Healthcare System on Trial

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He knew exactly what he was doing There was no hesitation insside the case of Luigi Mangioni accused in the brazen murder of healthcare CEO Brian Thompson. Brian was a lifelong friend. He was a wonderful person, a great father, a close friend to the victim, and two detectives involved in the manhunt speaking out for the first time. There's a lot of urgency. This guy took somebody's life. He's dangerous. When he lowered the mask That's when we were like, Ohh, we got something here. and the eyebrows were quite distinguishing. They looked like the CEO shooter peopleople were trying to learn who this person was. This was like an all American boy. They walked in the door and all the girls turned their head. The Luig I met that night wouldn't be capable of what he's accused of. This was targeted. He allegedly had writings about health care. I cannot understand how this person is seen as a hero. What does this say Violence is being celebrated. What does that say about our country A N notorious murder here on the streets of New York sparking both fury and fascination. New details and where the case might go from here I'm Lester Holt, and this is Dateline. Here is a killing in midtown Prereda and darkness of december fourth, twenty twenty four on the mostly empty Manhattan streets One man was up and ready for what was sure to be a busy day No shock to me that Brian was up in the first one arriving at that hotel Brian Thompson, the CEO of United Healthcare, was walking into this Hilton hotel for the company's annual Investors confference Jeff Alter is his friend and former colleague. in your industries, this is a big game. It's really our one opportunity to show who we are and what we're planning on doing in the upcoming year Jeff says the all day conference required months of preparation. Brian likely would have been working late the night before I knew how tough those days were and I had texted Brian from the train, you know, good luck today. So you texted him a note of encouragement. Yeah. Did he respond He didn't What his friend didn't know was that someone else had also been preparing for this day Brian was walking into a trap Did he sense the man approaching In a flash of violence, the paths of these two strangers intersected The mask manan fired three shots before fleeing. Leaving Brian to die on the sidewalk. Breaking news, a shooting in midtown. fifty year old Brian Thompson was shot multiple times Detective still on the scene. The response was immediate and intense. Police searching for that brazen gunman A shooting in midtown, Manhattan victim, a prominent businessman gunman on the loose I was still on the train and I was getting texts from former colleagues at first just saying I can't believe what happened to Brian My first inclination was Did he get sexed he Did he get fired? then he read the headlines. Just devastated Yeah know, I feel it. He was in the wrong place, the wrong time, mayaybe it got mugged or something like that Police quickly had a different take wasas your initial hunch targeted one hundred percent. Detective Sergeant John Griffin, now retired, was the senior sergeant of the NYPD's major K squad at the time This is his first interview about the investigation He says the NYPD accessed that security video of the murder almost immediately Told a story He stepped out from behind the SUV, knew exactly what he was doing. There was no hesitation. C clicks waiting for the victim This wasn't a muggking that led to the shooting. No It is very similar to a lot of narcotics related homicides that we've dealt with which can be targeted Absolutely This is in the NYPD's wheelhouse. This is what we do We have a crime scene unit that comes out. They have to take photos of everything. They have to block things off retired NYPD detective Joe Mitsopolis was on the team that worked the case trying to figure out who would target the fifty year old father of two from Minnesota You start widening your canvas. And a canvas is basically checking the area for evidence. No evidence would be shellcasings, there would be cameras, there wouldd be witnesses, that kind of stuff. That initial canvas made clear that the murderer Brian Thompson had nothing to do with his personal life. The motive was right here on the sidewalk twow spent bullet shells, a third unfired round each inscribe with a different word, delay, depose, deny I was like, whoa It's not just a shooting. on street Lorena O'Neill is a contributing writer at Rolling Stone. She has been reporting on the case from the beginning Starting with the story told by those three words. Which are words that are commonly used to criticize how the health insurance industry handles claims. It's suggesting at the pattern that they typically change. Right It was the first important clue for investigators? It definitely meant it was targeted. It definitely meant that it probably had some sort of a relation to the health care system The murder instantly transformed into something much bigger national venting of anger and frustration over the healthcare system. This was a man, this was a father of two, but in the discourse, he's being dehumanized. I think what ended up happening is the victim became the villain He has become a symbol as did Luig Man Giioni Tonight, we have new insights into the two men at the center of it all. He was very proud of where he came from. veryery humble I really think that the Luigi I met that night was still a normal person that wouldn't be capable of what he's accused of. I think millions of people see some of themselves in Mangioni, and that's why they love him so much We'll take an exclusive look inside the manhunt. Sometimes the best thing to do is go backwards. You were following a trail the opposite direction. Right. and try to answer the central question. This might have set the collision chorus of these two men in motion. That's a million dollar question, right United Healthcare CEO Brian Thompson had been gunned down on the street in Manhattan. Now the NYPD was hunting for a killer. What did you fear might happen if you didn't get the shooter in custody quickly? A lot of people thought that There might be more to come. And almost immediately, it was clear this was no normal murder case. Online sympathy was not with the victim. Of course people have no sympathy for the CEO of United Healthcaare. They're tired of CEO's making millions of dollars while their family members were not being taken care of properly. I don't think anyone should feel bad about this. Social media is fast and cruel hosting smiley faces that Somebody was murdered It's just beyond me Cruel is the word used. Really cruel for people who knew Brian Jeff Alter is the first person in Brian Thompson's inner circle to speak publicly about the case He wants people to know more about the man he got to know over some twenty years man who rose to corporate CEO small town kids. I have a farm boy. was that something he wore as a badge of honor Yes, He was very proud of where he came from, very humble particularly proud of his father, a hard wororking farmer even at the end of a long tough day, gave back to his town. Brian was valedictorian in high school and at the University of Iowa, where he studied business administration and accounting full scholarship. He married his high school sweetheart. She joined a prestigious corporate accounting firm in Minneapolis And the couple had two boys. In two thousand four, he moved over to United Healthcare, also in Minnesota Iowa still tugging at his sleeve He wanted to be all things for all people I think he thought that this was a wonderful opportunity for him to better the life of his children when he'd ask me, is he doing the right thing for his children Should they move back Brian was on a fast track to the top Was he the kind of guy that people looked at and said he's going to be CEO someday? We'd all say, yeah, he could be Brian did become CEO of United Healthcare in twenty twenty one. Hi, I'm Brian Thoppson. Here he is making a presentation at a healthcare leadership forum. Our mission and values are focused on helping people live healthier lives. And making the health system work better for everyone behind me. In just two years as CEO, he aggressively expanded the company biggest health inssurer in the country, covering nearly fifty million people Even as the company faced criticism for patient coverage Profits rose more than thirty percent. over sixteen billion dollars We're thrill to be the presenting sponsors. Brian also engaged in philanthropy and was named an honorary co chair of the Special Olympics he was beyond Just being a super smart driven person. he was a great person to be around The investors confference was another chance to boost the company Brian didn't make it there. And now, his killer was on the run Were you afraid you had lost him at that point No, we just hadn't found him He's there. We're gonna find something Investigators studied clues from the scene, those inscribed cartridges, and that CCTV video of the murder What do you know about the weapon that he used? We could tell right away that it was some sort of a semi automatic. It had something on the front, either like a homemade suppressor or a silencer type of thing. Was that a common thing that you uncover people with silencers? No twenty five years, I don't think I've ever actually encountered a silencer before that From the get go, tips flooded in Major case squad detective Joe Mitsopolis ran down some of the three hundred plus leads. They varied in, hey, that's my next door neighbor or this person has a vendetta against the health care system We had Tons of those. The FBI helped out with a lot of the out of state tips because we were getting tips from all over the country Do you remember anything in particular that spin out to you. There's one that I remembered where it was a families young child had died waiting for authorization for some sort of treatment. Others where a spouse had passed away Treatment was either denied or deemed not necessary They were horrible to read These people were fingering someone who they thought had a big enough of a grudge. Usually to commit violence. Yeah. When they were legitimate tips, you had to make sure that that person wasn't here in New York when this happened. those tips didn't lead anywhere Something else did. You can't be on guard twenty forty seven. There's gonna be little slip ups. 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How will you celebrate America's two hundred and fiftieth birthday with a perfect night's sleep Enjoy huge savings at the SRa july fourth sales event Save up to six hundred dollars hundred on CERDA Perfect SleeperX mattresses and adjustable base sets with the Q four support system that helps relieve aches and back pain. Limited time offer Visit aerta retailer today Perfect sleeper Perfect sleep, night after night Before detectives trying to track down Brian Thompson's killer, their most powerful investigative tool was practically staring them in the face. insside, taxi cabs, trains, buses, and on the streets So we're actually not far from the shooting, but we're at a different intersection in Manhattan right now. and we're being observed all over us everywhere. Cameras. Yep. John Griffin took us onto Manhattan streets and showed us how the NYPD built a video timeline of the manhunt. So that's controlled by the New York City police. Correct. And any detective can get that from their desk. So something happens here In case detector's going to look at that camera from his desk and figure out where you went And then they're going to go back and they're going to find all these buildings down here down here that have video And where they lose you, they're going go to those videos and try to pick you up and they're just gonna keep going. They they keep laying in the pieces? It's gonna keep going forward, forward, forward And there's almost nowhere to hide in the city Luster I remember us reviewing tons of the cameras that are always on the corners like that, just following you know, for A little bit of a second of all it captured and then it led to another block and then to another block As investigators search for the shooter, they did something that sounds counterintuitive Most people want to look forward, where did the guy go? How did he get away? Let's find him. an investigation, sometimes the best thing to do is go backwards You were following a trail the opposite direction, Right for the days before the murder. Somebody commits a crime and they just want to get out of there, and they'll do whatever they can not to be tracked Sometimes the twelve hours before that, they may not be thinking about the crime and you can't be on guard twenty four seven, There's gonna be little slip ups. But that's what you count on is the slip up. Exactly Here is the shooter before the murder, emerging from a subway station and pacing what would become the crime scene Investigators tracked him backwards, camera by camera to a Starbucks and to a hostel on Manhattan's upper west side And that's where the slip up happens A camera captured an image of a suspect with his mask lowered exposing his face. that was the one who was smiling. That's when we were like, Ohh, we got something here and's run Authorities say these clear photos are of a person of interest taken at the hostel They also got a name The suspect had checked into the hostel as Mark Rosario To find this Mark Rosarioell, they went back to a daisy chain of video clips taken after the murder Tacking his escape There was some really good, interesting video of him as he left the scene And then the bike up north into Central Park Cameras don't capture the whole of Central Park, about two and a half miles long But experienced investigators soon picked up the trail eventually tracked him up into northern Manhattan. So he abandons the bike at some point. Yeah. The last place that we had video of him was up near the Port Authority bus terminal by the GW brridge Then it was like, all right, well what are we going to do now? Where do we get to the end bin? That's where we wanted But his trail went cold Days tick by, and online, his support was growing. Activists set up a legal defense fund for the unnamed suspect. When did you first become aware that this figure was becoming Something of a folk hero There was some talk of that from right in the beginning How did you react to it, though, that people would think of him as a dogutter as opposed to a murder suspect It didn't sit well NYPD detectives routinely look at people that die either from homicides or accidents on the street And you see the fragility of life cannot sanctify somebody who does this and make them a hero. Five days after the murder, Brian Thompson's family and friends gathered under heavy guard at a church in Minnesota. It was a private invitation only funeral Jeff Alter couldn't be there. but says he's heart broke for Brian's family his wife, his children, his mother is who had just lost her husband not too long before that. Now she's losing one of her sons The law enforcement presence included a sniper on the roof, a recognition of a public sentiment surrounding Brian's murder There's also a reminder that the suspect was still out there for a law. You looked like the CEO shooter your. An arrest was coming along with a fascination about how this young man ended up accused of murder. So he walked in the door all of a sudden all the girls like, you know, turned their head looked at him. Like, Who's this new guy? Byrian Thompson's family was laying him to rest on that same day thousandousand miles away What is the address of your emergency? The manager of a McDonald's in Altona, Pennsylvania called nine hundred and eleven. It's not really an emergency. I have a customer here that some other customers were suspicious of A young man was eating breakfast alone. He looked like the CEO here fromor. A patrol unit arrived. Two officers approached with body cams rolling. Someone called I thought you were suspicious. Oh. Sould drive the un? Yes One officer took the ID and stepped away to call it in. He's got a driver's license and says for Zaria. And I'm like, New Jersey driver's license The name on the ID matched the name of the man who dropped his mask at that Manhattan hostel. But officers on the scene suspected it was a fake ID and pressed him for his real name, which he told them, Luigi Manioni He was arrested and extradited to New York spectacle of his arrival by helicopter, escorted by the mayor and a phalanx of law enforcement only intensifying the public's infatuation. Free Luigi Beautiful eybrows. They didn't know that America was gonna be rooting for the assassin, right They got to give the people what they want, right? try, but I cannot understand how this person is seen as a hero I try not to But I lose some faith in humanity We've all been trying to figure out who Luigi Menioni really is. Are you getting any closer? I've been working on it for about a year and I still don't know that I have everything Lorena O'Neill has interviewed more than thirty sources, family members, friends, and law enforcement trying to untangle Mangioni's life And she shared her reporting with us from everything that I've heard about him From his friends and family, he was just a friendly guy who didn't stand out as controversial or troubled or anything like that. He wasn't the stereotypical. Oh, he was quiet and kept to himself. He engaged people. No, he wasn't an outsider. He was social. He had friends. She learned that unlike Brian Thompson, Mangioni was born into a life of wealth and privilege. His family owned businesses, including a country club assisted living facilities and a radio station Aione was raised in suburban Baltimore The youngest of three The teachers I spoke with at Gilman were saying we always thought he'd end up making some scientific discovery or some technological advance for society. You mentioned Gilman. this is el leadite high school. very elite high school. Within the people that went to Gilman, he was known to be amongst the smartest. And Mangioni had something in common with Brian Thompson He was valatorian of his class It's been an incredible journey. And I simply can't imagine the last few years find any other group of guys Thank you Renioni got an Ivy League education in computer science and engineering In twenty twenty two, he relocated to Hawaii s moving in with a techy co living community called Surfbreak and worked as a data engineer for an online car marketplace. He was working remotely By all accounts, he was a very outdoorsy person and he enjoyed the lifestyle in Hawaii that he could have as a community of digital nomads He spilled his life out online Under the mrter Cactus Reddit handle widely believed to be his, there were posts about gaming and travel And aboutbout his health He was also at the time suffering with some kind of back ailment Yes, he had been complaining of back problems ever since he was in middle school And it seemed to get worse when he was in Hawai This post said, It went bad to the point where I felt it every day. I train in India, I train in a little yoga therapy. G good dealing with people with injuries Dorian Wright teaches yoga in Honolula I remember when Luigi came in because he's a good looking guy So he walksed in the door all of a suden the girls like, you know, turned their head looked at him, likeike whoo's this new guy? He said, Hey, my name's Luji. I said, Oh, nice to meet you. I'll take care of you. You know, he's such a mystery to so many people. What was your impression? Just a normal guy, like a normal young happappy, you know, kind a great smile Nothing out of the ordinary. Was he making friends Yeah, I heard he made a lot of friends. I know he was on Tinder because he matched up with one of our yoga teachers istorian says he worked with Menioni off and on for about a year How was his back? Was he improving Definitely. Yeah. He felt great. He said he felt way better after he did a class with me But as helpful as the yoga was, Manciioni's back problems didn't go away In the summer of twenty twenty three, he quit his job and traveled home for surgery to fuse two vertebrae posting X ray images of spinal scaffolders surgery seem to be a success Post said a week later He was on literally zero pain meds and was able to sit, walk, and stand for as long as he wanted Did he ever in your presence mention healthca? No, he never mentioned healthcare healthcare doesn't seem to add up No, because he came from a wealthy family And I also heard like he was able to pay his health bills. so it doesn't make sense What's his political ideology? His family, I would say, leaned conservative as far as Mangioni She His political views were a little bit more all over the map. I would say he seems to be more of a centrist And he seemed to, from some people that I've spoken with, be a fan of RFK Jr. While in Hawaii, Mangioni also helped start a book club. Manioni is an avid reader. He analyzes the books that he reads, he talks about them a lot One of the books taken up by the club was the Unobomber Ted Kosinsky's Mifesto provocative text challenging our corporate industrial society There were some initial reports that the book Club was disbanded after they read the Unibombers mananifesto. And what my reporting has shown is no it just kind of faded away. It wasn't like this big fight at the book cllub. One of the book club members I spoke with said, honestly, it was just an excuse to watch the sunset. This story seems to really confirm the same frustration that we keep hearing over and over again trying to find something at least helps us understand who he is as a suspect and potentially kill Right. And I think that people can go back into his life and say, okay, it was this It was the back pain. It was Ted Kazyinski I have found that people sort of use him as a Rars shark test for what they feel like is happening in the world If what was happening in Mangioni's mind is a mystery Maybe these handwritten notes hold a clue He says, it had to be done Frankly, these parasites simply had it coming. Running a business is hard enough, so why make it harder with a dozen different apps that don't talk to each other? Introducing OdDu, the only business software you'll ever need. 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This july fourth, save up to six hundred dollars hundred on SRDA Perfect SleeperX mattresses and adjustable base sets with a Q four support system that helps relieve aches and back pain. Visit A SRDA retailer today In early twenty twenty four, the investors confonference that would bring Brian Thompson to New York was many months away. halfway around the world, Luigi Mangioni decided to go from digital nomad to just no m He had told a friend he wanted to get away for a little bit. He was in Japan, he was in Thailand, and he was in India. He said he was just traveling. Christian Zucchini is a pro soccer player in Thailand. In mid twenty twenty four, he was with a friend in a bar in Bangkok When Man Gioni heard them speaking English and struck up a conversation My initial impression was that he's just a backpacker going through Asia. As they chattered over beers that evening, he says they touched on computer games, the volcanoes in Hawaii Healthca in Thailand I told them a story about how I went to the hospital to get a MRI and an x ray, and I had zero insurance. And after I go get the bill, it was about one hundred eighty dollars and he couldn't believe it. So That's what kind of sparked the conversation about health insurance in the US He says Mangioni had opinions about America's for profit system The way he spoke about the healthcare system is the same way anyone I meet that's living abroad speaks about it, honestly, including myself. The healthcare system in the US is different than other countries in a not a good way Nothing he said seemed angry or resentful. From Thailand, Mangjioni went to Japan where he told an acquaintance he wanted to Zen out. He ventured to the remote mountainous Nara region, popular with people seeking spiritual enlightenment and solitude So he's in Asia, he's not as communicative as he had been. What was he doing He was reaching out to bloggers and authors who spoke about political tribalism asking, how can we build community? How can we create more discourse? How can we connect? Would it be overstatement to say he was becoming a bit of an activist? I don't know if I would say activist, but I do think he was perhaps seeking a solution to a problem that he saw. I've heard all kinds of theories like, you know, he's in Thailand, he got radicalized, all these things I have no idea. Everyone's talking about it, though Everybodysed a million dollar question, right? In August, the twenty six year old Mangione flew back to Hawaii packed up his life there and made his way to San Francisco. That is the time when he started to go And when you say go dark, you mean in terms of his ideologies or we're dark in terms of we haven't heard from him. Go dark in terms of we haven't really heard from him. He does make a bank withdrawal in San Francisco in August. And then after the end of August, we do not know where he is. Some of his friends have told me that his family was reaching out to them. in the fall, saying, Have you heard from Luigi? We've lost touch with him. We don't know where he is His mother files missing persersons report in November Clues to what Manioni might have been doing in those months come from this red notebook. Police found in his backpack when he was arrested It contains dated handwritten entries What are some of the things in here that you think may represent major flags I think it's interesting to look at this excerpt from august fifteenth that says the details are finally coming together. I don't feel any doubt about whether it's right or justified. I'm glad in a way that I procrastinated because it allowed me to learn more about UHC. So this is where we see UHC specifically named Around the time of Mangioni's writings, United Healthcare faced a wave of negative publicity crriticized for high claim denials while profits were increasing The company tells Dateline its rate of denials is substantially lower than what's been reported Mangioni doesn't specify what he learned about United Healthcare, but prosecutors say the writings reference the company's upcoming investors conference He says, What do you do? you whack the CEO at the annual Parasitic Beancounter Convention. It's targeted, precise and doesn't risk innocence. Most importantly, the point becomes self evident. It's pretty chilling It is A few weeks later, CEO Brian Thompson was murdered and Mangioni was under arrest I mean, I was shocked. I was like He didn't seem like kind of guy would do something like that. The Luigi I met that night was still a normal person that wouldn't be capable of what he's accused of There is eight months to where the murder happened, so I don't know what happened after. How Luigi Mangioni might have changed from regular guy to what prosecutors describe as a brazen killer is a question Mangioni himself seemed to anticipate in his backpack, along with the entries from the red notebook, invvestigators found additional writings. exing a note addressed to them. Okay, this is the letter to the fed. Yes The note, to the Feds, contains what prosecutors describe as a confession to the FBI Mangioni writes to save you a lengthy investigation. I state plainly I wasn't working with anyone He says, it had to be done Frankly, these parasites simply had it coming And he says, evidently, I'm the first to face it with such brutal honesty Other notes found in the backpack appear to show he was thinking about ways to elude authorities. Some of these writings also could be interpreted as a checklist kind of things to do. Yes. I believe there was one that says pluck eyebrows and buy trash bags. He also talks about breaking camera continuity And he says, keepe momentum FBI slower overnight He talks about changing his shoes. He talks about getting a hot meal. He talks about buying batteries Fangioni also writes about the unibomber Ted Kazinsk are too violent If you're seen as a terrorist The message will be dismissed. And so he seems to be grappling with how do I get a message across United Healthcaare says Mangioni was never insured by the company, and there's nothing in his writings that mentions Brian Thompson by name The writings do suggest he considered other options before prosecutors say he targeted Health carere CEO He does refer to KMD or RMD would have been an unjustified catastrophe and tal a person or a company? I really don't know What's clear from this is, he says, the target is insurance, it checks every box Mangioni will face a jury of his peers later this year. But there are those who believe he is not the one who should be on trial. this should be two conversations. The state of the healthcare industry The murder of an innocent man should be its own conversation I think tens of millions of Americans don't find Brian Thompson or his ilk to be innocent of anything Giigi Mangioni is awaiting trial for federal stalking charges and state murder charges for the killing of Brian Thompson He pleaded not guilty to all of them and has spent the last year and a half in a detention center in Brooklyn, where his attorneys say he has been inundated with mail supportort coming from all over the world I think millions of people see some of themselves in Mangione and that's why they love him so much. He was accused of murder Millions of Americans wouldn't call it a murder They would call it something else entirely Sam Beard, a healthcare activist and co host of the Party Girls podcast helped establish that legal defense fund for Brian Thompson's killer before Mangioni was arrested The fund now sits at more than one and a half million dollars Americans are disgusted with the way that these parasitic health insurance corporations have inserted themselves between everybody that they love and their path to wellness, This feels like this should be two conversations, like the conversation you're having right now about state of the health carere industry The murder of an innocent man walking down the street should be its own conversation I think tens of millions of Americans don't find Brian Thompson or his ilk to be innocent of anything. You think that he deserved to be murdered on the street You know, when we when when when when once You know, he was at the helm of the largest private health insurance corporation that the world had ever seen. But did that make him worthy of being murdered I don't think that I can answer that question, but millions of people around the country seem to feel that way It's interesting how so many conversations about Maniani end up in a place where, well, I don't justify killing. I don't support anybody killing It's that butt, that butt you hear all of the time. When I'm speaking to people, they will say, off course, I don't condone violence. I am against murder I can understand why somebody would be upset at the health carere insurance industry and that butt. is what fueled the discourse after Brian Thompson's murder. Have you been at all surprised by the level of frustration? This is on court. No, because I hear the frustration every day in my job doctor Elizabeth Rosenthal is a best selling author and journalist who has written about the American health carere industry for thirty years. She's currently the senior contributing editor at KFF Health News, a national nonprofit news organization focused on healthcare She is also mentioned by name in Luigi Mangioni's writings as someone who has illuminated the corruption and greed of a healthcare system. To be clear, you don't consider himself an ally of him. No, no, no, of course not. He could mention me. he could mention a lot of other people who've written about this. You have said the system isn't broken, that it's actually acting as it was designed. What do you mean by that? Well, our healthcare system has in my lifetime changed from a system that was devoted to caring to a system that's devoted to profit and to maintaining itself. These are big businesses and That's what matters the most. And she says that by many measures, our for profit system is failing patience Everyone wants to blame someone or one part of the system And it's not any one part It's like a circular firing spot. We knew we disappointed people And we knew probably a lot of times we were unfairly criticized for the role that that You know, unfortunately, our U S. healthcare system puts the payers in Despite the criticism of their industry, Jeff says that among his colleagues Brian Thompson had a reputation as a caring conscientious executive It was always very mindful that at the end of everything that we did was a person and that person