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

by Malcolm Gladwell

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 can guess that too: Florida. A few years after that, he decided to run for governor of… you guessed it: Florida, where he served two terms before moving on to represent… yes, Florida, in the United States Senate. For a portion of the years that Philip Esformes ran a billion-dollar scheme of kickbacks, false billing, and illegal deals, the governor of his state was someone who had presided over a hospital system that ran a billion-dollar scheme of kickbacks, false billing, and illegal deals.