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AMA Endorses Largest Denier of Health Care Claims
Posted by Patrick Tuohey in Obama on October 5th, 2009
What appears to be the official blog of President Obama’s administration is all aflutter because the President will welcome, “doctors from across the United States to the White House to share their unique perspective on the struggles that American families face every day when it comes to health care.” (They posted today’s agenda in the name of transparency!)
The post even links to a National Public Radio (NPR) story in which a survey of medical professionals indicates they are among the biggest supporters of the so-called “public option.” A co-sponsor of the study, Dr. Alex Federman, indicates that, “physicians favored Medicare when it came to delivering care to patients. They thought Medicare was better when it came to autonomy and their decision making and their ability to get patients the care that they thought the patients needed.”
Furthermore, the American Medical Association (AMA) has endorsed the public option after an appeal from the President and despite, according to ABC News, the fact that “some member physicians at the group’s annual meeting [in June] likened the notion to communism.”
Beverly Gossage, Research Fellow for Show-Me Institute and founder of HSA Benefits Consulting wondered which insurance companies rejected the most claims. She found her answer in the AMA’s own 2008 National Health Insurer Report Card. The chart below appears on page 5 of the 16-page report.
Of the eight insurers listed, Medicare is most likely to reject a claim, sending away 6.85% of requests. This is more than any private insurer and double that of the private insurers’ average!
In short, the AMA is endorsing a plan whose closest existing example is the most frequent denier of claims. How the public option exemplifies “delivering care to patients” is unclear.
Turning Tea Party Patriots into Political Petitioners
Posted by Patrick Tuohey in Featured Story, News on October 3rd, 2009
As Americans rise up all across the country to challenge a political elite that many believe does not listen to them, it is important to consider the tools that people in many states have employed to directly affect change: the petition.
In Missouri, our Constitution includes the following passage:
The people reserve power to propose and enact or reject laws and amendments to the constitution by the initiative, independent of the general assembly, and also reserve power to approve or reject by referendum any act of the general assembly, except as hereinafter provided. (Article 3, Section 49)
The document clearly states that the people possess the right to initiate laws and constitutional amendments, even though they grant those same powers to their representatives in the legislature. This is an important since it permits the people to enact laws directly and without going through the standard legislative process.
Unfortunately, in Missouri and other states where the people enjoy this right, the initiative process is continually under assault from state legislatures—Republican and Democrat alike—even to the point of adopting unconstitutional limitations to them. Such efforts have included the following:
- A 1969 law in Oklahoma required that petition circulators be state residents. In December 2008, the Tenth Circuit Court unanimously struck down that law as unconstitutional. The Court did the same to a similar law in Colorado in 2002.
- A 2005 law in Ohio that restricted petition gatherers from being paid per signature was struck down by the Sixth Circuit Court struck in March 2008. Ohio appealed the decision but the U.S. Supreme Court declined to hear it. Similar pay-per-signature regulations have been overruled by federal district courts in Idaho, Maine, Mississippi and Washington.
- A Colorado law that required petitioners to wear badges with their name and whether they were a volunteer or paid circulator was struck down as unconstitutional by the U.S. Supreme Court in 1999.
A common argument for limiting the petition process is that it puts too much money into politics or that it invites fraud. Yet courts have found this not to be the case. In the 2005 ruling against Ohio, the Court concluded that prohibiting payment per signature would increase the costs and the time necessary to obtain the required signatures. The Court also rejected the evidence that this particular form of payment resulted in fraud.
Other legislators worry that petition drives can be funded and operated by people living out-of-state. In a December interview with the Springfield News-Leader, Rep. Michael Parson (R-133) said, “What’s happening is a company or a special-interest group can come in from out of the state, basically unload the signature gathers (from a bus), do a marketing campaign and change the Constitution of the State of Missouri.” It is important to note that Parson’s concern about out-of-state money and campaign workers doesn’t extend to candidate elections, like his own. His legislative efforts would only regulate out of state activity on campaigns for ballot initiatives, not campaigns for politicians.
Organizations such as Citizens in Charge are dedicated to preserving petition rights and even expanding them into new states. This is the first place tea party organizers should turn when considering how to leverage their clout. Ballotpedia.org is a website offering information about various ballot initiatives in Missouri and elsewhere. This service is important, because often the keys to the petition process are held by the executive and legislative branches—the very groups that the petition process is intended to circumvent. Even if a petition makes it to the ballot, the language that appears on the ballot may be written to opponents to change.
The Missouri general assembly recently debated real and substantive improvements to the initiative process, but the legislation did not survive the frenzied final few hours of the session. Look for these efforts to continue in January, and to remain a battleground all over the country.
The New Nixon: a Coverup, Tapes, and a Modified ‘Midnight Massacre’
Posted by Patrick Tuohey in Featured Story on September 28th, 2009
George Santayana said that those who do not learn from history are doomed to repeat it. This is certainly true in Missouri where the governor is embroiled in a burgeoning scandal dubbed ‘Ecoligate.’ His top staff apparently decided to keep secret a health report about a lake infected with higher-than-safe levels of E. coli. As every political junkie knows, it’s rarely the infraction that brings down a politician, it’ the coverup that ensues. Not only is Missouri’s governor a former 16-year attorney general, his name is Nixon.
These are the facts: On May 28, the Missouri Department of Natural Resources (DNR) learned that regular tests of the Lake of the Ozarks found dangerous levels of E. coli. In two areas, tests indicates levels 19 times greater than state standards, and half the swimming areas tested higher than federal standards. In fact, some of the tests hit the ‘maximum sample limit.’ Department procedure dictates that this report should be released to the public.
But the results were not released. Instead, the DNR deputy director and general counsel, Joe
Bindbeutel, claims he believed recent rainfall might have only temporarily elevated the levels and that an announcement could scare away tourists. The results were kept secret.
When the results hadn’t been released, as had become the custom in previous years, people began wondering about the results. Requests for the results, which were public records, were ignored. A subsequent investigation by Democratic Attorney General Chris Koster absolved the DNR of wrongdoing because the requests did not specifically cite the Sunshine Law (Missouri’s version of FOIA).
The Governor’s office claims it hadn’t learned of the test results until June 23. The media reported on the matter on July 15, and in that report, the spokesman for the Nixon administration criticized the DNR for not releasing the test results. Nevertheless, Nixon appointed Bindbeutel to a $100,000 job with the Administrative Hearing Commission on June 24–the day after they claim they learned of the test results.
Springfield News-Leader reporter Chad Livengood learned from emails released to him that Bindbeutel had asked for copies of the tests on June 3 in preparation for a meeting he was to have with a Nixon aide at the Governor’s. Earl Pabst, a 35-year veteran of DNR and deputy director of environmental quality, also told staff that Bindbeutel was planning to meet with the Governor’s office to discuss the E. coli problem on June 4. But the administration still says that E. coli was not discussed. Pabst has since announced his retirement. According to notes taken during a meeting of the Lake of the Ozarks Watershed Alliance, Binbeutel, said that, “the recent water testing has drawn the attention of the Director of DNR as well as Governor Nixon.”
When Livengood filed his Sunshine request for videotape to see which DNR officials visited Nixon’s office, his request was dismissed based on laws meant to protect security concerns from terrorists! But, writes Livengood, “Missouri Capitol Police provided a Nixon political appointee a copy of video surveillance tapes of the governor’s office, apparently ignoring its own policy barring such disclosures.”
Fast forward a few weeks and we have learned more. DNR director of communications Susanne Medley has resigned without explanation and has not responded to media requests for interviews. Transcripts of interviews she gave state Senate investigators indicate that she learned of the test results on May 29 and immediately passed on the information to the Governor’s staff. This fits with the widely held view of the administration. According the The Kansas City Star, “Nixon is said to run a top-down shop, meaning that his office is the focal point of all executive-level activity. Almost anything that goes on in state government seems to run through Nixon’s office.”
According to Livengood, Medley, “told Senate committee staffers investigating the department’s handling of the report that she told Nixon communications aide Jeff Mazur about the report on May 29.” She reported telling him the “results appear high” and that DNR staff would meet the following Monday to learn more. Medley said she called Mazur because all major news releases were to be run through him. This contradicts Nixon spokesman Jack Cardetti’s assertions that no one in the Governor’s office knew until June 23.
The Source, a Kansas City blog, has written extensively on the topic and suggests that Nixon may have been trying to protect a benefactor developer, Lynn Griswold. Griswold is a significant Democratic donor in Missouri, having given tens of thousands of dollars in contributions to Democratic state committees and candidates.
Griswold is accused in civil court Missouri in a lawsuit “of developing condos by the Lake of the Ozarks without proper sewage treatment facilities.” Untreated sewage can contaminate lakes with E. coli. The Source reports that, “Missouri is trying to impose a civil penalty of $10,000 per violation per day. A notice of violation was served on 10/15/2004, and as of 11/3/2008, they claimed the violations are ongoing.”
Before being appointed elsewhere, Bindbeutel claims to have had a few meetings with Governor Nixon in June. In one of those meetings attorney Chuck Hatfield was present. (This fact “inadvertently” was not reported to Senate investigators.) Hatfield is a former Nixon chief of staff, close confidante, and lobbyist. Although not registered as a lobbyist for Griswold, Hatfield is Griswold’s defense attorney in the civil suit mentioned above.
The Source suggests that the most plausible explanation is that in one of the meetings where Hatfield was present, Bindbeutel mentioned the high E. coli levels to Governor Nixon. The Source believes Hatfield may have asked Nixon to suppress the results and he did. Ken Midkiff, chairman of the Missouri Clean Water Campaign agrees, according to the Columbia Tribune. He told the paper, that testimony to Senate investigators, “confirms to me that the governor’s office directed and ordered DNR to withhold the data.”
Senate investigations into the matter are still underway. But in order to believe the administration’s changing, and at time contradictory line, one has to discount Medley’s assertion that she was in immediate and repeated communication with Nixon aide Mazur; one has to discount Bindbeutel’s and Pabst’s contemporaneous claims that the matter was to be discussed with Nixon on June 4; and one has to accept that Nixon would have appointed Bindbeutel on the day after learning that he had been risking public health by sitting on a DNR report.
The Source’s conclusion seems much more plausible, and would explain the delayed release of the report and Bindbeutel’s appointment elsewhere, the refusal to release security videotapes, and the mini-massacre of resignation and retirement that has followed.
On Saturday, The Kansas City Star editorialized that Nixon has abused the “public’s trust and put people’s safety in jeopardy.” That’s the best case scenario. At worst, Nixon has put the interests of a political contributor ahead of public safety and then orchestrated an effort to cover his tracks.