson was married with two children and started his corporate career as an accountant with PricewaterhouseCoopers. He obviously excelled at his chosen profession as he would go on to become the CEO of the largest health insurance company in the US.

The killer was lauded. The murder attracted huge media coverage

During his time at the helm of the insurance company, profits rose from $12 billion to $16 billion.

The reaction to his killing online caught many commentators in the media by surprise. Some people descried the reaction online as gleeful. The killer was lauded. The murder attracted a huge amount of media coverage.

Gun violence in America has been so normalised that a young man taking a gun and killing random strangers in a school or other public place such as a cinema is now so unremarkable and can occur without an inch of national media coverage.

So, what was so different about this case? In this incident, the victim appeared to have been specifically targeted. The bullet casings had ‘delay,’ ‘deny’ and ‘depose’, a reference to tactics insurance companies use to not pay out and increase profits.

Interactions with post were made in bad taste

The company Thompson worked for posted on LinkedIn and Facebook that they were sorry to hear about the death of their colleague. They had to suspend interactions with the post as most were made in what can only be described as bad taste.

Tens of thousands of people reacted to these posts with laughing emojis. There seemed to be very little sympathy for his family. Some commentators were horrified and genuinely gobsmacked by the reaction.

I read one LinkedIn post where someone claimed the murder was completely unjustified as Thompson was only doing his job. Hundreds of people felt the need to comment on the post and ridicule it.

And the truth is that Thompson was only doing his job – to increase the profits of the company. In a capitalist system, that is the role of the CEO of a major corporation.

Pressure in system to increase profits legally but unethically?

His responsibility is to prioritise the shareholders. And it’s his duty to do that by any legal means possible. Is there a pressure within the system to increase profits legally but unethically? I believe there is.

I also believe that when corporations do so, they cross a line into being undemocratic. I believe the general population has no issue with companies earning profits but I don’t think they are in favour of companies doing so unethically, even if what they do is technically legal.

In the aftermath of the killing, the internet flooded with personal accounts from patients and healthcare workers of specific instances where they felt insurance companies had acted in bad faith. Denying coverage for health treatment, for example. Or questioning the necessity of treatment.

I read an article where a doctor spoke of patients refusing treatment as the doctor could not guarantee the treatment would be covered by his or her health insurance.

You should never have a health system where accountants are deciding which treatments are essential and doctors have to second guess the accountants.

Vaguely aware of cruelty of America's healthcare system

When I first heard about Thompson’s murder, my first instinct was that the internet would celebrate it. I have spent time in America and was vaguely aware of the cruelty of its healthcare system. It is a running joke in its popular culture.

One of its biggest TV shows, Breaking Bad, is about a man who becomes a drugs kingpin because he gets cancer and can’t afford treatment. I was also not taken aback that so many people were surprised at this reaction.

I have many friends and family members who work for large corporations and they sometimes live in a bubble where they see the world through a different prism than the rest of society.

The comment of defence, that he was just doing his job, reminded me of the Milgram experiment. During that experiment, researchers deceived participants into thinking they were shocking learners for giving wrong answers.

Most participants will continue pushing a button that they believe is sending an electric shock to another person up to a point of inflicting pain and even death on another person.

Was Thompson just a participant obeying an instruction in a cruel murderous system? Grow the business, increase profits, any way you can? Personally, I feel sympathy for all involved.

Peter Kelly is a community pharmacist based in London and a stand-up comedian.