Police said that the man accused of shooting a high-ranking health insurance executive in New York had a written manifesto detailing his grievances with the industry. This was the first indication as to a possible motive.
Luigi Mangione, a 26-year-old Italian, yelled at officers and struggled as he walked into a Pennsylvania court wearing an orange jumpsuit for a hearing to extradite him to New York.
He is accused by police of killing UnitedHealthcare CEO Brian Thompson in Manhattan last week. This triggered a manhunt across the country that ended on Monday when he appeared at a McDonald’s in Altoona.
Mangione has fought extradition to New York. Blair County prosecutor Peter Weeks said that the complaint would create “more hoops…to jump through” and a court denied him bail while the process was ongoing.
Weeks stated that the defense attorneys have now 14 days to file motions opposing Mangione’s transfer to New York.
The suspect, who attended the elite University of Pennsylvania and reportedly comes from a wealthy family, could be heard shouting “unjust” and “an insult to the intelligence of the American people” as officers bundled him out of a car and into court.
The discovery of a manifesto that Mangione carried seems to support the theory that his anger was sparked by the complex and sometimes dysfunctional US healthcare system.
Joseph Kenny, the Chief of Detectives for the New York Police Department, said this on Good Morning America.
“It’s handwritten. He makes it clear that he is frustrated by the American healthcare system.

Kenny Mangione criticized the US health system for being among the most costly in the world, yet the US has a shorter life expectancy compared to other developed nations.
Kenny said, “He wrote a lot of articles about his disgust for the corporate American industry and especially health care.”
The New York criminal complaint states that Mangione had “written admissions of the crime”, but does not provide any further details.
The police have not confirmed that the bullet casings at the scene were marked with the words “delay”, “deny”, or any other language used by insurance companies to deny claims.
– The suspect was shaking –
Investigators questioned Mangione about the murder that took place last week, which made global headlines and shook up the American business community.
Altoona Police, flanked by New York Detectives, led him into the courtroom late on Monday wearing a dark sweatshirt.
Mangione, a New York resident, was charged with murder and two counts of criminal possession of an offensive weapon in the second degree.

The next time he is due in court will be on December 23. He has not yet entered a plea.
The White House condemned this shooting.
“This is horrific. Violence to combat any sort of corporate greed is unacceptable,” Press Secretary Karine Jean-Pierre told a briefing when asked about the grievances aired by Mangione.
Documents charging the suspect show that officers apprehended him after receiving a tip at McDonald’s. He was wearing a mask, and a beanie, and using a laptop while giving officers a fake identification.
The police searched him and discovered a 9mm gun that was capable of firing rounds. It also had a suppressor which could have been manufactured on a 3-D printer.
According to the criminal complaint, when officers asked Mangione if he’d been to New York in recent times, he “became quieter and began to shake.”
Police said that one of the fake identifications was used to check into a Manhattan hostel before the attack.
According to friends quoted in a New York Times article, Mangione had health problems. He suffered from severe back pain and underwent surgery to treat the condition last summer.
On what appears to be his social media account, a photo showed an X-ray image of a spinal column with a medical device.