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Friday, January 10, 2025 7:58:13 PM
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The Long, Tainted Ascent of JD Vance's Likely Replacement--and What It Says About Ohio
Among its many qualities, who knew that the city of Miami was an overwhelming leader in the occurrence of Medicare fraud?
Not me, until I read Malcom Gladwell’s latest book (“Revenge of the Tipping Point”).
But it turns out, South Florida is an absolute outlier when it comes to runaway Medicare fraud.
And, Gladwell explains, that is due to a phenomenon he calls a place’s “overstory” — an element to a place that takes hold, shapes behavior, and continues on, unique from other places. It may start for a particular set of reasons, but then takes on a life of its own, becoming a self-reinforcing characteristic and culture.
In Miami’s case, a combination of factors weakened the institutions of a once sleepy Southern town to the point where truly bold Medicare fraud practices (Gladwell describes phony offices and outrageous, “exotic” billing schemes in great detail) were not policed. And once they weren’t policed, they became the norm. And once the norm, they became the way to succeed. Y’know, because everybody’s doing it. Suddenly, those NOT frauding actually face a disadvantage.
Gladwell walks through one of the biggest Medicare fraud trials in history—involving cash kickbacks, lavish trips, “bribery, sham invoices….money laundering…[and] shady doctors.” The lawyer of the man found guilty for all this literally asserted in his defense that he had been an upstanding citizen in other locales until….he “came to Miami.”
That’s right: Miami was literally part of his defense. Within Miami’s “overstory,” the man argued that his behavior was the norm. He had been corrupted by it.
While the man was convicted and sentenced to 20 years in September 2019, another famous Floridian sympathized with his defense. In one of his final acts of his first term, Donald Trump commuted his sentence.
Gladwell also points out that the lax culture around fraud is so dominant that it helps explain how, after the hospital chain Columbia/HCA was busted for Medicare fraud (the first phase of the investigation emanated from its Florida office)—ultimately pleading guilty to all sorts of illegality while settling civilly for $1.7 billion—the CEO who’d “presided” over all those acts relocated to Florida
And ran for Governor….and won.
And then ran for Senate, and won.
Propped up by a forgiving Florida, the man was only a few votes shy of becoming Senate majority leader late last year.
Yes, I’m talking about Rick Scott.
Ohio’s Overstory
So that’s Miami’s overstory.
But when I read Gladwell’s chapter, you won’t be surprised to know that I quickly thought of Ohio.
Because the phenomenon he describes about the common practice and loose enforcement around Medicare fraud in South Florida of course reminded me of how Ohio politics have operated for too long as well.
Ohio’s “overstory” is clearly that pay-to-play corruption drives the state’s politics and corrodes public service. That’s the reason even the FBI considers us the leading state in the nation when it comes rot public corruption.
More: https://davidpepper.substack.com/p/scandalling-up-in-ohio?utm_source=post-email-title&publication_id=1171551&post_id=154507183&utm_campaign=email-post-title&isFreemail=true&r=ebxc&triedRedirect=true&utm_medium=email
The Long, Tainted Ascent of JD Vance's Likely Replacement--and What It Says About Ohio
Among its many qualities, who knew that the city of Miami was an overwhelming leader in the occurrence of Medicare fraud?
Not me, until I read Malcom Gladwell’s latest book (“Revenge of the Tipping Point”).
But it turns out, South Florida is an absolute outlier when it comes to runaway Medicare fraud.
And, Gladwell explains, that is due to a phenomenon he calls a place’s “overstory” — an element to a place that takes hold, shapes behavior, and continues on, unique from other places. It may start for a particular set of reasons, but then takes on a life of its own, becoming a self-reinforcing characteristic and culture.
In Miami’s case, a combination of factors weakened the institutions of a once sleepy Southern town to the point where truly bold Medicare fraud practices (Gladwell describes phony offices and outrageous, “exotic” billing schemes in great detail) were not policed. And once they weren’t policed, they became the norm. And once the norm, they became the way to succeed. Y’know, because everybody’s doing it. Suddenly, those NOT frauding actually face a disadvantage.
Gladwell walks through one of the biggest Medicare fraud trials in history—involving cash kickbacks, lavish trips, “bribery, sham invoices….money laundering…[and] shady doctors.” The lawyer of the man found guilty for all this literally asserted in his defense that he had been an upstanding citizen in other locales until….he “came to Miami.”
That’s right: Miami was literally part of his defense. Within Miami’s “overstory,” the man argued that his behavior was the norm. He had been corrupted by it.
While the man was convicted and sentenced to 20 years in September 2019, another famous Floridian sympathized with his defense. In one of his final acts of his first term, Donald Trump commuted his sentence.
Gladwell also points out that the lax culture around fraud is so dominant that it helps explain how, after the hospital chain Columbia/HCA was busted for Medicare fraud (the first phase of the investigation emanated from its Florida office)—ultimately pleading guilty to all sorts of illegality while settling civilly for $1.7 billion—the CEO who’d “presided” over all those acts relocated to Florida
And ran for Governor….and won.
And then ran for Senate, and won.
Propped up by a forgiving Florida, the man was only a few votes shy of becoming Senate majority leader late last year.
Yes, I’m talking about Rick Scott.
Ohio’s Overstory
So that’s Miami’s overstory.
But when I read Gladwell’s chapter, you won’t be surprised to know that I quickly thought of Ohio.
Because the phenomenon he describes about the common practice and loose enforcement around Medicare fraud in South Florida of course reminded me of how Ohio politics have operated for too long as well.
Ohio’s “overstory” is clearly that pay-to-play corruption drives the state’s politics and corrodes public service. That’s the reason even the FBI considers us the leading state in the nation when it comes rot public corruption.
More: https://davidpepper.substack.com/p/scandalling-up-in-ohio?utm_source=post-email-title&publication_id=1171551&post_id=154507183&utm_campaign=email-post-title&isFreemail=true&r=ebxc&triedRedirect=true&utm_medium=email
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