Tag Archives: health care

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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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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Obamacare: The Good, the Bad, the Ugly

Troubled Start But Strong Finish Likely

By Barry Rascovar

October 7, 2013–Let’s agree Obamacare’s sign-up period is off to a dreadful start. That Uncle Sam and most states botched the IT implementation phase is obvious. They get an “F” in computer science.

Is anyone surprised? How many times in the past has government screwed up technology initiation?

Flawed computer systems that crash often, can’t deliver on their lofty promises and cost billions to patch up are all too common on massive government IT projects (Exhibit One being the IRS).

Maryland’s botched IT approach to health care sign-ups seems especially ripe for criticism.MD Health Connection

That’s the bad news.

The Good News

On a positive note, this isn’t a dash but a long-distance race. There’s plenty of time to overcome the IT glitches. You’ve got till Dec. 15 to sign up for a health plan to gain coverage starting Jan. 1 and a full six months to get coverage starting later in 2014.

Early hang-ups on such a massive and complex undertaking had to be anticipated. Once computer snags and slowdowns are remedied, it will be interesting to see how enrollment turns out.

In states like Maryland, where the political establishment is a gung-ho backer of Obamacare, there’s a strong likelihood of broad acceptance. In states under Republican control, where leaders have made Obamacare the political Satan, enrollment may not be strong.

Indeed, this country could become a two-tier nation on health coverage split between the haves (states where most obtain health insurance) and the have-nots (states actively impeding efforts to give poor people and America’s underclass health coverage).

The Ugly

What’s playing out is, unfortunately, oddly familiar. An affluent, white, conservative ruling class primarily in Southern, Border and Southwestern states wants to re-create the United States in that image — even though they don’t have the votes to do it.

This also was the situation when Abraham Lincoln was elected president in 1860 and we know what came shortly afterwards.

This time, it is the Tea Party vowing to blow up the federal government to get its way.

The movement’s bitter hatred of the nation’s first black president sounds eerily similar to the vicious personal insults directed at Lincoln. There are strong overtones of racism and classism in the movement’s rhetoric and objectives.

Those with money and power in Tea Party states seek to deny those lacking money and power the right to receive health care, citizenship and the vote. It is a cynical, hedonistic movement pandering to the desires of narrow-minded, well-off folks who have no wish to help those less fortunate than themselves.

Who Wins?

In Maryland, you can spot overtures along these lines from political officials in Frederick and Carroll counties and from the First District’s ultra-conservative congressman, Andy Harris.

Maryland Rep. Andy Harris

MD 1st District Rep. Andy Harris

The plight of poor folks and minorities really doesn’t count for those politicians. They are pandering to the Tea Party crowd.

In rural parts of the Free State there’s a strong conservative tone to politics. That’s unlikely to change any time soon.

But the vast bulk  of the state’s population lies in Central Maryland, where liberal Democrats have a near-monopoly on public offices and public opinion.

So we know which side is going to win this argument in Democratic Maryland.

What’s less certain is the ultimate outcome in Tea Party states with fast-growing minority populations, such as North Carolina, Texas and Virginia. Next month’s governor’s election in the Old Dominion could give an indication as to which side is gaining the upper hand.

The Fate of Obamacare

Meanwhile, the dreadful stand-off in Washington continues with no end in sight. Republican hardliners don’t have an exit strategy.

One thing seems likely: Obamacare will remain on the books once the dust settles. Time is on the side of the president. As more and more citizens gain affordable health insurance, the Tea Party’s extreme arguments could bear less and less relationship to reality.

In the long run — a decade from now — Obamacare might prove unaffordable and unworkable as Republicans are predicting. Or it might be as ubiquitous and accepted as Social Security and Medicare. But that’s for another generation to debate.

The current leaders in Washington find themselves locked in a pointless and damaging food fight that in a few weeks could do great harm to the country and its economic stability.

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Look to Shock Trauma’s success

By Barry Rascovar / The Community Times / May 15, 2013

After a response team dragged unconscious firefighter Gene Kirchner from an intense three-alarm house fire on Hanover Road in the early hours of April 24, he wound up in the only place equipped to deal with his life-threatening injuries, the Maryland Shock Trauma Center.

Unfortunately, even the renowned doctors at Shock Trauma could not save Kirchner, an eight-year veteran of the Reisterstown Volunteer Fire Company.

He died last Thursday, only the second firefighter to die in the line of duty in the 100 years of the RVFC.

It is not often that Shock Trauma loses its battle to preserve life. Fully 96 percent of those admitted survive.

Trauma doctors there believe that if badly injured patients arrive at Shock Trauma within that “golden hour” following an accident they can be saved.

Using unconventional methods such as simultaneously treating multiple aspects of a patient’s critical injuries immediately upon arrival, the Maryland Shock Trauma Center has revolutionized emergency medicine.

But sometimes there is little doctors can do to help someone as critically injured as Gene Kirchner.

Ironically when the center’s staff and guests gathered for their annual gala recently, the evening centered on another fatality that had been turned into a remarkable “gift of life.”

Physician-in-chief Dr. Tom Scalia described how he and his team fought to revive a pedestrian who had been struck by a car, 21-year-old Joshua Aversano of White Hall. Sadly, Joshua’s brain injury was too severe.

At that point Joshua’s family made the decision to contribute Joshua’s body parts to help others. What followed was a true miracle.

Over a three-day period, six people were given life-saving organs, Joshua’s heart, liver, pancreas, kidneys and lung. It was a mighty tribute to Joshua and his family, and to the enormous skills of the Shock Trauma team at the University of Maryland Medical Center.

But the truly amazing part of the story was yet to come: using Joshua’s facial bones, skin, tongue, teeth and underlying muscle and tissue to perform the world’s most extensive full-face transplant.

Over 150 doctors, nurses and other professionals participated in this 36-hour marathon. The Virginia patient, who had lived as a recluse since a 1997 gun accident shattered his face, received a new lease on life.

When 37-year-old Richard Norris walked on stage, he was a man reborn with nary a wrinkle.

An incredible amount of research preceded the surgery, much of it funded by the Office of Naval Research. The hope is that similar facial transplants will aid servicemen maimed by explosives.

Each year, 8,600 gravely injured people arrive at Shock Trauma, most of them via State Police Medevac helicopter, part of Maryland’s integrated emergency medical network.

It is a remarkable organization, heavily supported by taxpayer dollars. They did their best to save Gene Kirchner. He would have been the first to recognize their heroic efforts.

Barry Rascovar of Reisterstown is a writer and communications consultant. He can be reached at brascovar@outlook.com.