The murder of UnitedHealthcare CEO Brian Thompson represented a horrific and indefensible act of violence. His family deserves our deepest sympathy.
As a physician and healthcare leader, I initially declined to comment on the killing. I felt that speculating about the shooter’s intent would only sensationalize a terrible act.
Regardless of the circumstances, vigilante violence has no place in a free and just society.
But now, more than a month later, I feel compelled to address one aspect of the story that has been widely misunderstood: the public’s reaction to the news of Thompson’s murder. Specifically, why tens of thousands of individuals “liked” and “laughed” at a post on Facebook announcing the CEO’s death.
What causes someone to ‘like’ murder?
News analysts have attributed the social media response to America’s “ simmering anger ” and “ frustration ” with a broken healthcare system, pointing to rising medical costs, insurance red tape, and time-consuming prior authorization requirements as justifications.
These are all, indeed, problems and may explain some of the public's reactions. Yet these descriptions grossly understate the lived reality for most of those affected. When I speak with individuals who have lost a child, parent, or spouse because of what they perceive as an unresponsive and uncaring system, their pain is raw and intense. What they feel isn’t frustration—it’s agony.
By framing healthcare’s failures in terms of statistical measures and policy snafus, we reduce a deeply personal crisis to an intellectual exercise. And it’s this very detached, cognitive approach that has allowed our nation to disregard the emotional devastation endured by millions of patients and their families.
When journalists, healthcare leaders, and policymakers cite eye-popping statistics on healthcare expenditures, highlight exorbitant insurer profits, or deride the bloated salaries of executives, they leave out a vital part of the story. They omit the unbearable human suffering behind the numbers. And I fear that until we approach healthcare as a moral crisis—not merely an economic or political puzzle to solve—our nation will never act with the urgency required to relieve people’s profound pain.
A pain beyond reason
In Dante’s Inferno, hell is a place where suffering is eternal and the cries of the damned go unheard. For countless Americans who feel trapped in our healthcare system, that metaphor rings true. Their anguish and pleas for mercy are met with silence.
It is this sense of abandonment and powerlessness, not mere frustration, that fuels both a desperate rage and anger at a system and its leaders who appear not to care. The response isn’t one of glee—it’s a visceral reaction born of pain and unrelenting remorse.
As a clinician, I’ve seen life-destroying pain in my patients—and even within my own family. When my cousin Alan died in his twenties from a then-incuurable cancer, my aunt and uncle were powerless to save him. Their grief was profound, unrelenting, and eternal. They never recovered from the loss. But Alan’s death, heartbreaking as it was, stemmed from the limits of science at the time.
What millions of Americans endure today is different. Their loved ones die not because cures don’t exist but because the healthcare system treats them like a number. Bureaucratic inefficiencies, profit-driven delays, and systemic indifference produce avoidable tragedies.
To appreciate this depth of pain, imagine standing behind a chain-link fence, watching someone you love being tortured. You scream and plead for help, but no one listens. That is what healthcare feels like for too many Americans. And until all of us acknowledge and feel their pain, little will improve.
Curing America’s indifference
When we focus solely on cold numbers—the millions who’ve lost Medicaid coverage, the hundreds of thousands of avoidable deaths each year, or the life-expectancy gap between the U.S. and other nations—we strip healthcare of its humanity.
But once we stop framing these failures as bureaucratic inefficiencies or frustrations and, instead, focus on the devastation of having to watch a loved one suffer and die needlessly, we are forced to confront a moral imperative. Either we must act with urgency and resolve the problem or admit we simply don’t care.
In the halls of Congress, lawmakers continue to weigh modest reforms to prior authorization requirements and Medicaid spending—baby steps that won’t fix a system in crisis. The truth is that without bold, transformative action, healthcare will remain unaffordable and inaccessible for millions of families whose anguish will grow. Here are three examples of the scale of transformation required:
- Reverse the obesity epidemic with a two-part strategy. Congress must tax ultra-processed, sugary foods that drive hundreds of billions of dollars in healthcare costs yearly. In parallel, lawmakers should cap the manufacturer-set price of weight-loss medications like Ozempic and Wegovy to be no higher than in peer nations.
- Change clinician payments from volume to value. Current fee-for-service payment systems incentivize unnecessary tests, treatments, and procedures rather than better health outcomes. Transitioning to pay-for-value would reward healthcare providers, specifically primary care physicians, who successfully prevent chronic diseases, better manage existing conditions, and reduce complications such as heart attacks, strokes, and kidney failure.
- Empower patients and save lives with generative AI. Tools like ChatGPT can help reduce the staggering 400,000 annual deaths from misdiagnoses and 250,000 more from preventable medical errors. Integrating AI into healthcare enables at-home care, continuous disease monitoring, and personalized treatment, making medical care safer, more accessible, and more efficient.
If elected officials, payers, and regulators fail to act, they will have chosen to perpetuate the unbearable pain and suffering patients and families endure daily. They need to hear people's cries. The time for transformative action is now.
Robert Pearl, the author of “ ChatGPT, MD,” teaches at both the Stanford University School of Medicine and the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.
Demonstrators rally outside the U.S. Supreme Court as justices hear oral arguments on whether President Donald Trump can deny citizenship to children born to parents who are in the United States illegally or temporarily, on Capitol Hill, in Washington, Wednesday, April 1, 2026. (AP Photo/Mariam Zuhaib)
Luz Angela Nuñez with her daughter Aisha Quershi Nuñez at their home in College Point, Queens. Photo: Mia Anzalone for Documented.
Kimberly Alvarez, 25, with her daughter Evangeline and her husband John Alvarez in Medellin, Colombia. Photo courtesy of Kimberly Alvarez.Alvarez arrived in New York City in February 2024 with her husband John Alvarez as asylum seekers from Venezuela. In April 2025, Alvarez found out she was pregnant with her first child, a baby girl. Her first reaction, she said, was fear.“How am I going to keep her alive?” she said. “That’s what I was thinking. ‘How am I going to be able to take care of her?’”At the beginning of Alvarez’s pregnancy, she said she was aware of the immigration enforcement occurring around the country, but vowed not to let it deter her from showing up to her doctor’s appointments.“When you went out, you were always on alert because you didn’t know if [ICE] might be around. I never saw anything suspicious,” Alvarez said. “But of course, you feel scared.”In October, when Alvarez was six months pregnant, her husband was detained by ICE agents at 26 Federal Plaza. When the immediate shock wore off, she obsessively checked the Online Detainee Locator System to find out where her husband went. A day later, she discovered that he was being kept at Delaney Hall detention center in New Jersey. Alvarez quickly set up an account to pay for phone calls, and every two days, she would pay about $10 for a one-hour call, updating her husband about the baby, her appointments and how she was doing.“Crying was the only way for me to release the tension,” said Alvarez, who worried that her lack of sleep and bad diet were impacting her baby. “Crying was the only way for me to release the tension.”—Kimberly AlvarezThat tension built up day by day, week by week following her husband’s arrest. Alvarez had stopped her work as a cleaner in the neighborhood’s synagogues two weeks before her husband’s detention because of her pregnancy. The plan, she said, was to rely solely on his income as a maintenance worker for “the food, the rent, everything.” Left with few choices, Kimberley had to rely on her mother’s income as a cleaner. The older woman had moved to New York from North Carolina to assist with Alvarez’s pregnancy. “I feel like I’m supposed to help my mom, not the other way around,” Alvarez said. “I felt powerless because I couldn’t do anything.”On Dec. 9, Alvarez gave birth to a daughter, Evangeline. While her baby was healthy, Alvarez’s anxieties did not go away. While she returned to cleaning synagogues a few months after Evangeline’s birth to help make ends meet, Alvarez and her daughter rarely left home. Alvarez said she felt paralyzed, getting frequent alerts from a neighborhood WhatsApp group when ICE was spotted nearby. One day, she said, ICE arrested her friend’s husband in Sunset Park, in an area where she would sometimes take Evangeline for walks.“I’m so afraid that I’ll go out and run into one of them and that they’ll take her away from me,” Alvarez said. “That’s my biggest fear, that someone will take her away from me and I won’t know where my daughter is.”In March, her husband decided to voluntarily remove himself from the United States and move back to Colombia, where he is originally from. It was a family decision, but it was not a happy one — hiring immigration lawyers was too expensive, Alvarez said, adding that staying in the U.S. felt too uncertain. 
