Luigi Mangione yells, “It’s completely out of touch and an insult to the American people, and their lived experiences,” before his hearing on Tuesday. Mirror photo by Patrick Waksmunski

Health care and health insurance officials who spoke to the Mirror on Tuesday condemned the widespread lionization of the 26-year-old man charged with killing the CEO of UnitedHealthcare on Dec. 4, in apparent retribution for what the man considers injustices perpetrated by that insurance company.

The officials, however, acknowledged widespread shortcomings in the system that alleged shooter Luigi Mangione considers to be evil.

“It’s scary, people rallying behind the guy,” said Zane Gates, a primary care physician who has been instrumental in creating local health care organizations designed to reduce or eliminate inequities in the financing and provision of health care. “It was a heinous crime.”

Still, “the health care industry is a mess. Anybody would agree to that,” said Gates, co-founder of capitation-based, primary care-plus organizations PeopleOne Health, which specializes in employee coverage, and Gloria Gates Care, which is exclusively for Medicaid recipients.

Gates and his partners have been trying to “disrupt the health care system,” said Val Mignogna, senior vice president for clinical operations at Gloria Gates Care, who has been involved with both organizations.

“(But) it’s horrific to think of solving a problem by taking someone’s life,” Mignogna said. “I’m so disturbed by that.”

The victim of the shooting, Brian Thompson, was a man with family and friends, and as a CEO, was answerable to a board of directors, investors and perhaps venture capitalists, and thus was a creature of the system, according to Mignogna.

“Everybody answers to somebody,” he said.

His company may have been among industry leaders in denying referrals for care, but the system created the “environment” in which those practices flourish, according to Mignogna.

“It’s a tough business,” he said.

Mignogna is further disturbed by online posts “demonizing” Altoona for being the place where someone alerted the authorities to Mangione’s presence Monday, leading to his arrest.

“Who wants to live in a world like that?” he asked rhetorically.

As a high school valedictorian and graduate of the University of Pennsylvania, Mangione is clearly intelligent, Mignogna said.

He’s also a member of a wealthy, influential family from Maryland, Mignogna observed.

With those advantages, he could have had a positive impact, to disrupt the existing system within the rules, as he and Gates are trying to do, he said.

Now, he will have no chance to effect such positive change, but will end up forgotten in prison, Mignogna predicted if Mangione is found guilty.

The health care system “is going in a bad direction,” said Patrick Reilly, one of Gates’ partners, whose expertise is in insurance.

There are AI programs being developed for providers that make it easier to “upcode” billing and there are opposing AI systems being developed for insurers to defeat that upcoding — and patients will be caught in the middle, Reilly said.

That is likely to create lots of additional frustration, he said.

“But I don’t condone (Mangione’s) actions, that’s for sure,” Reilly said. “Murder is bad.”

Moreover, under the current health care format, insurance companies aren’t evil, they’re just “doing what they’re allowed to do,” Reilly said.

He feels bad for the families and friends on both sides, he said.

The organizations that he, Gates and Mignogna have been involved in have extracted “80 percent of what most people use and pull it out of the insurance formula,” so professionals providing care are paid directly, he said.

The shooting was “a terrible act,” said Jonathan Ivy, associate professor of psychology at Penn State Harrisburg.

Yet it’s possible that the additional attention the shooting has focused on the health care system’s shortcomings in theory could create pressure that could lead to reform, if that pressure is maintained long enough, Ivy conceded, when questioned about that possibility.

He isn’t trying to justify the shooting, Ivy emphasized.

But there can be arguments that “the end justifies the means,” he said — without endorsing such an argument in this case.

The very possibility that such an argument could be valid speaks to the complexity of the feelings and emotions that course through society as a whole, according to Ivy.

“The common response is, ‘yes, there might be inequities, and we don’t condone violence,'” he said. “But a lot of people feel like they have no means to change this system, because it’s so big and amorphous.”

Most people agree that murder is abhorrent, but even acquaintances who are by nature “passive” have been expressing their understanding of the frustration behind the shooting, Ivy said — adding that the shooter’s motive hasn’t been definitively confirmed.

He’s not surprised by the lionization of the shooter, but he’s taken aback by the “extent and the breadth of how many aspects of society are looking at this guy like he’s a folk hero,” Ivy said.

Violence in the health care system isn’t new, Highmark spokesman Aaron Billger said in an email.

A national survey in 2023 by National Nurses United found that 82% of nurses have experienced at least one type of violent workplace incident, he wrote.

Nearly half have seen a rise in the rate of violence, he wrote.

Violent attacks against medical professionals overall grew by 63% between 2011 and 2018, according to a Bureau of Labor and Statistics study, he wrote.

Highmark has “a robust security program” across its health system and its insurance plan to combat this trend, Billger said.

The organization continuously evaluates that situation to make improvements, he wrote.

And “we are closely monitoring the circumstances surrounding the tragic killing of UnitedHealthcare’s CEO,” he added.

Highmark’s provider and insurance networks “maintain high consumer satisfaction scores,” he stated. “Keeping the best interests of our patients and members at the center of every decision” is the best way to maintain good will, he wrote.

The Mirror contacted 11 other health care-related organizations, most connected with insurance in some way, that declined to speak about the issue, or that didn’t respond.

Mirror Staff Writer William Kibler is at 814-949-7038.