I have been a primary care physician since 1994 and have been reflecting on the tragic murder of the CEO of UnitedHealthcare. The crime stands as a stark reflection of the profound frustrations many Americans feel toward the current health care system, which have been escalating for as long as I can remember. While the act itself is abhorrent and indefensible, its occurrence sheds light on deep systemic issues that have festered for decades. The structure of the U.S. health care system—one in which profit often takes precedence over patient care—has created a dynamic where billions of dollars in revenue are generated, yet millions of Americans struggle to access or afford the care they need. Insurance companies, including major players like UnitedHealthcare, operate in a system where their financial success hinges, paradoxically, on managing—or even denying—claims rather than ensuring the health and well-being of the population they serve. This event, shocking as it is, feels less surprising when considered in the broader context of America’s health care and current psychosocial landscape.
The American health care system is an outlier among developed nations, with its overwhelming focus on profit rather than universal access. Large insurance companies generate billions annually, benefiting from a system where the sick—rather than the healthy—drive revenue. This misalignment of incentives fosters mistrust among patients, who often feel trapped between skyrocketing premiums, unaffordable and often unattainable medications, and opaque billing practices. For many, the health care system appears less as a safety net and more as an obstacle course, leading to mounting resentment and hopelessness. This discontent is exacerbated by the growing wealth divide in the United States. While CEOs of major health care corporations receive multimillion-dollar compensation packages, many Americans cannot afford basic care. This stark inequity highlights systemic failures and fuels anger among those who feel abandoned by a system that prioritizes profits over lives. This feeling of abandonment is felt by patients and by most practicing physicians.
Additionally, the ease of access to firearms in the United States further compounds these tensions. Guns are easily obtainable in this country, and their ubiquity turns anger and frustration into potentially lethal outcomes—something we have seen repeatedly in public places that should be safe. In a society where individuals are increasingly polarized and alienated, the combination of systemic inequities and readily accessible weapons creates a volatile mix. The murder of the UnitedHealthcare CEO is emblematic of this dynamic: a desperate act stemming from a desperate situation.
This tragedy also underscores the broader implications of America’s failure to address both gun violence and economic inequality. Both issues are deeply interconnected with the frustrations patients feel about health care. Those struggling to make ends meet or grappling with insurmountable medical bills are more likely to feel that they have been left behind by a system that claims to protect them. The cumulative effect of these pressures pushes some individuals to the breaking point.
In the face of such crises, it is critical to recognize that reform is not only necessary but achievable. In his sentinel 2024 policy article, “Envisioning a Better U.S. Health Care System for All: Health Care Delivery and Payment System Reforms,” Robert Doherty of the American College of Physicians outlined a framework for improving the American health care system. Doherty’s vision emphasized the need for systemic reforms that prioritize patient outcomes, equity, and access. His words resonate today more than ever: better is not only possible, but it is also imperative for the survival of a just and functional society. Reforming the health care system requires addressing both its profit-driven nature and the broader societal factors that exacerbate its failures. Policies that reduce financial barriers to care, such as expanding access to affordable insurance, regulating drug prices, and incentivizing preventive care, are essential. Moreover, addressing the root causes of wealth inequality and enacting sensible gun control measures are equally critical to fostering a safer and more equitable society.
The murder of the UnitedHealthcare CEO is a grim reminder of the stakes at hand. While the act itself must be unequivocally condemned, it serves as a warning sign that our society has been pushed to its limits. The health care system in the United States is at a breaking point, and the need for reform has never been more urgent. This tragic event should not be dismissed as an isolated incident but rather as a call to action for policymakers, health care leaders, medical organizations, and society at large. We must confront the uncomfortable truths about our health care system and work toward a future where better is not just possible but realized. The time for change is now, and we cannot afford to wait for more tragedies to underscore the urgency of this moment.
Susan Y. Lee is an internal medicine physician.
