#department of health

[hellochildrenoftheatom]

Queer Jews Project Day 19 - Rachel Levine

The highest-ranking openly transgender public official in the United States Government, Dr. Rachel Levine has served as the Assistant Secretary of Health since 2021. That means she’s second in command at the Department of Health. Before her current job, she was The Pennsylvania Secretary of Health and lead her state through the COVID-19 pandemic. Throughout her career, she has focused on LGBTQ medicine, children’s health, and the opioid crisis.

Learn more about Rachel Levine here.

Queer Jews Project

[gwydionmisha]

I don't understand how this is legal.

[xtruss]

Photo: Here & Now/Co-Owner Tobly McSmith

The City’s Quiet Crackdown on Kava Bars. The Businesses Selling Kava and Kratom Have Found Themselves in a Legal No-Man’s-Land.

— By Chris Crowley, Senior Writer at Grub Street | CURBED

Tobly McSmith has had his kava bar Here & Now shuttered by Inspectors from the Department of Health and Mental Hygiene twice in the year and a half since it first opened on Allen and Bowery. “We’ve been scared of everybody who walks in,” McSmith says. In addition to pour-over Coffee and Espresso and Pots of Tea, McSmith sells Kava and Kratom Teas that his employees brew themselves, both plant-derived substances that his Clientele Consider Natural Options for Anxiety and Pain Relief and The health Agency Deems “Poisonous,” “Injurious to Health,” and “Unsafe.” This difference has led to the Bureaucratic Tug of War plaguing his business — from DOH violations for selling kava to a cease-and-desist letter to closure orders, two hearings, a trial, and a denial of his application to renew his food service establishment permit. He’s not alone — the city’s other kava bar owners are by now very familiar with the bright yellow signage announcing a shutdown: “Closed By the Order of the Commissions of Health and Mental Hygiene.”

The city’s quiet kava crackdown started in November 2022, when the Health Department issued a summons to KavaSutra, a kava bar on First Street. A couple of months later, KavaSutra got hit again at its 10th Street location, when the department “Embargoed” its kava products, according to a lawsuit KavaSutra’s owners later filed against New York City, Mayor Eric Adams, and the Health Department and Its Commissioner Ashwin Vasa. Then last spring, the agency shut down two kava bars in Williamsburg: Ka-Vá Kava Bar (the space is now a cannabis club) and Kava Social, which never reopened publicly but has operated as a private club since. It’s a fairly existential moment in the New York kava and kratom scene, but the saga has gone largely unnoticed by the wider public. This may be because it’s a small-ish market to begin with, a blip compared to the unlicensed cannabis market that has taken over the city’s retail landscape and baffled the city, state, and law enforcement officials tasked with regulating it. The client base for kava and kratom bars also includes a lot of recovering addicts, who are both used to being overlooked and perhaps would prefer to avoid any extra attention. (“I would say a good 60 to 65 of our customers are sober,” McSmith says.)

Craig, one of the regulars I met at Here & Now, said he started taking kava pills in 2010 after returning from Iraq, where he worked as a reporter for human rights organizations. “I was all kinds of messed up. I couldn’t sleep,” he says. He started using kratom early last year, when he walked by a kava bar. “I was like, this is the answer,” he says. Kava bars have since become a central part of his recovery, he says. “A lot of people here have helped me out. Staying on a couch, taking a shower,” he says of Here & Now. “I come here everyday, and I know all of these people.”

Kava, which is derived from the roots of the kava shrub, has for centuries had ceremonial and medicinal uses in the Pacific Islands, and those who use it find it calming and mood-enhancing without the judgment-impairing effects of alcohol. Many kava bars also sell kratom, which is made from the dried leaves of the kratom tree, an evergreen found in Southeast Asia. It’s also sold as a potent extract or pill at stores like Hot Sauce Exotics CBD & Kratom Store in little bottles that fit right alongside 5-Hour Energy drinks and poppers. Depending on the strength of the dose, it can act as a stimulant or a sedative, and it’s marketed here as a treatment for anxiety and addiction. Both are legal in the United States, but Only Kava Has Been Approved by the FDA as a dietary supplement for personal use (the agency says it has “Inadequate Information” on whether kratom poses a risk to consumers).

Together, Kava and Kratom are in a long line of regulatory puzzles the city has tried to solve over the years: CBD, Cannabis, Chefs curing their own charcuterie in-house, bodegas selling synthetic drugs like K2, and Chinatown business owners hanging Roast Duck in their windows. “It’s kind of a unique challenge for regulators to figure out how to tackle this because it is such a gray market industry,” says one lawyer whose clients include companies in the cannabis industry and others regulated by the FDA. She pointed to Tara Flour, which is made from the legumes of the plant of the same name, as an example of a substance that federal and state agencies struggled to regulate. In 2022, Daily Harvest recalled a product made with Tara Flour — a new ingredient in the US market — as the FDA and Center for Disease Control investigated reports of serious stomach pain from those who had consumed it. 500 people became ill, and 39 of them had their gallbladders removed. This May, two years after the initial recall, the FDA finally banned its use in food. Those in the kava and kratom industry have similarly seen uneven enforcement: federal regulators tend to go after the producers, while local agencies try to shut down sellers like Here & Now. And enforcement is uneven across the country; in Hawaii, where kava is Known as ‘Awa’ and is part of the native culture, the state’s Department of Health distinguishes between the way Hawaiians have consumed it for centuries, in beverage form, and the concentrated extracts that the health studies were based on. According to a 2023 World Health Organization report, there “are very few published adverse health effects arising from the traditional consumption” in the South Pacific. This is the method Here & Now says it is using.

Tobly McSmith behind the bar at Here & Now. Photo: Here & Now/Co-Owner Tobly McSmith

When McSmith’s bar was first hit with violations for selling kava last July, a health inspector made him dump all of the bar’s product — around $1,500 worth, McSmith says. It’s a sum that KavaSutra, a chain with several stores, could eat, but Here & Now, a smaller operation, couldn’t. In addition to dumping the product, McSmith had to promise not to sell kava and kratom and take down the menus.

The cease-and-desist order came the following month, and McSmith had a hearing in November. The judge ruled in the bar’s favor, dismissing the violations because of failure “to establish that kava or kratom is an adulterant, that when added to water, is poisonous, injurious to health, or unsafe.” The charges were also dismissed in a second hearing and in a December trial before an administrative law judge. None of this seemed to matter: the city wouldn’t renew Here & Now’s food service establishment permit and had issued a petition to revoke it. When reached about the kava bar shutdowns, a representative for the Health Department responded that New York health codes “prohibit” adding kava to food because of “significant” health risks: “We are requiring restaurants serving food containing kava or kratom to stop. And, if they refuse, we are requiring them to close.”

These substances can be dangerous, is the thing. In 2002, the FDA issued an advisory warning consumers that dietary supplements containing kava might be “associated with severe liver injury,” based on studies that measured the effects of highly-concentrated extracts, and in 2020, it published a memorandum concluding that kava is not generally recognized as safe. There have been dozens of lawsuits filed over kratom products, and one Washington family was awarded $2.5 million dollars in the wrongful death lawsuit of Patrick Coyne, who had been taking Kratom Divine’s Maeng Da strain to treat chronic back pain. Unlike Kava, Kratom is also found to mimic the effect of “scheduled opioid drugs,” according to the FDA. In a Tampa Bay Times analysis of 20 kratom products, researcher Abhisheak Sharma compared one of the tablets, 7ΩHMZ, to “legal morphine,” and a one-ounce bottle of another extract contained nine times the amount of mitragynine (an alkaloid in kratom that functions like opioids) that Sharma considers safe to consume in a day. And while kratom has been adopted by some as a tool for opioid recovery, some treatment groups think it’s detrimental to that process, and even potentially addictive.

But kava and kratom’s boosters make the same arguments as other harm reductionists: They’re just as invested in safety as the city. Shuttering legitimate businesses will only reward shady manufacturers. “Let’s regulate this. Let’s not sell extracts. Let’s have good sourcing. Let’s let customers know what the effects are,” McSmith says. “We’re all pro-regulation because it should be regulated. We don’t want people to get sick.” He says that Here & Now doesn’t sell extracts for this reason, and no other kava and kratom than what they brew in-house. Bartenders go through up to 20 hours of training, depending on their experience with kavatending, and McSmith says he’s careful about sourcing from reputable businesses. One night at Here & Now, he pulled out his phone to show me a photo of what he’d seen at a CBD shop. “Look at these kratom extracts,” he said. “No label, no real education about what you’re drinking, very high dosing, very dangerous.”

For now, McSmith is waiting for a sign that his legal limbo will end. The cafe’s permit expired in December, and he was told he had to wait to renew it until after the closure order was lifted. Then in February, after a judge recommended lifting that closure order, the permit renewal was still denied. His appeal was denied, too, in early May. This week, one of the bar’s regulars launched a GoFundMe to cover costs for the business’s “next legal step.” “We are closed by the city, no longer have a permit, and have until August to try and raise funds through donations and decide to challenge the arbitrary and capricious determination made by the city in state court under an Article 78 proceeding,” McSmith says. Health Department inspectors have been back twice, and cops paid the bar a visit as well.

Here & Now is still in business, kind of. The door is papered over, and curtains are drawn over the front doors. “It’s our community coming through to support us, for sure,” McSmith says. There are enough regulars to stay afloat, but it’s unclear how long this can last. For now, it seems unlikely that the city will come around to kava. Going back to court for the fourth time seems inevitable, he says: “They really try to drown you in paperwork and fines and lawyer time until you just give up.”

[afriblaq]

Interesting

Download: Goods Unite Us app (GUU)

[bitterbloodypettybetty]

#PLEASEHELP #PLEASESHARE This piece of shit hotel can untag themselves & block me, my cousin, or anyone else they’re threatened by telling the #TRUTH about their lies, shady and downright #ILLEGAL practices, but that will never change the fact that it’s real, nor will it ever shut me up or make me go away and stop fighting for #JUSTICE for them trying to ruin me. They took me to court & it was dismissed because they’re ignorant & I was on the right side of the law. I took great pleasure in the judge basically laughing & telling them how stupid they were. They threatened other staff with unwarranted suits for speaking up trying to do the right thing. They denied us our mail, refusing, returning, or destroying it for over TWO MONTHS. The old hag who took my job after pretending to care about my health issues & the poor management was even ignorant enough to post a sign admitting to it in public view (see following post). Then not only denied that they were breaking the law when it’s clearly a federal offense to tamper with mail of a current resident (even if you were trying to evict) but also threatened another staff members job, because they ASSUMED that person shared that public photo with me because the caverns supervisor is so desperate for friends that she gossips for attention, not caring that she’s cost someone else who is above & beyond a FAR better human than her their job. They rehired someone ineligible for rehire that was fired for sexual harassment & drug use while one of the THREE employees he sexually harassed is still employed there. Yet had just fired half the staff for supposedly not having any work for them?? They allowed maintenance to enter my room without my permission or even my knowledge until after the fact, in which the police had to inform them was NOT legal, as it happened more than once. They allowed a front desk employee who wasn’t even trained & only employed 3 MONTHS access to the entire staff’s payroll, (which was MY job that I was great at & I was still employed there at the time & my employees were upset since they trusted me & only me to do it), which in turn screwed half a dozen or more employees out of hundreds, some even thousands of dollars. They’ve had TWO employees found #DEAD in their staff housing rooms riddled with #BlackMold #asbestos & #bugs within 2 months. We were denied hot water in our rooms for over 4 MONTHS—that was when we HAD water, since that was cut off NUMEROUS times for weeks on end. We had raw sewage leaking up from the toilets filling the bathroom and even making its way out into the living & bedroom space for MONTHS. They charge employees rent to live like this, yet won’t properly pay them. I have contacted U.S. Equal Employment Opportunity Commission, Virginia Department of Health, Natural Bridge State Park, Department of Conservation, U.S. Postal Inspection Service, The News-Gazette, Lexington, Va etc. & quite honestly am disappointed at the lack of action. I have proof I was offered a severance & same old hag denied it later when it was time to pay up (again proof in my phone for a following post). I have far more photos, videos, & voice recordings of the disgusting state of this hotel & the immoral things done by its owners and management. I am in no way done posting.

[crytidsprinkles]

I ordered and just received my free tests! The expiration date on mine are the end of Jan. 2024 ❤️

And remember, test for at least 1 week, preferably longer, swap your cheeks as well as your throat not just your nose, track symptoms, be aware of ones requiring medical attention, get antiviral (don't accept no for an answer).

Isolate if you can (10 days to 2 weeks), tell everyone you were in contact with, mask until you test negative after testing period of (same as isolation). Rest often and as much as you can. And always monitor for symptoms and changes warranting ER visit.

Be aware hospitals, emergency departments and urgent cares may be swamped because of the significant increase in patients due to SARS-CoV-2, RSV, Flu, Pneumonia and other opportunistic infections as a consequence of ongoing SARS-CoV-2 spread since 2020.

Tests available with your local DHS (supplies, programs and access depends on your state. If you can definitely connect with people who do and find out if you can request any tests they could order or spare. This goes for multi panel tests in other countries if you know anyone abroad).

Originally posted December 30th 2023

[latestgovtjobnews]

UPSC hires specialists for Health Department; apply online via their site.

New Post has been published on https://www.jobsarkari.in/upsc-hires-specialists-for-health-department-apply-online-via-their-site/

UPSC hires specialists for Health Department; apply online via their site.

PHP error in Ad Inserter block 4 - Show Top Image Warning: Trying to access array offset on value of type bool

The Union Public Service Commission (UPSC) has released an online recruitment advertisement for specialist posts. Applications are invited for the following vacancies from December 23, 2023, to January 11, 2024.

1. There are 46 vacancies in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi. The vacancies are for the post of Specialist (Anaesthesiology). The vacancies are distributed as follows: SC-04, ST-06, OBC-30, EWS-01, and UR-05. One vacancy is reserved for candidates with benchmark disabilities.

2. There is one vacancy in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi for the post of Specialist Grade III (Bio-chemistry). This vacancy is for SC category candidates.

3. There are seven vacancies in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi for the post of Specialist Grade III (Forensic Medicine). The vacancies are distributed as follows: SC-01, OBC-03, and UR-03.

4. There are nine vacancies in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi for the post of Specialist Grade III (Microbiology). The vacancies are distributed as follows: SC-01, ST-01, and OBC-07.

5. There are seven vacancies in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi for the post of Specialist Grade III (Pathology). The vacancies are distributed as follows: SC-01, ST-01, OBC-01, and UR-04.

6. There are eight vacancies in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi for the post of Specialist Grade II (Plastic Surgery & Reconstructive Surgery). The vacancies are distributed as follows: ST-01, OBC-04, and UR-03.

The age limit for these posts is 50 years for SC/ST candidates, 48 years for OBC candidates, and 45 years for EWS/UR candidates. The closing date for online application submission will be considered as the crucial date for determining the age limit.

Candidates interested in applying for these posts are advised to visit the UPSC’s Online Recruitment Application (ORA) website at https://www.upsconline.nic.in. Detailed instructions and additional information can be found on the website. The advertisement and instructions can also be accessed on the UPSC’s official website at https://www.upsc.gov.in.

Please note that this summary has been shortened to 350 words while preserving important details and key points from the original text.

The Union Public Service Commission (UPSC) has released an indicative advertisement for online recruitment.

Applications are invited for various specialist grade III posts in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

There are a total of 46 vacancies, with one vacancy reserved for candidates with benchmark disabilities.

The age limit for the posts varies based on the category, ranging from 45 to 50 years.

The candidates can apply online through the UPSC website from 23rd December 2023 to 11th January 2024.

Introduction

The Union Public Service Commission (UPSC) has released an indicative advertisement for online recruitment.

Applications are invited for various specialist grade III posts in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

There are a total of 46 vacancies, with one vacancy reserved for candidates with benchmark disabilities.

The age limit for the posts varies based on the category, ranging from 45 to 50 years.

The candidates can apply online through the UPSC website from 23rd December 2023 to 11th January 2024.

Vacancy Details – Anaesthesiology

Specialist Grade III post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 46 (SC-04, ST-06, OBC-30, EWS-01, UR-05)

One vacancy reserved for candidates with benchmark disabilities.

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for SCs/STs, 48 years for OBCs, and 45 years for EWS/URs.

Vacancy Details – Bio-chemistry

Specialist Grade III post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 1 (SC-01)

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for SCs.

Vacancy Details – Forensic Medicine

Specialist Grade III post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 7 (SC-01, OBC-03, UR-03)

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for SCs, 48 years for OBCs, and 45 years for URs.

Vacancy Details – Microbiology

Specialist Grade III post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 9 (SC-01, ST-01, OBC-07)

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for SCs/STs and 48 years for OBCs.

Vacancy Details – Pathology

Specialist Grade III post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 7 (SC-01, ST-01, OBC-01, UR-04)

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for SCs/STs, 48 years for OBCs, and 45 years for URs.

Vacancy Details – Plastic Surgery & Reconstructive Surgery

Specialist Grade II post in the Department of Health & Family Welfare, Government of National Capital Territory of Delhi.

Total vacancies: 8 (ST-01, OBC-04, UR-03)

Pay Scale: Level-11 in the Pay Matrix as per 7th CPC plus NPA.

Age limit: 50 years for STs, 48 years for OBCs, and 45 years for URs.

How to Apply

Visit the UPSC website for detailed instructions and additional information.

The candidates can apply online through the UPSC website.

Online application dates: 23rd December 2023 to 11th January 2024.

Important Dates

Applications can be submitted online from 23rd December 2023.

The last date for online application submission is 11th January 2024.

Conclusion

The UPSC is recruiting specialists in different fields for the Department of Health & Family Welfare.

Online applications can be submitted through the UPSC website.

Make sure to check the eligibility criteria and apply within the specified dates.

Apply Now for Specialist Grade III Posts!

Don’t miss the opportunity to join the Department of Health & Family Welfare.

Apply online through the UPSC website from 23rd December 2023 to 11th January 2024.

Take your career to new heights with UPSC!

[ricisidro]

View this post on Instagram

A post shared by Jun Isidro (@rcisidro)

Department of Health (DOH) chief Dr. Teodoro “Ted” Herbosa and Department of Agriculture (DA) Secretary Francisco Tiu Laurel Jr., get CA nod

[vision200]

The best medical clinic software, approved by ministry of health, Department of health and DHA, connected to Malaffi, Riayati and Nabidh EMR, lets take a tour. Streamline your medical clinic operations with our cutting-edge clinic software. Enhance patient care, optimize scheduling, and simplify billing with our intuitive and efficient medical management solution. Explore how our software can transform your clinic's efficiency today

[nakeddeparture]

Barbados School Meals Service. Someone needs to speak to the worker and the Department of Health.

https://youtu.be/uFZCGKrB-Sw

Get to the bottom of this alleged and continuing breach of trust. Naked!!

Like. Share. Subscribe. Comment on YouTube.

[kenyagist]

Strengthening Healthcare in Kenya: The Role of the Ministry of Health

The Ministry of Health, Republic of Kenya, plays a pivotal role in safeguarding the well-being of its citizens and enhancing the country’s healthcare system. With a focus on providing quality healthcare services, the Ministry works diligently to address the health needs of the nation. This article explores the vital functions and initiatives undertaken by the Ministry of Health in Kenya, aiming…

[srmprpickups]

[ramblingmindofrayyan]

Sometimes it’s really lonely being me.

[dontmean2bepoliticalbut]

[canisalbus]

Haeresis

[mostlysignssomeportents]

America’s richest Medicare fraudsters are untouchable

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/11/13/last-gasp/#i-cant-breathe

"When you're famous, they let you do it": eight words that encapsulate the terrifying rot at the heart of our lived experience, a world where impunity for the powerful trumps the pain of their victims.

"Populism," is shorthand for many things: rage, despair, distrust of institutions and a desire to destroy them. True populism seeks to channel those totally legitimate feelings into transformative change for a caring and fair society for all. So-called "right populism" exploits those feelings, using them to drive a wedge between different groups of victims, turning them against each other, so that elites can go on screwing the squabbling factions.

The far-right parties that are marching to victory through a series global elections are different in many ways, but they all share one trait: they appeal to mistrust of institutions, claiming that the government has been captured by elites who serve them at the expense of the governed. This has the benefit of being actually true, and while the fact that far-right parties are owned by these government-capturing elites might erode their credibility, the fact that so many "progressive" parties have stepped in to defend the institutional status quo leaves an open field for reactionary wreckers:

https://www.politico.com/blogs/2016-dem-primary-live-updates-and-results/2016/02/hillary-clinton-donald-trump-slogan-219908

Why would voters turn out to support a "Department of Government Efficiency," run by a bully whose career has been defined by abusing the people he is in charge of? Maybe they're turkeys voting for Christmas, but they also have personal, traumatic experience with government departments that protected the abusive corporations that preyed on them.

Today on Propublica, Peter Elkind tells the incredible story of Lincare, the nation's leading supplier of home oxygen, a repeat-offender fraudster and predator that has made billions in public money without any real consequences:

https://www.propublica.org/article/lincare-medicare-lawsuit-settlements-oxygen-equipment

Lincare has been repeatedly found guilty of defrauding Medicare; in this century alone, they have been put on probation four times, with a "death penalty" provision that would permanently disqualify them from ever doing business with the federal government. In every case, Lincare committed fresh acts of fraud, but never faced that death penalty.

Why not? Lincare is far too big to fail. In America's bizarre, worst-in-class, world-beatingly expensive privatized health care system, even public health provision (like Medicare) is outsourced to the private sector. Lincare has monopolized oxygen, a famously very important molecule for human survival, and if it were disqualified from serving Medicare, large numbers of Americans would literally asphyxiate.

Lincare clearly knows this. Too big to fail is too big to jail, and too big to jail is too big to care. They are the poster children for impunity, repeat offenders, multiply convicted, and still offending, even today. Lincare has been convicted of fraud under the administrations of GW Bush, Obama, Trump and Biden, and they're still in business.

What a business it is! Elkind takes us to the asbestos-poisoned town of Libby, Montana, where more than 2,000 of the 2.857 population suffer from respiratory diseases from the open-pit mine that operated there from 1963-1990. The elderly, dying population of this town rely on Medicare and Medicare Advantage oxygen concentrators to draw breath, and that means they rely on Lincare.

That means they are prey to Lincare's signature scam: charging Medicare (and 20% co-paying patients) to rent an oxygen concentrator every month, until they have paid for it several times over. This is illegal: under federal rules, patients are deemed to have bought their oxygen concentrators after 36 months and contractors are no longer allowed to charge them. Lincare doesn't give a fuck: the bills keep coming, and Lincare patients who survive long enough have paid the company $16,000 for a $799 gadget.

When Brandon Haugen, a local Lincare customer service rep, noticed this and queried the company's home office in Clearwater, Florida (home to Scientology and the Flexidisc), he was given the brushoff. After multiple attempts to get company leadership to acknowledge that this was illegal, he quit his job, along with his colleague and childhood friend Ben Montgomery. Between them, Haugen and Montgomery had 14 children who depended on their Lincare paychecks. Despite this, they both quit and turned whistleblower, with no job lined up. Eventually, Lincare paid $29m to settle the claim, with $5.7m to the whistleblowers and their lawyers. For Lincare, this was part of the cost of doing business and the fraud rolls on.

Lincare doesn't just defraud Medicare, they also have a high-pressure commissioned sales force that has repeatedly been caught defrauding Lincare customers – overwhelming sick, poor, elderly people. Patients are pressured to accept auto-billing, then Lincare piles medically dubious gadgets onto their monthly bills, as well as useless, overpriced "patient monitoring" services. Customers with apnea machines are mis-sold ventilators by salesmen who falsely claim these are medically necessary.

Salespeople illegally auto-shipped parts and consumables for Lincare machines to patients, then billed them for it. To satisfy the legal requirement that they telephone patients before placing these orders, sales agents would call patients, put them on hold, then part the call until the patient hung up.

Salespeople are motivated by equal parts greed and terror. Make quota and you can get up to $8,000 per month in bonuses. Miss that punishing quota and you're out on your ass (which is why one salesperson ordered a medically unnecessary ventilator).

Lincare also habitually ignores requests to pick up medically unnecessary equipment, because so long as the equipment is on the patient's premises, they can continue to bill for it. As one Ohio manager wrote to their staff: "As we have already discussed, absolutely no pick-ups/inactivation’s are to be do[ne] until I give you the green light. Even if they are deceased." Execs send out company-wide emails celebrating regional managers who have abandoned pick-ups, like a Feb 2022 "Achievement Rankings" email that touted the fact that most regional centers had at least 150 overdue pickups.

Lincare represents a deep, structural rot in American society. They are too big to punish, and too powerful to regulate. A 2006 law meant to curb oxygen payments was gutted by industry lobbyists. Today, Congress is weighing legislation, the SOAR (Supplemental Oxygen Access Reform) Act, which will allow Lincare to bill the public for hundreds of millions more every year, raising rates and eliminating competitive billing. The bill is supported by patient advocates who are rightly interested in getting oxygen to patients who have been locked out of the system, but the cost of that inclusion is that Lincare will be even more firmly insulated from its corruption.

The Trump Administration will doubtless crack down on some of America's worst companies, and the furious voters who elected the only candidate who campaigned on the idea that America was rotten will cheer him on. But Trump has made it clear that he will select the targets of his administration based on whether they are loyal to him or stand in his way, without regard to whether they harm his supporters:

https://pluralistic.net/2024/11/12/the-enemy-of-your-enemy/#is-your-enemy

Companies like Lincare, repeatedly caught paying illegal kickbacks, know how to play this game.

Image: p.Gordon (modified) https://commons.wikimedia.org/wiki/File:Smoke_bomb_with_burning_fuse.jpg

CC BY 2.0 https://creativecommons.org/licenses/by/2.0/deed.en