Feds OK Fla. plan to move Medicaid clients

[highplainsdem]

http://www.macon.com/mld/macon/news/nation/12945917.htm


Posted on Wed, Oct. 19, 2005

Feds OK Fla. plan to move Medicaid clients

BILL KACZOR

Associated Press


TALLAHASSEE, Fla. - Florida received federal approval Wednesday for a pilot program that would shift thousands of Medicaid recipients into managed care.

Bush and other proponents say transferring responsibility to networks of doctors would provide better care, and control the escalating costs of the health insurance program for more than 2 million of the state's poor and elderly.

<snip>

AARP state director Bentley Lipscomb said his group, which has more than 2.7 million members in Florida, was not opposed to managed care, but he questioned the state's ability to implement such a large program.

"The administration wishes to trust big private insurance companies to handle this vital task," Lipscomb said in a statement. "Someone needs to ask the hard questions about how Florida's least fortunate will fare."

[bonito]

1. Enter now the caregivers n/t

[FloridaPat]

2. Give medicaid people the same lousy care as everyone else.

More privitization. More money to the insurance and hospitals and more screw jobs to the middle class.

[anotherdrew]

3. this is stupid, not as tho jeb doesn't have a history with shady HMOs

not that any of the rethug brain-dead jackass morons give a damn, but trusting jeb with anything to do with elder care, or care for anything, living or dead, is about the dumbest move that can be made.

this will not save penny one, if it does, it will only be by limiting care.

[Divernan]

4. Privatization formula =s Higher costs, reduced services

How can it be anything else? You're adding a layer of corporate bureaucracy plus a profit margin.

[rodeodance]

5. so why isn't AARP assuming responsibility to look into this matter?--they

just seem to be letting it happen.

[EFerrari]

19. Jeb Bush has been bilking Medicaid & Medicares for years. Link:

http://www.campaignwatch.org/more1.htm

JEB BUSH. In 1987, Miguel Recarey, a longstanding business associate of Tampa Mafia boss Santos Trafficante, fled the U.S. under three indictments for labor racketeering, illegal wiretapping, and Medicare fraud.1 His firm, International Medical Centers (IMC), which was America’s largest health maintenance organization for the elderly and which had received $1 billion in Medicare funds, collapsed.2 Recarey’s HMO left $222 million in unpaid bills,3 and was suspected of up to $100 million in Medicare fraud.4 “IMC is the classic case of embezzlement of government funds,” said William Teich, who headed the U.S. Office of Labor Racketeering in Miami. Teich called it a “bust-out operation” where money was “drained out the back door” and disappeared down “a black hole.”5

But in 1985, Recarey had faced a major obstacle to building his Medicare empire: a Department of Health and Human Services (HHS) regulation that restricted an HMO to drawing no more than 50% of its revenue from Medicare.6 Jeb Bush came to the rescue: he called both HHS Secretary Margaret Heckler and a top aide, C. McLain Haddow and successfully convinced them to waive the regulation for Recarey, Haddow testified to Congress.7 Bush’s lobbying of HHS took place during the same period that top-level Republican lobbyists whom Recarey had hired for $1 million were also courting HHS for the waiver.8 Bush said that said he did not recall making any calls to Heckler or Haddow, but confirmed that he made one call on Recarey’s behalf to Haddow’s assistant, to secure Recarey a “fair hearing” within HHS.9

Haddow added in a news interview that in November 1984, Jeb had also called Heckler and Haddow for Recarey about another problem - complaints to HHS from doctors and patients about IMC’s medical care and allegations that Recarey had embezzled funds a few years earlier from another hospital.10 Bush had told Haddow that “contrary to any rumors that were floating around concerning Mr. Recarey, that he was a solid citizen from Mr. Bush’s perspective down there , that he was a good community citizen and a good supporter of the Republican Party.”11

In 1986, the year after he successfully lobbied HHS to allow Recarey’s Medicare business to grow ultimately to a total of $1 billion, Jeb Bush’s small real estate firm received $75,000 from Recarey’s HMO for the purpose of finding it a new headquarters.12 Bush said that the payment was unrelated to his lobbying for Recarey.13 But Bush never did actually locate a headquarters for IMC, and the record suggests that the HMO had already selected the headquarters it ultimately moved into when it hired Bush.14 Jeb confirmed that he received $75,000 from Recarey without closing any real estate deals.15

Jeb’s defaulted loan from Broward Federal Savings and Loan in Sunrise, Florida transpired as follows.16 On February 1, 1985, Broward Federal loaned $4,565,000 to real estate developer J. Edward Houston, secured only by Houston’s personal guarantee. The same day, a company headed by Houston turned around and loaned the same amount to a partnership of Jeb Bush and Miami real estate developer Armondo Codina for them to buy a five-story building in Miami’s financial district.

Curiously, the Bush-Codina partnership was required to repay the loan from Houston “only as, if and to the extent that the cash flow from the building was sufficient to support those payments.” In fact, Bush and Codina made no payments at all on the loan prior to the final default settlement. In 1987 Houston defaulted on the $4.5 million Broward Federal loan, and the S&L sued both him and the Bush-Codina partnership. In an unusual settlement with the FDIC, Bush and Codina were obligated to repay just $500,000 of the loan and got to keep the building in the Miami financial district that collateralized the loan.

In 1991, federal regulators sued the officers and directors of Broward, charging that the loan used by Bush and Codina cost the savings and loan at least $4.97 million and was representative of the association’s negligent lending practices.17 The Bush-Codina loan contributed to the collapse of the Florida S&L, which cost taxpayers $285 million.18

[anotherdrew]

21. bush = mafia. how in hell could florida elect this piece of shit?

bush should face justice for this crap, not get to do it all over again.

[EFerrari]

22. I have no proof that Florida did elect this pos. n/t

[Mend]

6. You should look at the allowed drug formulary

Pfizer (big surprise, big donor to bush) gets all its drugs on the formulary without cutting their costs but generics are excluded. In return Pfizer has to administer the program, huh? And generic Paxil which is a lot cheaper than brand Zoloft isn't covered...no generics. It is really bizarro world.

[Rose Siding]

7. NYT has more on this...

snip>
President Bush has proposed similar changes at the federal level for several years, but Congress has not accepted those ideas. In Congress, Democrats and some moderate Republicans resisted the president's proposals on the ground that they would have allowed states to reduce coverage for very poor and very sick people. On Wednesday, Mr. Leavitt waived many provisions of federal law, letting Florida make the changes in a demonstration project.

Under the waiver, Florida will establish "a maximum per year benefit limit" for each recipient and fundamentally change its role. The state will largely be a buyer rather than a manager of health care.

http://nytimes.com/2005/10/20/national/20medicaid.html?hp&ex=1129780800&en=b25d71b2d3c4df2a&ei=5094&partner=homepage

[DeepModem Mom]

8. NYT: U.S. Gives Florida a Sweeping Right to Curb Medicaid

U.S. Gives Florida a Sweeping Right to Curb Medicaid
By ROBERT PEAR
Published: October 20, 2005


WASHINGTON, Oct. 19 - The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient.

Children under the age of 21 and pregnant women will be exempt from the limits.

The Florida plan says, "The state will set aside a specific amount of money for each person enrolled in Medicaid," based on the person's medical condition and historic use of health care.

Michael O. Leavitt, secretary of health and human services, approved the proposal 16 days after it was formally submitted to him, with strong support from Gov. Jeb Bush....


http://www.nytimes.com/2005/10/20/national/20medicaid.html?hp&ex=1129780800&en=b25d71b2d3c4df2a&ei=5094&partner=homepage

[The Backlash Cometh]

9. Do you all get the impression that the Bush family has worn out their

welcome?

[rodeodance]

11. these are Medicaid people--who speaks for them?

[rodeodance]

10. rationed health care has been here for years and yet the Repugs

diss socialized medicine because they say it is rationed.


......The Florida plan says, "The state will set aside a specific amount of money for each person enrolled in Medicaid," based on the person's medical condition and historic use of health care.

[Selteri]

12. And the stripping of care of people will continue. NT

[Lasher]

U.S. Gives Florida a Sweeping Right to Curb Medicaid

WASHINGTON, Oct. 19 - The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient.

<snip>

In his state of the state speech to the Florida Legislature in March, Mr. Bush called for transforming Medicaid, saying it was unsustainable in its current form.

<snip>

In an interview, Alan M. Levine, secretary of the Florida Agency for Health Care Administration, estimated that no more than 5 percent of Medicaid recipients would hit their annual limits. At that point, Mr. Levine said, "the health plan will still be responsible for providing services to the consumer, but the state's reimbursement would be limited to that amount."

Asked whether the beneficiary would be responsible for paying costs beyond the limit, he said: "That can happen today. There are arbitrary limits and caps embedded in the state Medicaid program, limits on home health services, doctors' visits, prescription drugs."

http://www.nytimes.com/2005/10/20/national/20medicaid.html?ex=1130472000&en=bfdf4895d7d50e08&ei=5043&partner=EXCITE

[Erika]

13. a death plan for the poor

administered by the GOP. Limits and caps.

[area51]

16. "a death plan for the poor"

Exactly. Why doesn't the nazi party buy gatling guns & just start killing decent Americans; it'd be faster. </sarcasm>

[jwirr]

31. Don't give them any ideas!

[cyberpj]

18. and don't forget - PROFITING PRIVATE COMPANIES AND STOCKHOLDERS.

[GetTheRightVote]

14. These are the right to life people right ??? Liers all of them.

jeb and georgie at it again, all in the family.

:kick:

[Erika]

15. So, a brain dead Terri Schiavo can die if she has no $?

and the religious right will see no problem? Interesting group of people. How many days until the idiot Bush is gone? And all his idiot relatives?

[ninkasi]

17. Yes, she can die if she has no money

During the Schaivo spectacle, with Chimp flying in to sign some piece to legislation which was part of the Republican's pandering to the "pro-life" goofballs of the religious fundies, a little black boy, Sun Hudson, was taken off of life support even though his mother objected. In Texas, the law allows hospitals to remove patients from life support if they can't pay the bills.

Sun Hudson's mother couldn't pay, so life support was removed. The Texas Futile Care Law was signed by then governor George Bush. I believe this was discussed here at DU, and Daily Kos wrote about it

http://meteor-blades.dailykos.com/story/2005/3/19/7441/23269

With Republicans, it's ALWAYS about money. I will say, that in Sun Hudson's case, he was born with such terrible genetic defect that he would have had to remain on life support always...he would never have lived anything approaching a normal life. Maybe, in time, his mother could have accepted this, and let him go. The outcome of both cases, Sun Hudson's and Terry Schaivo's, would have likely been death, but the response to them illustrates Republican hypocrisy.

[senaca]

20. How will this effect Hospice care?

Hospice is a godsend for people who are terminally ill and their families. We were able to do at home hospice for both our parents and the ability to spend their months and die with dignity surrounded by family members couldn't have been done without hospice.

[bobbieinok]

23. U.S. Gives Florida a Sweeping Right to Curb Medicaid

http://www.nytimes.com/2005/10/20/national/20medicaid.html

U.S. Gives Florida a Sweeping Right to Curb Medicaid

By ROBERT PEAR
Published: October 20, 2005
WASHINGTON, Oct. 19 - The Bush administration approved a sweeping Medicaid plan for Florida on Wednesday that limits spending for many of the 2.2 million beneficiaries there and gives private health plans new freedom to limit benefits.

The Florida program, likely to be a model for many other states, shifts from the traditional Medicaid "defined benefit" plan to a "defined contribution" plan, under which the state sets a ceiling on spending for each recipient.

Children under the age of 21 and pregnant women will be exempt from the limits.

The Florida plan says, "The state will set aside a specific amount of money for each person enrolled in Medicaid," based on the person's medical condition and historic use of health care.

more....

[Patsy Stone]

24. Just say, "Jeb!" n/t

[prolesunited]

25. And then what?

Let them die when they exceed their limits?!?!?

If they are on Medicaid, they already have spent down their assets. What are they supposed to do?

I wonder if all of the culture-of-life, Schiavo people will rally around these people on their deathbeds.

[ShockediSay]

26. TAX INCREASE!

on those least able to afford

[jwirr]

27. So this plan would take my daughter who was born

severely disabled and costs medicaid a lot of money and discard her when she is no longer a child? Without her meds and special supplies she would die? This is their f**king pro-life program? What is going to happen to the developmentally disabled in that state?

I once asked my church what they spent all the money they wanted for special needs programs on. I knew that medicaid/medicare and other programs supplied money for the care of this group as that is what pays for my daughter. They told me that they had to help this group of people in Florida because Florida had a lot of individuals that did not qualify for state help. Why do they qualify in one state for federal money and not another? I am so angry at the church and their asshole preznitz.

[HockeyMom]

28. As I said on another post,

I am starting to think the man is truly EVIL.

[mom cat]

29. Just starting?

He and his puppet masters reek of evil.

[leesa]

30. Private insurance does a terrible job of managing care...it's why our

healthcare system is collapsing. It's why you pay a ton more for premiums and get a lot less coverage than before.