Six months ago, a top executive at the third-largest company in America was shot dead. Brian Thompson, CEO of the $300 billion insurance arm of UnitedHealth Group (UHG), was murdered on his way to the company’s investor day in Midtown Manhattan.
At the time, UHG’s business had never been stronger. The health care giant also runs a prescription drug operation, employs thousands of doctors, and manages huge medical billing systems. Just a few weeks after Thompson was shot, the company reported that its revenue topped $400 billion in 2024—more than three times what it was 10 years ago.
But the murder forced UHG to face a harsh fact: The health care system has never felt more broken to the patients it’s meant to serve. The alleged killer is a man who was angry that UHG had soared in value even as it denied care to patients. On social media, disturbingly, thousands of people celebrated the killing. But a far larger number clearly feel that UHG and other insurers use their power for profit, not for the greater good.
Since then, UHG’s earnings and share price have plunged. In mid-May its CEO, Andrew Witty, stepped down; he was succeeded by Stephen Hemsley, the former chief whose acquisitions made the company huge in the first place. Hemsley will have to reckon with the imperative of striking a better balance in UHG’s priorities. Fortune’s Geoff Colvin explores the company’s dilemma in “How sick is UnitedHealth? How a wave of bad news wiped $280 billion off the insurer’s stock value.“
Across the board, American business performance was off the charts last year: 2024 was the
most profitable year on record for the Fortune 500, which posted a collective $1.87 trillion in earnings.
But plenty of business leaders still understand that stakeholder capitalism is the smartest long-term financial strategy, and that reinvesting profits in your employees and customers can build a better legacy for your company. Dozens of them can be found on our 100 Most Powerful Women ranking. Our “MPWs” not only control giant businesses, but use their power to create positive change for many.
Bill Gates and Warren Buffett are also examples of how profit—and the influence and wealth that come with it—can be leveraged to improve not just a company or an industry, but the entire world. The pair created the Giving Pledge to ensure that vast wealth gets distributed instead of hoarded.
Fortune recently got an exclusive look at Gates’ biggest philanthropic move yet: The Microsoft
cofounder, whose foundation has spent more than $100 billion trying to eradicate leading causes
of infectious disease and childhood death, pledged to dedicate almost all his remaining wealth to that cause. In all, it’s a commitment of another $200 billion (see “Bill Gates’ $200 billion moonshot: Inside the biggest bet on humanity a philanthropist has ever made.“).
Our team spent eight months reporting behind the scenes on how Gates arrived at this decision, and how the Gates Foundation will invest for maximum impact over the next 20 years—before it closes its doors completely.
Whether Gates’ determination will be an outlier in an era of “greed is good” resurgence remains to be seen. “The biggest unknown [is]: Do our fellow travelers stay generous, or do they tune out these millions of deaths and turn inward?” Gates told Fortune. In the long run, no leader can afford to put profits too far ahead of people.
This article appears in the June/July 2025 issue of Fortune with the headline “Power for good.”