The Mangione Case: A Leadership Wake-Up Call for Corporate America

By now, most people have heard about the killing of United Healthcare CEO Brian Thompson. Thompson was targeted and killed by a gunman in New York City last month. What has been surprising is the outpouring of sympathy – and even support - for the gunman himself.

Luigi Mangione was arrested on December 9 and charged with first-degree murder – among other charges – with one count that described the killing as an act of “terrorism”. When arrested, Mangione had a document that outlined the challenges he sees with the healthcare industry (“US has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy”). On the bullet casings, the words “deny, defend, depose” were inscribed – a chilling reflection of Mangione’s grievances. These words have since become a rallying cry for critics of the health insurance industry.   

Mangione’s arrest and the subsequent release of his manifesto has shined a light on the challenges with the American healthcare system, with many posting stories about how they or their loved ones were unjustly denied claims. One recent change within the health insurance industry (and everywhere) has been the use of AI to “enhance efficiency”. For companies like United Healthcare (UHC), this means using AI to process (or deny) claims through automated data collection, decision making, and fraud detection. Taking a step further back, AI models are being used to predict the likelihood of claim denials or approvals.

In researching this topic, I found story after story of people experiencing maddening bureaucracy and a seemingly profit-first motive within the health insurance industry. Consider the story of a 1-year-old in the ER who needed immediate brain surgery to reduce swelling. UHC took three days to approve the transfer because it involved crossing state lines. If the family had driven the baby themselves, UHC would have refused to cover the procedure at all. Another shared how his mother, battling cancer, was denied the critical scan needed to begin chemotherapy. UHC required her to wait eight weeks for approval, delaying life-saving treatment. By the time the scan was approved, the cancer had spread too far, and his mother tragically passed away. It’s gotten so bad that the US Department of Labor has stepped in and sued the claims administrator under UHC for denying valid medical claims.

This problem isn’t new.

Remember the 2002 movie “John Q” – where the main character (played by Denzel Washington) took a hospital emergency room hostage to get his son’s heart transplant, since it wasn’t covered by his insurance?

But this issue goes beyond the technology itself (another shameless plug for my book!). The reality is that the profit-first motive that exists in the healthcare industry has gone too far. It’s no secret – a top insurance executive recently admitted to practices that “prioritize shareholder profits over patient care”. While profit motive itself isn’t inherently evil, I’d much prefer the annoyance of having to subscribe to 5 different streaming services to watch NFL games than see people literally die so someone else can make more money.

This isn’t just about technology or profits; it’s about a system that has lost its way.

The Good Book reminds us, “The love of money is a root of all kinds of evil,” and we are witnessing the truth of that wisdom play out in real time. While we should in no way endorse Mangione’s actions, they are a symptom of a much larger problem: a universal outrage toward corporations that prioritize profits over people.

It’s time for leaders to step back and reevaluate their priorities. As a recent article in Harvard Business Review pointed out, Corporate America must focus on delivering value not just for shareholders, but for customers, employees, and communities alike. By adopting a “customer-first” approach – one rooted in integrity and empathy – leaders can rebuild trust while still achieving profitability.

As leaders, it’s not enough to just acknowledge these problems – we must act. Whether we’re leading a business, team, or our own communities, it’s on us to prioritize integrity and take a people-first leadership approach. By doing so, we can rebuild trust and create systems that truly serve the greater good.