Incident detail
On 4 December, the CEO of UnitedHealthcare (UHC), Brian Thompson, was shot and killed outside the entrance to the New York Hilton Midtown hotel in Manhattan, New York City. At the time of the shooting, he was walking to the hotel where the annual investors’ meeting for UnitedHealth Group (UHG), UHC’s parent company, was taking place. At the time of his death, Mr Thompson was traveling alone and without a personal security detail, despite having recently informed his wife of receiving threats. An individual, Luigi Mangione, was arrested and charged with murder five days later in Pennsylvania.
Although Mangione has not yet been convicted, and reportedly will plead not guilty when facing charges in court, it is nevertheless clear this was a planned and targeted attack, with animosity at the working practises of the US healthcare insurance industry serving as motivation. Inscriptions on ammunition casings, which are highly likely a reference to a 2010 book criticising the industry, and the recovery of evidence at the time of arrest which details more specific grievances with the country’s healthcare system as well as direct references to shooting a healthcare executive at a conference.
Impact and reactions
Official responses, such as from the White House and Pennsylvanian law makers, have condemned the killing of Mr Thompson. These sentiments have also been echoed by more traditional sources for news and information, such as television news, academic institutions, and satirists; however, the reaction from the public, particularly on social media has been, and continues to be, notably less sympathetic toward the victim. Even prior to Mangione’s identity being revealed following his arrest, a strong fandom narrative became viral, revering him as a heroic figure. Some viewed him as an avenger against a failing healthcare system, bestowing nicknames like “The Adjuster”. Social media platforms were flooded with tributes, including ballads on TikTok, discussions idolizing his escape on Bluesky, a look-alike contest in New York City, and dedicated playlists on Spotify.
After Mangione’s arrest, this support, based on the number of positive comments and actions, further grew. Less than a day after his apprehension, a variety of merchandise, including t-shirts, mugs, and tote bags, became available for purchase on Amazon and Etsy. Additionally, crowdfunding site GoFundMe reportedly took down campaigns supporting Mangione, while GiveSendGo raised nearly $30,000 in his support.
Sentiments akin to those posted across social media have also been expressed in the physical space. Indeed, wanted posters of healthcare CEOs’ Andrew Witty (UHG) and Heather Cianfrocco (Optum), alongside one of Brian Thompson adorned with a red X, have been put up around New York City. Furthermore, posters similar in style to the three naming healthcare CEOs but relating to individuals within banking and finance have surfaced. Wanted posters of Martin Smalls (BlackRock), Robin Vince (BNY Mellon), and Denis Coleman (Goldman Sachs) have so far been identified, with their appearance coinciding with the annual Goldman Sachs Financial Services conference taking place at the Conrad Hotel in New York. Referencing both the posters and online ‘hitlist’, the New York Police Department (NYPD) on 10 December issued a bulletin warning of an increased risk to the lives of healthcare executives.
As an immediate reaction to Thompson’s death, healthcare executives and insurance firms enacted a raft of measures to safeguard pertinent information about their executives, in an aim to reduce their public visibility. Notably, several U.S. healthcare insurance firms including UHC, Elevance Health, Blue Cross Blue Shield, CVS Health, and Medica removed their executives’ biographies and photographs from their websites. Further action was taken by Medica, and UCare, who along with UHC are headquartered in Minnesota. Medica announced that it would temporarily close its six offices “out of an abundance of caution”. Similarly, UCare closed its offices in the week following Thompson’s death after receiving a ‘concerning comment’ made in a phone call. Other reactions by healthcare insurers have included Centene’s decision to move their investor day to a virtual space, having originally intended to hold it in person on 12 December.
Analysis
The killing of UHC’s CEO highlights the risk to high net-worth individuals and business leaders, particularly those in industries that receive scorn from politicians, the public, or prominent media figures – these include individuals such as podcasters and social media influencers. Furthermore, it has greatly exposed the long-term deep antagonism with how the U.S. health system affects its citizens and how it is perceived by large facets of society.
Although providing a snapshot of wider public opinion, the veneration of Mangione across social media and other areas of the internet is particularly unique, as there are few, if any, instances of such public backing for a murder such as this. While glorifying violent incidents and idolizing perpetrators is not a new phenomenon, it has typically been confined to niche online subcultures like 4chan and 8chan. What sets this case apart is the clear shift in rhetoric, with explicit support for Mangione, exemplified by the hashtag #FreeLuigi, gaining traction on mainstream platforms.
Negative sentiment brought to the fore since 4 December, and the possibility for Mangione’s actions to act as an inspiration to others, have increased the risks to other executives albeit from a low base. While deep-rooted and widespread grievances exposed as a result of the shooting have so far overwhelmingly focussed on the healthcare insurance industry, there is possibility that the general anti-corporate sentiment aired in the aftermath of the shooting could result in anger being directed to other sectors. Aside from the healthcare industry, other business sectors that attract widespread condemnation in the U.S. and are therefore at greatest risk include oil and gas, tobacco, defense, technology, banking and finance, pharmaceutical, and real estate.
While currently high levels of exposed animosity, publicity surrounding the incident, and Mangione’s popularity could conflate to motivate further attempts to seriously harm or kill high-profile individuals, such an eventuality remains highly unlikely. Other actions, however, are significantly more likely to occur. These include widespread negative comments and abuse of individuals on social media platforms, protests at prominent company assets, individuals receiving threats to both them and their families virtually or in person and being assaulted with non-lethal intent. This increased level of threat to executives is likely to last for at least several weeks. However, it has the potential to continue into 2025, particularly if grievances, both real and perceived, are not addressed within industry or politically. Furthermore, the potential for other stakeholders, which include non-executive employees, shareholders, and investors, to become targets has heightened.
In addition to people risks, healthcare insurance companies in the U.S are highly likely to continue to suffer reputational damage and a slump in their share prices, with new negative information on industry practises becoming publicized – which is almost certain to occur – further degrading both of these metrics.
Should other industries become the focus, it would almost certainly lead to reputational damage and increase the possibility of direct action, such as protesting, employee harassment, and boycotts.
Advice and recommendations
Review your corporate risk management procedures, operational practices, publicity, contractual rights, and employee directives.
Review applicable insurance coverage for executives, the wider workforce, and the business’ potential liability. This could include but is not limited to: Key Person, Active Assailant, Corporate Benefits, Business Travel Accident (BTA), Kidnap for Ransom (Special Crime), and Workers’ Compensation/Employer’s Liability cover.
Be wary of knee-jerk reactions. the risk to your executives, organization and industry, using this as a baseline to inform decisions on the introduction of an Executive Protection program and the appropriate structure of one (note: this does not always have to include protection officers) or determine if an adjustment of posture or resourcing for an existing Executive Protection program is required.
Consider either the use of an in-house team or third party to evaluate the online exposure of executives’ sensitive information, including the availability of their home address or upcoming travel schedule by Open-Source Intelligence (OSINT) methods. Additionally, periodically search the dark web to identify whether executives’ private or identifying information has been released (doxed) or is for sale.
Consistently monitor all available reporting about your company and wider industry, in order to accurately understand the current public opinion. Highlight the differences between how the company is perceived by its executives, staff, and the wider public.
Review security around relevant company assets and events that your executives routinely attend. Limit publicising executives’ attendance at events, including conferences and annual general meetings. Additionally, consider executives attending events online, particularly if concerning sentiment has been identified towards the firm or industry.