In an earlier post on Rick Scott’s apparently defining campaign against Obamacare (The Nullification Crisis of 2013), we engaged in some speculation about the Florida Governor’s motivations, without reaching any definitive conclusions. For pundits on the right, such as the omnipresent Cal Thomas, Scott’s recent decision to allow Obamacare’s expansion of Medicaid to take place, after consistently denouncing the prospect, reeked of political calculation and potentially fatal apostasy. But for us, Scott’s decision provokes a Homer-Simpson style slap on the forehead, illuminating his underlying interests with great clarity. Now it all makes perfect sense, or rather, cents. But before we connect the dots, it is vital to come to terms with the hostile reaction of the “astroturf” Tea Party movement that feels betrayed by their erstwhile white knight.
Red in Tooth and Claw: The Vicious Social Darwinism of Cal Thomas
Cal Thomas, of course, was never going to shed much light on any of this. Far removed from reality – let alone the state of Florida – and too focused on controlling his readers instead of edifying them, Thomas’s complaints about the Governor’s surprising volte-face are infinitely more revealing about his underlying motivations than they are about Scott’s. Using all the loaded language of the Murdoch lexicon, Thomas accuses Scott of engaging in Democrat-style vote-purchasing with “borrowed money,” and lets rip with a blood-curdling plutocratic howl:
Sounding like a Democrat, [Scott] added that the state is obligated to help “the poorest and weakest among us.” No, governor, charities and religious bodies are obligated to help the weak and poor. State and federal governments have no such obligation. To claim they do empowers bureaucrats and politicians who are having a difficult enough time fulfilling their constitutional responsibilities. It also undermines the work ethic.
While we generally deplore the Leesburg Daily Commercial‘s insistence on beating us over the head with Thomas’s propaganda, this is an occasion for gratitude to the editors of our little rag. For it is hard to imagine a clearer and more repulsive exposure of the evil heart of the American plutocracy. Every reader of the Daily Commercial should take time to ponder what Thomas has just revealed (not that it wasn’t already obvious): the people who have been steadily sucking the wealth and income out of the United States do not give a hoot whether you live or die. Your health and well-being are not legitimate concerns of the larger society. To propose charities and churches as an institutional structure for protecting the vulnerable reflects a degree of callous ignorance and indifference worthy of Marie Antoinette, and may very well end up provoking a similar response. (Note, however, that the militarization of the surveillance state bodes ill for any prospect of genuine grass-roots rebellion. And the NRA, despite all its manly chest-thumping, will not be there to help when the next incarnation of the Occupy movement is forcefully suppressed by the hirelings of the oligarchy.)
Even the thin gruel of Obamacare, which, as we will highlight shortly, has far more to do with propping up the massive insurance complex than with the promotion of health and wellness among the citizenry, is too much for these Dickensian overlords. Hence Cal Thomas’s obligatory invocation of the Gipper’s remark that “a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” The Gipper knew what he was talking about: just look at his beloved military-industrial complex. Killing the weak and poor is most emphatically a legitimate task for the plutocrats’ state – and a highly profitable one, to boot – but any sign that we might be drifting toward a more compassionate society must be resisted lest inroads be made into those nice, big slices of the American pie. You’ll die before you get a taste of that.
Thomas comes closest to a meaningful insight when he observes that Rick Scott will have no trouble finding a remunerative position in the industry whence he came should he fail to be reelected. But Thomas presents that tidbit more as another slight against the apostate than as a tantalizing peek into the divisions within the plutocracy that need to be understood, exposed, and exploited by those of us who would like our country back. Since neither Thomas nor the Leesburg Daily Commercial is going to undertake that task, let us pry that little opening apart and watch the cockroaches scuttle to their respective corners.
Kerching!: The Privatization of Florida’s Medicaid Services
Generating far less heat in our corporate media than Obamacare, there has been another aspect to the Medicaid story in Florida that, in our view, turns out to be of central importance. Occasional reporting over the last year or so has allowed the public to know that the way in which Medicaid services are provided has been up in the air for some time. In certain parts of the State, Medicaid services have been delivered by experimental trials with for-profit, managed-care companies. Florida Republicans have been touting privatization as a way to control costs and improve the quality of service. Those of us who weren’t born yesterday understand what that pitch really means: privatization creates opportunities for owners to profit, whether or not the profit motive is compatible with the public interest. Thus, it was not terribly surprising that Rick Scott’s apparent reversal on the expansion of Medicaid under Obamacare came immediately on the heels of the Obama Administration’s approval of this for-profit model for all Medicaid provision in the state of Florida. Indeed, Scott had been preparing everyone for this announcement, saying for weeks that the Medicaid expansion would turn on the CMS’s decision to grant waivers for the privatization experiment to expand. Although the state legislature will need to endorse the expansion, and legislative leaders have been pretending that expansion and privatization are separate issues, it is long past time for all the pretenses to be dropped.
This expansion-privatization nexus is deeply troubling on numerous fronts. On the micro level, Florida’s experience with managed-care Medicaid has been anything but stellar. Echoing the concerns raised by the AP reporting seen locally in the Daily Commercial, the Tampa Bay Times observes that:
The privatization expands on a five-county pilot program that has been rife with problems. Critics worry for-profit providers are scrimping on patient care and denying medical services to increase profits. Some doctors have dropped out of the pilot program, complaining of red tape and that the insurers deny the tests and medicine they prescribe. Patients have complained they struggled to get doctor’s appointments.
Several health plans also dropped out of the pilot program, saying they couldn’t make enough money. Patients complained they were bounced from plan to plan with lapses in care. Nearly half of the 200,000 patients enrolled in the pilot have been dropped from at least one plan, federal health officials noted at one point during negotiations.
Despite these concerns, the allegedly socialistic Obama Administration gave the green light to expansion of the for-profit model. Why? The superficially obvious answer is that the Administration wants the states to – literally – get with the program and make Obamacare look like a national success; if this is what it takes to get Florida, the fourth-most populous state, on board, so be it. In that scenario, perhaps Rick Scott deserves grudging acknowledgment as a canny negotiator, getting what he wanted all along – the opportunity for his beloved health sector to make even more money – by playing hardball with the evil Feds. Scott himself stands to profit enormously from this victory. After leaving Columbia/HCA, Scott founded a chain of urgent-care clinics called Solantic. Early in 2011, he transferred his $62 million stake in Solantic to his wife’s trust. And now, Solantic has been handed a marvelous new business opportunity, after having its appetite whetted by all the drug testing that Scott mandated for numerous state employees. Kerching! indeed.
But there is also a macro-level problem beyond Rick Scott’s kleptocracy. The whole Obamacare model, much like George W. Bush’s grotesque Medicare Part D contraption, is designed to bring more business to the insurance industry. Sure, there is an intellectual argument for forcing everyone into the pool to manage risk and therefore costs. But there are also intellectual – to say nothing of moral – arguments for taking the profit motive out of health care entirely, and for some reason the American people were not allowed to hear those arguments. Despite widespread popular interest in a public option, our putatively pink president never put such an option on the table; in fact, he couldn’t withdraw it fast enough. Never mind the indisputable fact that other advanced economies deliver better health outcomes at a fraction of the cost. American policy-makers, despite all their whining about costs, are primarily interested in profit. Thus, the decision of the CMS to endorse for-profit care in Florida is wholly consistent with the prevailing ethos. The ultimate welfare of the people is most emphatically not the metric of the moment.
Laughter in the Distance
We seldom turn down an opportunity to chastise Obama voters for enabling a profound intensification of the inequality and imperialism they might be expected to oppose. But in this case the joke is very clearly on the Tea Party morons who backed a corporate criminal for statewide office. Seriously, folks, what the hell did you expect? Did you think you could trust someone who pled the Fifth that many times? Did you believe that a multi-millionaire with mysterious financial holdings was going to put the public interest ahead of that of his class? Truly, you got what you deserved. Yet the deepest guffaws must surely emanate from those quarters of the plutocracy that stand to gain the most from the health care scam that has been imposed upon the American people for at least a generation. This is one battle that the Koch Brothers, who have poured millions into Tea Party organizations like Dick Armey’s FreedomWorks, have not been able to win. Somewhere in the rarefied air of America’s elite, perhaps in the ski lodges of Aspen and Telluride, another group of owners is celebrating its turn to cement its grasp on the American throat. The suffering and death of the sick shall not impinge upon their celebrations.