Fired Hospital Admin's Story Reveals Flaws in Healthcare Hiring

 How can medical groups, hospitals, and other healthcare organizations make sure their job applicants are who they say they are, especially as staff shortages have sparked more urgency to fill vacant posts?

It's not always easy, requiring checking and double-checking -- and not relying just on the references or social security number supplied by the prospective employee.

Bay Area Hospital, a 129-bed facility in Coos Bay, Oregon, learned the hard way when a concerned citizen sent a tip last year that its newly hired chief operating officer had a long history of criminal convictions and incarcerations relating to fraud and theft against facilities -- as it turned out -- in at least four states.

A 2015 press release issued by the Middle District of Louisiana U.S. Attorney's office called Larry D. Butler a "Con Man

opens in a new tab or window."

Hidden History

Court documents filed 8 years ago said Butler applied for jobs using a social security number that he faked and a driver's license that he altered in order to conceal his criminal past. That history includedopens in a new tab or window 35 arrests primarily related to fraud, 10 criminal convictions going back to 1985, and numerous incarcerations, including a 5-year prison termopens in a new tab or window that began in 2015.

Butler, now 57, falsifiedopens in a new tab or window his employment history on his resumes and when prospective employers called, Butler pretended to be the previous employer, saying "Oh, he was a great employee," Louisiana U.S. Attorney Ryan Crosswell told the court.

In Baton Rouge a decade ago, Butler acquired company credit cards that he used to rack upopens in a new tab or window charges for "high-dollar" personal items such as appliances and furniture, and obtained cash that he transferred by wire. He reroutedopens in a new tab or window the credit card addresses so the bills went to him instead of the healthcare organizations that paid them.

According to his 2014 federal plea agreement

opens in a new tab or window filed in the U.S. Attorney's Office for the Middle District of Louisiana, Butler used these deceptive tactics to get hired as the vice president of information technology at the non-profit, now defunct Louisiana Health Cooperative (LAHC) in 2013, earning $168,000 a year.

He was fired from that position for racking up $66,000 in charges for personal items on the company credit card, the document said.

In 2014, using a falsified social security number and fake information on his resume, he got hired by the non-profit Mary Bird Perkins Cancer Center in Baton Rouge as director of facilities management, with a salary of $80,000 per year.

Butler was sentenced in 2015opens in a new tab or window to serve a 5-year prison term, followed by 3 years of supervised release.

After he was released from prison in 2019, he came to California, where he was reportedlyopens in a new tab or window hired by Mercy San Juan Medical Center, a 300-bed acute care hospital near Sacramento, as senior director of ancillary services.

Officials at Mercy San Juan, part of Dignity Health, declined to answer numerous questions about how it came to hire Butler, how long he worked there, what they knew of his past, or under what circumstances he left. Instead, it issued this statement:

"While we are not at liberty to disclose specific information about a former employee, we can share that Dignity Health has a stringent background check process in place to screen prospective employees, and we regularly conduct internal reviews of our hiring process to ensure the care and safety of our patients and staff."

After he left Mercy San Juan, he traveled northwest to Oregon, submitting false credentials to Bay Area Hospital (BAH), which hiredopens in a new tab or window him as its chief operating officer in May 2022 and sent out a press release touting his vast experience.

A storyopens in a new tab or window in the local newspaper based on that release said that at Mercy San Juan, Butler reportedly "oversaw hospital operations and ancillary services, including the bariatric program, infusion center, hyperbaric clinic, wound care, dialysis, radiology and clinical project implementation."

Clay England, BAH's chief human resources officer, told MedPage Today in a phone interview, "There's a lot of ways that people can falsify that information. We go off a social security number, and there's ways for people to manipulate that. ... The information he provided to us was false."

England also said that BAH's background checks were mostly performed by a third party vendor with research on Butler going back 7 years, "and all of that met our criteria." He added, "background checks are based upon the information that the applicants submit. That's all I'm going to say."

He would not say if the hospital's checks included Mercy San Juan, whether the hospital actually spoke with Mercy San Juan personnel about Butler's history, or what they said about his performance and background.

After Butler's hiring made the local news, England said the hospital got a call from a "concerned citizen," and after searching online discovered Butler's past. England said that Butler was on the job 4 days before he was suspended, and subsequently terminatedopens in a new tab or window.

England said that in Butler's short time with the hospital, he did not have access to anything that would cause concerns regarding fraud or harm to patients.

Asked if Butler had the potential to commit fraud or cause other problems for the hospital if he hadn't been promptly terminated, England said that was a very real possibility, "absolutely."

'Rushed' Background Checks?

The ability of a convicted felon to so easily get hired at so many organizations for prestigious leadership jobs provokes chills among hospital executives, who told MedPage Today that COVID-related staffing shortages may provoke some to cut corners, especially with staffing levels down as much as 30% in some acute care facilities.

Speaking generally and not about this case, Chris Van Gorder, President and CEO of Scripps Health in San Diego, said that health companies should be diligent in their hiring practices, with reference checks, past employer checks, plus third-party checks. "The key is doing a complete check," he said. He added, however, "I suspect with staff shortages these days, some of these checks might be rushed in some organizations."

England said the hiring process involving Butler was not rushed. "I don't believe we rushed this. We took weeks to do this background check," England said. He declined to name the third party vendor the hospital hired.

Bay Area Hospital issued a statement, which said in part: "Even the best system can be manipulated by an unscrupulous individual. That said, BAH's process is consistent with industry standards, and includes, amongst other things, a full state, county and national criminal background check, a minimum of three professional reference checks, and in-depth interviews."

"We do want to confirm and clarify; upon learning of any potential issues, Larry Butler was immediately placed on suspension. Furthermore, we have verified that no patient PHI was accessed nor did he have any access to our employees' sensitive personal information during his 4 days of employment."

England said that his hospital referred the situation to the Oregon U.S. Attorney's Office. "I don't know to what level they pursued that, or decided not to pursue it," he said.

As for how hospitals and other health organizations vet their prospective employees, much of that remains a mystery. MedPage Today tried to contact several third-party reference check vendors about recommended practices, but received no response.

The issue is complicated in California, which in 2018 passed the Fair Chance Act, also called the "Ban the Box" law. In an effort to reduce barriers for people with criminal histories, it prohibits employers from asking applicants about their conviction history prior to making a job offer. Other state laws limit the amount of information that organizations can share with other facilities about an employee.

But The Joint Commission has background check standards within its "Elements of Performance" criteria. It requires all of its accredited healthcare organizations to obtain and document criminal background checks on applicants, according to law, regulation, and the organization's policy, said spokeswoman Maureen Lyons.

If an organization failed to do that, she said in an email, "it will be cited as a Requirement for Improvement requiring a corrective action plan be implemented by the healthcare organization." Such a failure also may impact the organization's accreditation standing.

Asked if reports about background checks were submitted concerning the case of Larry Butler by either Mercy San Juan Medical Center or Bay Area Hospital, Lyons said that reports go back 3 years, and that neither facility reported such a case to TJC.

https://www.medpagetoday.com/special-reports/exclusives/104122

Doctors, Nurses Charged in Wide-Ranging COVID Fraud Schemes, DOJ Says

 The Department of Justice (DOJ) announced a slew of criminal charges

opens in a new tab or window against 18 individuals working in healthcare -- including doctors and nurses -- for allegedly stealing a total of $490 million in funds from federal health and COVID-related programs.

"Today's announcement marks the largest-ever coordinated law enforcement action in the United States targeting healthcare fraud schemes that exploit the COVID-19 pandemic," said Assistant Attorney General Kenneth A. Polite Jr. of the DOJ's Criminal Division, in a press releaseopens in a new tab or window.

This action follows two other enforcement actions, in May 2021 and April 2022, which prosecuted similar fraud schemes.

Those charged with the crimes took advantage of pandemic-era relief programs, including the Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program, Paycheck Protection Program (PPP), Economic Injury Disaster Loan (EIDL) Program, and the Health Care Fraud Unit's Provider Relief Fund (PRF) Initiative. They also billed Medicare fraudulently, and sold thousands of fake COVID vaccination cards.

The U.S. Government Accountability Office (GAO) previously reported that pandemic relief programs opens in a new tab or windowwere vulnerable to massive fraud, in part because they "lacked appropriate controls to prevent, detect, and recover fraudulent and other improper payments." For the EIDL and PPP programs alone, the GAO noted that the government estimated "improper payments" totaling $36.7 billion in 2022.

Lab Testing Elder Scam

Lourdes Navarro, 64, of Glendale, California, operated the Matias Clinical Laboratory with her husband, Imran Shams. They performed COVID screening for residents of nursing homes, rehab facilities, assisted living facilities, and primary and secondary schools. Though court documentsopens in a new tab or window said Navarro and Shams were previously excluded from participating in all federal healthcare programs, they billed Medicare, the HRSA, and a private insurer for respiratory pathogen panel (RPP) testing, but are alleged to have fraudulently added claims for tests that their clients didn't order or weren't needed.

They also reportedly told HRSA that some patients had been diagnosed with COVID when they hadn't been to get reimbursement for the RPP screening claims. Their superseding indictment alleges "additional loss" to the payers of $241 million, and reimbursement to the lab of an additional $39.9 million. From the bank accounts of Matias, they transferred money to themselves to use for "real estate, luxury items, travel, and household expenses," court documents said.

False Billing for the Uninsured

Anthony Hao Dinh, DO, of Orange County, California, is allegedly behind a $230 million fraud using the HRSA uninsured program, which was meant to provide uninsured patients access to COVID testing and treatment. The owner of Elite Care Medical Group and two surgery centers was the second-highest biller in the country to this program, and reportedly submitted claims for treatment of patients who were insured, and billed for services that weren't provided or were medically unnecessary. According to court documentsopens in a new tab or window, Dinh billed the uninsured program for "services allegedly provided to an entire command of National Guard soldiers" who had insurance.

The ear, nose, and throat doctor allegedly used much of the money for high-risk options trading. He allegedly lost over $100 million between 2020 to 2022, according to court documents. He also used the funds to buy a $1.1 million home, and transferred the property to his wife. Dinh is being charged with two others, who allegedly submitted 70 fraudulent loan applications to the PPP and EIDL programs to get $3 million in loans.

COVID Test Kit Racket

Latresia Wilson, MD, PA, 60, of Ocala, Florida, and Corey Alston, 45, the chief administrative officer of Heritage Pharma Group, are charged with illegally purchasing Medicare beneficiary identification numbers to bill the program for over-the-counter COVID test kits that weren't eligible for Medicare reimbursement. They allegedly submitted more than $8.4 million in Medicare claims for these test kits, regardless of whether Medicare beneficiaries actually requested the tests. Medicare paid more than $2.6 million based on the claims, court documentsopens in a new tab or window alleged, and Wilson funneled much of the reimbursement to Alston, and "retained a portion of the Medicare reimbursement payments for her own use."

COVID Aid for Luxury Cars, Real Estate, and Vacations

Melissa J. Watson, DNP, 50, of Slidell, Louisiana, owned a primary care clinic and purported medical spa before the pandemic, and is alleged to have submitted false and fraudulent documentation to HRSA's PRF and EIDL programs in a scheme to get $1.1 million for these businesses, which she spent for personal use. The PRF was meant to provide funding to healthcare professionals delivering COVID treatments, and EIDL provided low-interest loans to small businesses affected by the pandemic.

According to the DOJ, Watson used the funds to buy two luxury cars, "thousands" of dollars of real estate, a boat, a trailer, a time share, and "multiple luxury vacations." Court documentsopens in a new tab or window noted that Watson also paid off a $15,000 truck loan for another person, and $32,000 to a probation office in court-ordered restitution for the same person. The government has seized $500,000 from Watson's bank accounts, as well as her boat, trailer, and Range Rover Sport.

Midwife COVID Card Scheme

Two certified nurse midwives who ran a practice called Sage-Femme Midwifery in Albany, Sharon Springs, and Saratoga, New York, were charged in a conspiracy to defraud the U.S. by distributing around 2,700 forged COVID vaccination cards. Kathleen Breault, CNM, 65, and Kelly McDermott, CNM, 61, enrolled their practice as a COVID vaccine administration site and became one of the busiest sites in New York state, "outpacing large, state-run vaccination sites despite being a small midwife practice."

Because they were enrolled as a vaccination provider, they received genuine COVID vaccination cards and forged them to indicate vaccinations had occurred when they hadn't. According to court documentsopens in a new tab or window, Breault and McDermott even held vaccination clinic days, met with individuals, and destroyed vials of COVID vaccines instead of administering them. They allegedly provided vaccination cards to minors who were ineligible for the vaccine and to non-U.S. citizens.

Online COVID Card Hustle

A Utah man allegedly manufactured and sold as many as 120,000 fake COVID vaccination cards to customers across the country, particularly in states with more strict COVID restrictions, such as New York. Nicholas Frank Sciotto, 32, of Salt Lake City, sold the cards largely through Facebook and charged $10 per card, and offered a discounted rate of $7.50 each for orders of 100 or more (plus shipping), according to court documentsopens in a new tab or window. Co-defendant Kyle Blake Burbage, 32, of Goose Creek, South Carolina, allegedly bought and resold several packages of cards from Sciotto.

According to the DOJopens in a new tab or window, "the defendants significantly undermined the CDC's COVID-19 vaccination program and other governmental health-and-safety regulations and protocols." They are charged with conspiring to defraud the U.S. by obstructing the CDC's COVID-19 vaccination program.

https://www.medpagetoday.com/special-reports/features/104151

Lose Weight, Gain Huge Debt: 300 Bariatric Surgery Patients Sued by Provider

 Seven months after Lahavah Wallace's weight loss operation, a New York bariatric surgery practice sued her, accusing her of "intentionally" failing to pay nearly $18,000 of her bill.

Long Island Minimally Invasive Surgery, which does business as the New York Bariatric Group (NYBG), went on to accuse Wallace of "embezzlement," alleging she kept insurance payments that should have been turned over to the practice.

Wallace denies the allegations, which the bariatric practice has leveled against patients in hundreds of debt-collection lawsuits filed over the past 4 years, court records in New York state show.

In about 60 cases, the lawsuits demanded $100,000 or more from patients. Some patients were found liable for tens of thousands of dollars in interest charges or wound up shackled with debt that could take a decade or more to shake. Others are facing the likely prospect of six-figure financial penalties, court records show.

Backed by a major private equity firm, the bariatric practice spends millions each year on advertisementsopens in a new tab or window featuring patients who have dropped 100 pounds or more after bariatric procedures, sometimes having had a portion of their stomachs removed. The ads have run on TV, online, and on New York City subway posters.

The online ads, often showcasing the slogan "Stop obesity for life," appealed to Wallace, who lives in Brooklyn and works as a legal assistant for the state of New York. She said she turned over checks from her insurer to the bariatric group and was stunned when the medical practice hauled her into court citing an "out-of-network payment agreementopens in a new tab or window" she had signed before her surgery.

"I really didn't know what I was signing," Wallace told KFF Health News. "I didn't pay enough attention."

Shawn Garber, MD, a bariatric surgeon who founded the practice in 2000 on Long Island, New York, and serves as its CEO, said that "prior to rendering services" his office staff advises patients of the costs and their responsibility to pay the bill.

The bariatric group has cited these out-of-network payment agreements in at least 300 lawsuits filed against patients from January 2019 through 2022 demanding nearly $19 million to cover medical bills, interest charges, and attorney's fees, a KFF Health News review of New York state court records found.

Danny De Voe, a partner at Sahn Ward Braff Koblenz law firm in Uniondale, New York, who filed many of those suits, declined to comment, citing attorney-client privilege.

In most cases, the medical practice had agreed to accept an insurance company's out-of-network rate as full payment for its services -- with caveats, according to court filings.

In the agreements they signed, patients promised to pay any co-insurance, meeting any deductible, and pass on to the medical practice any reimbursement checks they received from their health plans within 7 days.

Patients who fail to do so "will be held responsible for the full amount charged for your surgery, plus the cost of legal fees," the agreement states.

That "full amount" can be thousands of dollars higher than what insurers would likely pay, KFF Health News found -- while legal fees and other costs can layer on thousands more.

Elisabeth Benjamin, a lawyer with the Community Service Society of New York, said conflicts can arise when insurers send checks to pay for out-of-network medical services to patients rather than reimbursing a medical provider directly.

"We would prefer to see regulators step in and stop that practice," she said, adding that it "causes tension between providers and patients."

That's certainly true for Wallace. The surgery practice sued her last August, demanding $17,981 in fees it said remained unpaid after her January 2022 laparoscopic sleeve gastrectomy, an operation in which much of the stomach is removed to assist weight loss.

The lawsuit also tacked on a demand for $5,993 in attorney's fees, court records show.

The suit alleges Wallace signed the contract even though she "had no intention" of paying her bills. The complaint goes on to accuse her of "committing embezzlement" by "willfully, intentionally, deliberately and maliciously" depositing checks from her health plan into her personal account.

The suit doesn't include details to substantiate these claims, and Wallace said in her court response they are not true. Wallace said she turned over checks for the charges.

"They billed the insurance for everything they possibly could," Wallace said.

In September, Wallace filed for bankruptcy, hoping to discharge the bariatric care debt along with about $4,700 in unrelated credit card charges.

The medical practice fired back in November by filing an "adversary complaint" in her Brooklyn bankruptcy court proceeding that argues her medical debt should not be forgiven because Wallace committed fraud.

The adversary complaint, which is pending in the bankruptcy case, accuses Wallace of "fraudulently" inducing the surgery center to perform "elective medical procedures" without requiring payment upfront.

Both the harsh wording and claims of wrongdoing have infuriated Wallace and her attorney, Jacob Silver, of Brooklyn.

Silver wants the medical practice to turn over records of the payments received from Wallace. "There is no fraud here," he said. "This is frivolous. We are taking a no-settlement position."

Gaining Debt

Few patients sued by the bariatric practice mount a defense in court and those who do fight often lose, court records show.

The medical practice won default judgments totaling nearly $6 million in about 90 of the 300 cases in the sample reviewed by KFF Health News. Default judgments are entered when the defendant fails to respond.

Many cases either are pending, or it is not clear from court filings how they were resolved.

Some patients tried to argue that the fees were too high or that they didn't understand going in how much they could owe. One woman, trying to push back against a demand for more than $100,000, said in a legal filing that she "was given numerous papers to sign without anyone of the staff members explaining to me what it actually meant." Another patient, who was sued for more than $40,000, wrote: "I don't have the means to pay this bill."

Among the cases described in court records:

• A Westchester County, New York, woman was sued for $102,556 and settled for $72,000 in May 2021. She agreed to pay $7,500 upon signing the settlement and $500 a month from September 2021 through May 2032.

• A Peekskill, New York, woman in a December 2019 judgment was held liable for $384,092, which included $94,047 in interest.

• A Newburgh, New York, man was sued in 2021 for $252,309 in medical bills, 12% interest, and $84,103 in attorneys' fees. The case is pending.

Robert Cohen, a longtime attorney for the bariatric practice, testified in a November 2021 hearing that the lawyers take "a contingency fee of one-third of our recovery" in these cases. In that case, Cohen had requested $13,578 based on his contingency fee arrangement. He testified that he spent 7.3 hours on the case and that his customary billing rate was $475 per hour, which came to $3,467.50. The judge awarded the lower amount, according to a transcript of the hearing.

Teresa LaMasters, MD, president of the American Society for Metabolic and Bariatric Surgery (ASMBS), said suing patients for large sums "is not a common practice" among bariatric surgeons.

"This is not what the vast majority in the field would espouse," she said.

But Garber, NYBG's chief executive, suggested that patients deserve blame.

"These lawsuits stem from these patients stealing the insurance money rather than forwarding it onto NYBG as they are morally and contractually obligated to do," Garber wrote in an email to KFF Health News.

Garber added: "The issue is not with what we bill, but rather with the fact that the insurance companies refuse to send payment directly to us."

'A Kooky System'

Defense attorneys argue that many patients don't fully comprehend the perils of failing to pay on time -- for whatever reason.

In a few cases, patients admitted pocketing checks they were obligated to turn over to the medical practice. But for the most part, court records don't specify how many such checks were issued and for what amounts -- or whether the patient improperly cashed them.

"It's a kooky system," said Paul Brite, an attorney who has faced off against the bariatric practice in court.

"You sign these documents that could cost you tons of money. It shouldn't be that way," he said. "This can ruin their financial life."

New York lawmakers have acted to limit the damage from medical debt, including "surprise bills."

In November, Democratic Gov. Kathy Hochul signed legislation

opens in a new tab or window that prohibits healthcare providers from slapping liens on a primary residence or garnishing wages.

But contracts with onerous repayment terms represent an "evolving area of law" and an alarming "new twist" on concerns over medical debt, said Benjamin, the community service society lawyer.

She said contract "accelerator clauses" that trigger severe penalties if patients miss payments should not be permitted for medical debt.

"If you default, the full amount is due," she said. "This is really a bummer."

'Fair Market Value'

The debt collection lawsuits argue that weight loss patients had agreed to pay "fair market value" for services -- and the doctors are only trying to secure money they are due.

But some prices far exceed typical insurance payments for obesity treatments across the country, according to a medical billing data registry. Surgeons performed about 200,000 bariatric operationsopens in a new tab or window in 2020, according to the bariatric surgery society.

Wallace, the Brooklyn legal assistant, was billed $60,500 for her lap sleeve gastrectomy, though how much her insurance actually paid remains to be hashed out in court.

Michael Arrigo, a California medical billing expert at No World Borders, called the prices "outrageous" and "unreasonable and, in fact, likely unconscionable."

"I disagree that these are fair market charges," he said.

LaMasters, the bariatric society president, called the gastrectomy price billed to Wallace "really expensive" and "a severe outlier." While charges vary by region, she quoted a typical price of around $22,000.

Garber said NYBG "bills at usual and customary rates" determined by FAIR Health, a New York City-based repository of insurance claims data. FAIR Health "sets these rates based upon the acceptable price for our geographic location," he said.

But Rachel Kent, FAIR Health's senior director of marketing, told KFF Health News that the group "does not set rates, nor determine or take any position on what constitutes 'usual and customary rates.'" Instead, it reports the prices providers are charging in a given area.

Overall, FAIR Health data show huge price variations even in adjacent ZIP codes in the metro area. In Long Island's Roslyn Heights neighborhood, where NYBG is based, FAIR Health lists the out-of-network price charged by providers in the area as $60,500, the figure Wallace was billed.

But in several other New York City-area ZIP codes the price charged for the gastrectomy procedure hovers around $20,000, according to the databank. The price in Manhattan is $17,500, for instance, according to FAIR Health.

Nationwide, the average cost in 2021 for bariatric surgery done in a hospital was $32,868, according to a KFF analysis of health insurance claims.

Private Equity Arrives

Garber said in a court affidavit in May 2022 that he founded the bariatric practice "with a singular focus: providing safe, effective care to patients suffering from obesity and its resulting complications."

Under his leadership, the practice has "developed into New York's elite institution for obesity treatment," Garber said. He said the group's surgeons are "highly sought after to train other bariatric surgeons throughout the country and are active in the development of new, cutting-edge bariatric surgery techniques."

In 2017, Garber and his partners agreed on a business plan to help spur growth and "attract private equity investment," according to the affidavit.

They formed a separate company to handle the bariatric practice's business side. Known as management services organizations (MSOs), such companies provide a way for private equity investors to circumvent laws in some states that prohibit non-physicians from owning a stake in a medical practice.

In August 2019, the private equity firm Sentinel Capital Partnersopens in a new tab or window bought 65% of the MSO for $156.5 million, according to Garber's affidavit. The management company is now known as New You Bariatric Group. The private equity firm did not respond to requests for comment.

Garber, in a September 2021 ASMBS webinar viewable onlineopens in a new tab or window, said the weight loss practice spends $6 million a year on media and marketing directly to patients -- and is on a roll. Nationally, bariatric surgery is growing 6% annually, he said. NYBG boasts two dozen offices in the tri-state area of New York, New Jersey, and Connecticut and is poised to expand into more states.

"Since private equity, we've been growing at 30% to 40% year over year," Garber said.

https://www.medpagetoday.com/primarycare/obesity/104144

Ukraine Planned Attacks On Russian Forces In Syria

 by Kyle Anzalone via AntiWar.com,

Kiev’s military intelligence agency believed it could carry out attacks on Russian soldiers and Wagner Group forces in Syria, forcing Moscow to redeploy military assets from Ukraine. The story was reported by the Washington Post using documents released by Jack Teixeira.

The Ukrainian defense officials believed they could use Kurdish forces to wage a proxy war against Russia in Syria. According to the Post, the plan never materialized as President Volodymyr Zelensky ordered an end to the planning in December.

It appears that Ukrainian officials engaged in some discussions with the Syrian Democratic Forces, a Kurdish militia backed by the US. The documents said the Kurdish officials requested training on drones and air defenses. Additionally, the Kurds said they would not attack Russian positions in areas held by the SDF, and requested their role in the operations be kept secret.

Ukraine declined to respond to questions about the document. A Kurdish official claimed the information was false.

Russian forces have been in Syria since 2015. President Vladimir Putin ordered his soldiers to aid the Syrian government led by Bashar al-Assad. At the time of Russian intervention, both al-Qaeda in Syria and ISIS were threatening to topple Damascus. The Russian soldiers helped Syrian forces turn back the advance of the jihadist groups.

While Moscow continues military operations in Syria, the Kremlin is attempting to end the conflict through diplomatic means. Putin is attempting to broker a deal to normalize relations between Syria and Saudi Arabia. Riyadh has been a primary backer of the anti-Assad militants in Syria and has received pressure from Washington to continue to isolate Damascus.

The document says Zelensky could allow the operations to proceed, but would likely require assistance from the US and Turkey. Ankara may be unwilling to support the covert proxy warfare as it views the SDF as a terrorist organization, and has long protested Washington arming the Syrian Kurds.

Additionally, the operations could inflame the war in Syria. The decade-long war has seen a dip in violence in recent years as Assad and his allies have consolidated control over most of Syria. The US and SDF occupy the eastern third of the country.

However, the SDF leadership has shown a willingness to work with Moscow. If Kurdish forces allow themselves to become a proxy force for Kiev, Moscow will likely aggressively target SDF positions in eastern Syria.

https://www.zerohedge.com/geopolitical/ukraine-planned-attacks-russian-forces-syria

FBI Blocking Release Of Nashville Trans Shooter's Manifesto

 If the Nashville shooter had been a straight constitutional conservative would the FBI be blocking the killer's manifesto, or would it be scrutinized for months on every mainstream media platform from day one?

The question is important because it illustrates the discomforting double standards in play whenever a mass murder is committed by a person on the political left (and there have been many lately).  If the manifesto outlines ideologically motivated intent then the actions of Audrey Hale, a biological woman identifying as male, could be labeled a terrorist act.  However, if the manifesto stays locked away from the public then there will always be suspicions but never any confirmation.  Certain political groups and activist groups benefit greatly from the suppression of Hale's motives.

Rep. Tim Burchett, (R-Tenn.) told The New York Post he knew the FBI was behind the delay of the manifesto's release, saying the news was “disappointing."     

Twenty journals, five laptops, a suicide note and various other notes written by Hale were seized from the house she shared with her parents as well as two memoirs, five Covenant School yearbooks and seven cellphones, according to a search warrant.

Metro Nashville Council Member Courtney Johnston states that the FBI has ruled out releasing the manifesto anytime soon.

“What I was told is, her manifesto was a blueprint on total destruction, and it was so detailed at the level of what she had planned...that document in the wrong person’s hands would be astronomically dangerous...” 

She added: “I personally don’t want to know the depths to which her psychosis reached…When I’m told by an MNPD high-ranking official that it keeps him up at night, I’m going to defer to that person in that agency that I don’t need to read that.”

Tennessee Bureau of Investigation Director David Rausch described the writings he had seen during a meeting with the Tennessee Sheriffs’ Association, saying: “The documents that we have, and I have viewed those, you know, one is specifically a plan and the other is some journal-type rantings.”

Was Audrey Hale a criminal mastermind?  It's highly unlikely given she was taken down by police within moments of the officers arriving on scene.  It is more probable that the FBI is following orders from political leadership to hide any documents that might embarrass Democrats, who are now closely aligned with trans activist groups and social justice organizations.  Democrats have effectively shifted the debate on the Nashville shooting over to gun control and trans rights, and have avoided discussing the potential ideological causes of the attack.  

Would such documents inspire further violence from the political left on a scale similar to what happened at Covenant School?  It's hard to say, but it doesn't seem as though activists need much encouragement these days.  The first and most obvious conclusion one can draw from the FBI's refusal to make Hale's writings public is that they are incredibly damaging to the trans movement, a class of people now protected by government officials and the corporate establishment.  

In other words, a message is being sent by federal agencies, the White House and others that if you are a trans person and you commit mass murder, you will enjoy special treatment.  The consequences of such a message are obvious.     

https://www.zerohedge.com/political/fbi-blocking-release-nashville-trans-shooters-manifesto

The Real Reason Behind China’s $10 Billion Offer To Taliban For Lithium

 by Venus Upadhayaya via The Epoch Times (emphasis ours),

A Chinese company has offered the Taliban $10 billion and a proposal to build key strategic infrastructure connecting north-south Afghanistan in exchange for access to the country’s lithium reserves. Some experts raised concerns that the offer would allow the Chinese regime to expand its influence in the region.

The proposal was discussed between a representative of Gochin and the acting minister of the Taliban’s Ministry of Mines and Petroleum, Sheikh Hadith Shahabuddin Delawar, in his office on April 13. The talks happened just a few months after the Taliban arrested two Chinese nationals trying to smuggle 1,000 metric tons of lithium-bearing rocks out of the country.

Experts said it needs to be seen if the deal is feasible, but once signed, it will have diplomatic and political ramifications, and the proposed infrastructure development will likely have a long-term strategic impact.

“Geopolitically, this deal could give China a significant advantage and influence in the region, as it secures a supply of critical resources and strengthens its presence in Afghanistan,” Maher Saadat, an exiled activist and Afghan affairs analyst, told The Epoch Times in an email.

Afghanistan’s lithium reserves potentially rival those of Bolivia, which has the world’s most significant amount of lithium resources. The Taliban’s Ministry of Mines and Petroleum said in a press release that the deal, once executed, will provide direct employment to 120,000 people and indirectly to 1 million.

Abhishek Darbey, a research associate of the Chinese Research Program at the New Delhi-based Center for China Analysis and Strategy (CCAS), pointed out to The Epoch Times in an email that China is among the first countries that supported the Taliban to form a government in Kabul following the withdrawal of the United States from the country. He believes the Chinese regime wants to control the region.

“In the case of Afghanistan, the country is important for China because the land domain of the Belt and Road Initiative will pass through this region, and a peaceful Afghanistan will create favorable conditions for the BRI to grow and progress,” he said.

“Also, China considers itself to be a major power of the region and, therefore, it wants to be a participant in [the] decision-making of the region or wants to be a power with a capacity to influence the regional politics,” he added.

Chinese Foreign Minister Wang Yi meets with Mullah Abdul Ghani Baradar, political chief of Afghanistan’s Taliban, in Tianjin, China, on July 28, 2021. (Li Ran/Xinhua via Reuters)

Lithium for the Taliban

Afghanistan’s lithium reserves are a quick source of money for the Taliban, but they don’t have a long-term strategic goal for it, according to the experts.

“They may view it as an opportunity to generate immediate revenue to fund their activities and consolidate their power, given their history of relying on various sources of illicit financings, such as drug trafficking and extortion,” Saadat said.

The Taliban’s focus on immediate financial gains—without considering the long-term implications and sustainable development of the lithium deposits—is likely to limit the potential benefits of the reserves for Afghanistan and its people, he said.

“[It] will not contribute to the overall socio-economic development and stability of the country with certainty,” he said.

The first lithium mine was discovered in Ghazni city in 2013. These rare mineral mines are located in five areas in Afghanistan: Herat, Shuryak Valley, Tagab District in Kapisa Province, Nawur District in Ghazni Province, and Badakhshan.

Darbey said the Chinese interest in the region is not new—in 2021, two Chinese companies were sent to Ghazni to conduct technical research and inspect lithium and goldmines.

While China’s lithium reserves are depleting, the Afghan deposits are unexploited. Five Chinese companies have set up their representative offices in Afghanistan, and around 20 Chinese companies have made inquiries about lithium projects, according to Darbey.

Delawar said that the contract of the mines in Afghanistan would be given according to the Taliban’s law.

Darbey pointed out that the Taliban government is already supporting Chinese investment in its wider mining sector, and China’s two largest lithium miners—Tianqi and Ganfeng—have already examined the lithium mines in Afghanistan.

https://www.zerohedge.com/political/real-reason-behind-chinas-10-billion-offer-taliban-lithium

How Government Caused Supply Problems

 The surging price pressures that brought inflation to four-decade highs in the United States have many causes. Some are truly external to the economic system: for instance, plants that produce semiconductors or their inputs in Korea and Malaysia shut down during Covid, causing a manufacturing bottleneck in cars and appliances. But others are due to wildly misguided fiscal and monetary policy.

Politicians have tried to blame the supply side for inflation, treating inflationary supply shocks as accidents outside government control. For example, in one speech last year, President Biden blamed Vladimir Putin, port disruptions, Covid, the supply chain, licensing delays for truckers, monopoly power, foreign investors, pharmaceutical companies, and the lack of energy investment for price increases. That’s just about everything . . . except the trillions of dollars of unnecessary fiscal expenditures his administration pumped into the economy while it was near full employment, or the Fed’s recklessly loose monetary policy in 2021. The administration spent $1.9 trillion on the American Rescue Plan, $1 trillion on the Infrastructure Investment and Jobs Act, and roughly $300 billion on the so-called Inflation Reduction Act.

No doubt the supply side has been a significant driver of inflation. Basic economics indicates that the steeper the supply curve, the more inflation a given demand shock generates. If the supply side has been as tight as the Biden administration thinks, then hitting the fiscal gas pedal was an especially bad idea. The current inflationary mess owes to a steeper supply curve interacting with government-driven demand shocks, but what is less well appreciated is that the steeper supply curve is itself a result of poor government policy.

First, consider labor supply. After the pandemic, much of the country experienced “labor shortages,” in which certain industries couldn’t find enough workers. These shortages drove up wages and pushed inflation higher. But the reduction in labor supply didn’t just occur by chance. Many older workers on the margin of retirement were able to leave the workforce a few years earlier than expected because their housing wealth blossomed; home prices rose by nearly 40 percent since the pandemic, owing much to both monetary and fiscal policy. Research indicates that if housing returns in 2021 had been more typical, labor-force participation among older workers would not have declined at all. Meantime, how many younger workers decided that staying home to trade cryptocurrencies and meme stocks was more fun—and financially rewarding—than working a real job? Those activities could be profitable only in an environment in which the Treasury gave people bags of poker chips and the Federal Reserve transformed securities markets into a casino. While economists think of monetary and fiscal policy primarily affecting aggregate demand, they have clearly affected labor supply, too, through nontraditional wealth and financial channels.

New programs have gone out of their way to twist the supply side. A bipartisan consensus maintains that the country needs to invest in better infrastructure and in critical technologies like semiconductors. But legislation for these ends is laced with provisions to make the supply side less efficient. For example, to receive CHIPS Act funding, semiconductor manufacturers have to provide affordable childcare for their workers, achieve worker diversity goals, “consult, engage and coordinate” with such stakeholders as labor unions and local nonprofits, use certain quantities of union labor, and pay sufficiently high wages. Each of these provisions, along with the compliance burden of fulfilling them, raises the cost of production. Irrespective of the worthiness of any of those goals, they shouldn’t hamper actions to shore up semiconductor resilience. Indeed, the cost to firms of complying with all these requirements will eat up part of the subsidies, resulting in an inefficient use of taxpayer funding meant to boost semiconductor capacity. The Infrastructure and Jobs Act is similarly loaded with provisions that will make infrastructure building significantly more inefficient and costly than it needs to be.

Finally, regulations make the supply side more brittle, and the Biden administration has expanded the regulatory state across most domains of government. The registry of new rules ranges from boosting minimum wages for immigrant workers, to lightbulb efficiency standards, to requirements that publicly traded companies monitor, audit, and disclose climate risks and impacts. With every regulation increasing the cost of doing business and slowing the entry of new firms, demand shocks produce more inflation than they used to.

That political actors have sought to blame inflation on the supply side is no surprise. If they can convince the public that Covid or Russia is to blame for inflation, then they can avoid electoral consequence for poor public policy. More surprising is that, after two years of howling that inflation was driven by the supply side, prominent figures continue to propose more supply distortions.

President Biden’s proposed budget for fiscal year 2024 calls for higher taxes on several fronts. For example, it would raise the tax on corporations from 21 percent to 28 percent. This would not only discourage investment but also provide a massive benefit to large conglomerates. Multinational corporations can afford high-powered lawyers and accountants to help them shift their profits abroad and lower their effective tax rates to rock-bottom levels. But smaller corporations that still pay the corporate tax rate and have little international footprint cannot do so, making them less competitive than larger firms. High statutory rates serve as a barrier to entry for smaller businesses and competitors generally, protecting incumbents.

The budget proposal would lift the capital-gains rate for high-income households to almost 40 percent. However, because capital gains taxes apply to nominal and not real returns, high inflation rates can drive real tax rates in excess of 100 percent of shareholder returns. If more than 100 percent of the real return is taxed, there’s no incentive to hold equities, since investors have all the downside risk and none of the upside. A country whose companies struggle to raise equity capital will not be able to undertake the necessary investments to maintain, let alone improve, its standard of living.

Biden is not alone in proposing steep tax hikes. Prominent economist Larry Summers has proposed raising taxes to control inflation, while Treasury Secretary Janet Yellen has called for higher income taxes on the rich. Unfortunately, higher taxes would further aggravate supply constraints: to levy a tax, the government has to target some activity that taxation inevitably discourages. Taxing investment means less investment. Taxing labor income means less labor income. It’s hard to see how higher taxes will help provide more labor supply or ease the worker shortage. At a time when the supply side is already on tenterhooks, further distortions are the last thing we need.

Policymakers should instead reform the supply side to help control inflation. For starters, the most powerful thing they can do is remove regulatory red tape, which prevents businesses from responding to the needs of the marketplace. Every rule is a compliance burden that increases the cost and time requirements of doing business, reducing competition and ultimately resulting in higher prices. Overly burdensome occupational-licensure rules keep people from switching jobs quickly to fill gaps in local labor supply or moving across state lines to respond to demand changes; excessive environmental regulations impede the development of new facilities. A less dynamic supply side leads to more inflation from demand shocks.

Second, the government should cease all expenditures from the Infrastructure Investment and Jobs Act and the Inflation Reduction Act until the economy has cooled sufficiently to accommodate them. When a wildfire is burning, stop pouring fresh oil on it. The Biden administration can delay these outlays until there’s sufficient economic slack such that the spending doesn’t produce further price pressures.

Finally, tax reform can help unleash the supply side, as well. Since taxes distort the efficient choices of economic agents, reductions in taxes can help reduce those inefficiencies. Lower rates, combined with a broader base—simplifying the tax code by removing tax expenditures and deductions—could provide a lot of help.

The current inflationary brew is a toxic mix of both supply and demand shocks. Politicians have bent over backward to argue that the supply side has contributed most of the price pressures, because they believe that it exonerates them of responsibility. Those claims are false. Even if supply were the exclusive driver of inflation, many supply problems can be traced directly back to government fiscal, regulatory, and monetary policy. And if public officials sincerely believed that the supply side was the root problem, they wouldn’t be proposing new supply distortions. They’d be proposing ways to improve the efficiency of the supply side and removing roadblocks that prevent firms from dynamically responding to the economy’s needs.

Stephen Miran is an adjunct fellow at the Manhattan Institute, co-founder of asset manager Amberwave Partners, and a former senior adviser for economic policy at the U.S. Treasury, 2020–21.

https://www.city-journal.org/article/how-government-caused-supply-problems