Thoughts on the murder of the United Healthcare CEO

Last week, the CEO of United Healthcare was shot in the street in New York. As I write this, the killer is still uncaught. Current ish coverage link: https://www.cnn.com/2024/12/08/us/brian-thompson-unitedhealthcare-gunman-search-sunday/index.html

A lot of the media has been focusing on how people on social media are not exactly sympathetic to the victim, with many people having mixed feelings, and some clearly supporting the killing. In general, wealthy CEO's of large companies are viewed with a certain amount of disdain, and health insurance companies are generally perceived as evil. In this case, the intersection of both makes it easy for people to rationalize this murder as a "good thing", and sympathize with the killer. I have thoughts, which are somewhat more nuanced.

The problems with the current health insurance industry in the US have been around for a while, but were sorta amplified by Obamacare (aka the very disingenuously named "Affordable Care Act", which did nothing to make health care more affordable, but did shift the costs around, while increasing them substantially over time). During the debate for the overhaul, the point was raised that if the US nationalized health care (a discussed proposition at the time), then the government would need to enforce some sort of cutoff for care, lest the plan bankrupt the government. This would happen because there would always be more costly options to extend life with diminishing returns, and with a blank check from the government otherwise, supply would be created to fill the demand. This gave rise to the specter of so-called "death panels", which ultimately shaped Obamacare into a bill which just forced people to purchase private insurance, and shifted the responsibility of determining coverage to those companies.

The problem is: that issue didn't just magically go away. The potential to make money extending life didn't go away either, and costs went up accordingly. Costs are still going up, and aggregate spending on medical care is overwhelming other costs in the country. By not addressing any of the underlying issues, Obamacare just made the problems worse, while shifting costs around so that the government could hide the problem behind "taxing the rich". Moreover, it increased the profits for health insurance companies (who are allowed to make a fixed percentage profit, on the billions of revenue the government gave them), and shifted the public blame to the people running those companies.

That brings me to another point, though: health insurance companies are also "evil", by any quantifiable definition of the term. United Healthcare used a half-assed software algorithm to automate denying benefits to increase their own profits, which might be one of the worst examples, but they all put profits over lives. Healthcare insurance decisions to deny covering care kill more people annually than any other normal "bad guys" (eg: terrorist groups). As the leader of a public company, that's the nominal job: you're tasked with optimizing profits, not saving lives.

But then the question arises: when is such a leader morally or legally responsible for the bad outcomes which their company directly causes? And if that point exists, does there come a point where killing those people represents a greater good for society? If that point doesn't exist, then who would be morally or legally responsible for heinous crimes against society perpetrated by corporations? Further, how much culpability do the individual workers have in those outcomes also?

I don't think those questions are easy to answer. Many people at present have de-humanized the CEO (his name was Brian Thompson; see how many online references refer to him as such, vs "The CEO of United Healthcare"... including this blog post). He had a family. But, as someone online wryly pointed out, so did Emperor Palpatine, but the audience uniformly cheered for his demise, because he was a demonstrable "bad guy", based on the bad actions of the organization he ran. It seems reasonable that CEO's at least have some level of accountability for the actions of the corporations which they run, otherwise there would be none. Yet, there's no legal accountability to speak of. Thus, the original societal question remains: how "bad" was his murder?

The societal benefit of trying to prevent societally destructive actions is beyond the scope of this post, but it does have some general value; that is, generally, murder should be considered bad, even if the person being killed is also bad. Societal stability depends, at least in part, with only standard enforcement of societal norms through a legal framework, and not ad hoc dispensing of "justice". However, it's hard to argue that in this case, the government has not at a minimum abdicated its responsibility for righting this "wrong" (particularly since, as with most societal evils, it very much helped create this wrong). Whether or not that gives rise to ethically justified alternative enforcement of greater societal "good" is an open question.

I don't have any specific easy answers for how to feel about this murder, and I'm somewhat torn. I think it would be beneficial if society found a way to encourage leaders of entities (corporations or otherwise) to feel a real obligation to align the actions of their organizations with societal interests, and if there was a societal punishment mechanism if they chose not to. I understand that would be a significant change from the status quo, though. I don't like how it has become populist fashionable to demonize some members of society (as Democrats are doing to wealthy people, for example); I think that's dangerous and societally destructive. But mostly, I think changes need to come through government policy to align with the well-being of society in the longer-term, something which much more often than not is sacrificed to the alter of short term political gains. And I think that is to the detriment of the whole society.

Anyway, that's my opinion, fwiw.