economics Paradigm Challenge

Those massive multi-billion dollar fraud fines the government keeps winning? They might actually be proof that they're failing to stop the crime.

March 27, 2026

Original Paper

Money Over Everything: Reimagining Health Care Enforcement

Jacob Elberg

SSRN · 6404903

The Takeaway

The Department of Justice treats financial penalties as the sole measure of success, which effectively turns serious violations into a predictable 'cost of doing business.' Because the system relies on whistleblowers seeking payouts rather than safety inspectors, financial recoveries keep climbing while the underlying dangerous behaviors remain profitable.

From the abstract

Annual press releases from the Department of Justice trumpet billions of dollars in annual recoveries and optimism that its health care enforcement regime deters even more fraud than it addresses. Yet DOJ's consistent recoveries can be seen as a sign that fraud continues unabated. While some scholars have questioned the deterrent value of the government's model of enforcement through civil settlements, little attention has been given to what may be the most important aspect of DOJ's effort-its f