I recently read through a bombshell of a web site called www.hmoblackbox.com. It describes allegations of waste, fraud and abuse at virtually every level of our federally mandated, state delegated, county and HMO administered Medical Assistance delivery. Among other immediate responses that crossed my mind is simply this: We must demand that those who distribute our tax dollars aspire to a higher standard of performance. If this is really going on, we just suck.
Two federal investigations are underway into how Minnesota does business. One is in response to the allegation that Minnesota Department of Human Services bureaucrats conspired with folks at the HMOs to “maximize” federal contributions to state programs. In plain English, that means they allegedly conspired to commit fraud. The other investigation has to do with the “donation” of $30 million from UCare to Minnesota. Both alleged boo-boos are indicative of colossal lapses of integrity.
The feds mandate that Minnesota deliver a variety of funds and services to her citizens. Minnesota responded in this instance by out-sourcing the bulk of the endeavor to our four major health plans: UCare, Health Partners, Medica and Blue Cross/Blue Shield. No journalist has bothered to ask just how dramatically this “out-sourcing” reduced the hiring of DHS employees. Perhaps the reason no journalist asked that question (or anything close to it) was that in spite of this massive “out-sourcing” DHS number of employees has grown. Usually out-sourcing reduces hiring. Not so at DHS. And did you know that once you get a job at DHS they will gladly pay for further education? I didn’t know that. Taxpayer’s money being used to fund advanced degrees for public employees so that they can qualify for higher taxpayer paid salaries from the departments in which they work. I picked the wrong line of work. But I digress.
HMOs were given about $4 billion taxpayer dollars last year (from feds and state 50/50) for delivering a variety of medical services to Minnesotans. HMOs administered about 75% of the gross. A paltry $1 billion of the leftovers went into the HMOs “reserves”. Insurance companies hedge “risk” by building “reserves”. But wait. This isn’t “insurance” per se. This is a pass-through entitlement that gets doled out and the HMOs get a fixed “margin”. There is no “risk” to offset with “reserves”. Does anyone else feel sick?
Attempts to require HMO transparency have been thwarted by republicans at the capitol. Read that sentence again slowly. The big four “non-profit” HMOs have spent a fortune to bury this disgusting perversion of the public trust. Politicians have responded by siding with the HMOs, not with the people.
Why is mainstream media so averse to exposing this alleged labyrinth of fraud upon fraud? Ever noticed how much advertising Blue Cross/Blue Shield, Medica, HealthPartners and UCare put in those papers and on those airwaves? Senators and Representatives , once respected as the hallmark of ethical conduct, now no more reputable than thieves. They were once the pride of my party. Now they have succumbed to the temptation and become wholly owned by the highest bidder.
But it’s not just republicans. Where is our Attorney General? Our “ Top Cop” has sat this one out. That’s just plain disgusting. Her mentor invented the exclusive“non-profit” health insurance monopoly in our state. The Commissioner of Department of Human Services may be charged with contempt for withholding information from U.S. Senator Grassley and Legislative Auditor Jim Nobles for their respective investigations. Seriously? http://www.startribune.com/opinion/editorials/147074875.html
Where in this state is the type of genuine leadership that stands up and says no more to this crap? Either raise the bar or sell your soul. What’s it going to be Minnesota?