Tonight on Dateline.
He stepped out from behind the SUV.
He knew exactly what he was doing.
There was no hesitation.
Inside the case of Luigi Mangione, 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 of 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, oh, we got something here.
The eyebrows were quite distinguishing.
He looks like the CEO shooter.
People 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 Luigi I met that night wouldn't be capable of what he's accused of.
This was targeted.
He allegedly had writings about healthcare.
I cannot understand how this person is seen as a hero.
What does this say if violence is being celebrated?
What does that say about our country?
A 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.
In the predawn darkness of December 4th 2024, 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 and 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 conference.
Jeff Alter is his friend and former colleague.
In your industry, 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 and 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?
Yep.
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 masked man fired three shots before fleeing, leaving Brian to die on the sidewalk.
Breaking news, a shooting in Midtown.
50-year-old Brian Thompson was shot multiple times.
Detectives still on the scene.
The response was immediate and intense.
Police searching for that brazen gunman.
A shooting in Midtown Manhattan.
The victim, a prominent businessman and a 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 sick?
Did he get fired?
Then he read the headlines.
Just devastated.
You know, I thought he was in the wrong place at the wrong time, maybe got mugged or something like that.
But police quickly had a different take.
Was your initial hunch targeted?
Yeah, 100%.
Detective Sergeant John Griffin, now retired, was the senior sergeant of the NYPD's major case 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, and it told a story.
We stepped out from behind the SUV, knew exactly what he was doing.
There was no hesitation.
It looked like he was waiting for the victim.
This wasn't a mugging that led to a shooting?
No.
But 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.
You 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 Mitsopoulos was on the team that worked the case, trying to figure out who would target the 50-year-old father of two from Minnesota.
You start widening your canvas, and a canvas is basically checking the area for evidence.
Now, evidence would be shell casings, there would be cameras, there'd be witnesses, that kind of stuff.
That initial canvas made clear that the murder of Brian Thompson had nothing to do with his personal life.
The motive was right here on the sidewalk.
Two spent bullet shells, a third unfired round, each inscribed with a different word.
Delay.
Depose.
Deny.
I was like, whoa.
Okay.
Okay.
It's not just a shooting on the 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 the pattern that they typically take.
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 a 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 Luigi Mangione.
Tonight, we have new insights into the two men at the center of it all.
He was very proud of where he came from, very 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 Mangione 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, but the opposite direction.
Right.
And try to answer the central question what might have set the collision course of these two men in motion?
That's the million dollar question, right?
UnitedHealthcare CEO Brian Thompson had been gunned down on the street in Manhattan.
And 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 UnitedHealthcare.
They're tired of CEOs making millions of dollars while their family members are not being taken care of properly.
I don't think anyone should feel bad about this.
Social media is fast and cruel.
People posting smiley faces that somebody was murdered.
It's just beyond me.
Cruel is the word you used.
Really cruel.
Yeah.
Particularly 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 20 years, a man who rose to corporate CEO from small town kid.
Iowa 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 hardworking farmer who 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 on a full scholarship.
He married his high school sweetheart, joined a prestigious corporate accounting firm in Minneapolis, and the couple had two boys.
In 2004, he moved over to UnitedHealthcare, 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.
And he'd ask me, is he doing the right thing for his children?
Should they move back?
But 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 2021.
Hi, I'm Brian Thompson.
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.
In just two years as CEO, he aggressively expanded the company, the biggest health insurer in the country, covering nearly 50 million people.
Even as the company faced criticism for patient coverage, profits rose more than 30 to over 16 billion.
We're thrilled 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' conference was another chance to boost the company.
But 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 silencer type of thing.
Is that a common thing that you uncover people with silencers?
No.
25 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 Mitsopoulos ran down some of the 300-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 any in particular that stood out to you?
There's one that I remember, where it was a family's young child had died waiting for authorization for some sort of treatment.
Others where a spouse had passed away and 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 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, but something else did.
You can't be on guard 24-7.
There's gonna be little slip-ups.
But that's what you count on, is the slip-up.
Exactly.
Before detectives tried to track down Brian Thompson's killer, their most powerful investigative tool was practically staring them in the face inside taxicabs 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.
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 if something happens here...
The 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 to go to those videos and try to pick you up and they're just going to keep going.
So you keep laying in the pieces?
Just going to keep going forward forward forward, and there's almost nowhere to hide in the city Lester.
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.
For an investigation, sometimes the best thing to do is go backwards.
So you were following a trail, but 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 12 hours before that they may not be thinking about the crime and you can't be on guard 24-7.
There's going to 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 happened.
A camera captured an image of the suspect with his mask lowered, exposing his face.
That was the one where he was smiling.
That's when we were like, oh, we got something here to run with.
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 Rosario.
Now they went back to a daisy chain of video clips taken after the murder, tracking 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.
They 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 Bridge.
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 ticked 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 do-gooder 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.
You 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 his heart broke for Brian's family.
His wife, his children, his mother 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 the public sentiment surrounding Brian's murder.
It was also a reminder that the suspect was still out there.
Not for long.
He looks like the CEO shooter from New York.
An arrest was coming, along with a fascination about how this young man ended up accused of murder.
So he walks in the door and all of a sudden all the girls, like you know, turned their head, looked at him like who's this new guy?
While Brian Thompson's family was laying him to rest on that same day, a thousand miles away.
911, what is the address of your emergency?
The manager of a McDonald's in Altoona, Pennsylvania called 911.
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.
It looks like the CEO shooter from New York.
A patrol unit arrived.
Two officers approached with body cams rolling.
Yes, sir.
Someone called tonight that thought you were suspicious.
Oh, I'm sorry.
Is your driver younger?
Yes, sir.
One officer took the ID and stepped away to call it in.
He's got a driver's license that says Rosario.
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 Mangione.
He was arrested and extradited to New York.
The spectacle of his arrival by helicopter escorted by the mayor and a phalanx of law enforcement, only intensifying the public's infatuation.
Free Luigi and his beautiful eyebrows.
They didn't know that America was going to be rooting for the assassin, right?
They gotta give the people what they want, right?
I 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 Mangione 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 30 sources family members, friends and law enforcement trying to untangle Mangione'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, Mangione was born into a life of wealth and privilege.
His family owned businesses including a country club, assisted living facilities and a radio station.
Mangione 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 an elite high school.
Very elite high school.
Within the people that went to Gilman, he was known to be amongst the smartest.
And Mangione had something in common with Brian Thompson.
He was valedictorian of his class.
It's been an incredible journey and I simply can't imagine the last few years with any other group of guys.
Thank you.
Mangione got an Ivy League education in computer science and engineering.
In 2022, he relocated to Hawaii, moving in with a techie 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 MrCactus Reddit handle, widely believed to be his, there were posts about gaming and travel.
And about 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 Hawaii.
This post said, I train in India.
I train in a little yoga therapy.
I'm good at dealing with people with injuries.
Dorian Wright teaches yoga in Honolulu.
I remember when Luigi came in because he's a good looking guy.
So he walked in the door and all of a sudden, all the girls, like you know, turned their head, looked at him like who's this new guy?
He said, hey, my name's Luigi.
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, happy, you know, and 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.
Dorian says he worked with Mangione 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, Mangione's back problems didn't go away.
In the summer of 2023 he quit his job and traveled home for surgery to fuse two vertebrae.
Posting x-ray images of spinal scaffolding.
The surgery seemed to be a success.
A 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 health care?
No, he never mentioned health care.
The topic of health care 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 Mangione, 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, Mangione also helped start a book club.
Mangione 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 Unabomber Ted Kaczynski's Manifesto, a provocative text challenging our corporate industrial society.
There were some initial reports that the book club was disbanded after they read the Unabomber's manifesto.
And what my reporting has shown is, no, it just kind of faded away.
It wasn't like this big fight at the book club.
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 that at least helps us understand who he is as a suspect and potentially a killer.
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 Kaczynski.
I have found that people sort of use him as a Rorschach test for what they feel like is happening in the world.
If what was happening in Mangione'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.
In early 2024.
The investors conference that would bring Brian Thompson to New York was many months away.
Halfway around the world, Luigi Mangione decided to go from digital nomad to just nomad.
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 Sacchini is a pro soccer player in Thailand.
In mid-2024 he was with a friend in a bar in Bangkok when Mangione heard them speaking English and struck up a conversation.
My initial impression was that he's just a backpacker going through Asia.
As they chatted over beers that evening.
He says they touched on computer games, the volcanoes in Hawaii and health care in Thailand.
I told him a story about how I went to the hospital to get an MRI and an x-ray and I had zero insurance.
And after I go get the bill, it was about $180, and he couldn't believe it.
So that's what kind of sparked the conversation about health insurance in the U.S.
He says Mangione had opinions about America's for-profit system.
The way he spoke about the health care system is the same way.
Anyone I meet that's living abroad speaks about it honestly, including myself.
The health care system in the U.S. is different than other countries. in a not a good way.
Nothing he said seemed angry or resentful.
From Thailand, Mangione 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 mean, I have no idea.
Everyone's talking about it, though.
Everybody says that's the million dollar question, right?
In August, the 26-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 more dark.
And when you say go dark, you mean in terms of his ideologies, or 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 a missing persons report in November.
Some clues to what Mangione might have been doing in those months come from this red notebook that 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 15th 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 Mangione's writings, United Healthcare faced a wave of negative publicity, criticized for high claim denials, while profits were increasing.
The company tells Dateline its rate of denials is substantially lower than what's been reported.
Mangione doesn't specify what he learned about UnitedHealthcare, 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 bean counter 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 Mangione was under arrest.
I mean, I was shocked.
I was like, he didn't seem like the kind of guy who 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 Mangione might have changed from regular guy to what prosecutors describe as a brazen killer is a question Mangione himself seemed to anticipate.
In his backpack, along with the entries from the Red Notebook, investigators found additional writings, including a note addressed to them.
Okay, this is the letter to the feds?
Yes.
The note, to the feds, contains what prosecutors describe as a confession to the FBI.
Mangione 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 a 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, keep Momentum FBI slower overnight.
He talks about changing his shoes.
He talks about getting a hot meal.
He talks about buying batteries.
Mangione also writes about the Unabomber, Ted Kaczynski.
If you're 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?
UnitedHealthcare says Mangione 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 the healthcare CEO.
He does refer to KMD or RMD would have been an unjustified catastrophe and talks about.
Is he talking about a person or a company?
I really don't know, but what's clear from this is he says the target is insurance.
It checks every box.
Mangione 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.
There should be two conversations.
The state of the healthcare industry.
But 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.
Luigi Mangione 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.
His support 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.
But he was accused of murder.
Millions of Americans wouldn't call it a murder.
They would call it something else entirely.
Sam Beard, a health care activist and co-host of the Party Girls podcast, helped establish that legal defense fund for Brian Thompson's killer before Mangione was arrested 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 the state of the healthcare industry.
But that 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.
Do 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 seemed to feel that way.
It's interesting how so many conversations about Mangione end up in a place where well, I don't justify killing.
I don't support anybody killing.
But.
It's that but.
That but you hear all of the time.
When I'm speaking to people, they will say, of course, I don't condone violence.
I am against murder.
But I can understand why somebody would be upset at the health care insurance industry.
And that but is what fueled the discourse after Brian Thompson's murder.
Have you been at all surprised by the level of frustration that this is uncorked?
No, because I hear the frustration every day in my job.
Dr Elizabeth Rosenthal is a best-selling author and journalist who has written about the American healthcare industry for 30 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 Mangione's writings as someone who has illuminated the corruption and greed of the health care system.
To be clear, you don't consider yourself 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 health care 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 patients.
Everyone wants to blame someone or one part of the system, and it's not any one part.
It's like a circular firing squad.
We knew we disappointed people.
And we knew probably a lot of times we were unfairly criticized for the role that you know.
Unfortunately, our US healthcare system puts the big payers in.
Despite the criticism of their industry.
Jeff says that among his colleagues, Brian Thompson had a reputation as a caring and conscientious executive.
He was always very mindful that, at the end of everything that we did was a person, and that person needed us to be at our best, and he would demand that of people.
You knew you were in an industry that was not liked by some, but you couldn't have imagined that someone would kill over that.
It's still beyond me that people who clearly have hate in their hearts would take somebody's life over what they did for a living.
Mangione's murder trial is scheduled to begin in New York this September.
Any good defense lawyer would try to keep out as much evidence as they can.
Laura Jarrett is senior legal correspondent for NBC News.
She says that, in addition to Mangione's notes, which some have called a manifesto, police also found a partially 3D printed handgun and a silencer in his backpack.
His defense has argued that the backpack search was unlawful.
But here the buck stopped with the judge who said no, the alleged murder weapon that gets to come in.
The alleged manifesto where he talks about the insurance industry, that now gets to come in.
Mangione's defense attorneys did not answer our questions about the case and told Dateline they're concerned about pre-trial publicity, including public statements made by the NYPD that they say threaten their client's ability to get a fair trial.
Laura Jarrett says in court, the defense may try to shift the jury's attention to the health insurance industry.
The defense benefits enormously if the judge allows them to make this about putting the insurance industry on trial instead of Luigi Mangione.
Now, prosecutors are going to fight hard, but the industry really is the backdrop to all of it.
It's why you have people lined up outside of that courthouse.
Because remember, as jurors and potential jurors are walking into that courthouse, they're going to hear the chants.
They're going to see the signs.
They're supposed to disregard it.
But the questions about the insurance industry has raised the stakes in a way I think we haven't seen in a long time.
Is this trial going to be about murder or the ethics of the health care system?
The only people who know the answer to that question are Luigi, his defense team and the prosecutors.
I think for the average American though, the health care system was immediately put on trial that day.
While that's a deliberation with no end in sight, a jury inside a Manhattan courtroom will soon decide Luigi Mangione's fate.
We may never know if it was rage frustration, misguided idealism or something else altogether that led to the deadly confrontation on that December morning.
But for those who cared for Brian Thompson, the reason for his death matters far less than remembering the life he led.
He's the victim.
Yes.
Yeah.
We can never forget that.
He was a great father, great husband, great son.
A wonderful person.
That's all for this edition of Dateline.
And check out our Talking Dateline podcast.
Andrea Canning and I will go behind the scenes of tonight's episode, available Wednesday in the Dateline feed, wherever you get your podcasts.
We'll see you again next Friday at 10, 9 Central.
I'm Lester Holt.
For all of us at NBC News, good night.
