After Medicare Fraud, What’s Next?: Florida Gov Rick Scott’s Extremely Profitable Policy Proposal
Florida Gov. Rick Scott is one of the most entertainingly shameless figures in American political life. In the 1990s, Scott headed Columbia/HCA Healthcare, the largest for-profit hospital in America. While Scott was running Columbia/HCA Healthcare, it got involved in a bit — okay, a lot — of fraud. As Forbes reported, the company “increased Medicare billings by exaggerating the seriousness of the illnesses they were treating. It also granted doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. In addition, it gave doctors ‘loans’ that were never expected to be paid back, free rent, free office furniture, and free drugs from hospital pharmacies.”
The scale of the fraud was so immense that Columbia/HCA Healthcare ended up paying more than $2 billion (PDF) back to the federal government in the single largest fraud case in history. (The previous record holder? Drexel Burnham.) Scott resigned shortly before the judgment came down.
Today, Scott is enjoying a second act as governor of Florida. And, as Suzy Khimm reports, he doesn’t seem all that chastened. Before running for office, he turned his $62 million stake in Solantic, the urgent-care clinic chain he founded after resigning from Columbia/HCA Healthcare, over to a trust in his wife’s name. Solantic doesn’t take traditional Medicaid, but it does work with the private HMOs that, under a 2005 pilot program, were allowed to contract with Medicaid. And Scott is now pushing a bill that would expand that program across the state making those HMOs — the ones Solantic works with — the norm for Medicaid.
Asked about the apparent conflict of interest, Scott said, “If you look at everything that I want to accomplish in health care in Florida is basically what I’ve believed all my life. I believe in the principle that if you have more competition it will drive down the prices.” And I believe him. But he could have sold his stake in Solantic when he got into government. Since he didn’t, the fact remains that Scott is pushing a policy his family stands to profit from immensely . Which is, for Scott, real progress. In the 1990s, he made his money off single-payer health-care programs by cheating them. Today, he’s making his money off single-payer health-care programs by running them. No matter how you look at it, it’s a step up.
By: Ezra Klein, The Washington Post, March 25, 2011
Changing Demographics: The GOP’s Census Problem
When the Census released its reapportionment totals in December, much of the focus was on the new seats in red states, and how it was a good thing for Republicans.
The data released by Census on Thursday, though, shows how those same population shifts are creating new challenges for the GOP.
While much of the shifting population is moving to red states, there is increasing evidence that it’s making those red states bluer, and most of the demographic trends are heading in Democrats’ direction.
Census Bureau director Robert Groves summed it up best Thursday: “We are increasingly metropolitan today, our country is becoming racially and ethnically more diverse over time … and geographically, there are a lot of areas of the country growing in number that have large minority populations.”
All three of those things suggest growing Demcoratic constituencies. Let’s look at each individually:
* The country is getting less rural: While 82.8 percent of the population in 2000 lived in metropolitan areas, that number is now 83.7 percent. A look at population changes county-by-county shows that many rural counties, especially in the solidly Republican middle of the country, actually experienced population loss over the last decade, while most of the big population growth was near big cities, where Democrats dominate.
* The country is getting more diverse: The minority population has increased dramatically to 36.3 percent and will only keep going down that path, as only a slight majority of U.S. children are white. And Republicans have major problems with minority populations. The black vote generally goes almost completely for Democrats, and even in the GOP wave in 2010, six in 10 Hispanics voted Democratic.
* The areas that are getting bigger are Democratic: A look at the states with the biggest growth over the past decade shows many of them have moved toward Democrats, including Nevada, North Carolina and Virginia (Obama was a surprise winner in all three, which had gone for President Bush in 2004). A look at the county-by-county growth in these states shows that the growth is focused in urban and Democratic areas — Las Vegas-based Clark County, Charlotte-based Mecklenburg County and the Research Triangle in North Carolina, and Northern Virginia all grew the fastest. That suggests that the growth is occuring in Democratic areas.
Now, just because Democratic-leaning demographics grow doesn’t necessarily mean Democratic voters will be created. For all we know, rural Republicans are moving into the city and making them redder.
But if Republicans want to compete in the decades to come, they need to be able to compete in metropolitan areas — likely by reasserting their dominance in the suburbs — and also be able to woo Hispanics, who now account for one in six people in the United States.
If they can’t, the demographics are just going to make it harder and harder.
By: Aaron Blake and Chris Cillizza, The Washington Post, March 25, 2011
Spending Cuts, Jobs, Growth: The GOP Austerity Delusion
Portugal’s government has just fallen in a dispute over austerity proposals. Irish bond yields have topped 10 percent for the first time. And the British government has just marked its economic forecast down and its deficit forecast up.
What do these events have in common? They’re all evidence that slashing spending in the face of high unemployment is a mistake. Austerity advocates predicted that spending cuts would bring quick dividends in the form of rising confidence, and that there would be few, if any, adverse effects on growth and jobs; but they were wrong.
It’s too bad, then, that these days you’re not considered serious in Washington unless you profess allegiance to the same doctrine that’s failing so dismally in Europe.
It was not always thus. Two years ago, faced with soaring unemployment and large budget deficits — both the consequences of a severe financial crisis — most advanced-country leaders seemingly understood that the problems had to be tackled in sequence, with an immediate focus on creating jobs combined with a long-run strategy of deficit reduction.
Why not slash deficits immediately? Because tax increases and cuts in government spending would depress economies further, worsening unemployment. And cutting spending in a deeply depressed economy is largely self-defeating even in purely fiscal terms: any savings achieved at the front end are partly offset by lower revenue, as the economy shrinks.
So jobs now, deficits later was and is the right strategy. Unfortunately, it’s a strategy that has been abandoned in the face of phantom risks and delusional hopes. On one side, we’re constantly told that if we don’t slash spending immediately we’ll end up just like Greece, unable to borrow except at exorbitant interest rates. On the other, we’re told not to worry about the impact of spending cuts on jobs because fiscal austerity will actually create jobs by raising confidence.
How’s that story working out so far?
Self-styled deficit hawks have been crying wolf over U.S. interest rates more or less continuously since the financial crisis began to ease, taking every uptick in rates as a sign that markets were turning on America. But the truth is that rates have fluctuated, not with debt fears, but with rising and falling hope for economic recovery. And with full recovery still seeming very distant, rates are lower now than they were two years ago.
But couldn’t America still end up like Greece? Yes, of course. If investors decide that we’re a banana republic whose politicians can’t or won’t come to grips with long-term problems, they will indeed stop buying our debt. But that’s not a prospect that hinges, one way or another, on whether we punish ourselves with short-run spending cuts.
Just ask the Irish, whose government — having taken on an unsustainable debt burden by trying to bail out runaway banks — tried to reassure markets by imposing savage austerity measures on ordinary citizens. The same people urging spending cuts on America cheered. “Ireland offers an admirable lesson in fiscal responsibility,” declared Alan Reynolds of the Cato Institute, who said that the spending cuts had removed fears over Irish solvency and predicted rapid economic recovery.
That was in June 2009. Since then, the interest rate on Irish debt has doubled; Ireland’s unemployment rate now stands at 13.5 percent.
And then there’s the British experience. Like America, Britain is still perceived as solvent by financial markets, giving it room to pursue a strategy of jobs first, deficits later. But the government of Prime Minister David Cameron chose instead to move to immediate, unforced austerity, in the belief that private spending would more than make up for the government’s pullback. As I like to put it, the Cameron plan was based on belief that the confidence fairy would make everything all right.
But she hasn’t: British growth has stalled, and the government has marked up its deficit projections as a result.
Which brings me back to what passes for budget debate in Washington these days.
A serious fiscal plan for America would address the long-run drivers of spending, above all health care costs, and it would almost certainly include some kind of tax increase. But we’re not serious: any talk of using Medicare funds effectively is met with shrieks of “death panels,” and the official G.O.P. position — barely challenged by Democrats — appears to be that nobody should ever pay higher taxes. Instead, all the talk is about short-run spending cuts.
In short, we have a political climate in which self-styled deficit hawks want to punish the unemployed even as they oppose any action that would address our long-run budget problems. And here’s what we know from experience abroad: The confidence fairy won’t save us from the consequences of our folly.
By: Paul Krugman, Op-Ed Columnist, The New York Times, March 24, 2011
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 