A CEO is murdered, with shocking results

UnitedHealthcare CEO Brian Thompson was shot dead outside a Manhattan hotel in early December. A suspect was arrested a few days later, and revealed to be Luigi Mangione. The alleged perpetrator now faces charges including murder as an act of terrorism.

Mangione is Ivy-League educated, and the scion of a well-to-do family. Upon his arrest, authorities discovered a handwritten manifesto in which he expressed deep animosity toward the US healthcare industry, criticizing the system’s inefficiencies and high costs, and describing its executives as “parasites.”

Outrage about a murder is to be expected; CEO Thompson was the father of two, and certainly did not deserve to have his life taken. But this case has had bizarre consequences. Mangione immediately garnered a huge online following, with many regarding him as a folk hero. Social media was flooded with messages of support praising the young man for rising up against the perceived injustices of the healthcare industry. Memes and merchandise appeared overnight. Crowdfunding efforts were initiated to finance the suspect’s legal defence.

The fact that a CEO was killed received markedly less public sympathy. The use and glorification of violence to address perceived injustices has of course been condemned by many. But the bigger news is about how many people support this event as a fightback against claims-denial and high health costs. America is deeply divided yet again. A high-profile trial will now ensue.

This dramatic event highlights a growing problem in America: that it may excel in medical innovation and specialized care, yet really struggles to deliver affordable and equitable healthcare to its citizens. World-class care for those who can afford it—but a glaring gap for those who cannot. The US spends as much as 18 per cent of its GDP on healthcare—far more than any other country. Insurance premiums, out-of-pocket expenses, and drug prices are extremely high for ordinary individuals and families. Millions remain uninsured or exposed to potentially catastrophic expenses in the event of a medical emergency.

Other countries offer universal coverage, cost control mechanisms, and far more efficient administration. Singapore, for example, has a mix of public health insurance funded by subsidies as well as mandatory personal savings, and a safety net for its poorest citizens. That country spends a markedly lower percentage of its GDP on healthcare, despite being an affluent nation with an ageing population.

Smart countries figured out long ago that healthcare is no ordinary issue—it’s a ticking time bomb. When people can’t access decent care, when they watch loved ones suffer because they can’t afford treatment, something deep and primal breaks. Trust in society crumbles. Anger boils. So these nations did the obvious: they found ways to ensure widespread coverage and equitable access. Some set up tax-funded systems so that care could be free at the point of use. Others made insurance mandatory but kept costs manageable through strict regulation. Different paths, same outcome: a healthcare system people can rely on. Because they understood that when healthcare feels rigged, it doesn’t just make individuals sick—it makes entire societies unstable.

What’s the lesson for chief executives, in healthcare and beyond? Perhaps you have just made a note to beef up security, or do not see this backlash as particularly relevant to your organization or industry? Ranjay Gulati and Alison Beard, writing in the Harvard Business Review, ask you to recognize the gravity of the situation. They point out that frustration with many corporations—whether from consumers, employees, or communities—has boiled over into outright outrage. We’ve drifted from a wary “I don’t trust you” to a seething “I hate you.” Recent surveys show that for a growing number of ordinary people, capitalism and its architects aren’t just suspect—they’re the enemy.

I have been beating this particular drum for decades: a business that is perceived to be exploitative is not sustainable. Exploitation may fatten your profits for a few years, but those seeds of resentment will grow into something far uglier and more explosive. Cutting corners on what you deliver to customers, squeezing employees while personally taking home bumper bonuses, or draining resources out of communities—if that’s the stuff you’re engaged  in, hey, there’s a big bill coming.

People remember how you made them feel. When anger turns to backlash, no slick PR campaign or executive mea culpa will save you. Here’s the fundamental point: real, sustainable success comes from creating value with people, not extracting it from them. Businesses that forget this fundamental truth aren’t just playing with fire—they’re building their house on the kindling.

So, if you’re a thoughtful corporation with genuinely good intentions, do not sleepwalk into next year without deep introspection. Your board and senior team should hold a high-level summit that asks some far-reaching questions. What is our true purpose for existence (the real one, not the fru-fru)? Whom do we truly serve? What value do we give out, rather than extract? No PR spin or ESG window dressing, please. These are questions about your soul as a business. Force for wider impact, or force for narrow gain? Builder or parasite? Gardener or strip-miner?

The answers will shape your place in the world. 

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