On Dec. 4, 2024, UnitedHealthcare CEO Brian Thompson was shot in front of New York Hilton Midtown by shooter Luigi Mangione. According to the Office of Public Affairs, Mangione’s crime was carefully planned out, from stalking Thompson to using a silencer on his gun. He also meticulously planned out his escape route.

According to BBC, while it is unclear what the exact motive behind Mangione’s suspected crime is, Mangione had felt resentment towards health insurance companies, calling them “parasitic.” Many people have noted how his extreme methods are morally unjustifiable, while others see him as a symbol for the fight against the injustice of the American healthcare system. 

For some, the shooting incident has brought attention to the issue of healthcare accessibility in the United States, but for the wrong reasons. “I think it’s kind of unserious because people on TikTok are making edits of [Mangione] and calling him hot and finding his Spotify. It kind of deflects from what really happened, like someone actually got murdered,” said senior Eva Rodriguez. 

As pointed out, a big reason for Mangione’s support, beyond just his actions, is that many people find him attractive. Things would likely be different, and in a negative way, if he was not as attractive, wealthy or if he were a person of color. According to Michael TenEyck, assistant professor of criminology at the University of Texas, there is a lot of research exploring how attractiveness can lead to decreased arrests and shorter sentences. Essentially, Mangione’s case is a strong example of pretty privilege. 

Some critics note the issue with Mangione’s violent ideology-driven actions are distracting from more effective ways to fix issues in healthcare. In some ways, this is a continuation of the rising trends of violence regarding political and social issues, such as the Jan. 6 riots and attempted assassinations on President Donald Trump. 

Other Mounds View students are relatively indifferent to the situation as a whole. “Even though [Thompson] was corrupt with his practices, in a way it didn’t matter if he died, because in the end, they’re just going to replace him with another CEO,” said junior Emman Gabriel-Veronque. Because the issues of US healthcare are systemic, the killing of one healthcare CEO arguably has little impact in changing the larger healthcare issues as a whole.

However, although in most cases people would consider a murderer to be criminal, Mangione’s frustrations have also raised support from the public. Forbes recognizes Mangione as a “social media folk hero,” emphasizing that the public is “rooting for the anti-hero.” Many people on social media see his fury as a symbol for their own anger at the unfairness of American healthcare costs and access.

Since Mangione’s arrest, support for his actions has grown. After his federal court appearance, a GiveSendGo donation was set up for him, where he has now received over 1,500 donations, raising more than $200,000 in defense funds. Despite many donors sharing messages defending his violent actions, the fundraiser is not intended to “celebrate violence,” but rather to fight for “fair legal representation.”

Supporters of Mangione have also shown their support through the spread of the phrase “Deny. Defend. Depose.” which is meant to criticize the actions of insurance companies that delay payment claims, deny claims, and defend their actions. These words were also written on the shell casings of the bullets found at the crime scene. Supporters have begun hanging signs with the phrase on buildings and roads. Graffiti of these words are prevalent worldwide too. 

While UnitedHealthcare is one of America’s biggest healthcare companies — covering over 49 million Americans — the recent shooting has sparked criticism against the company for its trend of denying claims and refusing to cover the costs of medical treatments from insurance companies. Some healthcare companies have even begun to rethink their policies. Anthem Blue Cross Blue Shield, the second largest health insurance company in the United States, had originally planned to implement a new policy that would limit the cost coverage for anesthesia procedures if the surgery went beyond a certain time limit in February, but decided against it due to backlash from the American Society of Anesthesiologists and the CEO incident.

Whether for or against Mangione’s crime, his actions have caused a variety of responses nationwide. Violent acts such as those committed by Mangione are often unjustifiable even if they do raise awareness for issues such as the high cost of healthcare. Regardless, his actions have sparked increased conversation about the U.S.’s controversial healthcare policies, with many wanting to see significant reforms.

According to the Centers for Medicare and Medicaid Services (CMS), the average American paid F$14,750 every year for healthcare in 2023 — a 7.5% increase from 2022 — which is more than double that of other wealthy countries. Moreover, healthcare has gotten so expensive in America that only 55% of Americans can afford it according to a poll by Gallup. There are many factors contributing to the cost of healthcare, and their implications have broader impacts beyond just the healthcare industry.

Many factors affect the cost of healthcare, but a huge reason behind the high prices is lack of competition between healthcare companies, creating monopoly-like conditions. “More competition actually lowers prices. If you have more small drug producers, they’re going to actually have to compete with each other. They’re going to end up actually charging lower prices,” said social studies teacher Aaron Oseland. The high concentration of pharmaceutical companies is evident in that America’s 25 largest pharmaceutical companies make up 70% of the industry’s revenue in 2023 according to the Innovation Technology and Innovation Foundation, a nonprofit public policy think tank.

Another large factor in the cost of healthcare is the lack of price regulations. In other countries, like Germany, the government limits the price of drugs depending on their necessity or demand. “[For] insulin or epinephrine, you would set a very low price, but something like Ozempic that people are doing just because they see it online, that would have a high price,” said Oseland. However, in the United States, there are few national laws or regulations regarding drug prices. Because of this, healthcare companies can often set the price of their drugs and services as high as they want, leading to increasing prices every year.

Due to rising costs of healthcare, the consequences of not having health insurance can become extreme. “I work with a lot of families who, because of lack of insurance or under insurance, they can’t access the care that they need, and the costs of accessing care out of pocket can be completely prohibitive,” said Mounds View nurse Alana Schmiesing. With the average cost of an emergency room visit at around $2,500 without insurance according to GoodRX and overnight stays exceeding $10,000, many people cannot afford to take care of their health issues without insurance. 

In the long run, the high cost of healthcare can prohibit individuals from taking preventative measures, like seeing their primary care doctor, that reduce further health risks in the future. “A lot of our primary care is being done in emergency rooms because people can’t access things like primary care or preventative care,” said Schmiesing. In other words, more patients are landing in the emergency room because of a lack of access to healthcare in the first place. This in turn can lead to even higher healthcare costs for these individuals. 

The high cost of healthcare can negatively influence the U.S. economy. According to CMS, health spending accounts for 17.6% of the U.S. Gross Domestic Product (GDP). This means almost one-fifth of all spending in the United States is spent on healthcare. Moreover, healthcare is one of the largest contributors to government spending. When government spending increases, whether from healthcare costs or other sectors, it causes inflation. Expensive healthcare also indirectly reduces economic growth because workers are less productive when they have medical issues that they cannot address.

Students at Mounds View also have strong opinions about the prices of healthcare. While there is not a clear consensus about how the price of healthcare should be reduced, students generally hope for greater regulation that decreases the ability of companies to raise the prices of drugs. “The amount of profit that healthcare companies are getting, it’s kind of ridiculous. And I don’t necessarily think that universal healthcare is the solution, but there definitely needs to be some caps,” said senior Abby Robbins. 

Moreover, making healthcare available to more people is important to students. “Availability is a big one, like trying to make it so everyone in all different levels of wealth can access it,” said junior Cole Zamansky. The long term consequence of disparities between healthcare access can lead to individuals with higher income having significantly longer life spans than those in lower income brackets. 

With the issue of rising healthcare costs becoming seemingly more overwhelming every year, it is easy to lose hope on healthcare prices decreasing. However, just by recognizing the issues in the system leading to higher prices and their consequences, there is growing awareness and pushback against the status quo of unaffordable healthcare in the U.S.

The U.S. spends about 17.6% of its GDP on healthcare, which is the most out of any developed country according to the Centers for Medicare and Medicaid Services, a federal agency within the United States Department of Health and Human Services. Nevertheless, the U.S. is one of the only highly developed countries that does not provide universal healthcare for all citizens regardless of employment status or income. Instead, the U.S. uses a healthcare system involving all four of the main national models for healthcare.

Out of the four main healthcare models, the Out-of-Pocket model is the only one that is not considered Universal Healthcare. People pay for their medical expenses directly, and this system is used mostly in poor or developing countries, including rural areas of Africa, India, China and South America, where many people go without ever seeing a doctor according to the National Library of Medicine. The U.S., however, uses this system combined with elements of the others. Because citizens still mostly rely on income to pay for healthcare, the U.S. is not considered a country with Universal Healthcare.

One model that uses Universal Healthcare is the Bismarck Model, named after former Prussian Chancellor Otto von Bismarck. This model requires everyone to obtain health insurance by contributing to a government fund, which is run by non-government insurers. This fund is then used to pay for people who need healthcare, even if they cannot afford it due to poverty or unemployment. 

When it was established, the insurance covered all blue-collar workers with paid sick leave and abundant access to doctors and medical care. Most importantly, Bismarck’s model helped reduce the blue-collar mortality rates in the late 1800s. Some countries that follow this model are Germany, France and Japan. In the U.S., elements of this model can be seen generally with working Americans who have insurance.

Another common healthcare model is the Beveridge Model, named after British economist William Beveridge, in which the government provides and funds healthcare through tax payments. Through this system, hospitals are owned by the government. Because this model has the government as the single-payer, it eliminates all other competition in the healthcare market and reduces costs. This system is funded mainly through income taxes; services are considered free as the patients’ taxes have already covered their hospital funds. The Beveridge Model is another example of universal healthcare, so aid by the government is provided to all citizens. Some places that follow this model are the United Kingdom, Sweden, Spain and New Zealand. Sweden’s healthcare, for example, is primarily funded by income taxes collected on both national and municipal levels. This is largely thanks to the 42.9% income tax compared to only 31.7% in the U.S., which allows the government to lower healthcare costs. The U.S. only follows this model when it comes to treating veterans.

The fourth most common system is The National Health Insurance Model. This blends the Bismarck and the Beveridge Model, where the government funds all healthcare through a government-run insurance program. One example is South Korea’s National Health Insurance (NHI), which provides universal healthcare coverage for all residents, including foreigners living in South Korea for longer than six months. The NHI covers most medical expenses, but many South Koreans purchase private health insurance as well. The government is able to keep the prices of medical services and pharmaceuticals relatively predictable through a standardized fee schedule, which lists predetermined fees for various medical services. This prevents providers from charging excessively and keeps healthcare costs predictable for patients. 

The U.S.’s complicated healthcare system is a reason that the cost of healthcare is rising. Compared to other countries, it can be inefficient because of the combination of different models. “U.S. healthcare costs are becoming more expensive because of all the people we have to pay just to go through the paperwork, to go through the hoops and to understand the ridiculous complexity of the American healthcare system,” said social studies teacher Aaron Oseland. He thinks that a simpler system would be cheaper. “You would see these costs shrink dramatically because you wouldn’t have to hire people whose job it is just to do billing.”

Looking at these different healthcare systems, there are many changes that the U.S. could adopt to refine its own healthcare system. Many developed countries, including South Korea and Sweden, have found ways to adopt a universal healthcare system in different ways while maintaining low prices for residents. Even if the U.S. does not implement a universal healthcare system, it can take more inspiration from these models or from other countries to make healthcare more affordable for its citizens.