For years, patients in the U.S. healthcare system have grown frustrated with a bureaucracy they don’t understand.
Doctors are included in an insurer’s network for one year but not the next. Getting someone on the phone to help can be next to impossible. Coverage of care and prescriptions is often unceremoniously denied.
This week’s fatal shooting of UnitedHealthcare CEO Brian Thompson has unleashed a wave of public feeling — exasperation, anger, resentment, helplessness — from Americans sharing personal stories of interactions with insurance companies, often seen as faceless corporate giants.
In particular, the words written on ammunition found at the shooting scene — “delay,” “deny” and “depose,” echoing a phrase used to describe how insurers dodge claim payouts — amplified voices that have long been critical of the industry.
“All of a sudden, I am fired up again,” said Tim Anderson, describing how his wife, Mary, had to deal with UnitedHealthcare coverage denials before she died from Lou Gehrig’s disease, or amyotrophic lateral sclerosis, in 2022.
Anderson said they couldn’t get coverage for machines to help his wife breathe or talk — toward the end, she communicated by blinking when he showed her pictures. The family had to rely on donations from a local ALS group, he said.
“The business model for insurance is don’t pay,” said Anderson, 67, of Centerville, Ohio.
“When Mary could still talk, she said to me to keep fighting this,” he added. “It needs to be exposed.”
For Anderson and others, Thompson’s death and the message left at the scene have created an opportunity to vent their frustrations. Conversations at dinner tables, office water coolers, social gatherings, and on social media have pivoted to the topic, as police efforts to find the gunman keep the case in the news.
Hans Maristela said he understands why the chatter is bubbling up. The 54-year-old caregiver in California was moved to comment on Facebook about UnitedHealthcare’s reputation of denying coverage. As a Catholic, he said, he grieves Thompson’s death and feels for his family, especially with the holidays around the corner.
But he sees frustration with insurers even among his clients, most of them wealthy older people who’ve not been shielded from high out-of-pocket costs.
“And then you know the CEO of this company you pay a lot of money to gets 10 million dollars a year, you won’t have a lot of sympathy for the guy,” Maristela said, citing Thompson’s compensation package that included base pay and stock options. “Health care is a business, I understand, but the obsession with share price, with profit, has to be reevaluated.”
University of Pennsylvania researcher Michael Anne Kyle said she’s not surprised by the growth of conversation around insurers.
“People are often struggling with this by themselves, and when you see someone else talk about it, that may prompt you to join the conversation,” she said.
Kyle studies how patients access care and said she’s seen frustration with the system build for years. Costs are rising, and insurers are using more controls such as prior authorizations and doctor networks to manage them. Patients are often stuck in the middle of disputes between doctors and insurers.
“Patients are already spending a lot of money on health care, and then they’re still facing problems with the service,” she said.
Insurers often note that most of the money they bring in goes back out the door to pay claims, and that they try to corral soaring costs and the overuse of some care.
In Ohio, Anderson said his initial reaction to the CEO shooting was to question whether it was connected to a coverage denial, like the ones he’d experienced with his wife.
“I definitely do not condone killing people,” he said. “But I read it and said, ‘I wonder if somebody had a spouse whose coverage was denied.’”
It’s something Will Flanary, a Portland-based ophthalmologist and comedian with a large social media following, saw online a lot in the shooting’s immediate aftermath and found very telling.
“It’s zero sympathy,” he said. “And the lesson to take away from that is not, ‘Let’s shame people for celebrating a murder.’ No, it’s: ‘Look at the amount of anger that people have toward this system that’s taken advantage of people and do something to try to fix that.’”
Flanary’s content, published under the name Dr. Glaucomflecken, started out as niche eye doctor jokes and a way to cope with his own experiences with two cancer diagnoses and a sudden cardiac arrest. But it has evolved, featuring character skits that call attention to and satirize the decisions of large health insurers, including UnitedHealthcare.
He said he’s never seen conversations around health insurance policy take off the way they did this week — and he hopes these new voices can help bring about change.
“I’m always talking about how powerful social media can be with advocacy,” he said, “because it really is the only way to put a significant amount of pressure on these corporations who are doing bad things for patients.”
They have seen him smiling on a hostel security camera, but don’t know his name. They found the backpack he discarded while fleeing, but don’t know where he’s gone.
As the search for UnitedHealthcare CEO Brian Thompson’s killer goes on, investigators are reckoning with a tantalizing dichotomy: They have troves of evidence, but the shooter remains an enigma.
Police don’t know who he is, where he is, or why he did it, though they are confident it was a targeted attack instead of a random act.
“The net is tightening,” New York City Mayor Eric Adams said Saturday.
Hours after he spoke, police divers were seen searching a pond in Central Park, where the killer fled after the shooting. Officers have been scouring the park for days for any possible clues and found his bag there Friday.
Late Saturday, police released two additional photos of the suspected shooter that appeared to be from a camera mounted inside a taxi. The first shows him outside the vehicle and the second shows him looking through the partition between the back seat and the front of the cab. In both, his face is partially obscured by a blue, medical-style mask.
Retracing the gunman’s steps using surveillance video, police say, it appears he left the city by bus soon after the shooting Wednesday morning outside the New York Hilton Midtown. He was seen on video at an uptown bus station about 45 minutes later, NYPD Chief of Detectives Joseph Kenny said.
With the high-profile search expanding across state lines, the FBI announced late Friday that it was offering a $50,000 reward for information leading to an arrest and conviction, adding to a reward of up to $10,000 that the NYPD has offered. Police say they believe the suspect acted alone.
Police provided no updates on the hunt Saturday, but investigators are urging patience — even with a killer on the loose.
Hundreds of detectives are combing through video recordings and social media, vetting tips from the public and interviewing people who might have information, including Thompson’s family and coworkers and the shooter’s randomly assigned roommates at the Manhattan hostel where he stayed.
“This isn’t ‘Blue Bloods.’ We’re not going to solve this in 60 minutes,” Kenny told reporters Friday. “We’re painstakingly going through every bit of evidence that we can come across.”
The shooter paid cash at the hostel, presented what police believe was a fake ID, and is believed to have paid cash for taxi rides and other transactions. He didn’t speak to others at the hostel and almost always kept his face covered with a mask, only lowering it while eating.
But investigators caught a break when they came across security camera images of an unguarded moment in which he briefly showed his face soon after arriving in New York on Nov. 24.
Police distributed the images to news outlets and on social media but so far haven’t been able to ID him using facial recognition — possibly because of the angle of the images or limitations on how the NYPD is allowed to use that technology, Kenny said.
On Friday evening, investigators found a backpack in Central Park that had been worn by the gunman, police said. They didn’t immediately reveal what, if anything, it contained but said it would be tested and analyzed.
Another potential clue, a fingerprint on an item he purchased at a Starbucks minutes before the shooting, has so far proven useless for identifying him, Kenny said.
Aided by surveillance cameras on nearly every building and block, police have been able to retrace the shooter’s movements.
They know he ambushed Thompson at 6:44 a.m. as the executive arrived at the Hilton for his company’s annual investor conference, using a 9 mm pistol that resembled the guns farmers use to put down animals without causing a loud noise. They know ammunition found near Thompson’s body bore the words “delay,” “deny” and “depose,” mimicking a phrase used by insurance industry critics.
Kenny said the fact that the shooter knew the UnitedHealthcare group was holding a conference at the hotel and what route Thompson might take to get there suggested that he could possibly be a disgruntled employee or client.
Investigators know from surveillance video that the shooter fled into Central Park on a bicycle and ditched it around 7 a.m. near 85th Street.
He then walked a couple blocks and got into a taxi, arriving at 7:30 a.m. at the George Washington Bridge Bus Station, which is near the northern tip of Manhattan and offers commuter service to New Jersey and Greyhound routes to Philadelphia, Boston, and Washington.
Investigators don’t know what happened next. They are searching through more surveillance videos but have yet to locate a video of the shooter getting on a bus or exiting the station.
“We have reason to believe that the person in question has left New York City,” Police Commissioner Jessica Tisch told CNN on Friday.
Police have determined from video that the gunman was in the city for 10 days before the shooting. He arrived at Manhattan’s main bus terminal on a Greyhound bus that originated in Atlanta, though it’s not clear whether he embarked there or at one of about a half-dozen stops along the route.
Immediately after that, he took a cab to the vicinity of the Hilton and was there for about a half hour, Kenny said.
At around 11 p.m. on the night he arrived, he went by taxi to the HI New York City Hostel. It was there, while speaking with an employee in the lobby, that he briefly pulled down the mask and smiled, giving investigators the brief glimpse they are now relying on to identify and capture a killer.
The gunman who killed the CEO of the largest U.S. health insurer likely left New York City on a bus soon after the brazen ambush that has shaken corporate America, police officials said. But he left something behind a backpack that was discovered in Central Park.
Nearly four days after the shooting of UnitedHealthcare CEO Brian Thompson, police still did not know the gunman’s name or whereabouts or have a motive for the killing. Investigators were looking at whether the shooter may have been a disgruntled employee or client of the insurer, Chief of Detectives Joseph Kenny told reporters.
The FBI announced Friday night it was offering a $50,000 reward for information leading to an arrest and conviction.
Video of the gunman fleeing Wednesday’s shooting showed him riding a bicycle into Central Park and later taking a taxi to a bus terminal that offers commuter service to New Jersey and Greyhound routes to Philadelphia, Boston, and Washington, D.C, according to Kenny.
Police have video of the man entering the bus station but no video of him exiting, leading them to believe he left the city, Kenny said.
Investigators on Friday found a backpack in the park that had been worn by the gunman during the shooting, police said, following a massive sweep to find it in a vast area with lakes and ponds, meadows, playgrounds, and woods.
Police didn’t immediately reveal what, if anything, it contained but said it would be analyzed for clues.
The gunman made sure to conceal his identity with a mask during almost all of his time in the city, including during the attack and while he ate, yet left a trail of evidence because of the nation’s biggest city and its network of security cameras.
The gunman arrived in New York City on Nov. 24 and shot Thompson 10 days later outside his company’s annual investor conference at a hotel just blocks from Radio City Music Hall and Rockefeller Center.
The gunman got off a bus that originated in Atlanta and made several stops along the way, Kenny said. Police have not determined where he got on the bus. Investigators have a list of passengers, but none of them would have had to provide an ID when they climbed aboard, Kenny said.
Investigators believe the suspect used a fake identification card and paid cash, Kenny said, when he checked in at the hostel, which has a café along with shared and private rooms and is blocks from Columbia University.
Investigators have tested a discarded water bottle and protein bar wrapper in a hunt for his DNA. They also were trying to obtain additional information from a cellphone found along the gunman’s escape route.
Photos of the suspected shooter that were taken in the lobby of a hostel on Manhattan’s Upper West Side appear to be from the only time he removed his mask, Kenny said. The images, show a man smiling in the lobby of the HI New York City hostel. They are among a collection of photos and video circulated since the shooting — including footage of the attack, as well as images of the suspected gunman at a Starbucks beforehand.
“From every indication we have from witnesses, from the Starbucks, from the hostel, he kept his mask on at all times except for the one instance where we have him photographed with the mask off,” Kenny said.
His roommates at the hostel also said he didn’t speak to them. Nothing of investigative value was found in a search of the suspected shooter’s hotel room.
Asked how close he felt police were to making an arrest, Kenny said, “This isn’t ‘Blue Bloods.’ We’re not going to solve this in 60 minutes. We’re painstakingly going through every bit of evidence that we can come across. Eventually, when apprehension is made, we will have to present all of these facts to a judge and jury, so we’re taking our time, doing it right, and making sure we’re going to get justice for this victim and closure for his family.”
Security video of the shooting shows the killer approaching Thompson from behind, firing several shots with a gun equipped with a silencer, barely pausing to clear a jam while the executive fell to the sidewalk.
Police were looking into the possibility that the weapon was a veterinary pistol, which is a weapon commonly used on farms and ranches if an animal has to be euthanized quietly, Kenny said — though he stressed that hadn’t been confirmed.
The words “delay,” “deny” and “depose” were scrawled on the ammunition, one word on each of three bullets, Kenny said. A law enforcement official previously told The Associated Press the words were “deny,” “defend” and “depose.” The messages mirror the phrase “delay, deny, defend,” which is commonly used by lawyers and critics about insurers that delay payments, deny claims, and defend their actions.
Thompson, a father of two sons who lived in a Minneapolis suburb, had been with Minnesota-based UnitedHealthcare since 2004 and served as CEO for more than three years.
The insurer’s parent company, UnitedHealth Group Inc., was holding its annual meeting in New York for investors. The company abruptly ended the conference after Thompson’s death.
UnitedHealth Group said it was focused on supporting Thompson’s family, ensuring the safety of employees, and assisting investigators. “While our hearts are broken, we have been touched by the huge outpouring,” the company said.
UnitedHealthcare provides coverage for more than 49 million Americans. It manages health insurance coverage for employers and state and federally funded Medicaid programs.
In October, UnitedHealthcare was named along with Humana and CVS in a Senate report detailing how its denial rate for prior authorizations for some Medicare Advantage patients has surged in recent years.
The shooting has rocked the health insurance industry in particular, causing companies to reevaluate security plans and delete photos of executives from their websites. A different Minnesota-based healthcare company said Friday it was temporarily closing its offices out of an abundance of caution, telling employees to work from home.