The social media response to the assassination of UnitedHealthcare’s CEO Brian Thompson in Manhattan on Dec. 4 was both deplorable and understandable. He quickly became a symbol for the anger and frustration of millions of Americans who have been denied health insurance coverage by companies like UHC.

Indeed, UHC outpaces its competitors in denying an estimated one-third of claims submitted; less than 1% of those denials are appealed. While leading the industry in claim denials, UHC reportedly paid Thompson an annual compensation of $10.2 million in salary, bonus and stock options.

There is a larger story here related to the societal impact of and response to income inequality. After the extreme concentration of wealth in America before World War II, there was a trend toward shared prosperity until the 1970s. After Reagan’s tax cuts for the wealthiest citizens and anti-labor deregulation of core industries in the 1980s, the top 1% saw rapid income growth while low- and middle-income households experienced minimal increases that were largely offset by inflation.

By 2024, the top 1% of households possessed 28.3% of the nation’s income, putting the United States at the top of the list of inequality among industrialized countries. The concentration of wealth is particularly harmful to minority populations. So-called “trickle down” economics did not work.

The real cost of this extreme wealth concentration was brought home to me by my first trips outside the U.S. during my graduate studies at the University of California, Los Angeles. I had been brought up in a very modest single-parent home in suburban New Jersey and had never had the opportunity to travel abroad before beginning on a doctoral program in anthropology.

To improve my Spanish skills, I spent a summer in an intensive language school in Antigua, Guatemala. I then traveled with a fellow graduate student to Venezuela to explore a possible site for dissertation research. Following that, and thanks to a grant from the Organization of American States, I carried out fieldwork on the northern coast of Peru for a full year, returning there several more times to do follow-up research. In the ensuing years I have had the great fortune of many more trips in Latin America and Europe.

I will always remember the powerful impression left by my education in other countries.

In Guatemala, which was suffering from a terribly violent anti-insurgency campaign during the time I visited, I witnessed a level of poverty far greater than anything I had seen in my home country. On the ride from the airport into Venezuela’s capital, Caracas, I was stunned by the huge squatter settlements that covered the mountainsides around the city center.

I arrived in Peru in 1980 just after the country had moved from a military dictatorship to an elected government, but was overwhelmed by violence from a revolutionary movement, the Shining Path, and the armed forces’ response to it. The taxi ride into the city passed by immense expanses of housing that ranged from rudimentary concrete structures to corrugated metal and cardboard shelters. As in Caracas, these slums, rebranded by the government as “young towns,” covered the hillsides.

I learned that the elite in these three countries recognized that their privileged position came at the cost of threats to their and their families’ safety. Their houses were walled compounds with barbed wire and armed guards. They commuted to work with bodyguards carrying machine guns. In Caracas, the wealthiest were flown by helicopter from their mansions to the roofs of the business buildings where they made their fortunes.

In Peru, even middle-class families like the one from whom I rented a beach house had attack dogs living on the flat roofs of their homes to dissuade intruders. This highly paranoid life style had become normal.

I fear that the United States may be headed toward this dystopian world. Income inequality is very likely to spiral in the coming years. The group of billionaire advisers and cabinet nominees Trump is assembling — with an estimated net worth of $340 billion — will go to work on extending tax cuts for the wealthy and slicing through what passes as the safety net for large swaths of the American public (Medicare, Medicaid and Social Security).

They will almost certainly reverse Biden’s rule allowing Medicare to negotiate lower prescription drug prices and will attempt to dismantle the Affordable Care Act, including protections against denials based on “pre-existing conditions.” Companies like UHC will have free rein to continue their predatory practices, further harming and indebting the sickest and poorest among us.

At some point, as in other countries that have gone down this path, violence will escalate and the rich will have to retreat to their gilded cages.

Unfortunately, the murder of Brian Thompson is a harbinger of things to come if America doesn’t change course. Even self-interest should incline the wealthiest to embrace a more equal distribution of the nation’s resources.

Donald Joralemon, emeritus professor at Smith College, lives in Conway.