The video is chilling. And unfortunately, so ordinary for the United States. The scene takes place on Wednesday December 4 in the morning. A man in a tailored suit walks past the Hilton Hotel in New York, located a stone’s throw from Times Square. Another man calmly appears behind him, brandishes a pistol and fires at least four times in the direction of his target. He leans over his dying victim before quietly fleeing. The scene was filmed by a hotel surveillance camera and has since been broadcast on several social networks.
In a country where guns circulate freely, this kind of scene has become quite common. But this cold-blooded assassination is not a news item like any other. The victim? This is Brian Thompson, CEO of the UnitedHealthcare group, the leading health insurance company in the United States. The alleged killer? A young man named Luigi Mangione, who was apprehended at a McDonald’s restaurant in Pennsylvania five days after the crime.
The media across the country dissect his journey with amazement. Mangione is not a misfit who would flaunt his firearm collections on the networks: he is an engineer, graduated from an Ivy League university (less than ten extremely selective establishments) and former valedictorian of a prestigious private high school. He’s athletic, comes from a wealthy east coast family, owns several country clubs and likely never met Brian Thompson until the morning of the murder. His motive? Take revenge on the American health system. “These parasites deserved it,” he explains in a handwritten note found on him during his arrest, before recalling that “the United States has the most expensive health system in the world while they are 42nd in terms of life expectancy.”
Immediately, social networks went crazy. On X (formerly Twitter), Mangione’s profile saw its number of subscribers explode in a few hours. Many Internet users defend the supposed criminal, who becomes a symbol of the fight against a system often perceived as unfair. The subject is highly flammable. Other platforms like Instagram and Reddit then took the decision to suspend the young man’s accounts.
Then, within a few hours, things took a confusing turn. Messages of sympathy and militant positions give way to numerous humorous memes which make the alleged murderer a real sex symbol. His vacation photos are hijacked and his abs are widely commented on. Some users even express a romantic or sexual attraction towards the young man. These behaviors have a name: hybristophilia. “We have famous and documented cases, like that of Ted Bundy who received many love letters, analyzes Doctor Thomas James Vaughan Williams, psychology researcher at the University of Huddersfield (England), but social networks really facilitate these phenomena.” Indeed, the anonymity of the platforms often allows users of social networks to express some of their strange impulses without fear of reprisals. The group effect then reinforces these behaviors.
The psychologist analyzes: “there is not always a clear way to identify Internet users who experience hybristophilia and those who simply demonstrate a platonic appreciation of the accused and his motivations .” The fact that many Americans themselves have a certain resentment towards health insurance companies made the young man almost “likable” in their eyes. “These behaviors can make people completely insensitive to the real issues of the case. A culture that is built around a lack of compassion for victims of crime and which celebrates those who commit it is a serious problem,” asks Dr. Vaughan Williams.
American malaise
The fact remains that the affair shakes the entire country and brings to the surface social questions that were rarely addressed during the presidential campaign which has just ended. The significant inflation which burdened the American budget during Joe Biden’s mandate certainly facilitated Donald Trump’s victory, but the question of health spending, on the other hand, was not the subject of very great attention. According to the Pew Research Centeronly 33% of American voters say that the future president has “explained his health policy well” and therefore know what to expect for the coming term.
However, the health situation is worrying. The average life expectancy of Americans has barely increased since the early 2010s and is struggling to catch up with the decline that the country experienced – like many others – at the time of the Covid-19 pandemic. Moreover, healthcare spending in the United States are the largest in the world: in 2022, current health expenditure in the international sense (DCSI, an indicator calculated by the OECD to establish comparisons) was 18.2% of GDP in the United States (around 6,500 euros in purchasing power parity) against only 11.9% of French GDP (i.e. 4,550 euros).
These colossal expenses can be explained by the importance of the private insurance system in the United States. Unlike France, where most expenses are covered by Social Security, Americans largely subscribe to individual insurance contracts, either through their employment or by direct purchase. Consequence: 8% of the country’s population (and 5.8% of those under 19) had no health insurance in 2023, according to official statistics. And among the remaining 92%, the reimbursements offered are very uneven. Exact data is difficult to obtain but all points in the same direction: a investigation from the NGO Kaiser Family Foundation (KFF) estimates that 17% of acts were refused reimbursement in 2021 while the National Association of American Insurance Commissioners (which regulates the sector overseas Atlantique) estimates this share between 14 and 16% last year. And things are getting worse.
“In the United States, health insurance companies are private companies that must maintain a high level of margin. Consequently, they increase the administrative barriers to access to care in order to save money,” notes Miranda Yaver, associate professor. at the University of Pittsburgh (Pennsylvania). The researcher interviewed more than 1,300 Americans for a forthcoming book on the United States health system: more than a third of respondents say they have already been refused medical reimbursements. At the same time, insurance company profits are soaring.
UnitedHealthcare, the company headed by Brian Thompson, saw its turnover increase by 14.6% between 2022 and 2023. Last year, moreover, its total profits amounted to 22 billion dollars, or 2 billion more than in 2022. Recently, the company has had to face several cases, one in which the company was accused of processing its clients’ files with AI as well as an investigation of the American antitrust administration to prevent it from acquiring a competitor. “It’s a bit unfair to only blame these companies who are just playing the market game,” says Miranda Yaver, “in reality, the whole system needs to be rethought.”
Sick society seeks remedy
During a press conference from his personal residence at Mar-a-Lago in Florida, future President Donald Trump declared on Monday December 16 that he would “take down the middlemen who do nothing and who line their pockets, to lower drug prices to levels no one has ever seen.” He then clarified that he did not know who these intermediaries were at this stage, but immediately, the shares of the main insurance companies in the country began to plummet.
In the streets of New York, some instead sought to take inspiration from Luigi Mangione by taking the law into their own hands. Posters with the faces of insurance managers have been put up throughout the city denouncing the profits made over the past few years. A frightening invitation to a manhunt.
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