On a freezing December morning in Manhattan, a CEO walked down the sidewalk, heading to what should have been just another investor conference. Moments later, he was gunned down in broad daylight — a moment that wasn’t random but calculated. The assassination of UnitedHealth Group CEO Brian Thompson wasn’t just a crime; it was a message. A powerful, chilling message that forces us to confront some ugly truths about the American healthcare system.

UnitedHealth Group is no ordinary company. With $371 billion in revenue last year, it’s the fourth-largest company in the U.S. Over the past decade, it’s swallowed more than 35 healthcare companies, influencing everything from insurance premiums to medication access. Decisions made at UnitedHealth don’t just impact profits — they determine whether patients can afford life-saving treatments, access their chosen providers, or even receive surgery in time.

Thompson stood at the helm of this healthcare empire, making tens of millions annually while overseeing policies that directly affected millions of lives. And yet, beneath the polished corporate image was growing unrest. UnitedHealth had become infamous for denying over 30% of claims, often leaving patients in devastating situations. It’s not just about losing loved ones to denied treatments — though that alone is heartbreaking — it’s also about financial ruin. Medical bankruptcy is one of the leading causes of financial collapse in America, a reality Thompson’s company profited from.

The killer, Luigi Mangione, didn’t act on a whim. His actions were deliberate, methodical, and horrifying. Security cameras captured his movements: purchasing energy bars at Starbucks, waiting for the exact moment Thompson stepped onto the sidewalk, and executing his plan with chilling precision. This wasn’t a random act of violence — it was an execution designed to send a message. And the message wasn’t subtle. Scrawled on the bullets used in the attack were three words: “Deny, Delay, Depose.”

For those in the insurance world, those words are hauntingly familiar. They echo an industry playbook criticized for prioritizing profits over patients. Delay claims long enough, and patients give up. Deny them outright, and hope they don’t appeal. If they do fight back, drag it out in court. It’s a tactic that maximizes profits while leaving patients — and often their families — fighting for their lives.

The aftermath of the assassination was seismic. Healthcare executives across the nation doubled their security. Meetings moved online. Names were scrubbed from corporate websites. But the public reaction was even more telling. While murder is undeniably wrong, there was an unsettling undercurrent of support for the message behind this horrific act. Across social media platforms, people expressed frustration, even relief, that someone had “finally” taken a stand against the system they feel trapped by — a system where profits come before people.

This assassination forces us to face some uncomfortable questions. How did we get here? How did we build a system where life-and-death decisions are made in boardrooms, driven by spreadsheets and profit margins? And perhaps most painfully, what can we, as pharmacists, do about it?

Our profession is rooted in care. Our oath is to prioritize patients, to advocate for their health and well-being. But how can we fulfill that promise when corporate policies undermine our efforts? When decisions about medication access, treatment approvals, and network restrictions are made far beyond the pharmacy counter, how do we ensure our patients get the care they need?

The healthcare model in this country is broken. Costs are astronomical. Middlemen profit disproportionately, offering little value in return. It’s a system that cannot sustain itself, yet change feels elusive. Will this tragedy force corporations to rethink their policies? Will it inspire pharmacists to demand a stronger voice in shaping healthcare? Or will the industry double down, entrenching itself even further into practices that hurt the very people it’s supposed to help?

This story isn’t just about the loss of one life — it’s about the millions of lives impacted by a system that prioritizes profit over people. It’s about the families left in financial ruin, the patients denied critical care, and the professionals like us who are left to pick up the pieces.

I believe the words left behind — deny, delay, depose — should haunt every healthcare boardroom in America. Not because of fear, but because they represent a reckoning. The public is demanding change. And while violence is never the answer, ignoring the underlying message would be a grave mistake.

So, what do we do? We advocate. We fight for our patients. We demand transparency and accountability from the corporations that dictate so much of our healthcare landscape. Because if we don’t, who will?

Let this tragedy be a wake-up call. The system is broken — but it’s not beyond repair. And as pharmacists, we have a role to play in rebuilding it.