One of the facts that has surprised some people about Luigi Mangione, the man who is alleged to have shot and killed the CEO of UnitedHealthcare, Brian Thompson, is that his politics were not easily classified as left-wing or right-wing. His Goodreads reading list largely consists of airport bestsellers like Yuval Noah Harari’s Sapiens, Tim Ferriss’s The Four-Hour Workweek, and James Clear’s Atomic Habits. (Plus one book that is very much not an airport bestseller, which I will get to.) He thought Tim Urban’s centrist manifesto What’s Our Problem? would “go down in history as one of the most important philosophical texts of the early 21st century.” (My own review of the book said it was a complete waste of the seven years Urban spent writing it.) Mangione was not exactly a 21st-century reincarnation of Gaetano Bresci, the firebrand Italian anarchist who shot king Umberto I. Instead, as the New York Times tells us, he was “an Ivy League tech enthusiast who flaunted his tanned, chiseled looks in beach photos and party pictures with blue-blazered frat buddies.”

But (assuming, again, that Mangione is guilty, which seems likely but has not been proven in court) the killing does appear to have a kind of “political” motivation. In the manifesto police found on him, which journalist Ken Klippenstein has posted in full, Mangione specifically describes his act as a response to the actions of health insurance companies:

“It had to be done. Frankly, these parasites simply had it coming. A reminder: the US has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy. United is the [indecipherable] largest company in the US by market cap, behind only Apple, Google, Walmart. It has grown and grown, but [has] our life expectancy? No[,] the reality is, these [indecipherable] have simply gotten too powerful, and they continue to abuse our country for immense profit because the American public has [allowed] them to get away with it. Obviously the problem is more complex, but I do not have space, and frankly I do not pretend to be the most qualified person to lay out the full argument. But many have illuminated the corruption and greed (e.g.: Rosenthal, Moore) [presumably Elisabeth Rosenthal and Michael Moore] decades ago and the problems simply remain. It is not an issue of awareness at this point, but clearly power games at play. Evidently I am the first to face it with such brutal honesty.”

If we take the manifesto at face value, then, Mangione appears to have thought he was striking a blow against injustice, giving a parasitic CEO what he “had coming.” And indeed, plenty of people seem to agree that the CEO of UnitedHealthcare was, at the very least, not a particularly sympathetic victim. Instead of the expected condemnations of the murderer, a flurry of social media users told healthcare horror stories about UnitedHealthcare and other insurers denying coverage for crucial treatment. The pent-up resentment was so strong that there were vastly more “laughing” than “crying” emojis on the Facebook announcement about Thompson’s death. 

We know that Mangione was correct about the private insurance industry. It doesn’t need to exist, and a single-payer system would save lives and massively reduce costs. (As Matt Bruenig shows, the amount of money spent on healthcare administration that would be saved under a single-payer system is so large that it is as if the U.S. has deliberately set up an entire economic sector devoted to manufacturing nothing but frustration and annoyance.) But while Mangione identified a very real injustice, it does not logically follow that it makes sense to assassinate the CEO of an insurance company. Mangione’s alleged crime is the act of someone who either can’t (or won’t) think of any way to take effective political action that could actually change the healthcare system for the better.  

In fact, there are some similarities between Mangione and another “author” he praised on Goodreads, Ted Kaczynski (aka The Unabomber), whose manifesto Industrial Society and Its Future Manione gave four stars. As my colleague Alex Skopic wrote in an informative analysis of Kaczynski, the Unabomber was, like Mangione, a perceptive and accomplished Ivy League graduate who saw some very real problems with the way the world works. In Kaczynski’s case, the problem was uncontrolled technological development, which he persuasively argued was wreaking major harm on the environment and on society. In the age of serious threats from the advancement of AI, Kaczynski seems prescient when he writes that the continuation of rapid technological development “will certainly subject human beings to greater indignities and inflict greater damage on the natural world, it will probably lead to greater social disruption and psychological suffering, and it may lead to increased physical suffering even in ‘advanced’ countries.”

But it does not follow from Kaczynski’s identification of the problem that it makes any sense whatsoever to send people bombs through the mail. Kaczynski’s targets were even less direct than Mangione’s, and included a computer store worker whose death Kaczynski seemed to relish. Kaczynski, like Mangione, had an inflated sense of his own importance. (Note Mangione’s obnoxious declaration, “evidently I am the first to face it with such brutal honesty.”) And Kacyzinski’s writings, like Mangione’s manifesto, entirely lack any persuasive explanation (or even an attempt at an explanation) of how individual acts of murder are going to do anything whatsoever to address the underlying crisis. In both Kaczynski’s and Mangione’s cases, the ostensible justification for the violence is to address a crisis or injustice, but one suspects they also found killing satisfying as a symbolic vengeful blow against a system they hated. In Mangione’s case, it seems as if personal pain may also have been at play; a serious back injury apparently caused major disruption in his life, although we don’t yet have evidence he had any particular interactions with United Healthcare. 

Both Kaczynski and Mangione had cut themselves off from their loved ones in the time leading up to their crime, and struck out as individuals, without being part of any group. (Kaczynski signed his manifesto “Freedom Club,” but he was the only one in the club.) Both of them, despite waging attacks in favor of what we might consider “left-wing” causes (environmentalism in Kaczynski’s case, against the private insurance industry in Mangione’s case), did not have traditionally left-wing political views. The Unabomber manifesto actually disparages leftists at length, and Mangione does not appear to have had any acquaintance at all with socialist or communist literature. 

I don’t actually think we should be surprised by that. Because in the case of these killers, we are not seeing radical leftists taking extreme actions. We’re actually seeing the actions of people who are intelligent enough to understand the world’s problems but who lack the kind of political analysis that could help them channel their anger in a constructive way. The fact that Mangione was not a leftist helps to explain why he just became enraged and lashed out with violence. If Mangione had been a leftist, he would have understood that political change comes from social movements, and that the path to justice comes not from isolated individual acts of murder but from joining together with others to build power. 

In other words, both Kaczynski and Mangione appear to have lacked a crucial instinct: solidarity, the feeling of being bound together with other human beings and inclined to work together with them to improve our condition. Instead of joining something, they severed themselves from society. They were individualists, and on our own we can accomplish little. Perhaps the most attention-grabbing thing a lone individual can do by themselves is to commit murder, but historically assassinations have not tended to produce positive social changes of any kind. (Though they can spark negative changes, such as a world war.) Killing a CEO does not dismantle the company, because the CEO is entirely replaceable. The challenge is to figure out how to kill an institution, which is much more complicated than killing a person. That’s what Mangione should have put his mind and effort towards. 

One reason it’s not easy to figure out how to eliminate an unjust institution like UnitedHealthcare is that our political system is broken, by which I mean that it does not carry out its basic function of representing the interests and preferences of the population. In a functional political system, a true democracy, someone upset over a problem could get together easily with other people concerned over the problem, and organize a campaign to do something about it, and if the solution was popular and practicable, it would be enacted. In our system, on the other hand, it doesn’t matter if the overwhelming majority of Americans want a healthcare system that functions entirely differently, because politicians who try to change it will be met with fierce resistance from the industry, which will try to destroy their careers if they do anything that endangers corporate profits. The industry will also put great effort into manipulating public opinion in order to try to frighten people and make them think that anything that damages the profits of an insurance company actually damages the public itself. (Former Cigna executive Wendell Potter has explained at length how ruthless the industry is in fighting against a single-payer solution.)  

Someone like Mangione, then, is left unsure what to do about the injustices he sees before his eyes. Certainly, he’s not going to find any answers in the pages of books by Yuval Harari and Tim Urban. Urban’s point of view, for instance, is basically that people need to stop being so partisan and stupid and instead think rationally about political questions. He doesn’t think about movements or about organizing. He offers nothing to someone who wants to change how healthcare financing works and needs to figure out how to fight corporate power. If Mangione had instead picked up books by Ralph Nader or Bernie Sanders, or the excellent new book Another World Is Possible by Natasha Hakimi Zapata, he would have found lessons on how we can respond to injustice together in ways that are constructive. Maybe he could have been among the new generation of young leftists who are organizing and running for public office, many of whom are accomplishing great things. But instead of leading the fight for single-payer, Mangione will likely spend the rest of his life in a prison cell. Like Kaczynski, he will probably receive lots of fan mail (many online consider him a heartthrob). But what will he have really achieved? I understand why people feel a certain righteous satisfaction at seeing a “parasite” felled. But Mangione’s choice is ultimately a tragic one, because it has both ended Thompson’s life and destroyed Mangione’s own. Marjorie Taylor Greene worries that this assassination may spark a chain of events that will result in single-payer healthcare. I hope so. If that happens, Thompson’s death will have some meaning. But in the real world of politics, power is built by organizing groups of people together who can pressure politicians, and without that pressure, very little is likely to change.

But change things we must. As we see the heartbreaking stories coming out about people having vital medical care denied by their insurance companies, the rage people feel knowing they are being swindled and even killed, we have to emphasize over and over: there is a solution. We can solve this. We can have a Medicare For All system that covers everybody, is free at point of use, and doesn't divert their money toward profit and administrative bloat. We deserve this. It's not radical, and anyone who refuses to advocate for it is insisting we must continue to suffer unnecessarily. The health insurance industry is clearly on the defensive after seeing this explosion of anger. They are struggling to justify their role, because ultimately they are entirely unnecessary. We should seize this moment, which has exposed dark truths that went undiscussed, to galvanize people in pushing for an actual better system. (And we should call out analyses, such as those you'll find in the New Yorker and New York Times, that lament the problem without telling people that a single-payer solution could do a great deal to fix what makes people so unhappy about their healthcare.) 

Mangione’s rage shows that it’s not just leftists who are upset about the healthcare system. There is a widespread understanding that Americans are getting a bad deal and that while the system is making some people rich, others are getting sick and dying unnecessarily. We should get to live in a world where “medical bankruptcy” is not a concept that exists. But while Mangione’s analysis of the world was correct, he needed a left political analysis. He didn’t have one, and so he couldn’t think of anything to do except kill a CEO. We ourselves have to think harder about what we can do to actually bring about health justice for all.