Revenge of the Tipping Point: Overstories, Superspreaders, and the Rise of Social Engineering

by Malcolm Gladwell

When I was driving around Miami with Pérez and Porras, I asked them about a man named Rick Scott. I didn’t expect them to answer the question—the matter is too sensitive for people employed by the federal government. But I could guess what they were thinking, because you can’t work in Miami, under the Miami overstory, and not wonder about the impact that people like Rick Scott had on people like Philip Esformes. Scott used to be the CEO of the large national for-profit hospital chain Columbia/HCA. In 1997, federal agents raided Columbia/HCA. In the first wave of the investigation, five senior company officers were ordered to appear before a grand jury. What division of the company were they all from? You can guess: Florida. Scott was not charged in the case, nor implicated in any wrongdoing. But he was forced to resign in disgrace. And a few years later, Columbia/HCA pleaded guilty to fourteen felonies—involving kickbacks to doctors, false billing, making illegal deals with other providers, and on and on—and ultimately paid what was then a record $1.7 billion in civil settlements. Where did Scott end up moving after leaving HCA? You