Self-Appointed Hero... or Villain?

The case of Luigi Mangione

Suspected murderer Luigi Mangione was scheduled to appear in U.S. court for New York’s southern district on March 19^th, 2025, but said appearance was postponed by one month. It seems that the country will have longer to wait for a verdict on the American healthcare system, which is what is really on trial in this case.

For those still unaware, in the early morning of December 4^th, 2024, UnitedHealthcare’s Chief Operating Officer Brian Thompson was gunned down in front of Manhattan’s New York Hilton Hotel. Shell casings recovered at the crime scene were inscribed with the words “deny”, “defend”, and “depose.” There was one word for each shell, in apparent homage to Counselor Jay M. Feinman’s Delay, Deny, Defend (2010), an in-depth denunciation of the health insurance industry. After a multistate manhunt lasting five days, Luigi Mangione was apprehended in Pennsylvania in connection to the murder. Reportedly, in addition to a partially 3-D printed pistol, ammunition, falsified identification, cash and foreign currency, a scrawled document which police inventoried as a “manifesto” of under 300 words was in his possession. It condemned the healthcare system, and praised its critics Michael Moore and Amy Rosenthal. Additionally, in specifying UnitedHealthcare, Mangione wrote that “these parasites had it coming.”

To no one’s surprise, the suspect’s ideology has turned the case into a cause célèbre for progressives. Feeding directly into the progressivist narrative of fat cats and sad sacks, journalists emphasized the inequity between record profits by healthcare insurance companies and patients struggling with healthcare costs. Jacobin bemoans that UnitedHealthcare’s profits have increased by almost 400 percent, despite the Affordable Care Act’s full implementation in 2014. FoxNews New York suggests that this windfall comes at the expense of UnitedHealthcare’s insured patients by way increased claim denials via artificial intelligence. Meanwhile, CBS News details how healthcare costs are becoming ever more burdensome, with debt related to healthcare as the chief cause of bankruptcy in the USA. Furthermore, Truthout avers that insurance costs have been quickly creeping upwards to consume almost $26,000 of the average family’s annual premiums since the Affordable Care Act’s promulgation in 2010.

Into this volatile admixture of social “injustice,” entered Luigi Nicholas Mangione. Mangione had an affluent upbringing in Maryland as a second-generation American, with a photogenic smile and washboard abs. His Ivy League master’s degree in engineering and globe-trotting lifestyle took him to exotic Asia and Hawaii. Mangione was in good health overall, except for chronic spinal pain from a condition called isthmic spondylolisthesis. Purportedly, he had reviewed the Unabomber Ted Kaczynski’s manifesto when participating in a Honolulu-based book club. During said club, his review quoted one commentator who had written “When all other forms of communication fail, violence is necessary to survive.”

Mangione cuts such a striking character to right the healthcare insurance industry’s wrongs that he has attracted a sizable following. He receives fan mail in jail whilst awaiting trial, and the GiveSendGo fundraiser for his legal defense has been crowdfunded by up to $759,000 thus far, with single donations in the amounts of $30,000 and $36,500. New York City Mayor Eric Adams – though embattled with his own federal indictments – choreographed himself into Mangione’s perp walk when Mangione was extradited from Pennsylvania to New York, just to bask in Mangione’s infamy. Even Senator Elizabeth Warren (D-Massachusetts) hopped on the bandwagon to excuse Mangione of his indictment, saying that “people can be pushed only so far,” oblivious to the fact that Mangione had never been a UnitedHealthcare patient and had no trouble whatsoever financing spinal surgery.

Of course, progressives see the inequity generated in the current healthcare insurance industry and conclude that it is a failure of government. The holy grail for progressives would be nationalized healthcare such as that practiced in the United Kingdom and Canada, where government politicizes decisions about who is worth treating with the system’s finite resources, and who winds up a sorry statistic. What is not realized in this evaluation is that the USA actually has two healthcare systems.

In distinction to the array of procedures covered by healthcare insurance are cosmetic procedures, which healthcare typically does not cover. Typically, these may be non-emergency interventions like liposuction, Lasik surgery to obviate the need for eyeglasses, or breast augmentation. On account of healthcare insurance not covering these interventions, a dynamic private market has emerged which has over time reduced costs, improved quality, and increased providers’ attentiveness to the patient. Afterall, it is the patient who directly pays instead of the healthcare insurance industry’s offshored and faceless bureaucracy. Unlike opaque pricing under the system of healthcare insurance – wherein providers either do not even know the related costs or are prohibited from divulging them – under the system of voluntary procedures like the aforementioned cosmetic interventions, patients receive beforehand a full itemization of all related costs and may have some leverage for negotiation on certain items.

Healthcare insurance will still be needed for catastrophic care, when circumstances preclude all negotiation. This is the scenario in which someone suffers an accident and is rushed to the emergency room for immediate attention, or a patient is diagnosed with a tumor which requires excision at the earliest. To invoice a patient’s healthcare insurance automatically for lower priority interventions only inflates the costs and worsens the bureaucracy for patients and providers (keep in mind that healthcare insurance claim denials mean that providers go uncompensated for aid already rendered to the patient). The last thing anyone should want is to introduce yet another layer of bureaucracy between patients and providers by having the government more involved in healthcare.

As for Luigi Mangione, New York has charged him with first-degree murder based on the crime’s apparent premeditation. Additional charges have been filed against him in Pennsylvania and the federal judiciary. The federal charges could result in the death penalty (inculcation of murder’s wrongfulness by committing murder against the offender strikes us Libertarians as absurdist). Mangione has pled not guilty to all charges and is therefore presumed innocent until adjudication to the contrary.

IF Mangione actually committed the crime (this is a hypothetical!), then acceptance of his guilt and the ensuing lengthy incarceration (if not capital punishment) would be more consistent with Mangione being a symbol for the noble cause of equitable healthcare, just as progressives are making him out to be. Mangione would thus have sacrificed his own life for a worthy cause, stoically suffering his decisions’ consequences. Sacrifice’s nobility inheres in the sacrificer giving up something which he values. Were Mangione to be acquitted in this scenario, it would mean that Mangione has made Brian Thompson – who was simply earning a living in an admittedly imperfect system – an unwitting and unwilling martyr for Mangione’s cause. It would mean that Mangione gave up a life which he never valued, and which was never his to give up. It would mean that Mangione — as the self-appointed hero for financially struggling Americans — is now asking them to crowdfund a legal defense so that he can elude the punishment for his crime. And far from being a symbol for nobler virtues, all this would make Mangione nothing less than a villain.