As Americans today, it’s easy to become somewhat desensitized to stories of greed. It seems there’s not a day goes by without a news story of greed, fraud and corruption hitting the headlines. But when companies’ desires to amass more, means they sink to new lows by exploiting America’s poor and innocent, it is reprehensible to just sit back as casual observers. More people need to follow in the footsteps of courageous female whistleblowers like Poonam Rai and Robin Fitzgerald, who in observing injustice, took decisive action. This country, with its current epidemic of moral and tooth decay, desperately needs this type of advocacy. Acting upon their moral instincts these brave women helped the government build a case and win a hefty $24 million dollar lawsuit against Kool Smiles and Benevis LLC, its corporate management company. According to the Department of Justice, over 130 Kool Smiles clinics, who provide dental care for underserved children, billed Medicaid for false services and more alarmingly, performed unnecessary, costly, and even dangerous dental procedures on vulnerable children. The DOJ claimed and proved that “…between January 2009 and December 2011, Kool Smiles knowingly submitted false claims for unnecessary baby root canals, tooth extractions and stainless steel crowns.”
While this country is one of the richest and economically developed in the world, there exists in it, a bizarre and untrue notion that those in the lower socio-economic bracket aren’t working hard enough to better their circumstances. The real truth is that there are hundreds of thousands of hard-working Americans, working every bit as hard as the CEOs of Fortune 500 companies—working three jobs to provide and survive – struggling to obtain their most basic human needs-food, clean water, adequate housing, and in this case, preventative and urgent dental care for their children.
While Kool Smiles denied that its corporate model and policies were knowingly developed around ripping off the system, a PBS Frontline investigation suggested otherwise. Kool Smiles argued that their goal was to meet a critical need created by the number of underserved in poorer neighborhoods. Contributing to the problem were the number of private dentists who were and are unwilling to take on Medicaid patients. Whether or not Kool Smiles started out with the intent to profit from the poor and whether they knew that the standard of care would be jeopardized as they ripped off Medicaid is unclear. But the evidence and the settlement point a heavy finger. And equally clear to most, any time service providers are incentivized by quantity versus quality, ethical and moral issues are likely to follow.
Although fleecing government run programs like Medicaid who provide insurance for nearly half of America’s children is disgusting enough, the fact that Kool Smiles performed unnecessary and even dangerous procedures that put children at risk is even more appalling. It begs further investigation as to whether the procedures performed on two children, who died at the same Kool Smiles in 2016, were more about the dentist(s) reaching their target quotas for the day than it was about providing the children essential dental care.
While it can be said that there are plenty stories of good, of corporations aiding the disenfranchised (even Kool Smiles and its equity partners have provided thousands of dollars in free care), and of neighbors helping neighbors, there are far too many situations where Americans turn a blind eye. This cannot continue, and in many cases it’s up to women to lead the way. This shocking story has to inspire women (and men too, for that matter) to wake up, question the status quo, report what they see—and act! This dreadful story should cause American’s to be up in arms; it is a call to action to be vigilant and report wrongdoing. In fact, by being unwilling to act, individuals unwittingly become participants to injustice. Being brave and bold like Poonam Rai and Robin Fitzgerald did in this case needs to become the norm rather than the exception.
Even if Kool Smiles is trying to clean up its battered reputation by providing free clinics and continued education in elementary classrooms, consumers need to remain constantly vigilant! Caregivers, mothers, healthcare workers and citizens everywhere need to trust their instincts, get second opinions, and continue to ask the tough questions that hold healthcare practitioners accountable for care plans and procedures. And if and when they suspect wrongdoing, they have to have the courage like the whistleblowers in the Kool Smiles case to take up arms against ethical and moral violations.