On a cold December morning, outside a Midtown Manhattan investor conference, the routine order of corporate America was shattered by the crack of gunfire. Brian Thompson, CEO of UnitedHealthcare, had stepped through the revolving doors into the icy air, only to be met by a hooded assassin who ended his life in an instant. Within hours, grainy CCTV footage flooded news networks, capturing the cloaked figure mounting a rented city bike and vanishing into the city’s endless sprawl.

A groundswell of public sympathy for the assassin followed, revealing a profound discontent with a system that has made healthcare an instrument of capitalist accumulation. The industry, built on the commodification of human suffering, profits from the very illnesses it exacerbates, leaving millions in financial ruin or premature death. In a nation where medical debt is the leading cause of bankruptcy and the lack of health insurance claims tens of thousands of lives each year, the act was seen by many not as senseless violence but as an explosive expression of the rage that simmers beneath the surface of a society that prioritizes profit over survival.

The assassination cast sudden and intense scrutiny on the healthcare behemoth and the system it epitomizes: a system designed to extract capital from human suffering. UnitedHealthcare, the fourth-largest company in the United States, oversees the healthcare of millions from birth to death, profiting at every stage. Recent revelations exposed the company’s approval of AI systems designed explicitly to deny claims, overriding the judgments of doctors and leaving patients without critical care. One such system, with an error rate as high as 90%, was used to reject treatments for elderly patients, decisions that often resulted in untimely deaths. The capitalist system weaponizes technological advancements to extract profit, turning innovations into instruments of oppression rather than liberation. Far from advancing society, this use of AI reveals how technology under capitalism advances only the interests of capital, deepening the exploitation of the most vulnerable and reducing life to cold calculations of profit and loss.

The assassination emerged from a society steeped in violence. In America, where mass shootings and the daily erosion of social well-being have become routine, the outrage of the ruling class over this singular act reveals their deep hypocrisy. The same bourgeoisie that profits from a healthcare system designed to deny care and generate suffering now recoils in fear when violence is directed at them. Far from a random incident, this moment lays bare the crumbling foundation of a capitalist system where privatization, division, and militarization are deliberately used to fracture the proletariat – but are now faltering in the face of growing discontent.

In their panicked response, the bourgeoisie and their propagandists, who at first moralized that "murder is unacceptable under any circumstances", now expose their glaring hypocrisy by seeking the death penalty in court against the alleged assassin, wielding the very violence they claim to condemn as a tool of retribution. This is because the ruling class frames upward violence as a threat to civilization, while systemic violence against workers is normalized as necessary for economic order. The bourgeoisie cloaks their defense of property and privilege in moral outrage, masking their indifference to systemic suffering.

After World War II, the Allied powers acted decisively to suppress class antagonisms and prevent revolutionary upheaval. The construction of welfare states, including universal healthcare and social programs, was not an act of altruism but a calculated strategy to pacify the proletariat and stabilize societies on the brink of unrest. These measures sought to integrate the European working class into the mechanisms of capitalist management, as unions gradually abandoned their revolutionary charge to collaborate with the state. Once instruments of class struggle, workers’ organizations were tamed and repurposed as tools of social peace, ensuring that economic demands were addressed only within the confines of capitalist relations. In this way, proletarian struggles were co-opted into reforms designed to secure and perpetuate the existing order.

Healthcare in the US

Across the Atlantic, however, the United States charted a different course. Unlike Europe, America, as the center of the primary global imperialist power where over half of the world’s productive power was centered, could rely primarily on its surplus to create a large labor aristocracy plumping up the American middle class with high paying jobs as a fruit of its post-war ascendancy. Hence, in the USA it was never needed to set up the European and USSR style medical coverage and instead other methods, such as the ones listed earlier were used to ensure labor peace, while forcing workers to be tied to their jobs in order to be able to have any kind of medical coverage, bypassing the system of taxation that would have otherwise been required to finance medicine.

The United States did also have its own welfare model in the face of the FDR “New Deal” and LBJ’s welfare and housing programs, which play the role of increasing labor peace but the American capitalist class did not aim to achieve full medical programs "Medicare for All" is one contemporary proposed reform legislation that is advertised as being able to create a government-run health plan covering everyone for doctor visits, hospitals, prescriptions, dental, and more, with no extra bills – paid through taxes, not private insurance, ensuring care for all without denials or networks. Any hope that the left of capital has to be able to achieve such a reform through programs such as Medicare for All are more than doomed in a period of declining profit rates as well which ensures the economic futility of the proposals of the capitalist left.

Another limited expansion of a medical welfare program was the Affordable Care Act(ACA), also known as “Obamacare”.. Since the passage of this bill the number of uninsured has decreased but, of the ones on Obamacare, 18% of claims were still denied and some of the plans based on ACA denied up to 80% of claims. At the same time, since the introduction of ACA a decade ago insurers, be they as a part of the program or not, have amassed $371 billion in profits, with UnitedHealth Group alone claiming 40% of those profit numbers and denying nearly one-third of claims, which is the highest denial rate for that industry. Revenues have soared since the number of uninsured has decreased as a result of tax funded ACA subsidies, mandates, and consolidation but also by increased prices for premiums, which have surged 52% since 2014, hitting $26,000 annually for working and middle class families, while CEO pay for the top insurers reached $75 million in 2023.

As a part of the trend of denying coverage in more cases, health insurers like UnitedHealthcare and Humana have been using AI tools such as nH Predict, to deny claims for elderly patients, which are reported to make errors often. With or without these high error rates, their aim is, amongst other things, to analyze patient data to predict necessary care durations, which are one of the many ways in which care can be denied, if the patient requires time to heal, for example, which can lead to premature termination of coverage and result in medical debt for patients or worse can result in a procedure not being done and even loss of life.

The U.S. private healthcare system capitalizes on human suffering as another opportunity for profit by performing what is essentially an extortion racket for procedures that can be denied based on technicalities while also, at the same time, allowing for pharmaceutical companies and “care providers” to jack up prices on important and sometimes life-saving procedures and medicines, causing many workers to go without, accumulate debt, not seek out care or suffer greater mortality. Hospitals, insurance corporations, and pharmaceutical giants operate as monopolistic gatekeepers, extracting wealth from workers while denying them care any time they can according to their own bureaucratic rules. Employer-tied health benefits further reinforce dependency, tethering survival to labor and increasing anxiety around organizing to fight the boss. Health benefits become tools of worker control, incentivizing dependence on employers and discouraging risk taking behavior through organizing, lest coverage be lost.

Bourgeois Justice and Blood Drenched Profits

The unwillingness and inability of both wings of capital to successfully deal with the medical question is palpable and with this in the background Luigi Mangione’s actions are being denounced by the bourgeois press as despicable, an effort to render him contemptible in the eyes of the public. The denunciation occurs alongside an implicit acknowledgment of his widespread popularity, evidenced by social media metrics such as likes and upvotes, which showed his immense popularity amongst the masses of social media platform users, a majority of which are workers.

Luigi Mangione comes from a family of fairly wealthy business owners, a member of the petit-bourgeoisie who, through his own experience of being denied coverage chose to take upon himself an act of terror against the figurehead of one of the most extortionate of the businesses within the insurance racket. His denial of coverage is what makes him relatable despite his wealth and privilege, because his experience is one that he shares with many working and middle class people, who have either experienced this directly or seen it second hand. This relatability combined with the fact that capitalist “justice” system is so incapable of bringing justice to those suffering from preventable medical calamities that it leads to such extremist direct action makes him a sympathetic figure and the bourgeois press and class out of touch and out of step with reality by comparison. Capitalist “justice” is not capable of dealing with the far greater crime of “social murder” as Engels called it, and few can find much fault with Mangione’s actions despite the formality of their criminality.

The media spectacle surrounding his trial transforms the event into an absurd display, with excessive police presence parading the accused to and from the courthouse more as a theatrical warning to others than as a measured application of “justice” in the bourgeois sense. In the face of the impotency and conscious maneuvering of both the capitalist left and right to deal with this issue the unconscious and semi-conscious workers are left to think of what other options are on the table since bourgeois rule fails them.

If excruciating back pain and claim denials are capable of driving an otherwise healthy and even wealthy man to commit terrorism against a leader of capital then it stands to reason that it can also drive a less fortunate and less individualist and fatalist and more class conscious individual to organize for the proletarian revolution with the International Communist Party, through propaganda work, direct action in transmitting its tactics and doctrine through the transmission belt of militant union struggle, etc as a prelude to the overthrow of that same decrepit capitalist system that produced the CEO of UnitedHealthcare. The time will also come when the next Red Terror is necessary for the suppression of the counter-revolution, though it is too soon to speak of this at this stage.

While the capitalist judicial system will likely attempt to make an example of someone like him, we must be clear that such desperate and tragic individualist acts are little more than another expression of the suffering at the hands of the prevailing social crisis but in of themselves do little to change the balance of power, instead it distracts the masses from the collective and concerted action necessary to coerce our enormous foe Capital, of which it’s individual servants are always replaceable cogs doing it’s bidding.

The False Recourse to Terrorism

Comrade Lenin wrote on this matter in his 1902 paper “Revolutionary Adventurism”, as did comrade Trotski in 1920 in "Terrorism and Communism".. Lenin criticized the Socialist-Revolutionaries’ idea of "excitative terrorism", which relies on isolated acts of violence by individuals to inspire mass struggle because such acts only create short-lived sensations, leading to apathy and passive reliance on future "heroes". The SR was a poorly organized and theoretically weak mostly petit-bourgeoisie party that, amongst other things, promoted excitatory terrorist acts, which they considered to be "big work", and prioritized it over trade union work, mass organizing demonstrations, which they dismissed as "petty work". Lenin correctly indicated this is a form of political adventurism born from a lack of firm principles.

Trotski, in turn, saw individualist terrorism as isolated and historically purposeless and the Red Terror as a powerful systematic tool of the ascending victorious proletariat to consolidate power, eliminate the remaining bourgeois elements of resistance, accelerating their demise effectively versus the aimless random acts of violence or the coordinated violence of the Tsar and whites, a class violence of a class which is falling out of favor.

CEO’s are easy to replace but the system that births them cannot be replaced by individual acts of terror. Only a genuine proletarian uprising leading to revolutionary war with the ruling capitalist class, and on an international scale (involving multiple of the largest most developed capitalist nations) at that, will be able to finally put this mode of production and broken system to an end. Individual acts of terror of this ilk may catch the imagination of the working class for a few days or weeks but they will never destroy capitalism, so wasting our energies on promoting this type of propaganda without clarifying exactly where and how it falls short is not something we will ever allow ourselves to engage in.

The anger that the working and even middle classes feel at the inadequacies of the healthcare system are not to be ignored but we should also differentiate the motivations of each of these social strata. The working class finds itself in the position of having to struggle at the workplace to even gain paid benefits or gain enough pay to purchase this insurance at the market rates for their income level. Labor aristocrats and small business owners find themselves paying ever higher prices for insurance that covers ever less and are likely the ones that will end up paying the taxes, should a “for all” version of healthcare ever pass. In one case, workers find themselves fighting ever harder to even get the minimum, while in the other, the middle classes find themselves being proletarianized and getting worse coverage with time.

Capital’s Real Terror: A Well Organized Class Union

We recommend workers, who are affected by these conditions to organize at their workplaces in existing unions while forming militant caucuses within them, demanding large monetary increases in pay. These combative bodies are the “transmission belt” of the party, so there will of course be intermingling between militant unionists those who are in and out of the party as this is an important part of achieving the transmission of the doctrine from the party to the class.

In a country like the United States, with the extortionate pricing for medication and basic services, the only way to get quality healthcare is to have enough money to cover the gaps of the already overly expensive insurance, so demanding such pay increases is partially also a a demand for access to healthcare and one that can be met immediately, while also intensifying the class struggle and preparing the ground for further militancy: class consciousness and the potential for ever stronger organization. It is indeed only one tactic, part of a larger strategy of class unionism that our party promotes and fights for as a vibrant militant alternative to lone wolf acts of supposedly anti-capitalist terror, and one strategy that will bear much more frightful fruits for the oppressed in the future.