By Riley McMurray
In this article I discuss the shooting of UnitedHealth Group CEO Brian Thompson, allegedly done by Luigi Mangione, as well as the apparent public support Mangione has received since the shooting. I also discuss successful union organizing initiatives within the healthcare sector led by author and activist Jane McAlevey. I argue that as union organizing represents a peaceful way of achieving and sustaining significant improvements within healthcare, violence such as vigilante murder is completely unnecessary. I suggest that whether or not Brian Thompson presided over a company with unethical healthcare policies, it is wrong and saddening that he was murdered. I also suggest that while Mangione allegedly committed the crime, he is deserving of social support and care rather than punishment.
Background
Just before 7 a.m. on December 4th in New York, CEO of the health insurance division of UnitedHealth Group Brian Thompson was shot in the back while on his way to an investor meeting.1 On December 9th, 26-year-old Luigi Mangione was taken into custody in Pennsylvania on suspicion of killing Thompson,2 and that night was charged in New York with Thompson’s murder.3 Mangione’s legal proceedings are ongoing.
Apparent public support for Mangione
On CBC’s Canada Tonight, with reference to Mangione, host Chris Glover noted “a startling amount of online support for the alleged killer has been pouring in.”4 Glover spoke with David Gilbert, a reporter with Wired Magazine, who emphasized
this isn’t celebrating a murder this is purely a chance for the people… to vent this pent up anger that they’ve had for years about the US healthcare system… millions and millions of people have either seen family members going through chronic pain, or dying in some cases, while these healthcare companies have continued to make millions and millions of dollars in profit… this wasn’t necessarily saying they want more people to be murdered or saying that the murdering is okay.
Gilbert’s measured analysis is welcome within the highly polarized discussion surrounding Mangione. However, peaceful alternatives of addressing significant problems with healthcare remain absent within discussions about Mangione. Such peaceful action towards improving healthcare is exactly what Jane McAlevey describes in her several books on union organizing. Insofar as unions provide a peaceful outlet through which the millions of people referred to by Gilbert can channel their pent-up anger, they should be considered when discussing Mangione.
Union Organizing: A Peaceful Method of Achieving Social Change
Before passing away in July of last year, Jane McAlevey was an incredible force within the union movement, leading contract negotiations against tough employers, helping workers form new unions, and guiding workers out on successful strikes. In her 2020 book A Collective Bargain, McAlevey draws the connection between social equality and the percentage of workers belonging to a union with the following data and visual aid:
In her book Raising Expectations and Raising Hell, McAlevey shows that strong unions are essential not just for promoting social equality generally, but that they can be used to drastically improve the healthcare system:
When the sorry state of patient care in this country is being discussed, legal regulation is brought up as a possible solution far more often than strong unions. But one look at the political quagmire surrounding health-care reform dumps a big bucket of cold water on all that. The most workable solution is the most obviously local: patient care issues can be solved on the spot by a strong union that sees these problems as shop floor issues. If the organization of workers in a hospital is weak, nurses will go on working to exhaustion, and patients will go on lying in pain, pressing call buttons that no one answers because one worker is frantically tending to three other call buttons. Even if we could pass laws regulating this sort of thing, the only appropriate enforcers would be the workers in the hospital. This is a problem that has plagued all kinds of efforts at social change, from labor to civil rights to the environment and more: we fight so hard to get the right policy or law, then forget that the only way to enforce it is through ongoing organizing and mobilizing at the base. The only way to stop unfair and dangerous hospital practices is for nurses and hospital workers to build strong organizations. Period.
While this quote from Raising Expectations refers specifically to patient care issues, in her books McAlevey frequently discusses the ways in which unions can be used to improve large-scale social policy as well:
In August 2018, Gallup reported that 62 percent of Americans approve of unions. And yet only 10.6 percent of Americans belong to one. If 62 percent of American workers were unionized, this country would be more like Sweden, where 67 percent of all workers are unionized, and they’ve created a societal standard that all workers have a right to high-quality free health care, a year each of maternity and paternity leave for a child’s first two years of life, free child care after that, a national mandatory six paid weeks of annual vacation, and the right to retire and enjoy the grandkids.
The difference between affecting small scale positive change in the workplace to issues such as patient care, and large scale issues such as negative healthcare policy on a social level are simply a matter of scale. In her books, McAlevey frequently suggests that large-scale change can be achieved by revitalizing unions to the point that they are capable of engaging in large-scale production-stopping strikes. A brief consideration of McAlevey’s organizing strategies are discussed below.
McAlevey’s Campaign in Las Vegas
From 2004-2008, McAlevey led a major effort by the Service Employees International Union (SEIU) to revitalize unions in Las Vegas. In her efforts McAlevey faced fierce opposition, with one employer spending five million dollars in 2006 alone to thwart her efforts. This money paid for experts from a notorious union-busting firm to pursue any and all strategic legal delays, to subject workers to captive audience meetings in which the union was slandered, to mail DVDs also slandering the union to all workers, to surveil workers, to hire security guards to (illegally) prevent union organizers from entering the hospitals, and more.
In the face of these challenges, McAlevey and her small team successfully employed tried and true union organizing tactics. Worker-leaders were identified and brought into the organizing efforts. Due to the respect they held in the eyes of their fellow workers, the worker-leaders were easily able to increase worker participation in the union from low percentage participation to supermajority participation. McAlevey measured overall worker participation based on what percentage of workers were willing to wear stickers or buttons with union messaging, take part in petitions and deliver these petitions by hand to their bosses, and take part in collective bargaining. McAlevey was often accompanied in bargaining by hundreds of workers.
McAlevey involved the union in various local electoral political campaigns that in short order bore fruit for the union. In one instance, public healthcare workers helped elect a pro-labour candidate to the Clark County Commission who went on to sit on the Public Health District Board. In order to advance their collective bargaining interests when the management team refused to bargain, the workers both sent hundreds of letters to board members, and arranged meetings with them. The workers attended board meetings in large numbers with large print-out banners, and ultimately succeeded in having the board instruct the management team to get back to the bargaining table. Of central importance to McAlevey from the beginning of her organizing campaign in Las Vegas was to organize all healthcare workers (not just nurses), and to “align the market.”
In order to have success in bargaining, being able to present a credible strike threat is essential for the union to pressure the employer into meeting their demands. If an employer believes they will be able to continue running their operations during a strike, the strike is undermined as the employer has little motivation to bargain. McAlevey understood that when workers in one workplace or industry are divided into different unions who may not strike at the same time, employers are better able to undermine potential strikes. With this in mind, McAlevey prioritized bringing as many workers into her unions as possible. This approach makes for far stronger bargaining power than unions who only seek to involve themselves with the most skilled workers in a given industry, such as nurses and nurses unions.
McAlevey also sought to “align the market.” As the hospitals she was organizing each had contracts that ended at different times, McAlevey bargained two contracts ahead, ensuring all of the initial contracts she had a part in bargaining ended at the same time. Then, when those contracts ended, the entire healthcare industry (all workers in all hospitals) would be primed for a massive strike, something which she knew would terrify the employers enough to have them agree to excellent contracts for the workers.
McAlevey’s strategy worked, and resulted in massive wins for the healthcare workers. Some of the highlights were fully employer-paid healthcare for the nurses and their families (not one health-care worker in all of Nevada had fully employer-paid individual health care, let alone employer-paid family healthcare), 17.5% raises, bilingual pay, transparent promotion, improved nurse-to-patient ratios, and the best on-call pay system in the region. The workers won other benefits that require some explanation, such as floating, orientation, drop language, two-tiering, HR management, shift differential, and site access. All of these benefits are explained in greater detail by McAlevey in her book.
In the short term, the pay raises and the employer-paid healthcare plan that the nurses won both increased access to healthcare for the nurses and their families. As discussed above, increasing the unionization rate within society better enables the working class to pressure governments into enacting and maintaining pro-social policies such as improved healthcare.
As unions provide effective channels through which people with pent-up anger at the healthcare system can work to have it improved, vigilante murder such as that Mangione is alleged to have committed is completely unnecessary. As an in-depth discussion of union organizing makes this point plain, discussing unions when considering Mangione is important in highlighting a peaceful alternative is available.
Two Lives Need Not Be Lost
Whether or not Brian Thompson presided over a company with unethical healthcare policies, it is wrong and saddening that he was murdered. He had two children.9 Likewise, it is sad to contemplate that Mangione may also lose his life, given he faces the death penalty on two charges.
Mangione has already experienced isolation and estrangement from his family. Prior to the shooting, his mother reported him missing after not hearing from him for several months.11 He should not now be isolated and estranged from society. Mangione should be embraced with social support and care in order to help him rehabilitate. A rehabilitated Mangione could reconcile with Thompson’s family and go on to be a voice for peace. While this is of course unlikely, it is nonetheless important to keep belief in a rehabilitative option alive inside of ourselves.