Like most of American healthcare, kidney care has for decades been plagued by red tape. The Trump administration says it wants to change that. On Tuesday, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced his department's Kidney Care National Plan, which promises to introduce more competition, reduce regulatory barriers, expand patient choice, and overhaul America's kidney transplant system.

Much of the plan focuses on barriers to entry in dialysis care, which treats nearly 558,000 Americans. While dialysis can be performed at home, most patients receive treatment at specialized facilities, which must comply with federal certification requirements governing equipment, staffing, water quality, and patient safety in order to participate in Medicare.

Kennedy argues that regulatory barriers have discouraged competition and innovation, leaving patients with fewer dialysis treatment options. "Dialysis technology is an extraordinary technology," said Kennedy at the press conference, but "because of monopolies in the system and the barriers to new entrants, we have not seen any real improvements in that technology."

Of course, the existence of large or even monopolistic companies is not in itself evidence of a problem, but government regulation can often entrench those companies' positions in the market. "I like the fact that they're recognizing that a lot of regulatory…barriers are contributing to the problem, and that's refreshing to hear," says Jeffrey Singer, a practicing general surgeon and senior fellow at Reason Foundation, the nonprofit that publishes Reason. Singer says that removing barriers that prevent new companies from competing with established providers could not only increase choice but also drive down prices.

HHS says that two companies, DaVita and Fresenius Medical Care, control approximately 74 percent of the American dialysis market. As of 2019, roughly a third of Americans lived in areas where the only available dialysis provider was one of those two companies, according to the agency. The administration argues that government regulation has helped entrench this dominance by making it difficult for new providers to enter the market.

To address this, the Kidney Care National Plan suggests a number of reforms, including simplifying certification requirements. HHS also plans to investigate whether dominant dialysis providers have used payment arrangements and legal strategies to secure higher reimbursements without delivering better care.

The 17-page report calls for a review of existing requirements, but it does not specify which regulations will be repealed, nor does it establish a timeline for doing so. It also does not propose any significant reduction in the government's role in financing the distorted market. Instead, the plan largely seeks to make existing government-financed systems such as Medicare more competitive and efficient.

Kennedy has also correctly identified the need for reform regarding kidney donations. Nearly 90,000 people are waiting for a kidney transplant at any given time in America, and 11 people die every day waiting for a kidney. The transplant process is currently managed by Organ Procurement Organizations (OPOs), which are federally certified nonprofits responsible for recovering organs from donors and coordinating their transfer. There are currently just 55 federally designated OPOs operating in the United States, and HHS argues that they behave as "regional monopolies." Since no new OPOs have been approved in the last year, the Kidney Care National Plan suggests fast-tracking certification.

The plan also seeks to make living kidney donation easier by reducing financial barriers. Following the passage of the Honor Our Living Donors Act in February, HHS revised federal reimbursement rules so that a donor's eligibility for financial assistance is no longer determined by the transplant recipient's income. Eligible donors can receive up to $6,000 to cover expenses, including travel, lost wages, and childcare.

However, the reforms proposed stop short of allowing kidney donors to receive direct compensation for the organs themselves, which remains prohibited under federal law. "I can sell my blood. Why can't I sell my kidney?" Singer asks.

Peter Jaworski, director of the Georgetown Blood and Plasma Research Group, feels similarly, arguing that financial incentives are available to nearly everyone involved in kidney transplantation except the donors themselves. "According to this plan, it's OK to use incentives to encourage them to be more productive, to actually do a better job," Jaworski tells Reason, referring to transplant surgeons, hospitals, and organ procurement organizations. "The only exception, once again, is the donor who is offering a kidney."

Better solutions exist, according to Jaworski, who points to the proposed End Kidney Deaths Act. The bill, which was introduced by Rep. Nicole Malliotakis (R–N.Y.) last year, would offer living kidney donors a $50,000 refundable tax credit, distributed over five years. "We have those systems in order to make sure that we can treat patients. That's the point of blood donation. That's the point of plasma donation. That's the point of kidney donation too."

America's plasma market is an excellent example of financial incentives encouraging donation. Unlike many other countries, the U.S. allows plasma donors to be compensated, and despite accounting for just over 4 percent of the world's population, it supplies approximately 68 percent of the plasma collected globally for manufacturing medicines.

"Why do you think America does it? Is it because in America there's way more altruism than in France or Italy or Belgium? No, it's because in the United States you can be paid to donate plasma," argues Jaworski.

The Trump administration appears to recognize that government overreach has stifled competition and restricted patient choice. It also recognizes that living adults donating kidneys will be part of the solution to the long, deadly waiting lists. But its plan leaves the government's outsize role in kidney care largely untouched. For patients facing years on dialysis or waiting for a lifesaving transplant, recognizing the problem is not enough.

The post RFK Jr. Wants To Cut Red Tape in Kidney Care. He Should Go Further. appeared first on Reason Magazine.

US President Donald Trump has failed to reach an agreement with Russian ruler Vladimir Putin on halting strikes against Ukraine's energy infrastructure. However, Trump is trying to shift the blame for this failure onto President Volodymyr Zelenskyy, he said on The Diary of a CEO podcast.

His words came amid Russia's four record waves of ballistic missile attacks, after US Special Envoy Steve Witkoff described Putin as a "humanitarian." Previously, US officials cut Kyiv off from US intelligence and lowered a speed cap on Starlink to pressure Ukraine into stopping strikes on Russia's oil refineries that bring Moscow revenue for its war.

Trump pins the problem on Kyiv, not Putin

Zelenskyy explained the behavioral pattern behind Trump's recent actions and statements. At first, Putin rejected his proposal for a ceasefire. Then, the US president blamed it all on him, explaining to his people that world fuel prices are rising because of him, which is not true at all, said the Ukrainian leader.

He pointed to the blocked Strait of Hormuz shipping chokepoint, not Ukraine’s refinery campaign, as the driver of higher prices.

He also noted that the volumes of diesel allowed by the US are insufficient to lower global oil prices.

Even so, Zelenskyy said he keeps a working relationship with Trump. What he will not accept is being cast as the villain in Russia’s war: by his account, the US president is rewriting the context, turning Ukraine’s leader into the target for a problem that starts in Moscow.

Earlier, experts said the diesel deal was unlikely to meaningfully lower diesel prices. For Putin, the agreement itself was a win.

Trump’s Russian diesel deal, which drew fury in Ukraine, is unlikely to lower prices, experts say

A former senior State Department official says it hardly matters whether the fuel arrives, because Putin “has already achieved the result he wants,” with Trump believing he has a pre-election card that could move markets.

Last week, the forensic digital security NGO Citizen Lab documented a cyberattack it named Adfection. It was found on 45 Al Jazeera journalists’ computers. It used zero-click spyware created by Israeli spyware developer Candiru, which implanted malware in ads displayed on a web page. It infected the computer and gave access to nearly every user activity, including email, texts, video and audio, browser activity, etc. The targeted user did not have to click on a link or download a file.

The campaign required an online company to buy the ads which compromised the device. It was an Israeli company called Discover-Tech. Its platform, Controlium, strips the anonymity of targeted individuals even if they have encrypted or masked their digital footprint. The ads also covertly directed millions of devices to Candiru’s servers, where their content was harvested for large-scale tracking and reconnaissance.

Citizen Lab noted that Discover Tech purports to be a legitimate ad company. But in reality, it is a front for large-scale Israeli espionage

This campaign required a second player, the spyware firm, Candiru. Ironically, it was named for an Amazonian fish which feeds on the blood of host fishes. Considering its business model, the name seems apt. Candiru wrote the code which was implanted with the ads. They then placed the ads on specific websites visited by targeted individuals.

Its partner, Discover-Tech, not only placed the ads but also amassed geo-data that let it identify and track targets, a process known as microtargeting. They track users’ physical location and follow their movements. The spyware also tracks devices in cellular, Wi-Fi, or VPN modes.

Discover-Tech placed 4 billion ad bids. The ads were served on 200,000 different Android and Apple apps and various websites. In particular, they targeted defence, foreign affairs, internal security, military and intelligence bodies. These agencies included NATO, the Pentagon, the International Criminal Court, Israeli government ministries (foreign, defence, police), and the European Parliament. In all, users in 23 countries were attacked.

Candiru, which designed Adfection, has led a mysterious existence since its founding in 2014. It has changed its name repeatedly to skirt sanctions and accountability. It is currently named Integrity Labs. Another bit of irony considering the “integrity” of malware design.

Its website claims it is based in Hong Kong with offices in various Asian cities. It doesn’t mention Herzliya, where it was founded and where its CEO is based.

In fact, Israeli companies seeking to shield themselves from exposure and avoid potential interference from Israeli regulations employ a well-known subterfuge by moving operations abroad. Similarly, Integrity Labs’ peripatetic existence “created a corporate buffer to distance its operations from US sanctions [against Candiru] while continuing to deploy surveillance tools.”

Who engineered the spyware campaign?

Citizen Lab declined to identify which country or government entity managed this overall project. It seems highly likely it was Israel, considering a majority of those targeted were either in Europe or the Middle East.

The most likely Israeli source for such a campaign is the IDF’s SIGINT branch, Unit 8200, whose mission is to intercept communications using precisely the tools developed by Candiru/Integrity Labs. 

Israel also has explicit interest in many of the entities targeted, including the Pentagon, ICC and Al Jazeera. Though Adfection appeared on Pentagon computers, Citizen Lab did not indicate whether US intelligence assets were attacked as well.

Israel is a world leader in developing surveillance, spyware, and cyber-attack products. The IDF field tests many of them in Palestine, which is among the most surveilled places on earth. There are tens of thousands of CCTV cameras, facial recognition technology, AI, drones, telecommunication intercepts, and a massive database compiled on every individual Palestinian.

Israel's primary signals intelligence corps, Unit 8200, has created multiple AI-based tools to exert control over a restive population. Among them are Where’s Daddy, Ha’bsorah (“Good News”), and Fire Factory. The AI program, Lavender, assigns a 1 to 100 score for all 2.5 million Gazans to determine if they should be killed. In other words, artificial intelligence makes life-and-death decisions leading to the murder of thousands of Palestinians.

Many Israeli companies like NSO Group, Candiru, Intellexa, Cellebrite, Circles and Paragon were founded by Unit 8200 veterans. They are leaders in the development of spyware used by police and intelligence agencies throughout the world to surveil—and even murder--human rights activists, journalists (among them, Jamal Khashoggi), and lawyers. They are products of the Israeli surveillance state, exported worldwide along with the oppressive values they represent.

Israel has created a Brave New World of digital surveillance and sold it to some of the most dangerous individuals and repressive regimes on earth. It is a World of chaos and cruelty, like Hobbes' war of all against all.

International bodies like the United Nations appear unable or unwilling to impose any regulation on these nefarious tools, which pose a grave threat to democracy, justice and human rights.

Richard Silverstein writes the Tikun Olam blog and is a freelance journalist specialising in exposing secrets of the Israeli national security state. He campaigns against opacity and the negative impact of Israeli military censorship.

Follow Richard on X: @richards1052

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Opinions expressed in this article remain those of the author and do not necessarily represent those of The New Arab, its editorial board or staff.

Officials in France are pressing online platforms like eBay and Vinted to remove items that were stolen during public disturbances over the weekend.

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