Several years ago, my insurance plan would only cover Admelog insulin to treat my type 1 diabetes, which caused my blood sugar to hover high for months. In the long term, prolonged high blood sugars can lead to complications like blindness and amputation. In the short term, they can lead to a life-threatening condition called diabetic ketoacidosis, which turns blood acidic.

When I asked my doctor to switch me back to Humalog, a type of insulin that had worked for me before, he refused: “It’s going to be too difficult for me to get a prior authorization from your insurance.”

It took weeks, but I was eventually able to convince him. And since then, after many similar experiences, I’ve left my home country of the United States for the Netherlands.

I have a Dutch passport, and decided it was no longer worth it for me to live in a country where the insulin and diabetes supplies I need to live are not only price-gouged but locked behind the door of hours-long hold times and teary fights with representatives from insurance and medical supply companies. Diabetes, after all, is the most expensive chronic disease to live with in the United States.

On Wednesday, Brian Thompson, CEO of UnitedHealthcare, known for being the private insurance company with the highest rate of claim denial, was assassinated on a Manhattan sidewalk. The online discourse instantly upstaged the news itself. Articles and social media posts about the event spurred a stream of comments expressing hatred for the health insurance industry. “Thoughts and prayers require a pre-authorization,” wrote one person underneath a Washington Post Instagram post about the event. The New York Times highlighted another comment found on TikTok: “I’m an ER nurse and the things I’ve seen dying patients get denied for by insurance makes me physically sick. I just can’t feel sympathy for him because of all of those patients and their families.” A UnitedHealth Group Facebook post about Thompson’s death received nearly one hundred thousand laughing emoji reactions.

On the shell casings of the pistols, investigators later found three words written: “deny,” “defend,” and “depose.” The first two words seemingly allude to the tactics insurance companies use to get away with denying claims. The last word suggests a possible motive. As of the time of this writing, a suspect has been named and apprehended in Pennsylvania, though few additional details have yet come out or been confirmed about him.

The news indirectly called to mind the many quiet deaths profit-driven health care has enabled. According to the Lancet, profit-driven health care causes 68,000 preventable deaths in the United States annually. While profiting $6 billion a quarter, UnitedHealthcare has used tactics like artificial intelligence and prior authorizations to automatically deny and delay life-saving care and send millions of Americans into debt.

There’s more than enough coverage of the assassination itself. What does lack reporting is why it took the murder of a CEO for mainstream media to finally, inadvertently, make the health care crisis front-page news. While I think some of the comments have gone too far in their celebration of murder, I’m less interested in morally assessing them than explaining them. Their volume makes clear the degree of public sentiment against the health insurance industry, something many of us have been screaming into the void for so long.

Why haven’t deaths from denied claims and insulin rationing been given the same amount of attention as this particular assassination? One reason is that patient deaths aren’t usually as visceral as sidewalk murder. There’s also the fact that lobbying power in Washington prevents Congress from not only passing universal health care — in the only developed nation that lacks it — but even seriously discussing the possibility, which has the effect of shielding the private insurance industry from scrutiny.

But there is one reason that has not been discussed enough: the amount of money profit-driven health care industries have spent on public relations, sponsorships, and advertising on major media channels.

I’ve seen the repercussions of this firsthand. In 2022, I cowrote a reported op-ed for a major American newspaper investigating how the money major diabetes nonprofits accept from insulin companies is a conflict of interest, essentially arguing that they have become PR firms for price-gouging pharmaceutical companies.

Just before scheduled publication, our editors reached out for comment to the parties being criticized. Breakthrough T1D (then JDRF) and the American Diabetes Association sent back a barrage of comments that our editors called “unprecedented.” The editors, overwhelmed by the nonprofits’ comments, told us we could either submit an extensive rework with no guarantee of publication or pitch the piece elsewhere.

After fifty-four pitches, a few rejections, and a lot of silence, our article found its new home here in Jacobin.

Pitches can be rejected for various reasons, but it should not take two writers fifty-four tries to get an essay, already edited by a major newspaper, to get picked up.

Insulin manufacturers advertise often, especially in major American newspapers. Most striking to me are the full-page New York Times ads Eli Lilly and Novo Nordisk have run over the years. These ads highlight the companies’ respective patient assistance programs, which have been proven unreliable for most, as a solution for those struggling to afford their insulin. The irony is that these ads are placed in a newspaper whose daily print delivery subscription is priced at $1,040 a year, an expense I doubt those who are unable to afford their insulin are able to pay.

In 2022, I searched the Atlantic’s website for the word “insulin.” The first article that came up was a sponsored post by Eli Lilly. The article highlights the company’s patient assistance program and even goes so far as to recommend that employers provide direct support to their struggling employees.

Dexcom, maker of the often life-saving continuous glucose meter that most diabetics cannot afford, has also invested heavily in advertising, regularly taking out $5.5 million in Super Bowl ads. In their 2021 ad, Nick Jonas, who has type 1 diabetes, rhetorically asks why diabetics are still pricking their fingers in a world with self-driving cars and other futuristic inventions. “Nick Jonas is the advocate of a privileged life with type 1 diabetes,” wrote Janina Gaudin, diabetes advocate and artist on Twitter/X. “Doing super bowl ads tells the rest of the world that diabetics are living their best life with diabetes technology when the reality is diabetics are dying because they can’t afford insulin.”

Why does the pharmaceutical industry advertise at all? Shouldn’t we find out about medications and durable medical equipment through our doctors? The United States is one of two countries worldwide that even allows direct-to-consumer advertising of prescription drugs. If mainstream media is participating in an act that most of the world deems unethical and illegal, it would make sense for them to lie low on the topic of profit-driven health care — or at least avoid digging too deep into the players involved.

Looking at the amount of front-page real estate and investigative force newspapers like the New York Times have given Thompson’s assassination makes me imagine a world where the same amount of energy was spent reporting on the deaths caused by profit-driven health care. With the same granular detail as the aerial maps and timelines of the suspect’s movements and escape, I would like to see more investigations into who has enabled the CEOs of the three insulin makers to price-gouge a $5 vial to $300 in lockstep.

“There’ll be a lot of hand-wringing over whether or not [Thomson’s assassination] was justified,” Miles Gray said recently on The Daily Zeitgeist podcast. “[But] the real issue is that we have completely normalized and we celebrate this system of squeezing profits out of people to the point of financial and emotional bankruptcy. The real discussion needs to be around whether or not our greed-based system of care is justified.”

By accepting money from pharmaceutical companies, many media companies have already answered that question.