He detailed some of his planning leading up to the murder. He said that he was motivated by years of back pain and what he believed was a health insurance system working against him. He said that, once he learned that the UnitedHealthcare Company was holding an investor summit in Manhattan, he e-mailed company leadership posing as an investor to get information about where and when this meeting was taking place.

And that's how he was able to confront Brian Thompson. Mangione also shared an observation with the judge that had clearly made an impression on him. He talked about how, while he was posing as a wealthy investor, leadership e-mailed him back within an hour, and he said that was in stark contrast to his interactions with insurers as a patient.