UnitedHealthcare CEO Brian Thompson was shot and killed as he walked to an investor meeting on Dec. 4 in New York City, a place about as different as can be from the small town in the Midwest where he grew up.Jewell, Iowa, is a farming community with a population of just 1,183. Thompsons father worked for decades there as a grain elevator operator.I cant say enough about them, said Rick Young, who knew the Thompsons in Jewell. A loving mother, a no-nonsense dad who was also tender-hearted.Thompson and his older brother would go fishing before school and church. He attended South Hamilton High School, where yearbook photos obtained by Scripps News show he played basketball and golf. He was crowned homecoming king in 1992 and graduated as class valedictorian, a State of Iowa Scholar and an All-State trombonist in band. After his death, the South Hamilton Community School District released a statement, calling Thompson a star student, athlete, homecoming king and respected leader.He stayed humble despite his many recognitions, Young said.You know, some people are street smart, some people are intellectually smart, some people are book smart, Young said. Brian had the gift of being all those different things. But that doesn't mean he walked around his head up in the clouds.After high school, Thompson attended the University of Iowa, graduating with a business administration degree he put to use in corporate America. He landed at UnitedHealth Group in 2004, becoming the CEO of UnitedHealthcare in 2021 with a pay of $10 million dollars last year, according to company financial records. During Thompsons time at the top of UnitedHealthcare, the companys rate of denials became a focus of investigators in the U.S. Senate who found the company among companies turning down more and more claims from some of its sickest patients.The Senate investigative report said UnitedHealthcares denials for post-acute care surged from 10.9% in 2020 to 22.7% in 2022.UnitedHealth Group defended its denial rate in a news release after Thompsons death, saying the company approves and pays about 90 percent of medical claims.RELATED STORY | How Luigi Mangione went from Ivy League engineer to alleged CEO assassinOther problems also clouded Thompsons short tenure as CEO. Earlier this year, a class action lawsuit accused Thompson and two other UnitedHealthcare executives of insider trading, saying Thompson sold over $15 million of his personally held UnitedHealth shares after learning the U.S. Department of Justice had opened an antitrust investigation, news that wasn't yet public. Members of the California Public Employees Retirement System and the City of Hollywood Firefighters Pension Fund then bought company stock at artificially inflated prices, according to claims in the lawsuit.Thompsons death led to harsh reactions online, including by some who placed part of the blame on insurance company practices.Thompson had been sympathetic to the struggle many Americans face trying to afford coverage.We all know healthcare costs too much and were doing our best to fix it, but theres a long way to go, Thompson said in a 2021 corporate promotional video. Those who track the industry say Thompson was someone advocating for reforms.Hes the CEO of that organization, but he tries actually to change it, said Stephan Meier, professor and chair of the Management Division at Columbia Business School.A former colleague of Thompsons at UnitedHealthcare, who asked not to be identified given the hostility towards insurers, said there is irony in Thompson being targeted and criticized online after his death."The one thing I remember about working for Brian is that he was challenging people internally to be different, the colleague said. It was never about the money; it was about how the members feel about us. You had to be a good steward of the business. The thought was, if you do all the right things, youll be rewarded.