Tuesday, April 2, 2019

If you would destroy health care in America your choice for a health care czar should be an enemy of health care

Ever since Trump named his first cabinet picks I’ve been saying that he follows a simple rule: X/AntiX. That is, for a government agency X, appoint someone AntiX who will inflict the most damage on X. Just for example, consider Betsy DeVos for education. Consider Ben Carson for HUD. Consider Mick Mulvaney for CFPB. And, as I posted yesterday, consider Stephen Moore, Trump’s nominee to Fed appears to have money management issues. “If you want to screw up the nation’s banking system, why not appoint a guy who, apparently and allegedly, has trouble managing money”.

Trump now continues this trend with the naming of former Florida governor Rick Scott as Trump’s point man for health care. LA Times columnist Michael Hiltzik wrote a scathing indictment of Trump’s health care point man: Trump putting Rick Scott in charge of his health care push is a sick joke. The article was reprinted in today’s edition of the Daily Star.

The hallmark of the Trump administration is its quest to put exactly the wrong people in charge of agencies and policies. But his designation of Sen. Rick Scott, R-Fla., as his point man on health care goes well over the line into self-parody.

Put simply, one could not find a worse figurehead for a push on improving health care than Rick Scott. As Florida’s governor, he presided over an epic decline in the state’s insurance coverage rate. He refused to accept Medicaid expansion under the Affordable Care Act, depriving 1.4 million residents of coverage they would have received with the change.

Scott presents himself as a health-care expert. He boasts: “I ran one of the largest health-care companies in the world.”

That company is Columbia/HCA, which Scott ran until 1997. He left just months after the federal government announced a sprawling investigation into whether the company had systematically defrauded Medicare, Medicaid and other government health-care programs.

That investigation concluded with what the Justice Department called the “largest government fraud settlement in U.S. history.” Columbia/HCA and several subsidiaries ultimately pleaded guilty to 14 criminal counts. The company paid $840 million in fines and penalties. The government tacked on an additional $881 million in penalties in 2003, bringing the total to more than $1.7 billion, which the Justice Department said was “by far the largest recovery ever reached by the government in a health-care fraud investigation.”

During Scott’s eight years as Florida’s governor, ending this year, Florida remained one of the sickest states in the union. Its uninsured rate among adults age 18–64 rose to 20.1 percent in 2017. According to the Centers for Disease Control and Prevention, that was the third-worst rate in the U.S.

The Commonwealth Fund, a health-care think tank, ranked Florida third worst in overall health metrics (48th out of the 50 states and District of Columbia). The state ranked 49th in measures of access and affordability of health care, prevention and treatment, avoidable hospital use and cost, and disparity in care between high- and low-income residents.

One major reason for this record is Scott’s refusal to expand Medicaid. He even rejected a 2015 proposal that would have covered 800,000 Floridians, albeit with the imposition of work requirements and co-pays.

This is worth repeating. “The hallmark of the Trump administration is its quest to put exactly the wrong people in charge of agencies and policies. But his designation of Sen. Rick Scott, R-Fla., as his point man on health care goes well over the line into self-parody.”

This is the guy Trump says will make the Republican Party “the party of health care.”

This might be seen as sick, but, unfortunately, it is no joke.

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