Healthcare companies are ending 2024 in the hot seat. Yet some of the pressures they're facing have been mounting all year — or longer. This month's killing of UnitedHealthcare CEO Brian Thompson thrust his company, and his industry, into the spotlight. It also sparked widespread consumer reckoning over denied claims and the high costs of care in the United States, where health care is the most expensive in the world. Now lawmakers on both sides of the political aisle are stepping up their scrutiny of the industry. But even before Thompson's shocking death on a New York City street, and its ongoing aftermath, the business of Big Health Care was having a rocky year. Costs are up, profits are down, top executives have lost their jobs, and investors are selling off the shares. This industry, which affects the lives and very well-being of the entire country, has been getting relentlessly bigger for years. Industry executives say that this growth allows big companies to offer a wider array of low-cost healthcare services to more people, while critics and consumer advocates say that the size and scale of these companies makes them opaque and expensive, and ultimately leads to worse outcomes for patients.