TFF ThinkTank｜Speaking Frankly: Luigi as a Warning from Afar

Professor Zeynep Tufekci, a sociologist and public affairs scholar at Princeton University, remarked that the public's reaction should serve as a wake-up call. She warned of a resurgence in the greed, exploitation, and economic inequality reminiscent of America’s Gilded Age in the late 19th century. Back then, acts of violence were primarily directed at corporate magnates, politicians, and judges—figures like oil tycoon John D. Rockefeller. Today, however, the concentration of wealth in society has surpassed even that era.

On the morning of December 4th, in Manhattan’s West 54th Street outside the Hilton Hotel, a series of chilling gunshots shattered the dawn’s silence.

By now, most of us have heard the story. Brian Thompson, CEO of United Healthcare, was killed on the spot. The suspect, Luigi Mangioni, fled the scene and initially evaded capture.

The NYPD and FBI launched an immediate manhunt. Soon, both names dominated headlines. The victim, Brian Thompson, began his career as an accountant and rose through the ranks at UnitedHealth Group, eventually serving as CFO of the Medicare & Retirement and Community & State divisions before becoming CEO in 2021. The suspect, Luigi Mangioni, hails from a prominent Italian-American family, with one of his cousins serving as a local legislator. Surprisingly, Luigi himself was a computer science student at the University of Pennsylvania and had once delivered a valedictorian speech at his high school graduation.

Six days later, Luigi was apprehended after being recognized by a McDonald’s employee. Despite being arrested, Luigi gained widespread public support—astonishingly, even from fellow inmates. During a NewsNation live report outside the jail, an adjacent prisoner shouted over the wall: “Free Luigi!” In Pennsylvania, over a hundred supporters gathered outside the courthouse during his arraignment.

On American social media, it seemed that sentiment heavily favored Luigi. One post on X read:

“He is a brave Italian martyr. Here, Luigi Mangioni is a hero. End of story.”

Protesters outside New York Federal Court hold signs reading: “NYC Government Funded by Billionaires: Free Luigi!” (AFP via Getty)

The news has continued to snowball. On the surface, Luigi isn’t someone named Zhang or someone who “looks like a criminal.” Yet he allegedly killed a CEO, driven by a desire for revenge against society. The aftermath has ignited a public outcry and sparked collective unrest.

On the United Healthcare social media account, the CEO’s obituary post was flooded with “laughing face” emojis. The comments were eventually disabled, but one lone laughing emoji remains at the end—chilling, if not dystopian.

Even in a country like the United States, where capitalism reigns and the illusion of free speech persists, it's hard to ignore the disturbing nature of such public sentiment. So, where did Luigi’s emotions come from?

The clues lie in the bullets themselves. Extracted from the CEO's body, the bullets were found to have three words etched into them: delay, defer, and depose. These are not random—they echo the title of a book published 14 years ago by legal scholar Jay M. Feinman: Delay, Deny, Defend, a searing critique of insurance companies’ claims-denial strategies. Feinman’s book exposes internal practices of major insurance firms like State Farm and Allstate, using real cases—such as Hensley v. Shelter Mutual—to show how these tactics harm consumers. He highlights how legal loopholes and algorithms undermine public trust in the industry.

Public dissatisfaction with the U.S. healthcare system runs deep. And the facts support it.

In 2023, amid widespread public frustration over inflation, UnitedHealth Group—the parent company of United Healthcare—ranked 8th on the Fortune Global 500 list, amassing $371.6 billion in total assets with a 15% increase. CEO Brian Thompson’s total compensation also rose to $10.2 million. What sparked even more outrage was the company’s success in lobbying Congress: spending just $5.86 million to block universal healthcare legislation.

While the corporation thrived, millions of American families were drowning in medical debt. According to the American Bankruptcy Institute, medical expenses are the leading cause of bankruptcy in the U.S. Of the 2 million bankruptcy filings each year, 62% cite medical bills as the primary reason. Over 200 million Americans have private health insurance—but nearly 1 in 7 claims is denied. With insurance giants wielding powerful legal teams, only 0.1% of people appeal. The rest give up.

Last year, Minnesota court records revealed that United Healthcare used AI algorithms to flag and limit mental health treatment claims. Over 90% of these denials were overturned in court. A U.S. Senate report from October noted that United Healthcare was especially likely to reject post-acute care claims for serious illness. In the past three years, denial rates for this category rose sharply: 10.9%, then 16.3%, and then 22.7%.

From this perspective, is Luigi simply a murderer who acted out violently?

Calling this an “isolated incident” sounds almost absurd. USA Today and other media have reported similar cases: in Florida, a woman was arrested for allegedly threatening a mass shooting after her health claim was denied by Blue Cross Blue Shield. In her recorded call, she ended with: “Delay, deny, defend. You’re next.” Sound familiar? She later told investigators she had no firearms and was only quoting the news. But she believed health insurance companies were “evil” and deserved “cosmic retribution.”

Across the ocean, violence and murder are already erupting from insurance disputes. As the global economy continues to decline, both insurers and consumers are increasingly anxious about finances. Who knows what might happen next?

While such extreme violence hasn’t yet erupted here, that doesn’t mean it won’t. Without stronger oversight, allowing the insurance industry to grow unchecked poses a grave risk to social stability. The issue of claim denial is more than a corporate malpractice—it’s a societal alarm bell. As wealth inequality deepens, insurers extract profit from the public, while everyday people remain trapped. The longer this persists, the higher the risk of violence—not just in America, but worldwide.

Yet the true lesson comes from another angle. As shameful as the act was, how can we ignore the immense societal reflection it triggered?

After the attack, Luigi’s actions, his ideology, and the failings of the insurance industry drew overwhelming attention. In a manifesto he wrote, Luigi said:

“Violence is a means to an end. These parasites (corporate executives) had it coming. I regret the trauma I caused, but it had to be done.”

In some way, he achieved his aim. If current public sentiment continues to build, it may force long-overdue reforms—goals that many industry advocates and social justice campaigners have failed to realize for years. From health policy advocates to presidential administrations that attempted healthcare reform, many have tried to wrestle power away from insurance lobbyists. Buried in the waves of online discourse are the voices of those with deep grievances—ones that reflect broader societal introspection. From this angle, Luigi’s act and its ripple effects become part of a larger mechanism of social self-correction. Everyone claims to prefer institutional solutions—yet the tragedy still unfolded. Even Tim Orban, one of Luigi’s favorite authors, expressed shock at his violent decision. But now that it has happened, the reflection and lessons learned are more vital than ever. This is where public discourse becomes irreplaceable. American media has dug deeply into this case. One particularly striking column comes from Jia Tolentino of The New Yorker:

“For those without money, without social connections in the hospital, and without the time to spend weeks on the phone, a rejected health insurance claim can instantly push them toward bankruptcy, suffering, or death. Everyone knows this. Structural violence—or more plainly, the absence of social justice—is now just a normalized feature of American life.”

Across the Atlantic, The Guardian has weighed in. Even on Chinese social media platforms, thoughtful commentary has emerged. Outlets like ours have tried to shed light on the deeper causes behind this tragedy.

In a pluralistic media environment, meaningful critique and commentary can shape a better future—serving as lessons for generations to come. Reflection is not “armchair quarterbacking.” Asking why Luigi didn’t choose peaceful means—or, in more familiar terms, “punishing the messenger instead of solving the problem”—misses the point.

A healthy playing field requires tolerance for the commentator’s booth. Prosecutors in Pennsylvania and the federal government are proceeding with Luigi’s case. We can expect justice to be served. We might even dare to hope for sweeping reforms—perhaps even globally.

These hopes have been voiced many times. But let us say this once more: We hope every society’s public sphere can show resilience and maturity when facing events like this—accommodating critical voices that can propel us forward. Even if Luigi's crime was horrific, how can public opinion be seen only as a threat?

“What truly brings people security is sunlight—not earplugs and blindfolds.”

Writer: Roy Chen

Editor: Tommy Kuang

Translation: Christina Zhang