Unhealthy Skepticism

Source: Suzanne Gordon and Jasper Craven, Washington Monthly, July/August 2018

The Department of Veterans Affairs was back in the news this spring—and, as usual, the news wasn’t good. … But here’s a different story about the VA, from the exact same time period, that major media outlets didn’t bother to report: In March, researchers at the nonprofit research organization RAND published a study revealing the gross inadequacies of New York State’s health care system to effectively treat veteran patients. A month later, RAND found that the quality of VA care was generally better than private health care. These were just the latest of scores of studies that have come to the same conclusion for nearly two decades now. … As the U.S. continues to debate what to do about its unsustainable health care system—and as conservatives continue to push for “free market” solutions, including privatizing the VA itself—the fact that a government-owned and -operated system is outperforming the private sector should be a major story. If VA care is as good or better than the alternative, how would pushing vets into private-sector care make them better off? But that question rarely gets asked, because too many people are unaware that the premise guiding these policies—that the private sector inevitably outperforms government—is false.

… The point is not that the VA has no problems; it does. The point is that by failing to compare it to other health care systems, journalists can present a distorted impression that plays into ongoing efforts to privatize an agency that outperforms the rest of the U.S. health care system on most metrics. … Most recently, with bipartisan support, Congress passed the VA Mission Act, a “reform” package that could massively divert more veterans’ care from the VA to private-sector providers—which, in turn, would likely force the closing of many VA hospitals. Meanwhile, the Trump administration would clearly like nothing better than to be able to outsource lucrative contracts for VA care to its friends in the private sector. If the press doesn’t get this story right soon, America’s biggest and most successful example of government-provided health care will soon pass into history.

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For the first time, a senator is opposing the VA secretary nominee
Leo Shane III, Military Times, July 11, 2018

Senate Veterans’ Affairs Committee members on Tuesday voted to advance the nomination of Robert Wilkie to be the next secretary of Veterans Affairs, but the move came with a symbolic and historic opposition vote against the move. The panel by voice vote sent Wilkie’s nomination to the Senate floor, but with Sen. Bernie Sanders, I-Vt., opposing the move. … Sanders, the former chairman of the committee, said he also intends to vote against Wilkie when his nomination comes to the full Senate for a vote. … “This has less to do with Mr. Wilkie than President Trump,” Sanders said following the vote. “Trump has been very clear about his desire to move to the privatization of the VA, and I suspect any of his appointees will try and move the agency in that direction.”

VA nominee pledges to oppose privatization
Source: Nahaniel Weixel, The Hill, June 27, 2018

President Trump’s nominee to lead the Department of Veterans Affairs on Wednesday said he doesn’t believe in privatizing the agency and pledged to oppose privatization efforts. “My commitment to you is I will oppose efforts to privatize,” even if it runs counter to the White House agenda, Robert Wilkie told a Senate panel. Under questioning from Sen. Bernie Sanders (I-Vt.), Wilkie said he would keep the VA “central” to the care of veterans, but indicated there can be a balance. Democrats and some veterans service organizations believe the White House is being influenced by Charles and David Koch, conservative billionaires who back the group Concerned Veterans for America (CVA), which is pushing to loosen current restrictions on veterans receiving private-sector care. …

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St. Luke’s sues prison contractor over $12 million in medical bills

Source: Audrey Dutton, Idaho Statesman, July 16, 2018

St. Luke’s Health System is suing an Idaho prison contractor over $12.6 million in medical bills it says the contractor hasn’t paid. The lawsuit was filed June 28 against Corizon Health, a company hired by the Idaho Department of Correction to provide medical care to Idaho’s inmates. The dispute stems from Corizon’s decision to pay St. Luke’s at the Medicaid rate for services the health system provided between July 1, 2014, and March 26, 2018. The Medicaid rate is “substantially lower” than the rate the health system says Corizon had agreed to pay, according to the lawsuit. St. Luke’s said it should have received 76 percent of its billed charges. St. Luke’s also seeks more than $3 million in interest on the medical bills, as well as a total of more than $600,000 for individual patients’ bills it says Corizon underpaid. … The lawsuit is the second filed by Idaho health care providers against the contractor. Saint Alphonsus Health System in April sued Corizon over similar claims, saying it was owed $14 million for medical care to inmates. Saint Al’s also sought $5 million in interest from the allegedly unpaid bills. …

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Prison violations led to amputations and death, Idaho inmates say
Source: Associated Press, March 27, 2017

Idaho inmates are asking a federal judge to penalize the state after saying prison officials repeatedly violated a settlement plan in a long-running lawsuit over health care, leading to amputations and other serious injuries and even some prisoners’ deaths. In a series of documents filed in federal court, the inmates’ attorney Christopher Pooser painted a bleak and often gruesome picture of the alleged problems at the Idaho State Correctional Institution south of Boise. The prison is the state’s oldest, with more than 1,400 beds, including special units for chronically ill, elderly and disabled inmates. Pooser and the inmates allege some prisoners were forced to undergo amputations after their blisters and bedsores went untreated and began to rot, and others with serious disabilities were left unbathed or without water for extended periods and given food only sporadically. The prison’s death rates outpaced the national average as well as rates at other Idaho facilities, according to the documents. And despite hearing evidence to the contrary, prison officials failed to double-check the numbers when its health care contractor, Corizon, reported being 100 percent compliant with state health care requirements. Meanwhile, prison officials were falsifying documents to make it look like all employees were trained in suicide prevention when many were not, the filings said. The inmates are asking the judge to hold the state in contempt of court and levy more than $24 million in fines against the Idaho Department of Correction. They say the state could cover some of the fines by recovering money paid under its contract with Corizon, but they also want the state to feel the budget hit so prison leaders will be motivated to make a fix. …

How an inmate’s death led to changes at the Hudson County jail

Source: Monsy Alvarado, NorthJersey, July 14, 2018

… Towle’s death in the early hours of July 14, 2017, and that of an immigration detainee five weeks earlier fueled allegations of medical neglect at the jail and spurred changes that included the early termination of the county’s contract with the company that provides medical care to inmates and the hiring this week of a new one. The county also embarked on a renovation that will expand the medical infirmary and mental health services at the jail at a cost of more than $1 million. … The Hudson County freeholders asked a “medical review panel” it appointed to examine the circumstances surrounding Towle’s death and that of the immigration detainee, Carlos Mejia-Bonilla, a native of El Salvador who fell ill at the jail and died later at Jersey City Medical Center. … The report, which was given to the freeholders in the spring, has not been made public. O’Dea said it prompted officials to terminate the county’s contract with CFG Health Systems LLC of Marlboro and look for a new medical provider for the jail. … Since the deaths of Towle, 48, of Washington Township in Warren County, and Mejia-Bonilla, 44, four additional inmates have died at the jail.

… “We had to get rid of the other one, no ifs, buts about it,’’ Anthony Vainieri, chairman of the Hudson County freeholder board, said, referring to CFG. “Everyone wanted us to get rid of it, the activists wanted us to get rid of it, the [jail] director wanted us to get rid of it, and with all the deaths, God forbid … something had to be done.” … On Thursday, the Hudson County freeholders approved a one-year, $7.68 million professional services agreement with Correct Care Solutions (CCS) of Nashville to provide medical and mental health care at the jail. …

Union rep: Keep food workers, hire private manager

Source: Lloyd Jones, Conway Daily Sun, July 17, 2018
 
Would the Conway School Board consider hiring a private manager for the food service program and retaining its 12 employees rather than going entirely the private route?  That’s the alternative AFSCME Council 93 Regional Coordinator Steve Lyons is proposing in order to save the jobs of his union members.  The board voted not to renew the 12 employees’ contracts and to authorize School Superintendent Kevin Richard to enter into negotiations with Cafe Service’s Fresh Picks, a Manchester-based food service provider, at its July 9 meeting. … Lyons told the district that once it goes down the path of privatization it probably cannot turn back.   “I think you are making a bad decision,” he said. “Getting out of it, you’re getting out of it for good. The companies will come in and replace your equipment. They’ll make it so it’s economically unhealthy for you to (switch back).” …

Increased costs put East Deer recycling program in jeopardy

Source: Tom Yerace, Valley News Dispatch, July 13, 2018

East Deer officials say they are baffled by and concerned about the skyrocketing cost of recycling over the past several months. “When we started this program, our cost was supposed to be $150 to $160 per month,” Commissioners Chairman Tony Taliani said. But the most recent recycling bill the township received from its refuse contractor, Waste Management Inc., showed an increase of nearly 600 percent, to $869. … At Taliani’s request, the commissioners delayed approving the bill pending an investigation. … The program started in May 2017 and the bill for that month was more than $300 because of start-up costs, he said. After that first month, the monthly recycling bill, assessed for the previous month, never topped $200. Taliani said that changed dramatically in April when the township received a $339 bill. That was followed by a $344 bill in May, $348 in June. …

‘First of many’: Lawsuit filed against state contractor blamed for Eastpoint wildfire

Source: Jeffrey Schweers, Tallahassee Democrat, July 12, 2018

This week marked the first claim filed in Leon County against the Tallahassee contractor responsible for setting the prescribed burn that’s been identified as the cause of the 820-acre Limerock wildfire that destroyed 36 homes in Eastpoint. … The Vinson/Cooper/Hattaway complaint alleges that Wildlands was engaged in an “ultra-hazardous activity while engaging in a controlled burn” and is strictly liable for all damages caused by the wildfire. The company knew of the foreseeable risk, the complaint said, and “could have reasonably taken precautions to eliminate the risks of the controlled burn.” …

… Wildlands was contracted by the Florida Fish and Wildlife Conservation Commission to burn a 480-acre area within the Apalachicola River Wildlife and Environmental Area to clear it of hazardous underbrush that can become fuel in a fire. The burn was ignited June 18 and extinguished six hours later. The next day, the burn boss said the burn went well and submitted an invoice for $26,400 to the FWC. The fire reignited June 24 and crossed over 600 acres of private land, razing several dozen properties a quarter-mile away on Buck Road, Ridge Road and Wilderness Road, leaving about 125 people homeless. A preliminary report by investigators with the law enforcement branch of the Department of Agriculture and Consumer Services said the prescribed burn caused the wildfire, ruling out arson and lightning. …

Company pays millions to settle allegations of overbilling on statewide contract

Source: WCVB5 ABC, July 10, 2018

A local supplier of electrical and lighting products is being required to refund nearly $1.2 million to hundreds of state organizations to settle allegations of overbilling on a statewide contract. Granite City, a Quincy-based company, will also pay another $1.18 million in fines. “This company engaged in a pattern of overbilling that cost hundreds of government agencies – including school districts, cities and towns – millions of dollars,” Attorney General Maura Healey announced. Granite City’s refunds will be paid to 285 public entities, including municipalities, school districts, libraries and hospitals. The company was supposed to sell equipment to those organizations at discounted rates, the AG’s office said. … In addition to the payments, the terms of the settlement bar Granite City from participating in public contracts for one year and require changes to the company’s business practices.

Consultant: District Wasting $1M Annually on Inefficient School Bus Routes

Source: July 10, 2018, School Bus Fleet

LAKEWOOD, N.J. — A school district here is wasting over $1 million a year, a transportation consultant has found, on inefficient school bus routes that it outsourced to private companies, while some of its own buses go unused, Asbury Park Press reports. The consultant, Ross Haber of Ross Haber Associates, was hired earlier this year to pinpoint potential cost savings in the public school transportation program, according to the newspaper. Lakewood Public School District spent about $9 million on public school transportation over the past school year. The report comes after the district took a $28 million loan from the state to settle a budget deficit for the upcoming school year, Asbury Park Press reports. … Haber’s preliminary findings are posted on the school district’s website and he shared an update on Thursday at a public meeting that was attended by school officials and dozens of district bus drivers and aides, Asbury Park Press reports. The report finds that inefficiencies include too many bus stops, empty seats on buses, and buses being contracted while some of the district’s own buses sit idle. …

Petty charges, princely profits

Source: Joseph Neff, The Marshall Project, July 13, 2018

… Brian Corbett has sewn up the bail bond trade in this largely rural corner of the nation’s poorest state, minting millions from people charged with minor offenses. Operating out of a Tupelo storefront behind the county jail complex, Corbett Bonding pocketed $2.6 million in fees over a recent span of 18 months — 46 percent on bonds of less than $5,000, the ceiling for most misdemeanors in the state. Brian Corbett, right, poses for a photo with Dog the Bounty Hunter. Corbett has 73 percent of the bail business in Lee County and 84 percent in neighboring Union County. (Photo: Marshall Project/USA Today Network) It was the highest take in Mississippi, according to a Marshall Project analysis of bonds tracked by the state Department of Insurance.

It is difficult to peer into the financial workings of the bail industry, where public sector services are performed by private companies largely shielded from scrutiny. New data collected by Mississippi and obtained by The Marshall Project offers a rare glimpse into how bail companies profit from the steady march of low-level offenders into county jails. Corbett Bonding is one of 193 bail companies in the state that over 18 months collectively took in $43 million — 36 percent from small bonds — in a state where the average annual income is under $22,000. … But this lucrative trade in petty charges may be coming to an end. A little-noticed but seismic change in state court rules last year — bolstered by lawsuits and a blunt-spoken state insurance commissioner — is making it easier for people charged with misdemeanors to leave jail earlier, or avoid it altogether, without securing a bond. It is a striking shift in a state that has long been one of the friendliest places in the nation for the bail bond industry. …

Trump Administration Backs Off Reshuffling of Student Debt Collection

Source: Andrew Kreighbaum, Inside Higher Ed, July 9, 2018

The Department of Education planned this month to begin reshaping the role of private debt collection firms in handling student loans by pulling defaulted borrower accounts from a handful of large private contractors. Lawmakers who control the department’s budget had other ideas. After a recent Senate spending package warned the department against dropping the debt collectors, the plan is on hold. And it’s not clear how those companies will figure into the Trump administration’s proposed overhaul of student loan servicing. Private loan servicers handle payments from borrowers on their student loans and provide information on payment plan options. … The tactics and performance of debt collectors have come under attack from Democrats and consumer advocates. And the Education Department has been involved in a years-long legal dispute over contract awards for the collectors. But the Trump administration, in a resolution of that legal fight, in May said it planned to cancel the entire debt collection solicitation. … Members of Congress, who have already expressed concerns about aspects of the department’s so-called NextGen loan servicing system, warned in separate appropriations bills against the move. … The week after Senate appropriators voted the bill out of committee, and just before it planned to start reassigning borrower accounts, the department notified collections firms it was postponing that step. …

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Editorial: The Student Loan Industry Finds Friends in Washington
Source: Editorial Board, New York Times, March 18, 2018
 
Education Secretary Betsy DeVos made clear even before taking office last year that she was more interested in protecting the companies that are paid by the government to collect federal student loan payments than in helping borrowers who have been driven into financial ruin by those same companies. Ms. DeVos’ eagerness to shill for those corporate interests is apparent in a craven new policy statement from the Education Department. The document claims that the federal government can pre-empt state laws that rein in student loan servicing companies if such a law “undermines uniform administration of’’ the student loan program. …

Banks Look to Break Government’s Hold on Student-Loan Market
Source: Josh Mitchell and AnnaMaria Andriotis, Wall Street Journal, March 7, 2018
 
Private lenders are pushing to break up the government’s near monopoly in the $100 billion-a-year student-loan market. The banking industry’s main lobbying group, the Consumer Bankers Association, is pressing for the government to instate caps on how much individual graduate students and parents of undergraduates can borrow from the government to cover tuition. That would force many families to turn to private lenders to cover portions of their bills. While that could mean lower interest rates for some, it could constrain funding to households with blemished credit histories. A group of investors also is lobbying for legislation to provide a clearer legal framework for “income-share agreements,” under which private investors provide money upfront to cover tuition in exchange for a portion of a student’s income after school. …

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