On June 27, 2017, the body of 26-year-old Alec Smith was discovered in his apartment, an empty insulin pen beside him. Smith had aged out of his mother’s insurance coverage just a month earlier and couldn’t afford the $1,300 monthly cost of insulin on his restaurant manager’s salary.

Alec, like one in four people with Type 1 diabetes, had attempted to ration his insulin, an extremely dangerous gamble. For Alec, it proved deadly, and he’s not the only one [1]. Over a dozen people with Type 1 diabetes have died from 2017 to 2019 due to insulin rationing [2].

Alec’s death wasn’t caused by medication shortages, but a system that priced his survival out of reach. This is the harsh reality for many in modern America. One in ten Americans has some form of unpaid medical debt. Unsurprisingly, uninsured, lower-income households are most negatively affected, with 85% reporting difficulty affording insurance premiums [3].

Wilsonville students offer a possible solution. “I think that employers should take a little bit out of their employees’ paychecks to make sure they have healthcare,” says Brayson Roethler, a Wilsonville senior. “When you look at how much companies pay for health insurance versus how much a single person would pay, companies pay a lot less.”

But even if more people gained coverage through their employers, they’d face a different threat: having their claims denied. The insurance industry denies around one in five claims (19%) [4]. Meanwhile, they successfully lobby for laws in states like Florida and Georgia that limited their liability and made it harder for patients to sue [5].

Despite claims of financial hardship, the seven largest health insurance companies made a combined $71.3 billion in profits in 2024. Since 2010, they’ve made over $371 billion in total profits. UnitedHealthcare led the pack with $32.2 billion in profit, a $2.2 billion increase from 2023 to 2024 [6].

UnitedHealthcare’s strategy for increasing profits was simple: deny more claims. They denied 32% of claims, which is double the industry average [7]. UnitedHealthcare was able to achieve these numbers by implementing an AI with a 90% error rate that systematically denied legitimate claims.

An ongoing class action lawsuit alleges that UnitedHealthcare knew only a fraction of people would appeal their denials. According to court filings, only 0.2% of patients appealed, despite 90% of appealed cases being overturned through internal appeals or administrative law judge rulings. The lawsuit claims the company systematically denied legitimate claims, counting on the fact that most patients wouldn’t fight back [8].

With this information, some will find it unsurprising that on December 4, 2024, a 26-year-old man with past experiences with the health insurance industry named Luigi Mangione shot and killed Brian Thompson, the CEO of UnitedHealthcare. When Mangione took violent action against the CEO of such a deeply unpopular corporation, many people understood the frustration that drove him [9].

The lack of mourning for Thompson we saw both online and in person is the result of a system that prioritizes profit over people. You would be hard-pressed to find someone who hasn’t been touched by health insurance companies in some way. Whether it be personally or through family and friends, their practices are well known and widely disliked.

This was a reaction to seemingly endless injustices suffered by thousands of Americans, but the shooting of one single person was not a productive action. The murder of Thompson did not change anything, and people still suffer under the same system today. 

“It’s a hard problem to fix, it’s a result of the structure of the economy itself,” says Wilsonville senior Windsor Layne.

And she makes a realistic point. Murder wasn’t the right solution, but what is? To be honest, I don’t know. Countries like France, Switzerland, and Japan have had this figured out for years. But in this country, I see powerful lobbyists buying politicians, I see billions of dollars being traded for thousands of lives, and I see decades of failed attempts to reform a corrupt industry. 

What I can’t see is a realistic solution. Maybe I’m wrong, I hope I’m wrong. I hope there’s organizing happening that will eventually build enough pressure. I hope that eventually the deaths will become impossible to ignore. But right now, all I see is a system that kills people like Alec Smith for profit, and no alternative path forward.