State of the Exception - March 2025 (Audio)
Added 2025-04-08 19:42:58 +0000 UTCAaron and Bryce give a brief update and answer patron questions!
Comments
I recall hearing that Nixon's HMO Act ended up offering avenues for mob money to go into the new HMO "insurance" rackets but I can't find anything about this online. I wish I could recall where I read it. What is true is that the protection racket became the model for health insurance and Nixon understood this going in. Check out this conversation where Nixon and Ehrlichman basically admit that their plan would open healthcare provision to massive profiteering/rent-seeking: https://en.wikisource.org/wiki/Transcript_of_taped_conversation_between_President_Richard_Nixon_and_John_D._Ehrlichman_%281971%29_that_led_to_the_HMO_act_of_1973:
Aaron Good
2025-05-03 22:17:49 +0000 UTCThere’s no proven, systemic connection between Health Maintenance Organizations (HMOs) and the Italian mafia. However, certain fraud cases in the healthcare industry — including those involving HMOs or similar healthcare providers — have, at times, intersected with organized crime, including Italian-American mafia families. These connections are typically financial in nature, not structural or ideological. Here are a few key points to clarify the context: ⸻ 1. Organized Crime in Healthcare Fraud • The Italian-American mafia has a long history of involvement in white-collar crime, including Medicare and Medicaid fraud, pharmaceutical diversion, and bogus clinics. • In the 1990s and 2000s, multiple FBI investigations revealed that certain mob-connected individuals were profiting from billing scams, fake medical equipment, and kickback schemes. • Some of these schemes involved front companies posing as healthcare providers — which could resemble HMOs in structure, but weren’t legitimate insurance organizations. ⸻ 2. HMO Abuses (Unrelated to Mafia) • HMOs have been widely criticized for denying care to save costs, prioritizing profit over patient outcomes, and engaging in complex billing practices. • These practices have generated public distrust but are generally corporate-driven rather than connected to traditional organized crime. ⸻ 3. Overlap in Fraud Techniques • The techniques used by mafia groups and corrupt healthcare execs often look similar: fake diagnoses, billing for non-existent procedures, patient kickbacks. • However, that similarity is due to the vulnerability of the U.S. healthcare system to fraud and abuse, not because HMOs are mafia fronts. ⸻ Notable Example: • In the early 2000s, members of the Lucchese crime family were implicated in a multimillion-dollar scheme involving phony physical therapy clinics in New York. These were not HMOs per se but operated like managed care facilities to siphon insurance funds. ⸻ Summary: While the mafia has exploited healthcare fraud, there’s no systemic or direct link between HMOs as an institution and the Italian mafia. The overlap exists mainly where financial crime and regulatory loopholes allow corruption — something that affects many large industries, not just healthcare.
Sunjay Kumar
2025-05-03 19:20:14 +0000 UTCWho wrote that?
Aaron Good
2025-04-14 13:23:57 +0000 UTCRan into this, seems relevant: https://data.ddosecrets.com/Casolaro%20Files/Book%20Proposals%20-%20Papers%20-%20Other%20Authors.pdf
Sean Atkinson
2025-04-13 05:07:51 +0000 UTC
