video 30 seconds:
It is not my custom to run an ad for a Republican candidate but this one just cries out for analysis. It would be hard to do analysis without viewing the object to be analyzed. So forgive me.
There is an awful lot packed into the 30 seconds of this message. A person needs to have a basic understanding of the underlying Privatized Medicaid issue that has been a huge issue in Iowa since it was unilaterally implemented by former Governor Terry Branstad in 2016.
Basing his reasoning on the old Republican canard that “private business can do anything better than government” Branstad handed the running of Iowa’s $5 billion per year Medicaid program over to private business to run. However, where the state was running the program for about 3% overhead that would go up a little bit – to 15% or so. So in order to make it worthwhile the new MCO companies would need to at least come up with a way to make their own costs back.
As far as we know that has yet come to pass. The administration has yet to provide any real auditing that shows just what is going on with the privatized Medicaid. Claims are all over the place. State Auditor Mary Mosiman claimed her office would perform a definitive audit, but that has failed to happen. That failure is not surprising considering it may contain some very bad news for her party just prior to the 2018 election.
One thing does appear to be pretty apparent about the Medicaid privatization: services have deteriorated to the customer who are Iowa’s poorest and most vulnerable citizens. Stories abound of cuts to services around the state. We have even experienced it in our family. Along with deteriorating services, providers are being paid at lower rates and very late if they are paid at all. Meanwhile the MCOs have received hefty raises for their “management.”
Medicaid privatization has been front and center in the Iowa gubernatorial campaign. Republican Kim Reynolds claims there is little wrong with the current state of privatized Medicaid in Iowa. Her challenger Fred Hubbell has promised to bring the management of Medicaid back to the state to manage.
So in order to illustrate how good Republicans believe the privatized management has been they have this 30 second commercial to show that a young mother would trust he most precious asset – he child – to a Medicaid system with privatized management. When I first saw this, I thought “this is a joke, right?” Unfortunately it isn’t and Kim Reynolds wants Iowans to believe that the leaders of these privatized companies would make better decisions about the health care of that little boy than would some “government.”
One must remember at this point that a major focus for these privatized companies is to cut costs of the Medicaid system. There are only a few ways to do that. One is to cut services. As noted before that is being done across the state and there have been some dire consequences including death.
Other ways to cut costs is to cut payments for services or simply not pay. This was also noted above. This making it difficult for many providers to stay in business. See a synopsis of Medicaid problems in Iowa here.
So as we watch this 30 second sound bite we note that the crux of the message is “don’t trust government to do anything right, they only screw things up.” In the case of Medicaid, no one was really complaining until Branstad decided that private business needed a big cut of that Medicaid b budget for ‘managing’ – something the state was already doing fairly well. The management companies are nearly up to taking 20% of the $5billion that was meant to be used for patient care. That is nearly$1 billion folks.
So the first message is “don’t trust government.” My observations have been that most of the reason we don’t trust government is that Republicans with their message of “government doesn’t work” must cause government not to work when they have the reins of power. Expect that to happen to Medicare and Social Security as soon as they can get their hands on it.
The implied message when “government run health care” is bashed is that the CEO of some private company cares more about health care decisions for her child. Really? When the CEO’s pay and stock price depends on him or her doing what they can to make big profits. You seriously think they give a crap about some kid when they stand to make a bigger bonus? No, I don’t think so either.
The other implied message is that “government” is some thing that we are removed from as citizens. As much as Republicans have pushed this BS line for decades the truth is that government is you and me. As such we have input through our representatives which should also include the governor. Over the years formal processes have been set up just so access is available. This was mostly done under Democrats by the way.
So you and I are the government. We have input through our votes and through various means of access that have been set up for that purpose.
Let us now compare that to the access you have to a private company. Can you call the CEO and complain? Good luck. Even if you could do you think he or she would care about your complaint? Their contract is not with you. Your complaint can be buried deep and forgotten. Any other formalized methods of access in the private system? Maybe if you are a stockholder. How about going through the government? Well why not just eliminate the “going through” part and return the control of public funds to the public?
The Hubbell – Hart campaign has a much more realistic take on the current Medicaid CRISIS in Iowa: (2 minutes)
A question to the woman in the Reynolds video – are you still willing to bet the life of your child on a for profit company making good decisions that may cut their profit? I sure as hell wouldn’t!
One question to Kim Reynolds (be honest now) – With what you have seen of the Medicaid administration by the MCOs would you be willing to put you care and that of your children and grand-children in their hands? I would be very surprised if you answered “Yes.” I surely wouldn’t.
Vote for Hubbell and Hart and bring control of Medicaid back where it belongs. And put the public back into the public’s business.