Tag Archives: The VSJ

The Rape of Florida Medicaid


The other day, in my post Without a Doctor, I claimed that the Medicare system here in Florida had been raped by the gubernatorial administrations of Jeb Bush and Charlie Crist; thus decimating their effectiveness as originally envisioned.

In the comments section of The VSJ, in ekg’s post They Really Will Stop at Nothing…our sparring partner lilMike, in a reply to me, asked:

Medicaid in Florida is trashed because Republicans have ruined it?

The short answer: YES! ABSOLUTELY!

In 1965, President Johnson signed the law establishing Medicare and Medicaid. The original purpose of the Medicaid program was:

The Medicaid program, authorized under Title XIX of the Social Security Act, was enacted to provide health care services to low-income children deprived of parental support, their caretaker relatives, the elderly, the blind, and individuals with disabilities.

Going way back to the days of Gov. Claude Kirk (whom I had the pleasure to know personally, regardless of his political leanings), Medicaid has been a prime target of Republican Death Squads.

Gov. Bob Martinez (whom I worked under while with the Florida Board of Nursing) cut, sliced, and pared Medicaid at an alarming rate, especially with regards to our elderly.

But it wasn’t until the reign of Jeb Bush (for whom I billed Medicaid and Medicare at a home health agency) that Medicaid in this state went under the greatest change.

One of Jeb’s first actions upon taking office was to kill his predecessor’s, Lawton Chiles (the only Florida governor in recent history to actually care about health care for children, the disabled and the poor) health care initiative for individuals and small businesses, the Florida Health Care Purchasing Alliance.

But that wasn’t Jeb’s first foray into the rape of Medicaid. In 2003:

Governor Bush is proposing to drop health care and long-term care coverage for about 26,000 seniors and people with disabilities, although they would retain prescription drug coverage.  The governor also is proposing steep increases in co-payments for prescription drugs, which likely would make it harder for some poor patients to afford their medications.  The state already implemented modest cuts in the Medicaid eligibility of elderly and disabled people last year.

In 2005, Jeb had the bright idea (not!) to be among the first to follow his brother George’s edict to make state Medicaid coverage over modeling it like (get this!) a health insurance company, complete with limits on coverage:

Gov. Jeb Bush of Florida and Gov. Mark Sanford of South Carolina, both Republicans, have proposed radical changes intended to inject market forces and competition into Medicaid. Under their proposals, the state would give Medicaid recipients a fixed amount of money to buy health care or private insurance.

Under Governor Bush’s proposal, Florida would contribute a fixed amount toward coverage for each Medicaid beneficiary. Patients could use the money to “opt out of Medicaid altogether and purchase health care insurance in the private market,” Mr. Bush said.

(Ironically, today Jeb is on the board of Tenet Healthcare, the same company required to repay the government over 900 million dollars in Medicare and Medicaid overpayments and is plagued by scandal after scandal.)

Even today, Jeb Bush’s failed Medicaid managed care decisions are affecting the State negatively:

”We’ve done the experiment. It has failed,” said Durell Peaden, the Senate’s health care budget chief. “The reports are unsettling. People couldn’t get to specialists, couldn’t get adequate care. And they couldn’t do it cheaply.”

I’m sure Lawton Chiles, the only Florida governor in 40 years to care about it’s citizens, is rolling in his grave right now
 
The son of Gov. Lawton Chiles said today Gov. Charlie Crist has “betrayed” needy children and old people by raiding a tobacco-funded trust fund for $700 million needed to balance Florida’s budget.
 

Supporting a Public Option: The Wrong Way


The other day, my friend Kelly posted a great blog at The VSJ, continuing her dismay over the big insurance companies cancelling policies of those with costly medical problems. Focusing this time on Ian Pearl, who has muscular dystrophy like our friend Chuck, she tells us what extent Pearl’s insurors will go through to keep from paying for his care:

 “In an e-mail to four other Guardian executives entered into evidence in the Pearls’ suit, company Vice President Tim Birely discussed how the company could “eliminate this entire block to get rid of the few dogs.”

In case you don’t understand what that means, Kelly succinctly explains:

“the New York-based insurer simply canceled lines of coverage altogether in entire states to avoid paying high-cost claims like Mr. Pearl’s”

In reply to Mr. Pearl’s lawsuit against the insurance company, and repeated by LilMike as a viable solution to the problem is this comment:

“As a last resort, Mr. Pearl would be admitted to a state hospital under Medicaid.”

Let me get this straight…The insurance companies and their Republican supporters like LilMike are dead set against a Public Option…yet are in favor of persons being denied insurance for long-term care receiving a type of government health care under Medicaid?

In another story I just came across, titled “He’s In the Army Now”, we hear thecaudle story of Bill Caudle, a recently laid off worker who, at the age of 40, enlisted in the Army in order to receive medical care for his wife Michelle’s ongoing battle with ovarian cancer. Unable to enroll in Wisconsin’s BadgerCare Plus public insurance program (apparently because the program had been suspended), Mr. Caudle decided to join the military after his COBRA insurance ran out.

Today, Mr. Caudle has become a right wing hero. No, not for the reasons you think. Because, and I quote:

“instead of reaching for a handout, the father puts his hand up to swear in and shows how to responsibly take care of his family…”

Nobody, I repeat, nobody should have to resort to having to join the Army at the age of 40 in order to get health care coverage for their spouse!

Let me get this straight…The Republican supporters are dead set against a Public Option…yet are in favor of persons without insurance joining the Army to receive another type of government health care?

Why are the Republicans so against a Public Option when government-run health care is so great?

Update: Pfc Bowe Bergdahl


In my recent post regarding Pfc Bowe Bergdahl, the young man who wasmedium_bowebergdahl “captured” by the Taliban, Kelly’s occasional sparring partner over at The Velvet Straitjacket, LilMike commented:

“This soldier just couldn’t have walked off base, he would have had to sneak away. And now he gets to make videos? I’m not sure he is a prisoner.”

I understand LilMike is a follower of all things right wing, neocon, and bows before the Gods of Rush and Faux News, but I find that it’s sad that he would actually imply that there’s something more to the story surrounding this young man ending up in Taliban arms.

Then I realized that is exactly what his heroes at Faux News are doing:

Faux News analyst, LtCol  Ralph Peters, calling Bergdahl a “deserter” and stating the Taliban should do us a favor and “just kill him”:

Then, a couple of days later, Riley appears on Bill O’Reilly’s show and repeats his accusations, going even further…

Really. I always thought the right wing, neocon,  followers of the Gods Rush and Faux News supported the troops. I guess not.

So, what is it about this young man that they hate so much they implore the Taliban to go ahead and “finish the job”?

Could it be that Bergdahl worked as a barrista at a coffee shop before enlisting? Or that he studied ballet?

Does Bowe Bergdahl not meet the criteria of being a soldier in the eyes of the right wing, neocon, followers of the Gods of Rush and Faux News?

Exposing the Sources – A Special Howey Truth Squad Report


I learned a long time ago that when dealing with Republicans like Kelly’s friend and occasional sparring partner, LilMike, that you have to look at the big picture when a source is cited. He often takes topics into directions unheard of while ignoring the issues at hand. Skewing facts to make a point is obviously an inherent trait of Republicans and LilMike uses it well. Which is why I like to check sources for the sources.

More  times than not, that source is about as crooked as Tricky Dick and is often a well-disguised sounding board for all things right-wing.

In today’s edition of the Howey Truth Squad, I’ll be tackling an innocuous little editorial from Investor’s Business Daily, one that taken at first glance would lead us to believe health care reform isn’t all that.

Let’s start with this part of the editorial:

The nonpartisan Lewin Group estimated in April that 120 million or more Americans could lose their group coverage at work and end up in such a program. That would leave private carriers with 50 million or fewer customers. This could cause the market to, as Lewin Vice President John Sheils put it, “fizzle out altogether.”

Hello? Lewin Group?

This Lewin Group????

Lewin Group Linked to Private Insurors

In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, scolded journalists for not mentioning that Lewin Group, the consultants who released a recent study claiming that a public insurance option would cost doctors and hospitals money, is ultimately part of a major insurance company.

(Lewin Group is) part of Ingenix, which is owned by Unitedunitedhealthcare Healthcare Group, the insurance behemoth that has been buying up insurance companies left and right, expanding its reach into just about every segment of the health-insurance market. Its flagship, UnitedHealthcare, helps make it the largest health insurer in the country.

It’s a safe bet that United is not too keen on a public plan that might shrink its business. The relationship is disclosed in the study and Lieberman turned up evidence indicating that there may be no formal protections in place for Lewin Group’s editorial independence.

She wondered why journalists, particularly those behind a widely used AP story, did not provide readers with any information or context on Lewin’s insurance industry ties and called on reporters to remedy their error next time Lewin Group comes up.

Wait. Did that say United Healthcare Group?

This United Healthcare Group????

Health Insurance Company Abuses

Most people don’t trust health insurance companies and with good reason. They are a powerful industry that is not easily prodded, pushed or intimidated into doing the right thing by their members. Insurance companies routinely abuse the trust of patients and providers alike.

A new report by Health Care for America Now outlines the habitual abuses perpetrated by health insurance companies, including leaving patients with high out-of-pocket costs, denying coverage for medically necessary care, preventing doctors from delivering care they feel is best for their patients, and unduly delaying reimbursement to patients and providers.

The report demonstrates how health insurance companies repeat the same abuses over and over again, despite being reprimanded and fined by state insurance agencies. For example, the report notes how the Texas Department of Insurance has fined United Healthcare millions of dollars for violating the state’s prompt payment law. The 2007 fine, $4.4 million dollars, was “the second time in two years and the fourth time since 2001 that Texas fined United Healthcare for the same type of violation.”

But Texas is not the only state where United Healthcare has perpetrated that particular abuse. The report also gives examples of similar fines being levied in Arizona, Georgia, North Carolina, and Ohio. And that is just the tip of the iceberg. Insurance companies are clearly not intimidated by state regulators. These companies seem to consider the fines they incur just the cost of doing business.

How much money must they be saving by breaking prompt payment laws if they are willing to keep violating the law over and over again?

It’s really simple. President Obama is not out to socialize our country. He’s not out to turn us all into card-carrying Zombies.  He doesn’t want to destroy our country. Regardless of what the Republican Doomsayers want you to think. Do we really want to listen to the same folks who sent us to Iraq…the same folks who destroyed our economy…the same folks who took the reputation of our Presidency and country and flushed it down the drain?

Let the President and Congress do their job. Isn’t that refreshing after what we were put through the past eight years?