The fatal shooting on Wednesday of a top UnitedHealthcare executive, Brian Thompson, on a Manhattan sidewalk has unleashed a torrent of morbid glee from patients and others who say they have had negative experiences with health insurance companies at some of the hardest times of their lives.

周三，联合健康保险高管布莱恩·汤普森在曼哈顿的人行道上被枪杀，引发了患者和其他许多人病态的欢呼，他们表示，他们曾在生命中最艰难的时刻与健康保险公司有过不愉快的经历。

It is unclear what motivated the incident or whether it was tied to Mr. Thompson’s work in the insurance industry. The police have yet to identify the shooter who is still on the loose.

目前该事件的动机尚不明了，也不清楚这是否与汤普森在保险行业的工作有关。警方尚未查明在逃枪手的身份。

But that did not stop social media commenters from leaping to conclusions and from showing a blatant lack of sympathy over the death of a man who was a husband and father of two children.

但这并没有阻止社交媒体上的评论者们迅速就此事得出结论，并明显表现出对这位丈夫和两个孩子的父亲的死亡缺乏同情。

“Thoughts and deductibles to the family,” read one comment underneath a video of the shooting posted online by CNN. “Unfortunately my condolences are out-of-network.”

“向他的家人致以哀思和免赔额，”CNN在网上发布的一段枪击视频下，一条评论写道。“不幸的是，我的哀悼不在赔付范围之内。”

On TikTok, one user wrote, “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.”

在TikTok上，一位用户写道：“我是一名急诊室护士，我看到垂死的病人被保险拒绝，让我觉得恶心。因为这些病人和他们的家人，我实在没法同情他。”

The dark commentary after the death of Mr. Thompson, a 50-year-old insurance executive from Maple Grove, Minn., highlighted the anger and frustration over the state of health care in America, where those with private insurance often find themselves in Kafka-esque tangles while seeking reimbursement for medical treatment and are often denied.

50岁的保险公司高管汤普森来自明尼苏达州梅普尔格罗夫，他的死亡引发了如此阴暗的评论，凸显出人们对美国医疗保健现状的愤怒和不满。在美国，在寻求医疗报销时，自费投保者经常发现自己陷入卡夫卡式的纠纷，且经常遭到拒绝赔付。

Messages that law enforcement officials say were found on bullet casings at the scene of the shooting in front of a Midtown hotel — “delay” and “deny” — are two words familiar to many Americans who have interacted with insurance companies for almost anything other than routine doctor visits.

执法官员说，在市中心一家酒店前的枪击现场发现的弹壳上有“拖延”和“拒绝”字样，许多美国人都熟悉这两个词，在与保险公司打交道时，除了常规的就诊之外，几乎任何事情都要遭到“拖延”和“拒绝”。

Mr. Thompson was chief executive of his company’s insurance division, which reported $281 billion in revenue last year, providing coverage to millions of Americans through the health plans it sold to individuals, employers and people under government programs like Medicare. The division employs roughly 140,000 people.

汤普森是其所在公司保险业务的首席执行官，该业务通过向个人、雇主和联邦医疗保险等政府项目下的人员出售健康计划，为数以百万计的美国人提供保险，去年的收入为2810亿美元。这一部门约有14万名员工。

Mr. Thompson received a $10.2 million compensation package last year, a combination of $1 million in base pay and cash and stock grants. He was shot to death as he was walking toward the annual investor day for UnitedHealth Group, UnitedHealthcare’s parent company.

汤普森去年获得了1020万美元的薪酬，包括100万美元的基本工资，外加现金和股票奖励。他在前往参加联合健康保险母公司联合健康集团的年度投资者日的路上遭到枪杀。

Stephan Meier, the chair of the management division at Columbia Business School, said the attack could send shock waves through the broader health insurance industry.

哥伦比亚商学院管理系主任斯蒂芬·迈耶表示，这场袭击可能会对更广泛的医疗保险行业造成冲击。

About seven chief executives of publicly traded companies die each year, he said, but almost always from health complications or accidents. A targeted attack could have much larger implications.

他说，每年大约有七位上市公司的首席执行官去世，但几乎都是死于健康并发症或意外。有针对性的袭击可能会产生更大的影响。

“The insurance industry is not the most loved, to put it mildly,” Mr. Meier said. “If you’re a C-suite executive of another insurance company, I would be thinking, What’s this mean for me? Am I next?”

“保险这个行业，说得委婉一点，不是什么受人爱戴的行业，”迈耶说。“如果你是另一家保险公司的高管，我会想，这对我来说意味着什么？我会是下一个吗？”

A longtime employee of UnitedHealthcare said that workers at the company had been aware for years that members were unhappy. Mr. Thompson was one of the few executives who wanted to do something about it, said the employee, who spoke on condition of anonymity because the company does not allow workers to speak publicly without permission.

联合健康保险的一名长期雇员表示，该公司的员工多年来一直清楚投保者的不满。这名员工说，汤普森是少数几个想对此采取行动的高管之一。由于公司不允许员工在未经许可的情况下公开发言，这名员工要求匿名。

In speeches to employees, Mr. Thompson spoke about the need to change the state of health care coverage in the country and the culture of the company, topics other executives avoided, the employee said.

该员工说，在对员工的演讲中，汤普森曾谈到改变国家医疗保险覆盖状况和公司文化的必要性，其他高管回避了这些话题。

Already, there is heightened concern among some public-facing health care companies, said Eric Sean Clay, the president of the International Association for Healthcare Security and Safety. The trade group includes members that offer security to some of the largest health care companies in North America.

一些面向公众的医疗保险公司已经开始高度关注这一问题，国际医疗保障与安全协会主席埃里克·肖恩·克莱说，该行业组织的成员为北美一些最大的医疗保险公司提供安保服务。

“The C.E.O.s are quite often the most visible face of an organization,” he said. “Sometimes people hate on that individual, and wish to do them harm.”

“首席执行官往往是一个组织中最引人注目的人物，”他说。“有时人们会憎恨这个人，希望伤害他们。”

But few health care companies provide security for their executives, he said, in part to avoid bad optics, or because it may seem unnecessary.

但他说，很少有医疗保险公司为高管提供安全保障，部分原因是为了避免负面影响，或者因为似乎没有必要。

In the hours after the shooting early Wednesday morning, social media exploded with anger toward the insurance industry and Mr. Thompson.

在周三早间枪击事件发生后的几个小时里，社交媒体上爆发了对保险业和汤普森的愤怒。

“I pay $1,300 a month for health insurance with an $8,000 deductible. ($23,000 yearly) When I finally reached that deductible, they denied my claims. He was making a million dollars a month,” read one comment on TikTok.

“我每月支付1300美元的健康保险，免赔额为8000美元（每年23000美元）。当我最终达到免赔额时，他们拒绝了我的索赔。可他，一个月赚100万美元，”TikTok上的一条评论写道。

Another commenter wrote, “This needs to be the new norm. EAT THE RICH.”

另一位评论者写道：“这需要成为新常态。打倒富人。”

“The ambulance ride to the hospital probably won’t be covered,” wrote a commenter on a TikTok video in which another user featured an audio clip from the Netflix show “Queen Charlotte: A Bridgerton Story.” In it, the queen makes a dramatic show of faux sorrow over a death.

“救护车去医院的费用可能无法报销，”TikTok的一个评论写道，另一位用户在视频中播放了Netflix剧集《夏洛特王后：布里杰顿的故事》(Queen Charlotte: a Bridgerton Story)的音频片段。在这首歌中，王后夸张地表达了对某人死去的虚假悲伤。

The shooting prompted a wrenching outpouring of patients and family members who also posted horror stories of insurance claim reimbursement stagnation and denials.

这起枪击事件引发了病人和家属的痛苦倾诉，他们还发表了关于保险索赔迟缓和拒绝的惨痛故事。

One woman expressed frustration with trying to get a special bed for her disabled son covered by UnitedHealthcare. Another user described struggling with bills and coverage after giving birth.

一位女性表示，她曾为残疾的儿子申请一张专用床，却难以获得联合健康保险公司的理赔。另一位用户描述自己生完孩子后在账单和理赔方面遇到的困难。

“It is so stressful,” the user said in a video. “I was sick over this.”

“当时压力太大了，”该用户在视频中说。“整件事都让我觉得恶心。”