“This is life or death for me.”

The couple have been married since 1991. Sarah describes her relationship with Jerry as ‘love at first sight’. Credit: Javafilms

Living in the United States, Sarah can only afford private health insurance through the support of her husband Jerry.

He says one-third of his pay goes straight to UnitedHealthcare insurance, which was supposed to cover the cost of Sarah’s treatment.

Support and sympathy

Authorities allege three words were etched on the bullet casings left behind at the scene of Thompson’s shooting: deny, defend, depose.

“We had coaching to be able to deny it [medical claims] … we would have scripts on screen explaining what to say to get them [customers] off the call, or maybe satisfy them.”

Nathalie Collins worked in the medical claims department at UnitedHealthcare for nine months. She alleges almost three months of her time at the company was spent in training. Credit: Javafilms

But it was the death of her former boss that provided the catalyst for Collins to speak out online.

The healthcare executive earned US$10.2 million ($15.8 million) in 2023, including base pay, cash and stock grants, according to The New York Times.

He now awaits further trial and a possible death sentence.

US authorities describe Brian Thompson’s death as a “premeditated, cold-blooded assassination”. But some believe, the jury is still out. Credit: Javafilms

It’s a case that has sparked public protests in support of Mangione.

While Mangione’s exact motive remains unclear, he has reportedly described the US healthcare system as “parasitic” and exploitative. He also alleges doctors postponed his spinal fusion surgery for years before he underwent the procedure in 2023.

‘Unravelling a scam’

Personal finance website Value Penguin also reported the company denied 32 per cent of insurance claims that year — a figure significantly higher than most industry averages.

“UnitedHealthcare approves and pays about 90 per cent of medical claims upon submission.”

Dr Elizabeth Potter (pictured, centre) says she is one of the last independent specialists in the Texas and services almost 40 per cent of people with breast cancer in the state. Credit: Javafilms

Breast reconstruction specialist Dr Elizabeth Potter believes insurance companies are increasingly fighting “obscene” life-threatening conditions with “technicalities and turns of phrase”.

“We’ve been paying into a system that isn’t there when we need it.”

Deny, delay, defend

The US Census Bureau reported that 92 per cent of people in the US had insurance for some or all of 2023. Yet surveys from that year have also found that up to 42 per cent of US adults with private insurance skipped medical care due to cost.

For decades, the Mangione name was associated with affluence. The family made a fortune in real estate in Baltimore’s Little Italy but have since retreated from public life. Credit: Javafilms

New York lawyer Steven Cohen has specialised in class action lawsuits against insurance companies for the past 15 years.

Medical debt is a leading cause of personal bankruptcy in the US. About 6 per cent of adults owe over US$1,000 ($1,600) and 1 per cent of the population have more than US$10,000 ($16,000) in debt due to health costs.

‘Free Luigi’ protests have been taking place across the US for months. It’s expected a crowd of supporters will gather in New York for Mangione’s 16 September court appearance. Credit: Javafilms

As Mangione prepares for his upcoming court appearance in September, his face continues to be plastered on mugs, T-shirts and flags.

“But I’ve also heard of people just giving up … not treating it and stopping treatment.”