Building a Mass Movement for Health Justice

Luigi Mangione’s legal defense fund has swelled to more than $1.3 million and is still growing daily. As the December 4 Legal Committee, we created that fund — but it would mean nothing without the donations, prayers, and support of people from around the world. As corporate social media platforms censored support for Luigi, the fundraiser page became a place for people to share stories of senseless death and suffering at the hands of the for-profit health insurance industry in this country.

There is a deep irony in the widespread support for Luigi. People celebrate an alleged murderer not because they hate reasonable debate or lust for political violence, but out of respect for themselves and love for others. Across the political spectrum, Americans experience the corporate bureaucracies of our health care system as cruel, exploitative, and maddening. They feel powerless in the face of the unnecessary dehumanization, death, and financial ruin of their neighbors and loved ones.

One year ago, the December 4 killing of United Healthcare CEO Brian Thompson temporarily suspended the usually intractable left vs. right polarization of America. Ben Shapiro’s audience revolted when he accused Luigi supporters of being “evil leftists.” Donors to Luigi’s fund come from across the political spectrum, and a common theme among them is their acute realization that the political differences of the culture war are largely manufactured to benefit the powerful. This was a crucial difference between Mangione’s alleged act and, for example, the assassination of Charlie Kirk. While the latter intensified existing political divides, the former seemed to strike upon the common ground of a different political landscape: from red vs. blue, or left vs. right, to down vs. up.

But a year on, it is clear that even bipartisan public support for killing a health care CEO on the street and the endless stories of suffering and death as a result of insurance claim denials are not enough to depose the for-profit health care system. Today, Medicare for All looks even more politically unrealistic than when Bernie Sanders made it the centerpiece of his presidential campaign.

This fact poses a challenge for Luigi’s supporters: Will his alleged act be remembered as nothing more than a salacious contribution to the true crime genre? Will we settle for him being installed as an edgy icon of celebrity culture, used to market fast-fashion brands and who knows what next?

We do not think his supporters, or anyone else who believes that health care is a human right, should accept that. But what would it take to make the events of last December 4 into a movement to build a more humane health care system in America?

For the last year, we have been asking this question of medical professionals, community organizers, scholars, and ourselves.

In our forthcoming book, “Depose: Luigi Mangione and the Right to Health,” we offer the beginnings of an answer: The history of the struggle for the right to health in America shows that it is indeed politically unrealistic to expect politicians to deliver it from above — but our own dignity and intelligence demands that this right be asserted by all of us from below. The widespread support for Luigi shows that the time has come for the long struggle for the right to health care to make a strategic shift from protest to political direct action.

Consider the sit-in movements to end Jim Crow laws and desegregate American cities. These were protests, insofar as participants drew attention to unjust laws — but they were also political direct actions. Organizers were collectively breaking those laws, and in doing so, were enacting desegregation. Activists organized themselves to support and protect each other in collectively nullifying laws that had no moral authority and, in the process, acted as if they were already free. This is what we mean by a shift from protest to direct action.

Less well known is the role of direct action in winning the eight-hour workday. For half a century, industrial workers had been struggling to shorten their hours so they could have some rest and joy in their lives. One decisive moment in this struggle came in 1884, when the American Federation of Labor resolved that two years later, on May 1, their workers would enact the eight-hour day. After eight hours, they would go on strike and walk off the job together. They called on other unions around the country to do the same and a number did — including in Chicago, where police deployed political violence to attack striking workers, killing two. While this action did not immediately win the struggle everywhere, it did succeed in beginning to normalize the 8-hour day and raised the bar for everywhere else to eventually do the same. The key is that this could only happen when workers stopped demanding something politically unrealistic and started changing political reality themselves.

The struggle for the right to health care has been ongoing in the United States for at least a century. At every turn, it has been thwarted by industry lobbyists and the politicians they control. But what would it look like to strategically shift the struggle for the right to health care in the U.S.? How would health care providers go on strike or engage in direct action without harming patients?

We found the beginning of an answer from Dr. Michael Fine, who has called on his fellow physicians to organize for a different kind of strike: not halting all their labor, but stopping the aspects of their work that are unrelated to their responsibility as healers. Fine writes, “We need to refuse, together, to use the electronic medical records until they change the software so that those computers free us to look at and listen to patients instead of looking at and listening to computer screens.”

A strike by health care workers could mean not the cessation of care, but liberating this critical work from the restraints imposed by profit-seeking companies. Beginning from this idea, all of us could organize to free the labor of health care from the corporate bureaucracies that act as parasites on the relationship between caregiver and patient.

If we step outside of our usual political bubbles and into a direct action movement to assert the universal right to health care, we might find that the common ground that Luigi’s alleged actions exposed is the precise point from which the wider political landscape may be remade.