Mangione: Man from Japan
Was Luigi inspired by Japan's most recent folk hero assassin? (Or was it the public healthcare system?)
In Japan, as I watched the events unfold after the assassination of Brian Thompson, the CEO of UnitedHealthcare, I had a very strange sense of déjà vu–it was like reliving the assassination of former Japanese Prime Minister Shinzo Abe in 2022. The events have unfolded in much the same way. The story shifts from the victim being the subject of empathy and the assassin being reviled to the victim being reviled and the assassin being worshiped as a hero. The stories have many parallels. At first, the nation is horrified as a prominent and wealthy figure is killed in broad daylight by a lone gunman. A lone gunman armed with a hand-made weapon. But then, gradually, as the circumstances of the shooter and his manifesto and motives come to light, the public reaction starts to shift. In fact, by the time the full story is out, public perception has almost shifted to a scenario in which the assassin is seen as a hero.
In the case of Shinzo Abe, the shooter had written a manifesto which he had sent to another journalist before the attack, explaining why he had done it. He felt his life had been ruined by "the Korean cult" known as the Unification Church, which had drained his family of its savings and driven his brother to suicide. He believed high-ranking politicians had protected this group for their own benefits. While he knew Prime Minister Abe wasn't solely responsible, he sought to highlight the strong connection Abe had to the group, and thus destroy the organization.
What strikes me as another chilling similarity is that both Abe and Thompson were tied—however indirectly—to systems that preyed on vulnerable people, extracting large amounts of money without offering much in return. The Unification Church siphoned fortunes from grieving families, exploiting their faith and desperation, while UnitedHealthcare, under Thompson’s leadership, became a symbol of corporate healthcare's relentless pursuit of profit, often at the expense of patient care and financial well-being. Both assassins, in their own ways, seemed to see their targets as emblematic of these broader systems of exploitation.
One other thing that makes these cases seem connected to me is that before the shooting, Mangione had lived in Japan, understood Japan's public healthcare system, and may have been aware of the folk hero status of Abe's assassin. These parallels weave a complex narrative, revealing how individual actions can shift public consciousness, much like as we have already seen here in Japan--and are now seeing in the United States.
Let's delve into the details:
On July 8, 2022, at 11:30 a.m., former Prime Minister Shinzo Abe was fatally shot while delivering a campaign speech in Nara, Japan. The weapon, a crude homemade firearm, belched smoke and steel pellets, crafted by a disillusioned former member of the Maritime Self-Defense Force. The attack, a stunning act in a nation famed for its low crime rates, left Abe collapsing to the pavement, his final words drowned in chaos.
The lone gunman: Tetsuya Yamagami.
Yamagami grew up battered by family tragedy after tragedy. His father, once an engineering professor at the prestigious Kyoto University, devolved into an abusive alcoholic and committed suicide when Tetsuya was just 4 years old. Yamagami’s mother barely had time to recover from the abuse and shock of being a newly single mother of three when her oldest son lost his eyesight to cancer at a young age. Perhaps it’s this shock and desperation that led her to the Unification Church.
At this point, I’m sure readers are aware of the Unification Church, or at least familiar with so-called “Moonies” — devout followers of the organization’s leaders, Moon Sun-myung and his wife Han Hak-ja. The organization and its members engage in a number of activities that leave a bad taste in people’s mouths — arranged marriages and unauthorized adoptions with more than a tinge of eugenics, encouraging estrangement from biological parents, and the January 6 attack on the US Capitol (no, really — one sect led by Moon’s youngest son is staunchly militant and far-right).
The dubious ethics of these activities pale in comparison to their main racket — money and politics.
The Unification Church has been able to enjoy so much influence in politics via the usual methods. In Japan, the some-600,000 members of the UC are encouraged to vote for the party during elections, even offering their services for free on the campaign trail. Political donations are common, and the church also reaches out to LDP politicians at every level of government to speak at their events — usually, for a healthy fee.
This isn’t just in Japan, either: President Donald Trump and former VP Mike Pence were paid $2.5 million and $550k respectively to appear at Unification Church-affiliated events between 2021 and 2022.
The UC is able to get a large proportion of these funds through “grassroots fundraising”. This, of course, reportedly means encouraging their followers to lie to prospective donors, or by lying to and manipulating their followers for money directly.
This is what happened with Yamagami’s mother, as well as countless other people involved in the church since its conception. The most notorious of these internal money-making tactics is “spiritual sales”. In some cases, a “sacred artifact”—usually a near-worthless trinket—is sold to a follower for an exorbitant price. Followers are also regularly encouraged to make donations to the church proportional to their devotion, which, naturally, should have no bounds.
Their money-making practices are widely considered to be extortion by some. Countless families have gone bankrupt due to the UC’s fundraising, and the Yamagami family was no exception. After dipping into their income, savings, and college fund and giving away over a billion yen, the equivalent of $700,000 USD, the family declared bankruptcy in 2002.
The financial situation meant that despite attending one of the best schools in Nara, none of the Yamagami children had a chance at attending university. Tetsuya Yamagami, who according to one paternal uncle “could have attended Kyoto University like his father”, had no choice but to join the Marine Defense Force.
His mother refused to leave the church, and the financial difficulties didn’t end. In 2005, at the age of 25, he attempted suicide, hoping that the life insurance money would help his family. Later, in 2015, his brother sadly succeeded in his own suicide attempt, desperate after a lifetime of economic hardship, disability, and parental neglect.
Ever since his family was torn apart by the Unification Church, Yamagami fantasized about making the cult’s leaders pay. He expressed wanting to kill the founder, Moon Sun-Myung; later, his wife Han Hak-Ja, who assumed the position as the head of the church after Moon’s death in 2012. In a blog comment in 2020, he remarked that he was obsessed with the idea of acquiring a gun to assassinate the whole family.
However, the family was out of his reach, hidden away behind borders and security. He knew someone else with strong ties to the church who he perceived to be culpable for the devastating effects of the church in Japan – former Prime Minister Shinzo Abe.
In September of 2021, Donald Trump gave a speech to a UC-affiliated group, receiving $500,000 USD. In his case, Shinzo Abe gave a speech entirely free of charge. Abe is known to have offered his services to the Unification Church and its affiliated groups many times without receiving financial payments. As early as 2015, I was aware of the deep ties but only a small portion of the Japanese media dared report on them. Why was Abe so friendly to the church? Part of this is his family history with the church: his grandfather, also a former PM, was heavily involved with the church when it first arrived in Japan and helped it become a prominent organization in the country.
In a letter to a freelance journalist and cult expert postmarked a day before the July 8th assassination, Yamagami acknowledged that the Moon family was his real enemy, but he was angry with Abe as one of the most influential Unification Church sympathizers in Japan, if not the most.
It turned out, many people shared his anger. At first, the police refused to name the religious group mentioned in Yamagami’s statement. It led many to believe that he was angry with the religious group, Soka Gakkai, which also has its own dark history.
But as more details came out about Yamagami’s motives after the assassination, his actions were perceived as unforgivable but frankly, also understandable. Many sympathized or even personally related to the distress caused by the Unification Church in targeting and manipulating his vulnerable mother.
He not only generated sympathy, but a number of women began to flock to him, expressing admiration and attraction for him; they were dubbed "Yamagami Girls" by the media. Details about the abuse, neglect, and tragedy of his childhood, as well as his squandered intellectual promise, were not only points of affinity for many, but also points of attraction for some. His letter to the journalist was not just principled, but apparently so well written that women fell for him after reading it. Strong values and intelligence proved to be sexy yet again.
More than anything, Yamagami was increasingly lauded as a hero, a vigilante able to punish villains that no one else dared to touch.
The Unification Church was usually met with indifference or suspicion by the wider public, but the shooting raised awareness about their hand in the Japanese government via the leading party, the Liberal Democratic Party (LDP). Public opinion soured on both the Church and the LDP.
Alarmed by the growing anger of the public, the LDP reluctantly started to investigate their members’ ties to the Unification Church and found that nearly half had ties to the organization. Prime Minister Kishida then ordered members to cut their ties or face expulsion. Four months after the attack, in October, Kishida announced an investigation into Abe’s ties to the church. A month later, the government launched a formal investigation into practices within the organization; the next month, the Diet passed a law offering debt relief to victims of predatory fundraising tactics by religious organizations. The Unification Church is also currently in the process of being stripped of its privileges as a registered religious group; namely, tax benefits — hitting them where it hurts.
Really, as far as assassinations go, it was a stunning success. Yamagami should be proud. (Let me make it clear that in no way do I condone murder. Although Abe was a corrupt and cruel politician whose policies benefited the wealthy, increased poverty, and crushed press freedom, he didn’t deserve being shot in the back. We send our condolences and other plentiful sentiments to the Abe family and supporters.)
When Luigi Mangione was apprehended by police for the December 4 shooting of United Healthcare CEO Brian Thompson, I wasn’t the only one with a sense of deja vu. One post on Ameba, a popular blog site, drew comparisons between the homemade and untraceable “ghost gun” used by both shooters.
Mangione, like Yamagami, was intelligent. He was valedictorian in high school and went on to the Ivy League University of Pennsylvania to get double Bachelor’s and Master’s degrees in computer science.
But his problems were quite different. He and his family never struggled with finances, but Mangione had health problems since childhood. Persistent back pain, a souvenir from a run-in with Lyme Disease at age 13, turned debilitating after an accident in 2022 that caused his spinal bones to slip out of place. For the better part of two years, he was in severe pain, forcing him to leave his job. He detailed his struggle to get adequate treatment for his condition (called spondylolisthesis) on now-deleted Reddit posts, the below excerpt reported by The New York Times:
We live in a capitalist society…I’ve found that the medical industry responds to these key words far more urgently than you describing unbearable pain and how it’s impacting your quality of life.
The “key words” are to emphasize how the unbearable pain affects the quality of your work — quality of life is almost irrelevant. It’s hard to miss the sardonic bitterness in his words about the healthcare system. Mangione’s critiques of American culture and society were abundant, and if I may say so, mostly founded. His disdain at the healthcare industry, which he had the unfortunate displeasure of being involved with, was just one of these issues. He disapproved of the culture he perceived to be smartphone dependent, social media addicted, and increasingly isolated. He abhorred overconsumption.
After he recovered, he did what many do when they are exhausted by life in America and have some savings in the bank: he packed a backpack and took a jaunt around Asia to, in his words, “zen out”. From February to March, he took a trip to Thailand and Japan. He seemed to like Japan, coming back to the country at least one more time in April, although it’s not known exactly where he was and for how long for most of 2024.
He clearly spent a lot of time learning about Japan. He spent enough time to write a very detailed manifesto of what he thought Japan needs to do to solve its declining birth-rate but that's something we'll take up in another post.
Why was he charmed by this country?
Japan is a remarkably easy place to live for the average person.
Japan also has an affordable and tremendously effective public health care system.
Japan's constitution enshrines the right to health as a fundamental guarantee, placing the responsibility on the state to ensure its realization. This commitment paved the way for the introduction of universal health care coverage in 1961, a milestone in the nation's dedication to health equity.
Here’s what the World Economic Forum has to say about it: Japan's early adoption of Universal Health Coverage (UHC) has garnered global recognition, establishing it as the country with the longest healthy life expectancy in the world. One of the key factors behind this achievement is Japan's robust health insurance system, which has been in place for more than half a century. All permanent residents living in Japan for more than three months are required to join the system, ensuring access to appropriate healthcare services at an affordable cost.
A defining feature of Japan's healthcare system is its free-access policy, which allows patients to choose any healthcare provider—from small clinics to large hospitals equipped with the latest medical technology. Furthermore, all medical services are provided at a uniform price nationwide, ensuring fairness and equity in healthcare access.
I’ll tell you what it’s like from personal experience. Almost everyone pays health insurance to the government, but the rates don’t go up if you get ill, and you are almost never denied the treatment you need. You get to choose where you are treated. I have been treated for liver cancer and colon cancer in Japan--and the medical costs have not been detrimental. If I need an MRI to make sure I’m cancer free, the doctor orders it. There's no "deductible" that has to be cleared first. I'm not going to have to pay $1000 because I don't have insurance or my insurer won't authorize the check. There's no insurance broker in my way, trying to deny me the best coverage to raise the profits of their business. On Saturday, I will go to the hospital of my choice for my annual physical, which is paid for by the ward where I live. Japan invests in preventive medicine. Probably one of the reasons people here live longer.
Forget Luigi for a second. Japanese people reacting to the motive behind the assassination were fascinated by the convoluted nature of American healthcare, and outright confused about how insurance companies like United Healthcare structure their policies. They objected to his methods, yet sympathized with his cause. It was reminiscent of the public reception to Tetsuya Yamagami.
And what’s a principled assassin without his fangirls!
From another blog, preceded by critique of the US healthcare system:
Mangione has seemed to receive similar treatment by the public as his Japanese counterpart. He’s hot, he’s smart, and he makes some good points.
Social media was not abundant with sympathy for Thomspon, who had spent 20 years of his career at a company widely criticised for its policies restricting and denying medical care for patients against doctors’ recommendations. This meant pain, suffering, and the worsening of symptoms into irreversible chronic conditions in some cases. In the worst outcomes, their policies led to early or even potentially avoidable deaths.
United Healthcare is not the only insurance company guilty of these policies; however, it has the largest market share in the industry, is the fourth largest company in America by market cap, and also reportedly denies claims at the greatest rates.
It’s also worth noting here that Mangione was never enrolled with United Health Care. But he turned 26 in May 2024, which to many young Americans is a daunting, uncertain age — the age when you’re officially kicked off of your parents’ insurance plan. His peers, as well as many Americans, face unstable access to health care.
Not to mention, chronic back pain like what Mangione struggled with is one of the most prevalent medical issues in America. It’s hard to not sympathize with his experience —and frustration—with getting care. The reticence from doctors and insurers alike mean that patients who could benefit from invasive but potentially permanent solutions to their pain being turned away. Instead, they’re encouraged to mitigate their pain with lifestyle changes, but predominantly medication.
At the lower end of the pain scale, it could mean popping an Advil multiple times a day, but for many Americans chronic pain means opiates. In fact, more than half of regular, prescribed opiate users take the drug for back pain. To make matters worse, opiates are often inadequate in treating chronic pain, meaning patients are taking a highly addictive, powerful, potentially damaging drug for little reason. Opioid addictions run rampant in America; the healthcare industry, including insurers, can be seen as heavily to blame.
Yamagami is a more obvious assassin. He’d expressed wanting to kill Unification Church leaders for years. He felt they’d exploited and brainwashed his mother, stolen their family’s savings, and kept him from ever having a chance to succeed in life. He was suicidal and so was his brother. He had nothing to lose by killing Abe. He got a gun. In the end, his terms were accepted; the country started to change.
Yamagami’s nearly suicidal assassination of Abe is easy to understand in many senses. He had nothing to lose. Mangione has a lot to lose, perhaps even his life with the charges he is now facing.
He lived in Hawaii with friends, he had quit his job but had plentiful options given his degrees and experience. He was charming, kind, well liked, seemingly mentally stable.
There were signs that he was liable toward extremism — an affinity for the Unabomber’s manifesto, for one — but he was known to be intellectually curious, and few sympathizers actually go so far as to carry out an assassination.
Let’s admit there’s not yet solid evidence for Mangione being inspired by Yamagami, nor the public healthcare in Japan. It’s not improbable that he was aware of both. If you live in Japan for a few months and take a deep dive into the culture, as he clearly did, you can reasonably conclude he was aware of both. But we can learn quite a bit from the similarities in the way that they are both being canonized as folk heroes. Their causes are not fringe causes; they were fighting to correct injustices being perpetrated at a systematic, institutional level on all members of the public.
In parting words, I’d like to draw attention to one point of comparison where it’s frankly too soon to tell. In the months following the assassination of Abe, the government was shaken. They immediately took actions to denounce the Unification Church and investigate their LDP ties, including the ties between Abe and the church. Public opinion was clear and unchallenged.
Public opinion turned so harshly against Abe, once the darling of the right-wing media here, that 60% of the public opposed his state funeral. That’s right, the majority of the Japanese people felt it was a waste of taxpayer money to honor their former Prime Minister.
However, it took months for legislation in Japan to address the issues Yamagami railed against, and actions against the Unification Church are ongoing. Especially in the aftermath of a tumultuous election, addressing the healthcare system somehow seems to be the least of America’s problems. President Elect Trump’s remarks renouncing both the shooting and the cause were as lucid as ever:
"I think it's terrible… I think it's really terrible that some people seem to admire him, like him. I was happy to see that it wasn't specific to this gentlemen that was killed; it's just an overall sickness as opposed to a specific sickness. That was a terrible thing, it was cold-blooded. Just a cold-blooded, horrible killing. And how people can like this guy -- that's a sickness actually, that's really very bad. Especially the way it was done, it was so bad – right in the back. A thing like that, you just can't believe some people – and maybe it's fake news – I don't know… it's hard to believe that can even be thought of. But, it seems that there's a certain appetite for [the gunman]. I don't get it.
With the nation in limbo, it’s too early to call whether Mangione’s actions will change the system for good. In fact, it’s too early to call whether he did it in the first place — his trial takes place in February.
The trial of Yamagami hasn’t even started. The Japanese government desperately wants to avoid the trial because it will remind the public once again that the ruling party betrayed them to buddy up with a reviled religious group.
In Washington, many representatives clearly denounced the attack but also denounced what many consider to be a broken healthcare system. Representative Maxwell Frost (D-FL) told Business Insider, "There's so much animosity and hatred of this system that people are looking beyond maybe their typical moral scope to meme this guy, or to praise him, because the issue is just so pervasive…That's something to take note of."
Whether lawmakers and regulators — and especially insurers—like it or not, the crack of a gunshot is always able to turn people’s heads.
It’s not clear what the outcome of the UHC assassination will be.
Immediately following the attack, insurance companies covertly hid the names of their executives from their websites and increased security. Insurers have also quietly made changes to some of their most unpopular cost-cutting measures already.
Was Mangione inspired by Yamagami? Maybe we’re asking the wrong question. Instead, should insurance companies be inspired by the aftermath of the Abe assassination to reform themselves before someone does it for them?
Americans now, like Japan in 2022, have been given a national moral determination to make: whether the times are desperate enough to call for such desperate measures.
Public opinion is a fearsome thing—just ask the LDP. In last year’s elections, they lost political power for the first time since 2009. A reckoning is coming for America’s health care industry—perhaps, the USA should be looking at Japan for some answers.
I really enjoyed reading this, thanks Jake!
This is an angle to the Mangione story that no one has picked up on, and although it's speculative and perhaps unverifiable, as a lead into how this could have happened, it certainly is compelling. Thanks, Jake.