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Most Americans don’t spend much time thinking about health care policy. They don’t have to. They feel it every year when premiums rise, deductibles climb, and another chunk of their paycheck disappears into a system that rarely seems to work in their favor.
American health care is expensive, confusing, and quietly disempowering. Money moves constantly — from workers to employers to insurers to administrators and eventually to providers — but too rarely stays with the people who earned it. When the bills arrive, families are told what they owe, not what they saved or controlled.
A system that won’t let people save for their own medical needs is not protecting them. It is protecting itself.
That should bother us.
Health savings accounts were designed to fix part of this imbalance by giving people something rare in modern health care: ownership. An HSA lets individuals set aside money for medical expenses, invest it if they choose, and carry it with them year after year. The money is theirs. It doesn’t expire. It isn’t reassigned. Institutions do not manage it on their behalf.
Ownership changes behavior. People who control their own money plan differently. They ask questions. They think long-term. They stop acting like passive participants in a system that treats them as cost centers instead of decision-makers.
Yet millions of Americans are barred from opening an HSA.
Not because they don’t need one or cannot afford health care. It’s simply because the law says they are not allowed.
Under federal rules written more than two decades ago, HSA eligibility is tied to a narrow category of insurance plans. As a result, more than 140 million Americans — including many with traditional employer coverage and rising out-of-pocket costs — are blocked from saving for health care the way they save for retirement or education.
In no other area of American life do we accept a rule that says: You may pay continually, but you may not save.
No one is barred from opening a retirement account because of the kind of pension an employer offers. No one is blocked from saving for college because of where a child goes to school. Yet in health care — often the largest and most unpredictable expense a family faces — ownership remains conditional.
That is no accident. It’s the predictable result of a system built around institutions rather than individuals. Complexity gets rewarded. Intermediaries profit from it. Ordinary people are expected to navigate the maze without meaningful control over the dollars they contribute.
Prices often remain opaque until after care is delivered, which means families learn what something costs only when the bill arrives — too late to make an informed choice.

The result is a system where spending rises, trust erodes, and prevention gets talked about far more than it gets practiced.
Expanding access to health savings accounts would not solve every problem in health care. But it would address one of the most basic ones: the absence of real personal agency.
The fix is not complicated. It requires trusting people with their own money.
Every American should be able to open an HSA, regardless of insurance type.
This is not a call for a new entitlement or government program. HSAs are privately owned accounts. They rely on responsibility, not mandates. They rest on a simple belief: When people have control, most will use it wisely.
That assumption may feel unfashionable in modern policymaking. It still reflects how Americans live. People save for retirement. They save for education. They save for emergencies. Health care should not be the lone exception — especially when the costs are so high and the stakes so personal.
A system that won’t let people save for their own medical needs is not protecting them. It is protecting itself.
If we want health care that costs less and works better, the answer is not more management. It is more ownership.
The real question is not whether Americans can be trusted with their health care savings. It is why we have spent so long pretending they can’t.
Biomedical research has produced extraordinary breakthroughs that have saved countless lives. But too many promising drugs now stall in federal review, and children with rare diseases are paying the price.
I’m a bioscientist. My work has focused on how healthy cells function and how that knowledge can be applied to therapeutic enzyme development. I’ve spent my career working inside the disciplines that move a treatment from lab bench to patient: protocol design, reproducibility, evidence standards, and layered human testing to ensure safety.
Is this simply bureaucracy doing what bureaucracy does? Or are rare pediatric therapies effectively facing a higher bar inside the system?
Standards, evidence, and process matter. But so does urgency.
Children with rare diseases do not live on regulatory timelines. They lose function month by month — speech, mobility, independence, even the ability to breathe on their own.
Of the more than 6,800 known rare diseases, about 70% begin in childhood. Better-known examples include Duchenne muscular dystrophy, Gaucher disease, and cystic fibrosis.
Developing therapies for these children is difficult, expensive, and slow even under the best conditions. Treatments such as Ultragenyx’s UX111 for Sanfilippo syndrome, Sarepta’s Elevidys for Duchenne, and Regenxbio’s RGX-121 for Hunter syndrome can take decades to develop, years to move through trials, and still more time to reach the children who need them.
That reality makes avoidable regulatory delay even harder to defend.
Too often, applications do not stall because the underlying science has failed. They stall over manufacturing or procedural concerns — in many cases, issues that are fixable and not directly tied to whether the therapy is clinically helping patients. Those delays can undermine the purpose of the FDA’s accelerated approval pathway, which exists to move critical treatments to patients faster while additional data is collected.
As a scientist, I was particularly troubled by the FDA’s recent rejection of a promising Hunter syndrome treatment and by yet another clinical hold placed on its development despite positive trial results.
That raises an uncomfortable question: Does the review process itself need review?
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The approval path for UX111 is another example. The therapy went through the rigorous biologics license application process, only to be delayed by a manufacturing hold.
Elevidys offers a similarly painful lesson. More than 1,200 Duchenne patients received the treatment over three years. Then, after two non-ambulatory patients (including one with underlying complications) tragically died, the FDA pulled the treatment from all patients, leaving families crushed and panicked.
Children are waiting too long for access to potentially life-changing therapies.
Yes, medical breakthroughs have increased. But so have regulatory burdens tied to approval and release. By the time many of these therapies reach the market, a decade or more has passed. In rare pediatric disease, that delay has a name: time children do not have.
Sometimes, it is their entire lifetime.
Manufacturing processes can be improved. Facilities can be upgraded. Paperwork can be corrected.
Lost neurons and muscle fibers cannot be replaced.
FDA leaders, along with Congress and the White House, should push for a smarter accelerated approval process — one that allows multiple requirements to be addressed simultaneously when appropriate, instead of serially dragging out timelines. If regulatory review had moved more efficiently, the Sanfilippo treatment might have cleared on its original 2025 approval timeline. Duchenne patients might not have lost access to the only available gene therapy. Hunter syndrome patients might not still be waiting.
This debate is not about abandoning safety or efficacy standards.
Ultragenyx has said manufacturing improvements are addressable and not directly related to product quality. Sarepeta responded to FDA concerns over Elevidys by requesting black-box warnings while allowing treatment to continue for ambulatory patients. In the RGX-121 Hunter syndrome case, the FDA rejected the use of a long-accepted biomarker (cerebrospinal fluid) used in the trial.
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These decisions do not help children with rare diseases. Timely, science-based approvals would.
And the stakes go beyond today’s patients. Regulatory efficiency also affects whether companies continue investing in rare-disease therapies at all. Orphan drug development requires major upfront investment, long timelines, and often poor financial returns. In many cases, these programs are closer to philanthropic science than blockbuster pharma economics.
When developers face repeated slowdowns across different diseases, sponsors, and technologies for reasons unrelated to core clinical safety or efficacy, the signal to the market is clear: Don’t take the risk.
That is how innovation gets smothered.
At some point, the pattern at the FDA becomes impossible to ignore. Is this simply bureaucracy doing what bureaucracy does? Or are rare pediatric therapies effectively facing a higher bar inside the system?
Those are scientific and ethical questions that deserve honest answers.
Accelerated approval does not mean lower standards. It means applying standards intelligently. It means allowing earlier access while confirming evidence continues to accumulate. It means recognizing that “wait and see” is not neutral. It is a choice that guarantees disease progression in children who cannot afford delay.
Good science and compassion are not competing values. We can maintain rigor and still act with urgency.
The FDA has the authority. The science is moving. The children cannot wait.
Accelerated approval is not cutting corners. It is using every tool we have to save time families do not have.
Rural health care in America faces a host of chronic challenges: high costs, limited access, and aging infrastructure. For millions of families across the heartland, these problems aren’t abstract — they determine whether patients can see a doctor, reach a hospital, or receive timely care close to home.
By expanding flexibility, encouraging innovation, and meeting rural communities where they are, policymakers have begun to confront the unique realities of rural health care.
More than 60 million Americans — nearly one in five — live in rural areas where patients routinely travel long distances only to find fewer doctors, hospitals, and clinics available to serve them.
Under-resourced communities face over-sized health challenges. Nowhere is this more evident than in rural America, where higher rates of chronic disease, premature mortality, and addiction persist compared to the rest of the country.
In recent months, the Trump administration and Congress have advanced a set of reforms — largely overlooked in the national debate — that directly address long-standing disparities and structural weaknesses in rural health care, and they could meaningfully strengthen care delivery in these communities, improve health, and save lives.
The most significant of these efforts is the Rural Health Transformation Program, established last year in President Trump and the Republican Congress’ signature One Big Beautiful Bill Act. This $50 billion program represents the largest investment ever dedicated specifically to rural health, far exceeding the scale of prior grant programs. States that receive awards can use these resources to modernize and stabilize their rural health systems.
The program allows states to invest in innovative care models tailored to rural realities — whether expanding outpatient capacity, strengthening the health care workforce, or upgrading aging facilities. Instead of imposing a one-size-fits-all approach, the program gives states the flexibility to design reforms that reflect local needs and constraints.
Although media attention has shifted elsewhere, the White House and congressional leaders should continue to emphasize the long-term importance of this investment. The program addresses a foundational weakness in America’s health system and delivers tangible support to rural communities that have too often been left behind.
As part of the recently enacted FY 2026 appropriations legislation, Congress also extended Medicare telehealth flexibilities through December 31, 2027, delaying a return to statutory barriers that once limited access to telehealth services. Telehealth allows patients to connect with specialists, receive mental health services, and manage chronic diseases without traveling hours for an appointment.
In communities facing persistent provider shortages, telehealth has become not a convenience but a lifeline — a bridge over miles of empty road, connecting rural patients to care that would otherwise remain out of reach.
The FY 2026 appropriations legislation also reauthorized the Acute Hospital Care at Home initiative, which allows eligible patients to receive hospital-level care in their own homes. This approach reduces costs, eases pressure on rural hospitals with limited capacity, and improves patient satisfaction. For small hospitals struggling to keep beds staffed and doors open, Acute Hospital Care at Home offers a practical way to deliver high-quality care while preserving local access.
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Finally, although Congress has not yet enacted it into law, lawmakers are working to reauthorize the Rural Health Care Services Outreach Program. This program supports community-based efforts to expand access to care, strengthen coordination among providers, and address persistent service gaps. Its grants help rural health systems collaborate across institutions and tailor solutions for populations that too often fall through the cracks.
Taken together, these reforms do not promise a quick cure — but they do offer a realistic treatment plan. They don’t strengthen rural health care because it’s easy; they make it easier because rural health care must be strong. While these efforts will not eliminate every challenge rural communities face, they are designed to deliver tangible improvements that deserve recognition.
By expanding flexibility, encouraging innovation, and meeting rural communities where they are, policymakers have begun to confront the unique realities of rural health care. Yet as the news cycle moves on, these achievements risk being overlooked. Policymakers in both Congress and the executive branch should resist the urge to rush to the next challenge and instead highlight the significance of these steps in the right direction.
Editor’s note: This article was originally published by RealClearHealth and made available via RealClearWire.
Never before have we seen a technology that offers such an impressive veneer of competence, yet demonstrates such dangerous incompetence when it actually matters. It’s what happens when government works together with the largest tech companies to monopolize the public square, prematurely promote AI for the wrong uses, and exaggerate the boundaries of its limitations. “Just good enough” can work for some functions of life, but not if you are on the operating table.
When humans outsource their measured judgment to what poses as an expert but lacks internal resistance when unsure of facts, you get catastrophic failure.
Reuters is reporting, based on lawsuits from several injured patients, that in the rush to approve AI-assisted medical devices for surgery, the FDA is receiving a record number of malfunctions leading to injuries during surgery. Additionally, companies are being forced to recall these products at a record pace.
Specifically, the report highlights TruDi from Acclarent, a software that provides imaging and real-time feedback to ENT surgeons during delicate procedures. The product had already been on the market for three years in 2021, at which time the FDA received seven complaints of malfunctions and one complaint of patient injury as a result of error. At the time, this was within the realm of normal baseline adverse event reporting. In 2021, however, Acclarent introduced machine-learning algorithms to the software.
Since then, the FDA has received 100 unconfirmed reports of malfunctions and eight instances of serious injuries.
What sort of injuries? In numerous instances, the software reportedly hallucinated and allegedly misinformed surgeons about the location of their instruments while they were using them inside patients’ heads. While causation is yet to be proven, patients who underwent operations with TruDi guidance since 2021 have reported:
Anyone familiar with using LLMs can easily understand how AI could misidentify anatomy. “The product was arguably safer before integrating changes in the software to incorporate artificial intelligence than after the software modifications were implemented,” one of the suits alleges.
TruDi is one of at least 1,357 medical devices using AI that are now approved by the FDA. That is double the number the agency allowed through 2022, which means that somehow the FDA was able to properly scrutinize nearly 700 AI medical devices in three years. There are currently only 25 scientists working in the Division of Imaging, Diagnostics and Software Reliability, the key agency that assesses the safety of these products.
The apparent rush to market with overhyped and exaggerated capabilities of LLM is clearly reflected in the results from recalls. Researchers from Yale and Johns Hopkins recently found that 60 FDA-authorized medical devices using AI were linked to 182 product recalls, with 43% of those recalls having occurred less than a year after the devices were approved. According to the study published in JAMA, that’s about twice the recall rate of all devices authorized under similar FDA protocols.
Notably, most of the companies associated with the recalls in the JAMA analysis were publicly traded companies. “The association between public company status and higher recalls may reflect investor-driven pressure for faster launches, warranting further study,” warn the authors.
According to one lawsuit in Dallas, the doctor using the TruDi system was “misled and misdirected,” leading him to cut a carotid artery — which resulted in a blood clot and stroke.
The plaintiff’s lawyer told a judge that the doctor’s own records showed he “had no idea he was anywhere near the carotid artery.” The patient, Ralph, was forced to have a portion of skull removed as part of the remedial treatment, and he is still struggling to recover his daily functions a year later.
This is part of a broader problem of laziness on the part of AI users and the desire for speed and shortcuts creeping its way into health care. Researchers from Oxford, in a recent study published in Nature Medicine, found that among 1,300 patients who used LLMs to diagnose medical problems, many of them were provided with a mix of bad and accurate information. They found that while the AI chatbots now "excel at standardized tests of medical knowledge," their use as a frontline medical tool would "pose risks to real users seeking help with their own medical symptoms."
Again, “just good enough” is nowhere near enough for health care. The fact that a majority of the information is correct is even more dangerous.
The problem with LLMs is that they present themselves as the most qualified and knowledgeable cognitive human being, capable of adapting to a dynamic situation. However, despite the confidence, lack of hesitation, and even coherence that they offer, they lack the ability to use judgment through error and revision. When humans outsource their measured judgment to what poses as an expert but lacks internal resistance when unsure of facts, you get catastrophic failure.
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In public policy, particularly the FDA and approval of AI technology in health care, we must not fall into the trap of prioritizing speed over safety. That must be the guiding principle in the deployment of these technologies. The money that has been thrown at these technologies and the fact that the return on investment is still lagging should not induce us into a frenetic and rushed approval.
As a percentage of GDP, AI investment is bigger than the railroad expansion of the 1850s, putting astronauts on the moon in the 1960s, and the decades-long construction of the U.S. interstate highway system in the 1950s through 1970s, according to the Wall Street Journal. The difference is that this is all unproductive debt not producing any meaningful revenue. Now, these companies are desperately paying “influencers” to shame people into using their products.
Hopefully the technology will get better, but we should not continue prioritizing this technology in its current iteration without major changes. Nor should we ever mistake generative AI as a replacement for the human mind rather than a potential tool for augmentation of the human mind. Safety always comes first, and God created human judgment and human ethics powered by a human brain to be the last line of defense against danger.
A woman who underwent breast removal surgery at 16 years old was awarded $2 million in the first medical malpractice lawsuit brought by a detransitioner to go to trial.
'There will be thousands of court cases of children who were mutilated by evil doctors.'
Fox Varian, 22, sued her New York-based psychologist and plastic surgeon, and their respective employers, after regretting the 2019 surgery.
Varian's attorney contended that the health care professionals misdiagnosed and improperly treated her for gender dysphoria.
The defense claimed that Varian did not express regret about the surgery until years later, filing the lawsuit in 2023. They also argued that it was Varian's decision to use "he/him" pronouns, change her name, wear a chest binder, and undergo breast removal surgery.
Varian's lawyer claimed that her psychologist "drove the train" and had been "putting ideas" in her head.
Varian's mother testified that she opposed the surgery. However, she consented to it because she feared her daughter might commit suicide otherwise. She claimed that Varian's psychologist intensified her concerns.
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During her testimony, Varian described her reaction to the surgery.
"I immediately had a thought that this was wrong, and it couldn't be true," she stated, adding that she has since suffered nerve pain that feels like "searing hot ... ripping sensations across my chest."
"Shame. I felt shame," Varian said. "It's hard to face that you are disfigured for life."
The six-member jury determined that the medical professionals involved overlooked essential steps in assessing whether Varian should proceed with the permanent procedure and failed to communicate adequately with one another.
The jury concluded that these failures were a "departure from the standard of care," awarding Varian $1.6 million for past and future pain and suffering, and $400,000 for future medical expenses, the Epoch Times reported.
Varian's attorney, Adam Deutsch, had requested $8 million in damages.
The case was not about whether the surgery was appropriate for a minor. Instead, it concerned whether the health care professionals followed the proper steps to prioritize Varian's treatment, including delivering an accurate diagnosis.
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"I have identified 28 detransitioner lawsuits filed to date. Varian v. Einhorn was the first to go to trial and the first to win a judgment, making history," wrote Benjamin Ryan, an independent journalist who attended the three-week trial.
Elon Musk reacted to Varian's legal victory.
"There will be thousands of court cases of children who were mutilated by evil doctors, modern day Mengeles," Musk wrote, referring to Josef Mengele, an infamous Nazi doctor who became known as the "Angel of Death" for his gruesome medical experiments.
"The schools, psychologists/psychiatrists and state officials who facilitated this will pay dearly too," Musk added.
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A nurse in Florida who allegedly said he would refuse to administer anesthesia to conservative patients is no longer registered in the state.
Erik Martindale appeared to post on his Facebook account, “I will not perform anesthesia for any surgeries or procedures for MAGA. It is my right, it is my ethical oath, and I stand behind my education. I own all of my businesses and I can refuse anyone!”
'Healthcare is not contingent on political beliefs, and we have zero tolerance for partisans who put politics above their ethical duty.'
Libs of TikTok shared a screenshot of the comments in a post on X, calling for him to be immediately fired and stripped of his license.
After facing backlash online, Martindale claimed that his Facebook, Facebook Messenger, and Instagram accounts had been “hacked.” Libs of TikTok disputed his claim, sharing another screenshot of a post Martindale apparently made on his Threads account.
“I will not perform anesthesia on any surgeries for registered Republicans,” the Threads post read.
“Erik is now claiming his FB and IG were hacked. There’s a slight problem. It was on threads too. Was your threads also hacked Erik?? Lmao,” Libs of TikTok wrote. “Nobody is buying this Erik. We have all the receipts!”

As of Friday morning, all of Martindale’s social media accounts appeared to be deactivated.
On Thursday, Florida Attorney General James Uthmeier announced, “Effective today, Erik Martindale is no longer a registered nurse in Florida.”
“Healthcare is not contingent on political beliefs, and we have zero tolerance for partisans who put politics above their ethical duty to treat patients with the respect and dignity they deserve,” Uthmeier added.

The Florida Department of Health website shows that Martindale’s license was voluntarily relinquished. The department notes that such action “does not constitute discipline.”
The Department of Health did not respond to a request for comment regarding whether Martindale’s license was surrendered or revoked. Blaze News was unable to contact Martindale for a statement.
Last week, Uthmeier announced that Florida had revoked Lexie Lawler’s ability to practice nursing in the state after she posted a video on social media wishing a life-altering birth injury on White House press secretary Karoline Leavitt.
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Americans seeking mental health or addiction treatment often encounter a system that claims to coordinate care but rarely delivers it quickly. As demand for behavioral health services rises, a basic question deserves a clear answer: Who actually controls behavioral health care in the U.S., and is that control helping or hurting patients in crisis?
When someone finally reaches out for help, he encounters waiting lists, paperwork, and network gaps that push him toward emergency care or no care at all.
Nevada offers a revealing case study. The state’s Department of Health and Human Services certifies programs and distributes federal grants. County and regional commissions convene advisory meetings to reflect local priorities. Medicaid sets reimbursement rates and payment timelines. Managed-care organizations impose prior authorizations that can delay or deny treatment. Each layer is designed to promote accountability. Together, they often produce delays.
The result is not a coordinated system but a fragmented patchwork of public agencies, insurers, and contractors. Federal funding arrives with compliance requirements that consume clinicians’ time. States enact parity laws to ensure mental health and substance abuse treatment is covered like other medical care. Legislatures debate how to curb investor influence over clinical decisions, insisting that licensed professionals — not financial managers — direct care.
These tensions are unfolding as Washington rethinks the structure of federal health policy. The proposed Administration for a Healthy America would consolidate agencies such as the Substance Abuse and Mental Health Services Administration into a single entity. Supporters promise efficiency; critics warn that consolidation could slow local responses.
At the state level, the policy picture is equally unsettled. In 2025, lawmakers across the country revised behavioral health statutes with competing priorities: workforce shortages, crisis response systems, parity enforcement, and the elimination of out-of-pocket costs. Some states strengthened insurance mandates. Others reconstructed governance and funding to regain control over fragmented delivery systems.
Federal policy choices loom over the whole picture. Potential Medicaid funding cuts and weaker enforcement of mental health parity threaten access as demand continues to rise. Proposed budget changes could reduce support for community mental health clinics, suicide prevention programs, and substance abuse treatment — services that are often the last line of defense before emergency rooms or jails.
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Technology adds another complication. States are beginning to regulate artificial intelligence in behavioral health, with some banning AI-driven psychotherapy outright and others exploring guardrails for diagnostic or treatment support tools. These debates reflect a larger concern: the potential for innovation to replace clinicians or create unregulated substitutes for human judgment.
What patients experience is the cumulative effect of misaligned authority. Financial power, regulatory oversight, and clinical delivery point in different directions. When someone finally reaches out for help, he encounters waiting lists, paperwork, and network gaps that push him toward emergency care or no care at all.
Reform should start with three principles. First, policymakers must reduce administrative burdens that trap providers in compliance while patients wait. Second, insurance reforms must deliver real parity in access — not just coverage on paper. Third, oversight should protect quality while allowing local systems to innovate and respond quickly to community needs.
Behavioral health care is not a niche service. It is a public safety imperative and a core function of a serious health system. Until policy shifts its focus from control to care, patients will continue to pay the price.
A delivery nurse was stripped of her ability to practice in Florida after she posted a video online wishing harm on a pregnant Trump administration official.
A video circulated on social media of Lexie Lawler, a then-nurse for Baptist Health Boca Raton Regional Hospital, stating that she hopes White House press secretary Karoline Leavitt suffers a painful childbirth that leaves her with permanent injuries.
'Making statements that wish pain and suffering on anyone, when those statements are directly related to one's practice, is an ethical red line we should not cross.'
"As a labor and delivery nurse, it gives me great joy to wish Karoline Leavitt a fourth-degree tear. I hope that you f**king rip from bow to stern and never s**t normally again, you c**t," Lawler stated in the video.
Lawler was fired this week from her position with Baptist Health Boca Raton Regional Hospital.
"The comments made in a social media video by a nurse at one of our facilities do not reflect our values or the standards we expect of health care professionals," a spokesperson for the hospital told the Palm Beach Post. "Following a prompt review, the individual is no longer employed by our health system."
"While we respect the right to personal opinions, there is no place in health care for language or behavior that calls into question a caregiver's ability to provide compassionate, unbiased care," the spokesperson added.

Florida Attorney General James Uthmeier reacted to the Lawler video, stating, "Being fired isn't good enough. Any healthcare worker who fails to uphold his or her obligation to provide adequate, safe healthcare should not be licensed in Florida. No excuses!"
Lawler responded to the public pushback in a separate video posted to social media.
"They murdered a man in Minnesota, and you motherf**kers are coming after me because I used bad language?" Lawler said, referring to the death of Alex Pretti. "F**k you. I'm on the right side of this. F**k you."

Uthmeier announced on Wednesday that Lawler "is no longer allowed to practice nursing in Florida."
"Making statements that wish pain and suffering on anyone, when those statements are directly related to one's practice, is an ethical red line we should not cross. I'm proud of @FLSurgeonGen for taking this decisive action," he wrote.
Lawler's husband, Tim, created a GoFundMe requesting $14,000 in donations for his wife's legal fund. As of Wednesday afternoon, the fund had raised over $10,000.
"Lexie Lawler was fired for political speech," the GoFundMe post reads. "She is a liberal woman who used her personal social media — on her own time — to sharply criticize a public figure tied to a cruel, harmful administration. Her words were blunt, angry, and unapologetic. They were directed at power, not her workplace. That speech was lawful. The retaliation was real."
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