Despair over the US healthcare system Why a suspected murderer is being celebrated like a hero

A cold-blooded crime in the middle of Manhattan shakes up the USA. But that's not all: the crime also exposes the anger and despair many Americans feel about the healthcare system.

Even before the police arrested the suspect, the 26-year-old was celebrated on the internet as the "Robin Hood" of the 21st century. And this despite the fact that he allegedly shot the head of the billion-dollar US insurer United Healthcare in the middle of New York. The horror of the crime quickly gave way to the concentrated anger of many people towards the American healthcare system and the insurance industry in the USA. And Luigi M., who is accused of the murder, was quickly stylized as a hero.

T-shirts, hoodies, coffee mugs and shot glasses with the distinctive face of the man accused of murder are now available to buy on the internet. The police expressed fears that Luigi M. could be celebrated as a "martyr and role model" and inspire imitators. The governor of Pennsylvania, Josh Shapiro, warned against glorifying the perpetrator and described the attention in the case, especially on the internet, as "deeply disturbing, as some wanted to celebrate the killer instead of condemning him".

The web follows its own laws when it comes to what becomes hype. Events, people and narratives quickly become popular in a very short space of time and develop a momentum of their own - regardless of how they are perceived in the analog world. Nevertheless, the killing of insurance boss Brian Thompson not only stirred up the USA, but also revealed the desperation of the healthcare system. A debate broke out. Where does the anger come from?

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Enormous costs for treatments

The healthcare system is highly organized in the private sector. Hospitals and insurance companies in the USA are largely privately owned. Supply and demand play a central role. There is no general, state-organized health insurance as in many European countries. Instead, the system is based on a mix of private insurance and public programs for specific population groups.

According to the health data tracker Peterson-KFF, the USA has the highest per capita expenditure on health in the world. This is due to high drug prices, doctors' fees and administrative costs. Access to medical care is heavily dependent on insurance. According to official figures, around eight percent of the population is uninsured despite progress. There is great inequality: lower-income groups often have less access to good healthcare services.

Medical care in the USA is considered to be technically advanced, with cutting-edge research and technology. At the same time, there are significant differences in quality depending on the region, hospital and insurance status - many people fall through the cracks and don't get the help they need.

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What does this mean in everyday life?

- In the USA, employees often receive their health insurance through their employer, who covers part of the costs. The benefits vary, as companies cooperate with different insurance companies. If you change jobs or become unemployed, your health insurance no longer applies.

- High co-payments The insured person's co-payment for treatment or medication is often very high in the USA. The deductible that policyholders have to pay out of their own pocket each year before the insurance covers the costs is usually several thousand US dollars.

-No free choice of doctor Many insurance companies work with a network of doctors. For treatments in other practices, the insurance only pays a small part of the costs - or does not cover them at all.

- Pre-authorization for certain treatments Particularly expensive treatments such as operations or MRI scans, but also aids such as prostheses, must be approved in advance by the health insurance company. This process can take a long time - important treatments are thus delayed. Many insurance companies use artificial intelligence to process these applications.

-Complicated contracts The fact that there are so many different insurance providers with various offers can make it difficult to keep track of the insured benefits. In addition, standard insurance policies often do not cover dental treatment, and aids such as hearing aids or glasses are often not paid for.

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Billions in debt

The words "deny", "defend" and "depose" were written on bullet casings seized at the scene of the crime. Investigators assume that this is a reference to a slogan used by insurance critics to describe the companies' strategy: "Delay, deny, defend". In a manifesto, the arrested man writes about insurance companies that are only focused on profit and "parasites" - he calls United Healthcare by name. The crime took place in the middle of Manhattan - for many a symbol of capitalism par excellence.

Even though the investigation is ongoing, there are indications that the alleged shooter - a graduate of an elite university and son of a wealthy family - was specifically targeting the insurance industry with his crime. He has obviously struck a nerve with some people. According to a survey by the Gallup polling institute, 81 percent of respondents are dissatisfied with the cost of medical care in the USA.

There, a mountain of debt amounting to billions has grown in connection with medical treatment. According to Peterson-KFF, six percent of all adults have medical debt of more than 1,000 US dollars, and around one percent of adults have more than 10,000 US dollars each. Due to the high costs, many people do not even go to the doctor and illnesses remain untreated. Many people are frustrated, desperate - and angry.