Category Archives: Medicine/Health Care

Stonewalling MD Health Exchange Probe

By Barry Rascovar

April 7, 2014 – The Maryland General Assembly concludes its 2014 session Monday in good shape – except for one monumental omission: the mystery surrounding Maryland’s fatally flawed health exchange, which has squandered uncounted tens of millions of dollars.

It’s now clear both Gov. Martin O’Malley and Lt. Gov. Anthony Brown are content to stonewall and impede any detailed investigation of what went wrong in setting up the Maryland Health Benefit Exchange until well after the June 24 primary election.

Gov. Martin O'Malley

Gov. Martin O’Malley

Is there a cover-up going on?

Judge for yourself.

On Thursday, the state’s legislative auditor told lawmakers he had been thwarted in his attempt to conduct a meaningful review of the health exchange.

Because the exchange’s leaders only gave state auditors what was available to the public, “We don’t have the complete story,” said the chief auditor, Thomas Barnickel III. “There’s a lot we don’t know.”

Heavily Redacted

The documents auditors received were heavily redacted — a sure sign things are being hidden from view.

It’s also not in line with accepted auditing practices of state government agencies.

But when the governor and lieutenant governor want to make sure no one gets to the bottom of this historic debacle any time soon, the administration knows how to obfuscate.

No Sign of Rebecca Pearce

For instance, the exchange gave auditors 600 emails to or from Health Secretary Josh Sharfstein — the administration’s spokesman on this issue — but nary a single email involving Rebecca Pearce, who ran the troubled exchange until December.

Could such an astounding omission have been accidental?

The redactions were so numerous in the 14,500 documents that auditors couldn’t determine if the controversial contract awards were done legally or appropriately.

MD Healthcare Connection

MD Healthcare Connection

Auditors also couldn’t figure out how the exchange went about selecting the vendor who screwed up the exchange’s computer program — Noridian of North
Dakota — or how in the world the exchange opted to buy off-the-shelf software — as opposed to customized software — from IBM.

This software proved incapable of doing the job.

Auditors did learn from documents there was confusion within the exchange over points of contact, meeting schedules, lack of a program manager and even a lack of details about the project plan.

They made one definitive finding: The exchange conducted no performance testing whatsoever.

Is it any wonder this lemon of a software program crashed on Day One and has yet to fully recover?

Limited Document Release 

Exchange leaders also saw to it auditors didn’t get enough information to figure out who made those horrendously poor decisions, who was really in charge and who should be held to account for this debacle.

Democratic leaders in the legislature aren’t in any hurry, either, to pin some of the blame on Brown because that would hurt his campaign for governor.

So no one was indignant when it became clear last Thursday at a hearing in Annapolis that the legislature’s own auditors had been stonewalled.

Earlier in the week,  O’Malley and Brown laid out their own line of attack: We’re not at fault because it’s the evil contractors who messed up.

And who, exactly, hired those contractors? Aren’t those the ones who ought to be fingered?

What was Brown’s role as co-chair of the exchange’s oversight committee?

Lt. Gov. Anthony Brown

Lt. Gov. Anthony Brown

Didn’t he have to approve those contracts? Or was he only a figurehead?

It’s clear now the prime contractor never should have been chosen in the first place. Is that the contractor’s fault or the O’Malley-Brown administration’s?

What genius decided to launch the state’s most complex and expensive IT project with off-the-shelf software?

Is it IBM’s fault the O’Malley-Brown administration decided to take the cheaper route  and ended up with a turkey that was never designed for the tasks assigned it by the exchange?

Bait-and-Switch Tactic

Is it Noridian’s fault the O’Malley-Brown administration pulled a bait-and-switch?

Exchange leaders signed a fixed-price contract with Noridian that included 261 requirements for the software program — and then later added 227 new requirements, changed 28 of the original requirements and dropped 73 of the mandates Noridian had bid on.

O’Malley seems content to blame IBM for what went wrong. Yes, IBM made the off-the-shelf software, but it was never tailored for the complicated interfaces envisioned by the IT gurus in Maryland government. Yet IBM is now the governor’s fall guy.

Now IBM is pushing back. The computer giant says it went the extra mile to fit a round peg into a square hole, but it couldn’t “overcome the state’s failure to properly manage the implementation of the exchange.”

We may never know if that’s true because O’Malley won’t launch an impartial investigation. Indeed, he’s not launching any investigation into how potentially hundreds of millions of tax dollars were wasted.

This is the guy who wants to run for president?

Permanent Stain?

What an unmitigated calamity. No authority figure in Maryland state government wants to get to the bottom of this disgrace. No public group is pressing for action, either.

We’re left with an appalling mess.

The lack of accountability, transparency and responsibility — if not remedied — will become a permanent stain on the record of O’Malley and Brown. History will not remember this episode kindly.

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Obamacare Accountability — Oregon, not MD, Got It Right

By Barry Rascovar

March 31, 2014–Today’s the deadline for folks in Maryland to start the application process for health insurance under the Affordable Care Act. If you miss this deadline, you face a tax penalty next year.

The good news is that tens of thousands of people have health insurance who couldn’t — or wouldn’t — obtain it before.

The bad news is that Maryland’s health exchange has been an unmitigated disaster — a painfully small number of people actually applied and paid their initial insurance bill.

MD Healthcare Connection

MD Healthcare Connection

Those responsible for this stupendously costly debacle aren’t going to be held accountable.

Those at the top of Maryland’s political food chain still stonewall this issue hoping it fades from public view.

State legislators have ordered a slow-motion assessment of the damage by their own analysts. It’s doubtful this will be a detailed, CSI-style examination of what went wrong.

By the time the report surfaces in mid-summer it will be too late: The decision on what comes next — most likely connecting Maryland to Connecticut’s software system — will be made (as early as this afternoon).

And by the time that legislative report appears, the June 24 primary will have come and gone — and with it any danger Lt. Gov. Anthony Brown’s gubernatorial campaign might be fatally damaged by the findings.

It’s also possible any legislative report will be sanitized by House and Senate leaders so as not to embarrass Brown (by then he could be planning his inaugural) and Gov. Martin O’Malley, who has national aspirations.

What a shocking lack of accountability to the public.

The Oregon Way

It stands in stark contrast to the way another liberal, Democratic state, Oregon, handled its own Obamacare calamity.

Oregon, like Maryland, has a two-term Democratic governor, John Kitzhaber. It has Democratic majorities in both houses of its Legislative Assembly.

But unlike Maryland, Oregon has a strong second party. Republicans hold 26 of 60 House seats and 14 of 30 Senate seats.

With such a potent countervailing force, it’s no wonder Governor Kitzhaber wasted little time launching an independent probe of his state’s dysfunctional health exchange, known as Cover Oregon.

Oregon Gov. John Kitzhaber

Oregon Gov. John Kitzhaber

Its Oracle-based software crashed so badly on Day One that all applications were done by hand. Yet Oregon still signed up more people for health insurance than Maryland.

What the independent review in Oregon found is likely to be mirrored in Maryland — if there’s ever a similar third-party critique.

Among the Oregon findings:

–“There was no single point of authority on the project.”

–The governance structure “was not effective.”

–There were “competing priorities and conflicts between [state] agencies.”

–Cover Oregon failed to hire a prime contractor or a system integrator.

–The governor and others were repeatedly warned by Cover Oregon’s quality assurance firm, Maximus, that the project was seriously off-track. These warnings started years ago and were ignored.

–In 2011, Maximus wrote that the state was acting as its own prime contractor and thus was assuming “more of the overall project risk.” How true.

–There was no Plan B as required by federal law — but there was a backup plan in case the lights went out.

–Cover Oregon picked off-the-shelf software; Oracle claimed it required only 5 percent customization. The actual number was 40 percent.

–The selected software “was not stable” and to this day “more items are breaking than are being repaired.”

–Top state officials “did not understand or acknowledge the significance of the website issues” until it was too late.

–There was a lack of “a consistent, cohesive enterprise approach to management of the project.”

–There was “no authoritative direction.”

–There was “Ineffective and at times contentious” communications and a “lack of transparency.”

Cover Oregon

The Oregon report is highly critical of the Executive Steering Committee leading the project — similar to Maryland’s oversight panel co-chaired by Brown and Health Secretary Joshua Sharfstein:

–“Oversight authority was inconsistent and at times confusing or misinterpreted.” This led to “unclear or incorrect understanding about the true state of the project approaching the Oct. 1, 2013 deadline.”

–The steering group lacked “formal meeting notes and decision tracking and documentation.”

–Perhaps worst of all, the Oregon project did not have “a single enterprise decision-tracking tool to document and manage decisions across entities.”

When Kitzhaber received the damning 77-page report in March, he cleaned house.

He fired the state’s top health official — a longtime friend and ally — who had been running the exchange since January. The chief operating officer and chief information officer of Cover Oregon also got the heave-ho. (The exchange’s original leader had been forced out in December.)

The Maryland Way

Don’t expect such drastic action in Maryland. It doesn’t fit the image O’Malley and Brown want to project going forward. Accountability is giving way to practical political considerations.

Still, the Oregon autopsy rings many familiar bells in Maryland. What happened in Oregon seems to have happened here.

Here’s what a forensic analysis of Maryland’s failed healthcare sign-up effort is likely to show:

*O’Malley and Brown created the exchange as an independent agency unshackled from the state’s formal procurement process. Support services and the normal chain of command within state government were lacking.

*Brown and Sharfstein never gave the project the intense oversight and strong, authoritative leadership it needed.

*They hired the wrong contractor — a minor-league player in the world of healthcare IT — who then quarreled bitterly with the sub-contractor it hired to do the IT project’s heavy lifting.

*No one was riding herd on the contractor.

*The state’s IT gurus picked off-the-shelf software to save money and time, software that never had been used in this way.

*There was no back-up plan in case Plan A failed (as it did).

Quality assurance and system integration were lacking. There was no general manager and no effective tracking system.

*There was no exhaustive trial period built into the schedule. 

*There was a lack of clear and honest communication up and down the line. Transparency continues to be a problem.

What Citizens Deserve

That pretty much sums up what went wrong in Maryland — even without an impartial investigation by outside experts.

But it is worth considering whether Maryland citizens deserve the same type of no-holds barred forensic autopsy Oregon conducted into its health insurance debacle.

In a lopsided one-party state like Maryland, that may prove far too embarrassing for those in power to let it happen.

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Is a Higher Minimum Wage Counter-Productive?

By Barry Rascovar

March 24, 2014 — Since it’s an election year, Democratic politicians in Annapolis are eager to pass an increase in the minimum wage. Gov. Martin O’Malley is poised to promote a higher minimum wage law in Maryland as part of his incipient campaign for national office.

But is it a good idea? Will there be unintended consequences in the form of job reductions?

That could well be the case, based on a recent Texas A&M economic study. It’s also the findings of a February study by the Congressional Budget Office.

Minimum Wage Increases

Minimum Wage Increases

Bottom Line: A jump in the minimum wage by 10 percent (Maryland’s proposal is 13 percent in Year One and a cumulative 39 percent over three years) will have a significant negative impact on future job hiring.

The non-partisan CBO forecasts that a federal hike in the minimum wage from $7.25 an hour to $10.10 an hour could mean a likely loss of 500,000 jobs nationwide, although there’s a chance the job loss could top one million.

The Texas A&M study may be more relevant in that it looked at new job creation in the year following previous minimum wage hikes. “Net job growth falls in response to an increase in the minimum wage,” it concludes.

Tom Firey of the Maryland Public Policy Institute figures this could mean the loss of 25 percent of all newly created jobs in Maryland if the General Assembly ups the minimum wage.

His adds: “In this miserable economy, the last thing we need is to further handicap job growth and business start-ups.”

All this is fascinating data and under normal circumstances the facts and figures should prove persuasive.

Not for politicians in an election year, though. Not when labor unions and liberal advocacy groups are going overboard promoting a higher minimum wage as the Second Coming.

Minimum Wage protester

But beware of the side effects: Higher consumer prices, a contraction of small retail businesses and unemployment for many now employed at the minimum wage rate.

The trade-off: help for the lowest salaried workers, who would see their pay (before taxes) go up by 3 percent.

Yet raising the minimum wage amounts to a shotgun approach: Only 19 percent of those who would receive this raise come from households below the poverty threshold of $15,730 for a family of two and $23,850 for a family of four.

Indeed, 29 percent of those benefiting from a $10.10 minimum hourly wage would come from households earning three times the poverty level ($46,190 for a family of two, $68,450 for a family of four).

An Alternative Route

A far better way to deliver financial support to the lowest-paid workers is increasing the federal and state earned income tax credit. One hundred percent of that money winds up in the hands of a low-wage worker earning less than $15,000 annually (the cap is $54,000 for a couple with three children). It’s a highly effective income supplement for low-wage workers.

That’s not going to happen in Maryland because a more generous EITC means a big hit to the governor’s budget, whereas raising the minimum wage socks it to small businesses primarily, not the government.

Yet given Maryland’s shaky economic recovery, lawmakers in the Senate are beginning to have second thoughts about sharply raising the state’s minimum wage. After all, Maryland lost nearly 10,000 jobs in January. Passage of the governor’s bill might accelerate those job losses.

It’s a Catch-22 for liberal Democratic lawmakers. Advocates standing on the sidelines promote this bill as a huge boost to the economy. Yet no impartial economic study comes to that conclusion.

Middleton’s Demand

Now a key senator, Thomas McLain (Mac) Middleton from Charles County, has thrown a new issue on the table. The governor’s bill ignores the plight of workers who care from the state’s developmentally disabled. They’d end up earning less than the new minimum wage.

Middleton won’t move the governor’s bill until this oversight is addressed. Developmental workers — 18,000 in community settings — deserve far more in wages than they’re paid ($9.82). They perform some of the most emotionally trying work in society tending to 25,000 developmentally disabled people in Maryland.

Even more egregious, the state pays its own developmental workers in rural state residential facilities much more. That fundamental inequity makes no sense except in terms of saving money when the state budget is formulated.

O’Malley’s minions are negotiating with Middleton and likely will find a way to satisfy the senator. Yet this problem is just the tip of the iceberg.

How many other job categories within state and local governments will have to be adjusted because of a $10.10 minimum wage? Is it affordable?

Passage Coming

There’s no doubt a modified version of O’Malley’s bill will be approved.

It may not have all the bells and whistles far-left advocates and the governor desire, such as an automatic cost of living increase and a big boost in salaries for tipped workers.

The path to $10.10 might be phased in more slowly. More exemptions might be added to cover college students working the summer beach season in Ocean City.

In the end, though, Maryland lawmakers will put a higher minimum wage on the books — even though it may not make sound economic sense and might prove the wrong way to address this dilemma.

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MD’s Obamacare Fiasco Continues

By Barry Rascovar

March 3, 2014 – HOW HIGH will it go? How much more will it cost the O’Malley-Brown administration to fix or totally replace the dysfunctional online health insurance system that it bragged about until it crashed on Day One?

It already is the most costly debacle in state history.

MD Healthcare Connection

MD Healthcare Connection

None of the state’s options are appetizing.  Meanwhile, the problems keep mounting, the latest being $30 million in extra taxpayer expenses due to the computer software’s inability to identify recipients no longer eligible for free Medicaid insurance.

Just fixing this deeply flawed software will cost untold tens of millions of dollars. Moving to a new, proven software system used in another state could send new spending into the stratosphere. Converting to the federal system has heavy costs as well as severe limitations and the potential for more breakdowns.

Frantic Scramble

“It seems like we’re shooting in the dark,” said an exasperated Del. Addie Eckardt, an Eastern Shore Republican at a hearing last week. She’s right.

State officials have been frantically scrambling ever since the administration’s highly touted online system froze and refused to work as promised on Oct. 1.

Officials are still grasping for straws, hoping the new prime contractor can make lemonade out of this lemon of an IT jalopy.

As for the next step once insurance enrollment closes on March 31, it’s another shot in the dark. Whatever the choice, it will be very expensive.

But will it work? There’s no guarantee that it will.

What a mess.

Loss of Federal Funds

Complicating matters is the looming end of federal largesse. Come 2015, the state is supposed to foot the entire bill for its health insurance exchange.

Maryland has expended $182 million in federal funds with little to show for it.  How much the state will be on the hook after Jan. 1 is another unknown, but we do know it will no longer by Martin O’Malley’s problem.

Gov. Martin O'Malley

Gov. Martin O’Malley on the air

What a distasteful present he’s leaving on his successor’s desk.

It’s baffling that no one running the legislator or the administration is insisting on an immediate and thorough investigation of this historic screw-up. This won’t be viewed favorably by future historians.

Not only is accountability lacking but the O’Malley-Brown administration is running away from this question as fast as it can.

Where’s Anthony Brown?

Note that Lt. Gov. Anthony Brown, the widely promoted point man on healthcare reform, continues to be missing in action. Yet he owes the Maryland public a full and frank explanation of his central role in this debacle.

How this affects Brown’s candidacy for governor remains of pivotal importance.

Lt. Gov. Brown testifies on healthcare bill

Lt. Gov. Brown testifies on healthcare bill

Does his “deer caught in headlights” performance disqualify him from serious consideration?

Is this the type of evasiveness on vital issues we can expect from him if he’s elected governor?

Do we want a governor who takes cover when controversies rage and lets underlings take the heat for him?

As Desi Arnaz famously said to Lucy, Brown has got “some ‘splainin’ to do.”

More Sinkholes Ahead?

Meanwhile, legislative committees continue to treat this disgraceful public embarrassment with kid gloves. History will not look kindly on their performance, either.

Digging out of this enormous sinkhole hasn’t been easy. The road ahead looks susceptible to similar perils.

What’s lacking is responsible, accountable leadership. That could become a dominant bone of contention as the June 24 primary approaches.

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Read other columns by Barry Rascovar at www.politicalmaryland.com

Cooking MD’s Obamacare Books?

By Barry Rascovar

Feb. 25, 2014 — UNBELIEVABLE. Maryland’s healthcare exchange debacle has entered the realm of the absurd.

On Friday, the exchange announced it had signed up a mere 3,000 subscribers for private insurance over the past week, bringing the total to a pathetic 33,000. The initial private insurance goal: 150,000.

MD Healthcare Connection

MD Healthcare Connection

Yet on Sunday we learned the exchange had magically surpassed its six-month goals — thanks to a too-convenient mistake by a economic research consulting group connected to a state  university.

Instead of an overall sign-up goal of 260,000 (Medicaid plus private insurance), the number was slashed to 160,000.

How handy: So far 190,000 people have signed up, thanks to 90,000 recipients who were previously on Medicaid and were shifted automatically to the new program.

What a bizarre way to declare victory!

More Bad News

We also learned on Sunday all work on a $19 million small business healthcare exchange ground to a halt three weeks ago, dismaying private insurers.

On Monday, the exchange belatedly announced it had fired — finally — the online sign-up system’s prime contractor at a closed-door meeting Sunday night.

The contractor, Noridian Healthcare Solutions of North Dakota (yes, North Dakota), already has been paid $67 million for producing a deeply flawed computer contraption (1,538 identified “defects” so far) that crashed on Day One. The hits keep coming.

O’Malley’s Response

To give Gov. Martin O’Malley his due, he had Health Secretary Josh Sharfstein tell a legislative committee on Monday the administration will not use those conveniently revised numbers but instead would stick with the original figures that actually were two-year, not one-year, goals.

Good for him.

But where was Lt. Gov. Anthony Brown, the designated point man on healthcare reform? The campaigning candidate once again wasn’t around to answer the hard questions from lawmakers.

And once again there was no indication anyone in the administration wants to launch a thorough investigation to pinpoint accountability for this historic screw-up any time soon.

Not only is it likely the state wasted at least $200 million in taxpayer dollars, but thousands of citizens in need of health insurance were denied that opportunity due to government incompetence — or worse.

It’s the biggest fiasco in recent Maryland history, yet no one in elective or appointed office seems to care enough to take action to find out who’s act fault until after the June 24 primary election.

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MD’s Quarter-Billion Dollar Healthcare Fiasco

By Barry Rascovar

Feb. 16, 2014 — ACCOUNTABILITY is sorely lacking when it comes to Maryland’s botched rollout of Obamacare. Lt. Gov. Anthony Brown  is nowhere to be found when tough questions are asked. Gov. Martin O’Malley deflects “who’s at fault” inquiries, focusing instead on getting the deeply flawed software partly operable.

The computer system’s main contractor, Noridian Healthcare Solutions, blames its prime subcontractor, who in turn accuses Noridian — a healthcare services company, not an IT firm — of incompetence and conning the state. Given that Noridian has received $65 million to construct a failed system, the subcontractor may have a point.

No Probe Planned

Perhaps Health Secretary Josh Sharfstein will decide in April or May to pull the plug on this IT horror show and start all over with a proven system from another state or join the federal healthcare sign-up exchange. That will cost a pretty penny.

But no one seems in a hurry to find out who screwed up.

Governor O'Malley explains IT fixes to Maryland's healthcare rollout.

Governor O’Malley explains IT fixes to Maryland’s healthcare computer rollout.

Democratic state lawmakers have put off till the summer a Department of Legislative Services analysis of what went wrong. That fits nicely with their support of Brown’s campaign to succeed O’Malley. It will be a long time after the June 24 primary before that DLS report surfaces.

Lt. Gov. Anthony Brown

Lt. Gov. Anthony Brown

Those same lawmakers tried to ignore the ongoing scandal during the current General Assembly session, but public pressure led to a series of hearings that deal with fixing the system rather than assessing blame. This helps Brown immensely, since he’s most likely to be fingered as the state official who was asleep at the switch.

First District Rep. Andy Harris wants the Department of Health and Human Services to probe Maryland’s waste of a quarter-billion federal dollars on a nearly inoperable system but that’s a political stunt by a tea party Republican who is becoming a nattering nabob of negativism.

U.S. Rep. Andy Harris

U.S. Rep. Andy Harris

Meanwhile, the O’Malley-Brown healthcare exchange continues to limp along with 29,000 Marylanders enrolled in private health plans — just one-sixth of the way to Brown’s previously stated goal of 180,000 and one-fifth of the way toward O’Malley’s 150,000 sign-up goal.

It’s a mess, the worst waste of taxpayer dollars in memory. Yet no one is launching a probe. It’s all being handled with kid gloves and diplomacy so as not to hurt Brown’s election bid or O’Malley’s longshot run for the White House.

Impartial Report

What’s needed is the equivalent of the Preston Report. Back in 1985, Maryland suffered a calamitous collapse of its privately insured savings and loan industry. It cost the state and S&L depositors hundreds of millions of dollars.

Gov. Harry Hughes and lawmakers created the Office of Special Counsel to probe “all aspects of the events” leading up to the S&L crisis. A prestigious Baltimore attorney, Wilbur (Woody) Preston, and a small team of his associates produced a package of legislative reforms and a 450-page report that detailed what went wrong and why. It was a honest and thorough assessment.

Special Counsel Wilbur Preston delivers his S&L report in 1986 (Baltimore Sun)

Special Counsel Wilbur Preston delivers his S&L report in 1986 (Baltimore Sun)

That’s what’s required now — an impartial dissection of this costly embarrassment by someone willing to lay out the facts without worrying about whether the blame falls on the lieutenant governor, the governor, the health secretary or the IT vendors.

How much of the blame belongs to O’Malley, who ultimately is responsible for what goes on in his administration? This was, after all, the most important initiative the state has undertaken in ages.

How much of the blame for this healthcare fiasco sits on Brown’s shoulders?

e’s made a big deal of his leadership on this reform, though he’s recently tried to weasel out by claiming he was only in charge of the legislation (also severely flawed) setting up the exchange.

Brown clearly was a figurehead leader — a general who showed up for the public meetings but left everything to his underlings. Even when he said he learned of the computer snafus, he apparently failed to sound the alarm.

Bleak Outlook  

Since Democratic lawmakers aren’t willing to ask the tough questions before the gubernatorial primary, and the governor has shown no eagerness to create a special panel to probe this scandal, we may never learn enough to reach a conclusion.

Even the DLS report is likely to be scrubbed of any finger-pointing at state leaders. That’s especially true if Brown wins the June 24 Democratic primary. Top Democrats in the legislature will circle the protective wagons around the presumptive governor.

What a mess.

We will glean quite a bit about the exchange’s IT failures from the competing lawsuits filed by Noridian and its prime subcontractor, EngagePoint. But that won’t lift the fog surrounding actions of healthcare exchange leaders, the governor and the lieutenant governor.

Sadly, this is one mystery that may never be solved.

 

 

 

 

 

Brown’s Healthcare Albatross

By Barry Rascovar for MarylandReporter.com

January 20, 2014 — MARYLAND’S LIEUTENANT GOVERNOR, Anthony Brown, has a problem that won’t go away — his still unexplained leadership role in the state’s disastrous Obamacare rollout.

This is the biggest sticking point in Brown’s run for governor. It could become an insurmountable obstacle if public attention remains focused on those computer glitches and poor sign-up results.

Week One of the General Assembly session brought no relief.

Brown testified before two panels on a Band-Aid measure to rescue perhaps thousands of Marylanders who couldn’t sign up for health insurance because of the state’s horribly dysfunctional software product.

Lt. Gov. Brown testifies on healthcare bill

Lt. Gov. Brown testifies on health care bill

Reading from a prepared text is one of his strong points. Answering questions isn’t. Brown ducked the few hard queries tossed his way and headed for the door without fully admitting his responsibility for Maryland’s $170 million embarrassment.

He left Health Secretary Josh Sharfstein behind to make a heartfelt apology, give an explanation of what went wrong and take the heat.

What Wasn’t Asked

This left a number of key questions hanging:

  • Was Brown a figurehead leader of the health care insurance rollout?
  • What did Brown know about the behind-the-scenes fiasco that was building over the past year?
  • When did he know it?
  • Why didn’t he roll up his sleeves and get fully engaged in the administration’s most important project for which he was the designated point man?
  • Why was he left out of the loop?

We may never get complete answers.

While a few legislative committees will poke around in the state’s Obamacare closet, this won’t be a Watergate-style investigation.

Too many Democrats already have endorsed Brown for governor. They will take care not to make the lieutenant governor look bad.

Questions Won’t Go Away

Yet unless the sign-up numbers improve dramatically — not likely — the public will receive constant reminders of Maryland’s health care belly-flop during the General Assembly session.

And once the legislature goes home, the governor’s race will heat up, with Brown the center of attention.

Attorney General Doug Gansler, his chief rival, will spend most of his $6.3 million treasury reminding voters of Brown’s leadership role in the state’s biggest disaster since the savings and loan collapse in the 1980s.

Televised debates between the gubernatorial candidates could provide a flashpoint. It may be the only time Gansler gets to directly point a finger at Brown for his culpability in the health care disaster and demand an answer.

Thanks to the Washington Post, we have a picture of the chaos and astounding incompetence that surrounded Maryland’s ill-fated launch of its health insurance exchange. (A grand total of four people signed up that first day.)

And thanks to the Baltimore Sun, we have a reminder of how screwed up the health care debacle remains. (Inadvertently directing people trying to sign up to call a Seattle pottery shop. The snafu continued for four months. A day after The Sun alerted state officials, the poor Seattle shop owner was still getting calls from frustrated Marylanders.)

Then today, the Post and  The Sun reported another screw-up. Up to 1,078 informational packets, containing the new Medicaid sign-up’s name, date of birth and Medicaid ID number, were mailed by the state to the wrong addresses — exposing those people to possible identity theft and delays in receiving medical care. The state blamed it on a “programming error.”

If people’s health weren’t at risk, these human absurdities would make a hilarious “Seinfeld” episode.

Brown’s Dilemma

The self-identified leader of this healthcare reform, Anthony Brown, remains all but invisible as the situation unravels.

How is he going to explain all of this?

At last week’s legislative hearings, he refused to apologize for what happened. He pretty much pointed an accusatory finger at everyone else for hiding the cold, hard truth from him.

Still, Brown appears well positioned to capture the governorship.

He’s got the establishment’s political endorsements. He’s got Gov. Martin O’Malley doing everything he can to ease his path to victory. He’s got more money to spend on his campaign than Gansler.

Yet it might not be enough if Anthony Brown continues to wear that conspicuous health care albatross around his neck.Albatross hung around his neck

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You can read Barry Rascovar’s other columns at www.politicalmaryland.com

 

 

 

 

 

MD Healthcare Leader? It’s Not Anthony Brown

By Barry Rascovar

For MarylandReporter.com

Dec. 23, 2013 – Who’s in charge of Maryland’s computerized Obamacare rollout? Until recently, Lt. Gov. Anthony Brown wanted you to believe he was the man.

For years, he’s been describing himself as Gov. Martin O’Malley’s “point man” on this crucial health insurance program. The governor’s press staff dutifully gives Brown co-authorship and quotable lines every time there’s a press release.

Yet it has become painfully clear Brown is not the “point man” on Obamacare, Maryland-style.

What Webster Says

By every dictionary definition, Brown fails that test.

Point man: “a person in the forefront of an economic or political issue” (Webster’s College Dictionary).

Not so. Brown is in his usual position – in the background as the governor’s second banana. At media events, he talks only when the governor directs him to do so.

Point man: “A man who has a crucial, often hazardous role in the forefront of an enterprise” (American Heritage Dictionary).

This doesn’t describe Brown’s role, either. His healthcare designation is symbolic, not substantive.

He co-chairs an oversight panel on healthcare reforms but it is Maryland’s health secretary, not Brown, who’s done the crucial, heavy lifting and taken the brunt of criticisms from legislators.

Point man: “the leader or spokesperson of a campaign or organization” (Collins English Dictionary).

Brown is neither leading the pack on Obamacare nor acting as spokesman for the computerized rollout – except when the governor is out of the country.

O’Malley Takes the Lead

More often than not Brown has had little to add to what more informed officials have to say about this terribly botched IT programming that continues to plague Obamacare in Maryland.

He’s avoided tough-questioning reporters and responded only in a few choreographed situations.

 

Anthony Brown brushes off healthcare questions from WBAL's Jayne Miller.

Lt. Gov. Anthony Brown brushes off healthcare questions from WBAL’s Jayne Miller.

Once the governor returned this month from his business development trip to Latin America, he stepped forward to answer the difficult questions about the healthcare insurance rollout. Brown has been relegated to a cheerleading role:

  • O’Malley is the one who ordered emergency IT fixes by mid-December.
  • O’Malley is the one who turned day-to-day authority for the exchange over to his top healthcare adviser.
  • O’Malley is the one who dispatched his information technology guru to figure out how to fix this deeply flawed project.
  • O’Malley is the one who announced hiring a Columbia-based computer management company to end this software nightmare.
  • O’Malley is the one holding a flurry of media events to discuss the rollout, both pro and con.
Governor O'Malley explains IT fixes to Maryland's healthcare rollout.

Governor O’Malley explains IT fixes to Maryland’s healthcare computer rollout.

Other than comments to back up the governor’s remarks, Brown has contributed little to the discussion.

Death-Watch Job

None of this is surprising.

Lieutenant governors in Maryland are pitifully neutered. They hold office for a single constitutional purpose – to replace the governor if the state’s leader dies or is incapacitated.

Brown has spent the vast majority of the past seven years in campaign mode, delivering prepared speeches at every conceivable event around the state.

He’s not deeply involved in policy decisions – no lieutenant governor is. The governor’s tight-knit inner circle of aides and advisors makes sure of it.

How Brown explains all this to voters is his biggest problem now that his lack of real responsibility has been laid bare.

Evaluating Anthony Brown

The lieutenant governor may be O’Malley’s heir apparent, but does this heir deserve that title?

His track record is slim. Until the botched healthcare rollout put Brown in an embarrassing spotlight, he was an unknown to most voters.

His future depends in large measure on O’Malley’s ability to find a way out of this healthcare debacle.

If enough IT patches make the Maryland Health Connection reliable and usable for both applicants and insurers, public ire may die down by the June 24 primary – D-Day for Brown.

But if computer glitches and foul-ups persist and tens of thousands of Marylanders are denied enrollment, if the state can’t provide insurers with accurate customer data and if public fury increases by early summer, Brown’s chances of winning could tumble.

The Obamacare debacle in Maryland has exposed Brown’s vulnerabilities. It could mark an inflection point in the nascent 2014 gubernatorial campaign.

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Gansler, Cardin, Obamacare and More

Odds and Ends

By Barry Rascovar

October 31 — THESE ARE THE the times that try Doug Gansler’s soul. Has anyone ever had a bumpier stretch in recent Maryland political history?

The attorney general has been mocked, frequently, on national TV programs for his lame explanation of his appearance at, and hands-off attitude toward, a raucous high school graduation beach blowout this summer.

That followed his argumentative responses to State Police complaints that Gansler is a reckless, back-seat driver oblivious to traffic laws and speeding tickets.

Well, here’s some good news: Gansler’s lack of identity with most Maryland voters (72 percent either didn’t recognize his name or were neutral toward him in the latest Gonzales poll) is a thing of the past.

EVERYONE knows Doug Gansler today.

Jay Leno jokes about him. Local radio talk shows conducted saturation bombing. The story’s gone international.

Gansler explaining himself

Gansler explaining himself

Of course this means Gansler’s negatives have soared, too. Only four percent in the Gonzales poll said they had an unfavorable impression of Gansler. That number is sure to skyrocket.

Here’s the really good news for Maryland’s twice-elected attorney general: Believe it or not, we are still eight long months from the Democratic primary. That’s a couple of lifetimes in politics.

If Gansler can regain his equilibrium and develop a cogent and sensible response to his recent gaffes, we may yet have a closely contested election for governor next year.

*     *     *     *     *

IT WON’T BE easy, though, for Gansler to put this controversy behind him. The media is in a feeding frenzy.

 It’s “get Gansler” time.

The Baltimore Sun delivered a hatchet job on Sunday that sought to compare Gansler’s moments of poor judgment with criminality by other elected officials.

In its print edition, the front-page headline read, “Weathering a political storm.” It was an even-handed account of how officials recover from political gaffes. But the comparisons made in the article, and especially the photos placed next to the front-page text, equated the attorney general’s modest mishaps to far more serious misdeeds that sent Marvin Mandel, Marion Barry and Dale Anderson to prison and Bill Clinton to the brink of impeachment.

Since when is failure to break up a high school graduation beach party a criminal offense?

How does violating traffic laws equate with Mandel’s criminal corruption conviction, Barry’s drug conviction or Anderson’s jail time for corrupt activities while in office?

None of them ever ran for higher office after their scandals, as Gansler is now doing. That’s another unfair comparison.

Clinton’s sex scandal does raise troubling character issues, but comparing that national moment of political angst to Gansler’s situation is ludicrous — and laughable.

Still, the damage has been done.

Just to rub it in, Sunday Sun editors also ran a 1,400-word critique on the way visual television imagery is responsible for Gansler’s pounding.

It was an interesting but way-too-long essay. And, of course, the editors couldn’t resist re-running that condemnatory photo of Gansler at the teen beach party. Another Sun “gotcha” moment.

Lost in the editors’ haste to pile on was The Sun’s October 24 editorial on the Gansler brouhaha — a measured, carefully nuanced analysis about difficult choices parents have to make while raising teenagers. It was a far cry from the tabloid journalism the newspaper’s editors presented to its readers on Sunday.

*     *     *     *     *

QUICK QUIZ: Who is leading the race for Maryland attorney general?

According to the latest Gonzales poll, the winner, by a mile, is that old, reliable favorite — “Undecided”.

Gonzales Polling CompanyThe results show that few voters even know who’s running for A.G.

The only reason Del. Jon Cardin polled 25 percent was due to his well-known uncle, the U.S. Senator from Maryland. Still, “Undecided” beat Jon Cardin in the poll by nearly 2-to-1.

It’s a good thing the office in question isn’t much more than a glorified law firm serving state agencies.

Voters aren’t likely to learn a lot about the candidates running for attorney general by the June 24 primary. It’s not a pressing matter for them. Besides, the gubernatorial candidates will dominate media attention and saturate the state with commercials.

Thus voters could end up picking an attorney general based on “the name’s the same” or the candidate who appears on the most local endorsement tickets.

It’s unlikely the outcome will be decided by deep voter knowledge of the A.G. candidates.

*     *     *     *     *

AN INSURANCE FRIEND reminds me that all the buzz about the number of Obamacare sign-ups since October 1 is highly misleading and meaningless.

As anyone in the insurance game will tell you, a new client doesn’t count until that individual writes a check to cover the first month’s invoice.

This won’t occur until close to the sign-up deadlines under the Affordable Care Act — late December and late March.

Until then, ignore the sign-up propaganda emanating from the White House, the State House and Republicans saboteurs. Two months from now we’ll know a lot more about the success or failure of this dreadfully managed rollout.

*     *     *     *     *

ISN’T IT IRONIC that no one is protesting as Baltimore City is about to spend at least $83 million on “smart” meters to help the city accurately bill residents for water usage?

When BGE and PEPCO sought to install similar “smart” meters to measure precise, real-time electric use, alarmist groups protested before the Public Service Commission about alleged health hazards from the meters’ wireless signals.

Smart Meter Protest in California

Smart Meter Protest in California

Those strident protests persuaded the PSC — despite the lack of scientific evidence — to impose needless smart-meter restraints on the utilities that will cost tens of millions of dollars.

As the Tea Party and smart-meter protesters have learned, it pays to yell at the top of your lungs.

Baltimore City officials are getting off lucky.

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Ben Carson’s Split Personality

Brilliant Surgeon, Wacko Political Views

By Barry Rascovar

October 14, 2013 — As a pediatric neurosurgeon, Ben Carson was spectacular. His extraordinary eye-hand coordination and three-dimensional skills led to the world’s first separation of twins joined at the head — a 22-hour procedure requiring an expert Johns Hopkins surgical team of 70.

As a philanthropist, he and his wife are exemplary leaders in awarding scholarships to deserving youths who strive to be the best, regardless of economic or societal circumstances.

But as a novice political commentator, Ben Carson is displaying a less admirable side.

Dr. Ben Carson

Dr. Ben Carson

The first glimmer of this surfaced over the winter when he embarrassed President Obama at the National Prayer Breakfast, an annual, non-partisan event designed to be spiritually uplifting. Instead, Carson delivered a gloomy speech about “moral decay and fiscal irresponsibility” directed at the man sitting by his side.

For this deed, he became an instant hero to far-right conservatives. Fox News and the Wall Street Journal urged him to run for president.

Another outburst critical of same-sex marriages sparked a protest movement last spring among students at the place that had put him on a pedestal — the Johns Hopkins University School of Medicine. This uproar grew so fierce Carson stepped down as commencement speaker to avoid a nasty scene for himself and the university that had nurtured his rise to super-star status.

Conservative Media Commentator

Now that he is a retired neurosurgeon, Carson has embarked on a new career as a right-wing talking head for Fox News, the Tea Party station.

On his first day, he equated President Obama to Vladimir Lenin and equated the Affordable Care Act (“Obamacare”) to communism.

He inaccurately attributed to Lenin the line that “socialized medicine is the keystone of the arch to the socialist state. . . . because it gives you control of the people.” (As far as the Library of Congress can glean from its research, it’s a made-up quote.)

In another outburst, he claimed to be a victim of the Internal Revenue Service’s witch hunt against right-wingers because he’s been tagged for a tax audit this year. He offered no further evidence.

Then on Friday he called Obamacare “the worst thing that has happened in this nation since slavery. It is slavery, in a way. It is making us all subservient to the government. . . . It [is] about control.”

Yes, Carson wins the prize for “wacko comments of the week.”

He wins in a landslide.

Defining Socialized Medicine

Is Obamacare socialized medicine, as Carson insists?

Not really.

Socialized medicine implies a nation’s health-care system is fully controlled and paid for by the government.

That’s the way it worked in the old Soviet Union:

  • All doctors, nurses and medical staff were state employees working in state hospitals and health facilities.
  • Private medical services were illegal.
  • The Soviet government dictated the number of doctors, the number of surgeries and the amount of medicine dispersed.

Cuba has a similar system today.

Other countries have a far more modest, and less dictatorial, form of universal health care run by the government — Britain, Finland, Spain, Israel and Canada.

Obamacare is a weak sister next to those socialized programs.

Examining Obamacare

If Carson wants an example of socialized medicine in this country, he shouldn’t point to Obamacare but to the military medical systems, the Veterans Administration, the Tricare government program for military families, Medicare and Medicaid.

None of those U.S. programs allows private insurers to sign up millions of Americans for health care coverage. Obamacare does.

Obamacare lets individuals choose their own private insurance plans from a wide array of options. People are free to choose their own doctors, too.

Individuals who already have health insurance don’t have to change.

Government subsidies support a big chunk of Obamacare, but the choice is still in the hands of individuals as to how much of their own money they want to spend on health care.

There’s no opt-out provision in other nations’ health care programs. Under Obamacare, anyone determined to go without health care can do so, but there’s an annual fee involved.

That hardly constitutes “socialized medicine” and it hardly amounts to oppressive government control and enslavement.

The U.S. vs. The Industrialized World

If universal health care coverage is so mendacious, why is it that every industrialized country in the world has some form of it, except the United States?

Are all those countries marching in lock-step to the drumbeat of Comrade Lenin’s ideology?

Are the VA and U.S. military health systems part of a grand communist conspiracy?

Obamacare is a modified version of Medicare, which has been around for nearly 50 years without limiting individual freedoms for seniors.

Today’s Medicare supplements function much the way Obamacare works: The government qualifies private health plans, which then vie with one another to win enough applicants to make a big profit.

Sad Transformation

That’s good old American competition at work, though the rules of the game are written by our elected representatives in Washington.

In Carson’s eyes, though, this is the second coming of an Orwellian, Leninist society.

It’s sad to see Carson transform himself from a much-admired recipient of the Presidential Medal of Freedom into a right-wing, apocalyptic voice.

Even worse, he has abandoned the scientific method that guided his earlier career. That time-honored approach demands rock-solid, well-tested proof before sweeping assertions and hypotheses are accepted as fact.

Ben Carson has forsaken the scientific method for political pontificating.

It’s a great loss for society and for those who once held this philanthropist and man of medicine in such high esteem.

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