Luigi Mangione, anti-health insurance vigilante, was prophesied by this horror movie
The Saw series debuted in 2004—and Kevin Greutert, perennial Hollywood horror editor, was there from the beginning.
Greutert edited the first five Saw entries, helmed the next two (Saw VI and Saw VII), edited the two succeeding installments and finally directed what seems to be the swan song in the fictional universe of this Saw series, Saw X. Amidst these films, Greutert has also edited a handful of horror cult classics, such as Room 6 (2006), a campy haunted hospital flick starring a scream queen-worthy Christine Taylor, and directed Visions (2015), a paranormal thriller set in lush California wine country and featuring Isla Fisher.
Yet few are as topical as a movie which, at least in terms of its title, would in theory not stand out from the rest of this group. Indeed, it isn’t even the only movie here to include “six” in the title: Saw VI, the single best liberal satire on health care ever captured on celluloid.
I don’t consider that statement hyperbole. Indeed, I’ve written about it for publications like Salon Magazine and Dread Central, have a critics’ review posted on Rotten Tomatoes and delivered an academic lecture on the film in 2023 at Sarah Lawrence College. Yet with the exception of the Dread Central retrospective, all of these tributes occurred before Saw VI became relevant to the news cycle.
That is because on December 4, 2024, a health insurance executive named Brian Thompson was shot to death in Midtown Manhattan. The United Healthcare CEO had been on his way to an annual investors’ meeting, but Thompson’s murderer saw to it that he never arrived.
Instead, Thompson’s name will be forever linked with that of Luigi Mangione, a former data engineer who law enforcement accuses of killing Thompson because “frankly, these parasites simply had it coming.” By way of explaining why, Mangione pointed out that America “has the #1 most expensive healthcare system in the world, yet we rank roughly #42 in life expectancy.”
With a single bullet, Mangione reopened a conversation that many thought had been closed. President Barack Obama’s landmark legislative achievement, the Affordable Care Act, had in the subsequent dozen years expanded health care to 40 million people, expanded Medicaid to 40 states, and thereby covered 21 million low-income adults under 65, and protected 133 million people with preexisting conditions from losing their coverage. Despite these steps forward, however, Mangione accurately pointed out that health insurance companies still jack up prices, decline crucial coverage, and otherwise harm ordinary people when they get sick.
Yet it is worth returning to the Obama era, with its concomitant crusade for health care reform from 2008 to 2010, because Thompson’s murder was prophesied by a popular horror franchise that released its sixth installment in 2009. In Saw VI, a new Jigsaw Killer named Mark Hoffman (Costas Mandylor) continues the mission created by his mentor John Kramer (Tobin Bell) by putting health insurance executives through a series of brutal tests that act out the death-panel-like mentality these companies use when making coverage decisions. Although Mangione did not mention Saw VI in his manifesto, the movie’s title began to trend shortly after the event.
One person who noticed this renewed attention was director Kevin Greutert, who has been involved with the Saw series since the first film. Saw VI was his directorial debut; because of its high quality, Greutert was later hired to direct Saw VII and Saw X.
“Fast forward and Luigi Mangione has allegedly killed Brian Thompson, the health care executive, and suddenly Saw VI is back in the news,” Greutert said. “I found that interesting and exciting, even though I definitely do not in any way endorse what Luigi did.” He was instead moved that his film became part of a “culturally relevant moment,” noting that Saw VI had entered the same conversation evidenced by a Saturday Night Live audience erupting into applause at the mention of Luigi’s name. Greutert even marveled that a musical has been made about Mangione.
“There is something going on here that’s worth noticing,” Greutert said. “There is a lot of anger in the country right now over this topic and lots of political topics. I’m just glad to have made a film that has sustained relevance.”
Certainly the filmmakers never imagined Saw VI would be so relevant at the time they were making it. Indeed, Greutert admits they hadn’t even suspected health care reform would become a signature issue when they began choosing their villains for the new sequel.
“We wanted to do something, make a movie that was about something, but we didn’t necessarily know that the health care was going to become such a loaded issue while we were making the film,” Greutert said. Despite real life offering a Saw-level twist of its own by making the film prescient, the filmmakers leaned into it.
“We were excited when the film did come out, and a lot of people said, ‘Oh, wow, a political Saw movie! That’s very cool!’” Greutert said. “Some people assumed we were advocating in a Democratic way instead of a Republican way or something like that. But I think for the most part people appreciated that we were taking on this subject. There was some catharsis, I think, to see Jigsaw put health care executives in a series of his traps.”
At the same time, Greutert is concerned that this catharsis could lead to ugly consequences. Vigilante murders should be left to the world of fiction, he argues. Real-life violence along the lines of Kramer and Hoffman can only lead to very dark places.
“I think that there is a point when a society is getting repressed where everything is on the table in terms of going against the establishment,” Greutert said. “But as Americans, we’re so far from that, even now in this horrific era that we’re in.” Yet as he contemplates political violence like President Donald Trump’s attempted coup on January 6th, he realizes that extreme violence is not impossible.
“I think that there’s a lot of boredom and intellectual laziness in America and a lot of manipulation by very cynical politicians and corporations that are corralling people into these fake reality bubbles,” Greutert said. “We’re all falling into it in our own way, but some are a lot worse than others.” This is why, despite Saw VI being relevant as a movie about violence inflicted against evildoers, he believes “God help us” if society deteriorates into that type of actual violence, “because it’s very hard to recover from something like that without first going all the way.”
One day, I hope that the concept of people dying of treatable ailments because they can’t afford health care becomes a distant memory. If that happens, perhaps future generations will watch Saw VI in the same way they read Uncle Tom’s Cabin, as a chronicle of a great injustice made at a time when it was still prevalent.
In that case, we will not need to fear vigilantes like Mangione being hailed by otherwise well-meaning people as a hero.
Until that happens, though, Saw VI will continue to be relevant for the same reasons that Luigi Mangione allegedly murdered Brian Thompson. As John Kramer himself put it:
“These politicians, they say the same thing over and over and over again; ‘Healthcare decisions should be made by doctors and their patients, not by the government.’ Well, now I know they’re not made by doctors and their patients or by the government. They’re made by the fucking insurance companies.”
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