After the suspected assassin of UnitedHealthcare CEO Brian Thompson was revealed as Luigi Mangione, a bright young man from a well-to-do family, thousands of pundits rushed to tell us why he did it. I, however, held back. Because, unlike them, I’d actually met Mangione, and I knew all was not what it seemed.
For days after the revelation, my phone buzzed incessantly from journalists asking me for comment. I found it hard to say anything coherent, because my mind was a storm, constantly replaying memories of my interactions with the suspect, trying to find meaning in even our most banal exchanges.
In the days since, I’ve developed some detachment from the situation, and now I feel clearheaded enough to offer my full opinion. Here it is.
Mangione first reached out to me via email on April 6. He said he was a longtime fan of my work, and had just purchased a $200 founding membership to my blog, The Prism, which entitled him to a two-hour video call with me. A month later, on May 5, we had our chat.
He was warm and gregarious from the outset, praising my writing and telling me how excited he was to speak with me. Mangione said he was on holiday in Japan, and I asked him about it. He said that while he loved many aspects of Japanese culture, such as its sense of honor, he believed Japan was full of “NPCs,” or non-player characters—which is internet slang for people who don’t think for themselves. He then told me a story he’d first mentioned in an email: One morning in Japan, he saw a man having a seizure in the street, so he ran to the nearest police station for help. They followed him back to the man, but refused to cross any street if the stoplight was red—even if the road was empty—as the man was seizing on the ground. Mangione lamented what he called “a lack of free will” in Japan, by which he meant a lack of agency.
I quickly realized that agency was a major concern of Mangione’s. He identified three of my articles that particularly resonated with him, all of which describe threats to human autonomy.
Mangione went on to explain why he felt Japan was the future dystopia I’d warned about in some of my writings. He spoke of the hikikomori, Japanese men who lived their lives alone in their bedrooms, sedating themselves with video games, porn, and other shallow entertainments. For Mangione, such people had lost control over their lives, becoming mindless slaves to stimuli much like the cops who stopped at red lights even when it made no sense.
But it wasn’t just Japan. Mangione believed people everywhere were becoming NPCs, increasingly living their lives as a series of reflex reactions rather than consciously choosing their behaviors. Japan was merely the canary in the coal mine; the West was following closely behind, driven by tech companies intent on mesmerizing us into being servile consumers. Mangione feared that once we’d surrendered our agency, we’d surrender everything else.
Unlike most people who decry others as “NPCs,” Mangione showed enough awareness to identify that he, too, lived much of his life on autopilot, confessing that he sometimes wasted whole afternoons doomscrolling social media. He said he wanted to regain some of the agency he felt he’d lost to online distractions, so we spent much of the chat discussing ways he could become more active.
I told him about my favorite philosophy, Stoicism, and how it could teach him to ignore distractions and focus his mind on living more deliberately. Mangione listened intently, and showed much curiosity, gently stopping me to ask me to explain terms he didn’t know.
I also suggested to Mangione that he should avoid automating the tasks he wanted to improve at, and should instead seek to make these tasks fun, by turning them into games. This led us to discuss my essay about gamification, “Why Everything is Becoming a Game.”
Mangione had much to say about this essay, not least because it involves the story of the Unabomber, Ted Kaczynski, who shared Mangione’s belief that modern life is destroying our agency. Kaczynski was a terrorist whose bombs killed and maimed innocent people, and I made it clear that, while I agreed with some of what he’d written in his manifesto, I found his actions abhorrent. Mangione agreed, saying something like, “He deserved to be taken seriously, but he also deserved to be in jail.”
Besides Kaczynski, Mangione’s intellectual tastes were relatively normal. Writers he spoke fondly of included Tim Urban, Sam Harris, Yuval Noah Harari, Jonathan Haidt, and Aldous Huxley. His political views were less conventional; when I asked him if he was voting in the presidential election, he scrunched his nose and said he wasn’t crazy about Donald Trump or Joe Biden, but liked some of the things Robert F. Kennedy Jr. was saying. I regard RFK Jr. as a crank who regularly pushes harmful pseudoscience, but I didn’t mention it so as not to derail the conversation.
Somehow, from there we ended up talking about intergenerational trauma, and it was here that we had our only significant disagreement. Mangione implied that he believed trauma could be directly inherited, and that it accumulated in families much like generational wealth. He claimed to have based this view partly on his own personal experiences. (I can’t elaborate.) It sounded to me like he was describing a pseudoscientific misinterpretation of epigenetics, popularized by activist-academics and books like The Body Keeps the Score.
The idea that trauma is passed down epigenetically is not only unscientific, it’s also un-agentic; if you believe your trauma is hardwired into your DNA, you’re prone to passively accept it rather than actively trying to overcome it. And so, in a bid to increase Mangione’s agency, I pointed out, as politely as I could, why he was wrong.
After we exchanged pleasantries and ended our chat, I sent Mangione an article debunking epigenetic trauma. Mangione replied shortly after, thanking me for the article, and explaining what it had taught him. He also told me he’d bought me a six-month subscription to the app Readwise Reader, because he knew my job required extensive research, and believed the app would help.
I have Asperger’s syndrome, so I’m a poor judge of social cues. Further, I’ve liked every subscriber I’ve had a video-call with (and I’ve had many), so I’m probably not very discerning in that regard. But, to me, Mangione seemed like a particularly nice guy.
It wasn’t just that he’d bought me a subscription to an app that he thought might help me. It was that he showed a desire to help even people he didn’t know, frequently expressing concerns about humanity generally, and wishing to find ways to improve everyone’s lives. He viewed most people as NPCs who needed to be awakened, but he never came off as arrogant, regarding himself as equally zombielike in many of his thoughts and behaviors. His view of society was somewhat pessimistic, but he tempered it with a sense of humor and a focus on finding solutions rather than merely complaining. And although he seemed to have some unscientific views, he was always open to other viewpoints, and was willing to update his beliefs if corrected.
We interacted on social media several times afterward, and each time he seemed as polite and thoughtful as he’d been in our chat. As the summer ended, I largely withdrew from social media, so I didn’t notice Mangione had vanished.
And then, a few months later, Brian Thompson was shot dead.
Many people celebrated the murder, mocking the victim and lionizing the killer. Some were frustrated that health insurance cost so much, and some were outraged that they or a loved one had been denied medical claims. For this they blamed Thompson, the CEO of the U.S.’s largest health insurance company.
But while thousands reacted with laughter emojis to Thompson’s murder, and with love-heart emojis to his alleged murderer, I was sickened. Vigilantism is always wrong. If you celebrate someone gunning down a defenseless person in the street, then you advocate for a world in which this is an acceptable thing for anyone to do. You, in fact, advocate for a world in which a stranger can decide that you’re also a bad person, and gun you down in the street. In such a world, I promise you, your health insurance would cost much more.
The murder would’ve been shocking even if I didn’t know the alleged murderer. But when Mangione was revealed as the suspect, everything became surreal. My mind raced back to our chat, searching for clues that he could’ve done this. The only thing that stuck out was when Mangione briefly mentioned healthcare in the U.S. was expensive, he also said we Britons were lucky to have a socialized National Health Service. But even this statement, by itself, gave no indication that Mangione was capable of what he was being accused of.
When someone is found to have committed murder, friends and relatives will usually say things like, “I can’t believe it, he seemed like such a nice guy.” I instinctively said the same thing about Mangione. But as the shock faded and my wits returned, I ceased to be surprised. I’ve long known that people who are capable of great kindness also tend to be capable of great cruelty, because both extremes are often animated by the same crazed impulsivity. It’s why many of the people celebrating the murder are those who self-identify as “compassionate” leftists. And it’s why most of history’s greatest evils were committed by people who thought they were doing good.
Much more puzzling than the cruelty was the stupidity. Mangione had seemed intelligent, far too intelligent to do something so dumb. Sure, smart people are better able to rationalize stupid actions and beliefs, but Mangione’s alleged rationalization, given in a 262-word “minifesto,” was nowhere near the intellectual standard I would’ve expected of him.
The data blogger Cremieux Recueil dismantles the minifesto line by line, but, to give an example, it claims “the U.S. has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy,” ignoring the fact that the U.S.’s healthcare costs are broadly in line with its income level, and its life expectancy has little to do with health insurance and much more to do with Americans being disproportionately obese, violent, and drug-addicted. Further, the minifesto makes basic factual errors, like confusing market cap with revenue. The writer even admits he doesn’t know what he’s talking about: “Obviously the problem is more complex, but I do not have space, and frankly I do not pretend to be the most qualified person to lay out the full argument.”
Not only was the justification for the targeting of Thompson stupid, but the targeting itself was stupid. While it’s true that UnitedHealthcare has the highest denial rate for medical claims, the CEO doesn’t set the approval rate of a health insurance company’s payouts—that’s done by the actuaries, who themselves are constrained by various considerations, such as the need to keep costs low, including for policyholders. But even if Thompson did have carte blanche to set his company’s approval rates, it wouldn’t have made a big difference.
Health insurance companies don’t get rich by denying payouts for claims. As the economics blogger Noah Smith points out, UnitedHealthcare’s net profit margin is just 6.11 percent, which is only about half of the average profit margin of companies in the S&P 500. If UnitedHealth Group decided to donate every single dollar of its profit to buying Americans more healthcare, it would only be able to pay for about 9.3 percent more healthcare than it’s already paying for.
According to the Harvard economist David Cutler, who has written extensively about the U.S. healthcare system, the main reason healthcare costs in the U.S. are high is because of administrative inefficiencies. Insurance companies and organizations that deal with them, such as hospitals, have become bureaucratically bloated to administrate a wildly unstandardized healthcare system, and this bloat now accounts for one-third of the delta between U.S. healthcare costs and those of other high-income countries.
The ultimate point here is that Thompson was not the problem. He was a normal, flawed guy trying to keep costs low both for his company and his policyholders, while keeping his fiduciary duty to shareholders, whose investment his company depended on. He was a cog in a vast and unfair system that’s controlled by no single person but by the cumulative actions of millions of people operating in their own immediate interests. Kaczynski called such decentralized problems “self-propagating systems,” recognizing that they weren’t the result of human coordination, but rather, a lack of it.
If Kaczynski’s bombs and book-length manifesto couldn’t destroy such a system, then Mangione’s alleged 3D-printed pistol and shoddy minifesto certainly won’t. You can’t kill your way out of a problem that’s ultimately no one’s fault.
Still, people allocate agency strategically, to assign praise to allies and blame to enemies. Mangione’s supporters misattribute total agency to Thompson, so they can scapegoat him for a societal problem he had little control over. Meanwhile, they deny all agency to Mangione, claiming he was pushed to do what he allegedly did by a corrupt system or simple back pain.
But, while they’re wrong about Thompson, they may have a point about Mangione. If he was in extreme pain, or in the grip of mental illness, it would explain why a man who was consistently thoughtful in his interactions with me could have committed a monumentally thoughtless act, rationalized by an equally thoughtless note.
On the other hand, if Mangione was mentally or physically unwell, it’s unlikely he’d have been able to forge documents, acquire a 3D-printed ghost gun, plan and carry out a meticulous assassination, and then evade authorities for almost a week while traveling across states in one of the most surveilled regions on earth.
In my limited interactions with Mangione, I never got the impression he had spinal or mental issues. But I did get the sense he felt alienated. He often decried the lack of social connection in the modern world, and on a couple of occasions, he lamented that the people around him were “on a different wavelength” to him.
On June 10, I received my last communication from Mangione. It was a seemingly innocent request; he wanted me to help him curate his social media feed. I’d already given him tips on how to do that, so the question struck me as odd. I directed him to a relevant article I’d written and offered to answer any questions he had about it. I never heard from him again.
In retrospect, I wonder if his request was an awkward cry for help, as a New York Times journalist told me it was his last known online communication. It’s hard not to wonder if, had I answered his call, things might have turned out differently.
I don’t know if Mangione ever found the agency he was searching for. If he didn’t, I hope he gets the help he needs. And if he did, he will soon discover that the price of agency is culpability.
This piece was originally published on The Prism.