As the only wealthy country without universal health care, the U.S. is a global outlier, with both the highest health care spending and the worst health outcomes across several metrics, a new report by the Commonwealth Fund confirms. A report released on Tuesday found that, in 2021, the latest year for which data is available, the U.S. spent 17.8 percent of its gross domestic product (GDP) on…
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Medicare Advantage plans for seniors dodged a major financial bullet Monday as government officials gave them a reprieve for returning hundreds of millions of dollars or more in government overpayments — some dating back a decade or more. The health insurance industry had long feared the Centers for Medicare & Medicaid Services would demand repayment of billions of dollars in overcharges the…
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Defying the guidance of the nation’s leading medical organizations, Republican Utah Gov. Spencer Cox on Saturday signed into law a bill banning gender-affirming care for minors in the state. Passed by the Utah House of Representatives on Thursday and the state Senate on Friday, S.B. 16 prohibits gender-affirming surgeries for trans youth and bars hormonal treatment for new patients who were not…
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The United States is the only industrialized nation in the world without universal healthcare. Instead, Americans are forced to rely on a mixture of profit and nonprofit private and public healthcare insurers and providers. The United States federal government provides healthcare coverage through Medicare to individuals ages 65 years and older, and to some individuals with disabilities, military veterans, and children through Medicaid and the Children’s Health Insurance Program (CHIP).
Around 26 million Americans, about 8% of the population, including just under 2% of children, have no health insurance coverage at all. Low-income families are more likely to be uninsured, with the high cost of health insurance cited as the main factor as to why people remain uninsured in the US. The lack of coverage significantly worsens Americans’ access to health care and many face unaffordable out-of-pocket medical bills if they do seek care.
A study published in 2019 found 530,000 bankruptcies filed by individuals every year are due, at least in part, to medical debt.
A 2009 study by Harvard Medical researchers found that 45,000 Americans die every year directly as a result of not having health insurance. 13% of Americans, about 34 million people, reported in a 2019 Gallup poll that they had a friend or family member pass away prematurely after being unable to afford medical care.
The uninsured rate has declined since the COVID-19 pandemic as a Federal Public Health Emergency (in place until at least January 2023) has laxed continued enrollment eligibility for individuals with Medicaid. It’s estimated that anywhere from 5.3 million to 14.2 million Americans could lose Medicaid coverage when the federal public health emergency is lifted.
Nearly an additional 50 million Americans are underinsured, as many Americans with health insurance have to pay fees and copays on medical treatment ranging from drug prescriptions to doctor visits, or pay deductibles—out-of-pocket costs that must be reached before a health insurer begins to cover medical costs. A 2018 survey conducted by NORC at the University of Chicago found 57% of Americans have been surprised by a medical bill they initially thought was covered under their health insurance, often due to a doctor being out of their health insurer’s network or a product or test not being covered under their health insurance plan.
Around 155 million non-elderly Americans rely on health insurance coverage provided through their employer, with the average annual premiums in 2021 for employer-sponsored health insurance sitting at $7,739 for single individual coverage and $22,221 for family coverage. On average, 17% of costs for individual coverage and 28% of the costs for family coverage come out of workers’ own income.
When an individual loses their job, they must find new healthcare coverage or sign up for a federal program called the Consolidated Omnibus Budget Reconciliation Act (COBRA), to extend their healthcare plan up to 18 months. However, workers must pay the full costs and an administrative fee to do so, which can be prohibitively expensive. ‘Job lock’ is a term referring to workers feeling compelled to remain in an undesired job for fear of losing income or benefits such as healthcare coverage, and the number of employers offering health insurance coverage has been declining as costs rise for both employers and workers.
Despite the lack of universal healthcare coverage in the US, the country spends significantly more on healthcare related costs than comparable countries. In 2021, the US spent an estimated $12,318 per person on healthcare, the highest per capita compared to other wealthy nations in the Organisation for Economic Co-operation and Development (OECD). Excluding the US, the average for wealthy OECD countries was $5,829 per person, with the UK spending $5,387 per person.
$1,055 per person in the US was spent solely on administrative costs, compared to $97 per person in the UK. A 2019 analysis by the Center for American Progress estimated the US spends $248 billion on excess healthcare administrative costs annually. The significant healthcare spending costs in the US do not translate to better health outcomes; life expectancy in the US in 2021 was 76.1 years and the US ranks behind other wealthy countries in performance metrics for health care outcomes. The US spends less per person on long-term healthcare costs than the average for OECD countries.
Medical costs are the largest contributor to personal debt in the US, surpassing all other debt in collections combined, and hitting individuals in states that have declined to expand Medicaid, people in low-income communities, and Black Americans the hardest.
A 2022 analysis by the Kaiser Family Foundation found 23 million Americans, 1 in 10 US adults, have significant debt from medical expenses, at least $250, owing a total of at least $195 billion in medical bills. Middle-aged adults and Black Americans are most likely to hold some form of medical debt. In a 2022 poll, the Kaiser Family Foundation found that 4 in 10 US adults, or 41%, reported having medical or dental debt, which includes debt owed on credit cards, collection agencies, family, friends, banks, or other lenders. Thousands of Americans are forced to crowdfund for assistance with high medical bills and costs related to debilitating illnesses such as cancer. The online fundraising organization GoFundMe claims over 250,000 fundraisers started by individuals or organizations are started every year, raising more than $650 million per year. The majority of crowdfunding campaigns for medical expenses fail, with research showing almost 90% do not reach the set goals and only half reach 25%of the set fundraising goal, and campaigns in the highest income ZIP codes raised significantly more funds.
Americans pay higher prices for prescription drugs than any other country in the world, at rates 2.5 times as high as prices in similar-income nations. According to a poll conducted by the Kaiser Family Foundation in February 2019, 24% of adults and 23% of senior citizens reported difficulty in affording their prescription medications. A Gallup poll published in November 2019 reported 22.9% of Americans could not afford their prescription medications at least once over the past year. The discrepancies of prescription drug prices are so high, Americans who live near the borders of Canada or Mexico frequently take trips over the border just to buy prescription drugs because the savings for the same exact drugs are so substantial. These high costs often result in Americans filing for bankruptcy due to the burden of medical debt. A study published in 2019 found 530,000 bankruptcies filed by individuals every year are due, at least in part, to medical debt.
As debt for individuals continues to pile up, hospitals go out of their way to collect, even suing families for payment. A recent investigation by Kaiser Health News of more than 500 different hospitals in the US found at least two-thirds of hospitals sue patients over medical bills, including legal actions such as garnishing wages or placing liens on their property. A quarter of hospitals sell patients’ debts to debt collectors and about 1 in 5 hospitals deny non-emergency medical care to patients over past-due medical debt.
Medical costs are the largest contributor to personal debt in the US, surpassing all other debt in collections combined, and hitting individuals in states that have declined to expand Medicaid, people in low-income communities, and Black Americans the hardest.
In many cases, Americans either ration medication or delay medical treatment because of the high costs. For example, an estimated 1.3 million out of the 8.4 million Americans who rely on injections of insulin to control their diabetes were forced to ration their medication due to the exorbitantly high prices set by pharmaceutical companies. Numerous stories have been reported in the media in recent years of families losing loved ones after they were forced to ration insulin because they couldn’t afford to keep up with the costs of it.
All of the harrowing statistics, economics, and moral failings of the American healthcare system provide numerous reasons for why the US needs universal healthcare.
Additionally, a poll conducted by Gallup in 2019 found 25% of Americans reported they or a family member delayed treatment for a serious medical condition due to the potential high cost, and an additional 8% said they or a family member delayed medical treatment for a less serious condition due to cost.
Further compounding the problem, the US also does not mandate paid sick or family leave, while nearly all other industrialized nations do so. Over 33 million American workers do not have a single paid sick day.
Numerous news reports in the US in recent years have exposed harrowing instances of exorbitant medical bills, costs, and unethical business practices rampant in the US healthcare industry. During the COVID-19 pandemic, several individuals faced thousands of dollars in medical bills for treatment, despite legislative efforts to mitigate or eliminate costs for COVID-19 care. A 2022 Gallup poll found 1 in 3 Americans ages 50 and older have forgone food to be able to pay for healthcare; 37% of Americans ages 65 and older who qualify for Medicare and 45% of adults ages 50-64 reported concern they would not be able to afford needed healthcare services in the next year.
US health insurers reported record profits shortly after the onset of the pandemic and the largest US health providers have reported billions of dollars in profits, while healthcare workers have reported brutal working conditions during COVID-19 outbreaks, deaths of healthcare workers, and understaffing. A 2022 study authored by a researcher at the Yale School of Public Health estimated that universal healthcare in the US would have saved more than 338,000 lives and $105 billion in healthcare costs during the COVID-19 pandemic. The United States surpassed 1 million reported COVID-19 related deaths in May 2022.
All of the harrowing statistics, economics, and moral failings of the American healthcare system provide numerous reasons for why the US needs universal healthcare. Medical debt shouldn’t exist and the consequences of gatekeeping healthcare through economic barriers continues to have devastating consequences for American communities, families, and individuals, and is detrimental to public health.
This need has been popularized among progressives under calls for Medicare for All, which has received support in polls among Americans by a firm majority across the political spectrum. However, corporations profiteering off the status quo of the current broken healthcare system have stymied this support and need for reforms in Congress, where only 122 Democrats in the House and 15 senators have cosponsored a Medicare for All bill.
This post was originally published on The Real News Network.
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New polling finds that the proportion of Americans who have delayed medical treatment due to costs has hit a record high as the pandemic rages on and it becomes harder for the working class to afford regular and emergency costs. According to Gallup, 38 percent of Americans had either put off seeking medical treatment themselves or a member of their families did so in 2022. This is a 12 percent…
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Mount Pleasant, S.C. — Most of the 30 volunteers who work at the 130-bed, for-profit East Cooper Medical Center spend their days assisting surgical patients — the scope of their duties extending far beyond those of candy stripers, baby cuddlers, and gift shop clerks. In fact, one-third of the volunteers at the Tenet Healthcare-owned hospital are retired nurses who check people in for surgery or…
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Over 7,000 nurses, represented by the New York State Nurses Association (NYSNA) and employed by two major hospitals in New York City, ended their strike in the wee hours this week on January 12. Management had returned to the negotiating table to meet the nurses’ primary demands for increased staffing and wage increases. These nurses, from Montefiore Medical Center and Mount Sinai Hospital…
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California Attorney General Rob Bonta on Thursday sued the six major companies that dominate the U.S. insulin market, ratcheting up the state’s assault on a profitable industry for artificially jacking up prices and making the indispensable drug less accessible for diabetes patients. The 47-page civil complaint alleges three pharmaceutical companies that control the insulin market — Eli Lilly and…
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We speak with one of the 7,000 nurses on strike now in New York City at two hospital systems that account for more than a quarter of all hospital beds in the city, and a journalist who has documented how hospital CEOs are boosting their own pay by millions of dollars while slashing charity care. The strike began Monday after nurses failed to reach a new contract agreement with Mount Sinai Hospital…
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On January 2, Damar Hamlin, Buffalo Bills forward and a National Football League (NFL) star, suffered cardiac arrest on the field during a prime-time playoff game, following a “routine” tackle. Millions of fans and other football players were in shock watching as paramedics brought an unconscious Hamlin off the field. Confusion ensued, and while NFL leadership wanted the players to come back to…
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Healthcare industry lobbyists who are used to exerting significant influence over legislation and committee activity in Washington, D.C. are fretting that they may see their sway diminish after Sen. Bernie Sanders — a vocal opponent of K Street’s outsized power — takes over the Senate’s top health panel in the new Congress. Politico reported Tuesday that “multiple lobbyists representing health…
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For many of us, the fall of Roe v. Wade was one of the most devastating events of 2022. When Politico published a leaked draft of the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, I was deeply rattled. My intellectual awareness that such an outcome was likely, given the Republican’s seizure of the Supreme Court, had not prepared me emotionally for the sight of those…
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The pharmaceutical industry and its Republican allies in Congress are openly signaling their plans obstruct at every turn as the Biden administration looks to begin implementing a recently passed law that will allow Medicare to negotiate drug prices for the first time in its history. In November, Sen. Marco Rubio (R-Fla.) and several other Republican senators introduced legislation that would…
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Updated: Ebrahim Yusuf Ali AlSamahiji was a 39-year-old Bahraini citizen and an employee at the Aluminium Bahrain Company (ALBA) when Bahraini authorities arbitrarily arrested him from his home on 15 October 2015 without presenting an arrest warrant. During his detention, he was subjected to torture, sexual assault, religion-based insults, provocation, insults, enforced disappearance, solitary confinement, denial of communication, reprisals, isolation, and medical neglect. He was sentenced in an unfair trial based on evidence extracted under torture in a terrorism case known as the “Nuwaidrat Warehouse Case” and is currently serving his life sentence in Jau Prison.
On 15 October 2015, at 3:00 A.M., masked plainclothes officers arrested Ebrahim from his home. They raided his house while he was asleep, awakening and terrifying his wife and children. The officers did not present an arrest warrant or state the reason for the arrest. They searched the house and confiscated electronic devices including cellphones and computers. Ebrahim was then transferred by the officers, some of whom were holding cameras, to a small black bus with tinted windows, while other police cars were surrounding the area.
Ebrahim managed to call his family when he arrived at the Criminal Investigations Directorate (CID) to inform them of his location, but the line was then cut. He then forcibly disappeared for 23 days. After that, he was able to make a second call, but the officers prohibited him from telling his family about his condition and what he was subjected to.
Ebrahim’s torture began when he was transferred to the bus on the day of his arrest and continued during his interrogation at the CID. CID officers threatened and severely tortured him to extract a coerced confession for a crime he did not commit. They beat him with batons all over his body, stripped him naked, stomped on his face, put a shoe in his mouth, and sexually assaulted him. The officers also verbally abused him by insulting his religion, his sect, and its religious leaders, and severely beat him when he refused their orders to repeat insults to his Shia sect. He was denied access to legal counsel during this time. Ebrahim initially refused to confess to the pre-prepared charges, but after being threatened with rape, he confessed to the fabricated charges related to the Nuwaidrat warehouse case. As a result of the torture, Ebrahim suffers from frequent headaches, back and leg pain, recurrent eye infections, and damaged teeth.
On 7 November 2015, three weeks after his arrest, officers forced Ebrahim to appear before the Public Prosecution Office (PPO) at dawn. He was deprived of food and sleep for three weeks, causing him to hallucinate. The prosecutor, in the presence of his lawyer, threatened to subject him to further torture if he did not confess to the charges against him. The officers also threatened to harm his family members if he did not confess. As a result, Ebrahim was forced to confess to the charges against him before the PPO. The lawyer noted that Ebrahim was narrating the events rapidly, as if he had been instructed on what to say.
When his family was finally allowed to visit Ebrahim at the CID, they noticed traces of beatings on his hands and legs and observed his difficulty in moving. He told his family about the violations that he was subjected to. After that, he was transferred to the Dry Dock Detention Center.
In 2017, a police officer from the Dry Dock Detention Center entered Ebrahim’s cell and provoked and insulted him. In response, Ebrahim asked to see the officer in charge. Instead, a group of officers entered his cell, beat him, and took him to the officer in charge, who then ordered his transfer to solitary confinement. Consequently, Ebrahim was forcibly disappeared for two weeks. He filed a complaint with the Ombudsman about this incident, but the unit manipulated the case, portraying Ebrahim as the perpetrator. The Ombudsman concluded that he had violated the laws of the Reform and Rehabilitation centers and referred the case to the court. On 10 May 2017, the court sentenced him to one month in prison and a fine for insulting a public official. Ebrahim tried to appeal the verdict, but to no avail.
Ebrahim was not brought before a judge within 48 hours of his arrest. He was not given adequate time and facilities to prepare for his trial, which began eight months after his arrest. He was unable to present evidence or challenge the evidence against him, communicate with his lawyer during the trial, and was prevented from attending some sessions. Moreover, the court used confessions extracted under torture as evidence against him in the trial. On 28 December 2017, more than two years after his arrest, the Fourth High Criminal Court sentenced Ebrahim and nine other defendants to life imprisonment and revoked their citizenship in the Nuwaidrat warehouse case. Ebrahim was convicted of 1) joining a terrorist group, 2) possessing and manufacturing weapons, fireworks, and explosives, and smuggling them by sea for terrorist purposes, and 3) training in the use, manufacture, and smuggling of weapons, fireworks, and explosives in Iraq and Iran with the intention of committing terrorist crimes. Many of the charges brought against Ebrahim during the trial sessions were different from what he confessed to during the investigation, confirming that some of the charges were fabricated by the court. For example, he was accused of smuggling weapons by sea because he owns a cruiser. The weapons training charge was completely fabricated yet used against him during the trial. His family also believes that the court manipulated the case and added charges to Ebrahim AlSamahiji’s case that were originally intended for another defendant with the same first name, Ebrahim. Furthermore, the family believes that a third person, also named Ebrahim, was convicted on similar charges due to sharing the same name with both Ebrahim AlSamahiji and the co-defendant named Ebrahim. On 30 May 2018, the Court of Appeal upheld Ebrahim’s sentence, and the judge who issued the appeal ruling was the same judge who issued the initial verdict, in violation of basic fair trial rules. On 8 February 2020, the Court of Cassation reinstated Ebrahim’s citizenship but upheld the rest of the sentence. After the initial verdict in the Nuwaidrat warehouse burning case, Ebrahim was transferred to Jau Prison.
Ebrahim was repeatedly threatened, insulted, and provoked by officers at both the Dry Dock Detention Center and Jau Prison. He was repeatedly subjected to enforced disappearance, solitary confinement, deprivation of communication, and medical negligence for eye, dental, stomach, and knee issues. His family submitted several complaints to the Ombudsman and the Special Investigations Unit regarding his torture, unfair trial, medical negligence, enforced disappearance, solitary confinement, and communication cutoffs, but to no avail. Moreover, Ebrahim was subjected to reprisals several times after these units received complaints about his situation.
On 17 November 2022, widespread protests broke out in the political prisoners’ buildings in Jau Prison to protest the insulting and mistreatment of prisoner Sheikh AbdulHadi AlMkhawdar, a prominent cleric and opposition leader, by prison officers. This mistreatment prompted Sheikh AlMkhawdar to declare a hunger strike. Ebrahim was among the protesters in Building 8, showing solidarity with the Sheikh. The prisoners refused prison officers’ orders to return to their cells, demanding a meeting with the director of Jau Prison, Hisham AlZayani. The protests escalated after a delegation of prisoners met with AlZayani, who showed indifference to the insult that Sheikh AlMkhawdar had endured and to the Sheikh’s declaration of a hunger strike. The delegation then demanded a meeting with Sheikh AlMkhawdar, who demanded them to stop the protests during the meeting. The prisoners’ representatives agreed with the prison administration that prison officers would conduct a simple superficial search inside the prison wards to confiscate papers and banners used in the protests. However, the officers reneged on the agreement. Ebrahim said in an audio recording that officers began tearing up the furniture in Building 8, where he was held, and confiscated his and his colleagues’ personal belongings while they were praying Friday prayers, preventing them from continuing their prayers. Ebrahim objected to this search, telling the officers that they had broken their previous pledge to conduct a superficial and unprovocative search. The officers then accused Ebrahim of incitement and of possessing a private cell phone inside the prison, and transferred him to solitary confinement for six days in retaliation.
After his solitary confinement ended on 23 November 2022, the Jau Prison administration continued to take retaliatory measures against Ebrahim. He was isolated by being transferred to Building 2 and placed with foreign criminal prisoners who were addicted to smoking and drugs. In an audio recording, Ebrahim reported that his cellmates would not stop smoking, causing him to almost suffocate on 30 November 2022 due to his asthma, which was exacerbated by the smoke. Additionally, he complained in the same recording about blood being scattered all over the place resulting from prisoners’ deliberate self-inflicted wounds during bouts of hysteria. He expressed concern that he could be infected with AIDS.
Ebrahim’s contact with his family was frequently cut off during his isolation due to the frequent breakdown of phones inside the building, often caused by prisoners cutting the phone wires. Additionally, he reported that these prisoners were using his own personal belongings.
During his isolation, Ebrahim suffered several asthma attacks due to exposure to smoking by the addicted prisoners who shared the same cell with him. Despite his family’s repeated requests to see an asthma specialist doctor, the prison administration consistently referred him to the prison clinic doctor, who, without conducting any examination, always claimed that Ebrahim was not suffering from anything. His wife submitted several complaints to the Ombudsman regarding his situation in isolation, demanding proper treatment and transfer to another building suitable for his health condition. However, the Ombudsman’s response was always that Ebrahim was in a building suitable for his status and classification in prison and that he had no health issues, completely ignoring the slow death he was suffering from.
On 4 January 2024, Ebrahim was attacked by two foreign criminal prisoners in the cell where he was isolated, resulting in a quarrel and an injury to his left hand. Subsequently, the prison administration forcibly disappeared him for a week. His family was left in the dark about his well-being, fate, and whereabouts, only to later learn that he was held in solitary confinement. Ebrahim was subsequently moved back to the same cell with the prisoners who had attacked him in Building 2 at Jau Prison. After enduring over a year in isolation, Ebrahim was eventually relocated to Building 8, specifically designated for political prisoners.
Ebrahim continues to suffer from medical neglect while experiencing tooth pain, colitis, stomach inflammation, and chronic eye inflammation. He also endures knee pain resulting from an untreated old knee fracture. Additionally, he grapples with complications from gallbladder removal surgery, gastric fluctuations due to stomach sensitivity to medications, and chronic injuries stemming from torture. Despite his repeated requests over the years for treatment and his deteriorating health condition, the Jau Prison administration persists in denying him his right to proper medical care.
Ebrahim’s warrantless arrest, torture, sexual assault, religious-based insults, provocation, insults, forced disappearance, solitary confinement, denial of communication and access to a lawyer during interrogation, unfair trial based on evidence extracted under torture, retaliation, isolation, and medical negligence all constitute clear violations of the Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment (CAT), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social and Cultural Rights (ICESCR), to which Bahrain is a party. Moreover, the violations he faced during his imprisonment, particularly medical negligence, constitute a breach of the United Nations Standard Minimum Rules for the Treatment of Prisoners, known as the Nelson Mandela Rules.
Americans for Democracy & Human Rights in Bahrain (ADHRB) calls on the Bahraini authorities to immediately and unconditionally release Ebrahim. ADHRB also urges the Bahraini government to investigate allegations of arbitrary arrest, torture, provocation, insults, forced disappearance, solitary confinement, denial of communication and access to a lawyer during interrogation, religion-based insults, retaliation, and isolation, and hold perpetrators accountable. ADHRB further calls on the Bahraini government to compensate Ebrahim for the violations he suffered, including injuries resulting from torture. ADHRB warns of Ebrahim’s deteriorating health condition resulting from years of medical neglect and urges the Jau Prison administration to urgently provide him with appropriate and necessary medical care, holding it responsible for any further deterioration in his health.
The post Profile in Persecution: Ebrahim Yusuf Ali AlSamahiji appeared first on Americans for Democracy & Human Rights in Bahrain.
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Less than three weeks after ProPublica and the New Yorker published an exposé of hospice fraud, members of Congress have called on the Department of Health and Human Services to “immediately investigate this situation.”
In a letter sent Friday to the Centers for Medicare and Medicaid Services and the Office of Inspector General, the bipartisan leaders of the Comprehensive Care Caucus wrote that “Medicare fraud cannot be tolerated, especially when it is being perpetrated on our nation’s most vulnerable patients.”
The ProPublica-New Yorker investigation described how the lucrative design of the Medicare benefit incentivizes many profit-seeking hospices to cut corners on care and target patients who are not actually dying. It chronicled the lack of regulation and the frustrated efforts of whistleblowers to hold end-of-life care conglomerates accountable. And it drew on state and federal data to reveal how, in the absence of oversight, the number of for-profit hospice providers in California, Texas, Arizona and Nevada has lately exploded.
The letter’s signatories — Sen. John Barrasso, R-Wyo., Sen. Jacky Rosen, D-Nev., Sen. Deb Fischer, R-Neb., and Sen. Tammy Baldwin, D-Wis. — decried the “troubling trend” spotlighted by the reporting and requested a briefing from the agencies within two weeks about plans to “address the proliferation of fraudulent hospice providers.”
The story’s findings are also being cited by lawmakers and lobbyists in New York, where Gov. Kathy Hochul is considering signing legislation to outlaw the creation of new for-profit hospice providers in the state. At the moment, all but two of New York’s 41 hospices are nonprofit. Assemblyman Richard Gottfried introduced a bill, which passed this summer, to keep things that way. “We can close the barn door before the horses have gotten out,” he said. “The article raised the level of awareness around issues with for-profit care.”
Published last month, the investigation provoked what industry leaders have called a “much-needed” conversation on how Americans die — along with demands to improve those deaths. “The abuses detailed in the article call for a reform of the Medicare hospice benefit that can reduce the opportunities for fraud and abuse,” the National Partnership for Healthcare and Hospice Innovation, a group for nonprofits, said in a statement. In public letters, LeadingAge, another association for nonprofit providers, and the American Academy of Hospice and Palliative Medicine, an organization for hospice professionals, separately emphasized that “change is needed.”
Lobbying groups whose members include for-profit providers — the National Hospice and Palliative Care Organization and the National Association for Home Care & Hospice — took issue with the investigation’s focus on “bad actors” but said in a joint statement that its members look forward to working with lawmakers “to implement solutions to address the isolated problems highlighted by the article without jeopardizing access to the Medicare hospice benefit.”
Dr. Ira Byock, a palliative care physician, author and former president of the American Academy of Hospice and Palliative Medicine, echoed the calls for greater monitoring of the hospice system in the wake of the investigation. “Hospice in America is gravely ill,” Dr. Byock wrote in an op-ed published last week by STAT, the health care news site. “I am hopeful that the article will spark a long-overdue internal reckoning by the field — my field — and the industry we gave rise to.”
Hospice began more than 60 years ago as a countercultural charity movement to help patients die with comfort, support and as little pain as possible. After the 1980s, when President Ronald Reagan authorized Medicare to cover the service, dying became a big business. In 2000, less than a third of all hospices were for-profit. Today, more than 70% are. Between 2011 and 2019, the number of hospices owned by private equity firms tripled. For profit-seeking providers, hospice is lucrative: Medicare pays a fixed rate per patient a day, regardless of how much help is offered. The aggregate Medicare margins of for-profit providers hover around 20% compared with just 5% for nonprofits.
Studies have found that for-profit hospices are more likely than their nonprofit counterparts to have less skilled staff, reduced clinical services and fewer home visits in the last days of life. Their patients have longer stays and leave hospice alive at higher rates. Last year, citing the research, three members of the Senate Finance Committee requested information on the quality of hospice services provided by Kindred at Home, the country’s largest home care chain. (Kindred’s hospice subsidiary was recently spun-off and sold to a private equity firm.) “We are concerned that when applied to hospice care, the private equity model of generating profit on a rapid turnaround can occur at the expense of dying patients and their families,” they wrote. Analysis of the data is ongoing, senate staffers said.
Assemblyman Gottfried said that the pending legislation in New York is an attempt to prevent the profiteering that’s unfolded elsewhere from seizing his home state. Jeanne Chirico, who heads the Hospice and Palliative Care Association of New York State, said that her group regularly fields calls from venture capitalists looking to break into the market. So do her members. Mary Crosby, the CEO of East End Hospice, a nonprofit located on Long Island, said that once or twice a month investors make offers. “We’re a particularly attractive acquisition target because we struggle financially and we’re not linked to a larger health care system,” Crosby told me. “But if you’re actually providing the kind of interdisciplinary care that is based on the original hospice mission, as we are right now, you’re not going to be making a lot of money.” Her hospice covers around 20% of its operating costs from donations, she said.
New York would not be the first state to bear down on its hospice sector. California has enacted a temporary ban on new hospice licenses, after the Los Angeles Times uncovered a dramatic increase in hospices that far outpaced the demand for services. In a report released this spring, state auditors found that since 2015 the Department of Public Health had never suspended a hospice license and had revoked a license only once. “The state’s weak controls have created the opportunity for large-scale fraud and abuse,” they said.
ProPublica and the New Yorker’s reporting outlined how California’s pattern of disproportionate growth is spreading to other states. In Arizona, Nevada and Texas, the rise in new Medicare-approved hospices since 2018 now accounts for around half of all hospices in each state. Unlike New York, these states don’t have “certificate of need” requirements for hospices, which means there’s no strict limit to the number of providers that can open in a given area.
The simplest way to understand the recent hospice boom is to see it.
Rapid Rise in Hospices Concentrated in West and SouthwestA ProPublica analysis of Medicare data reveals a sharp uptick in providers since 2018.
(Source: <a href="https://data.cms.gov/provider-data/topics/hospice-care">CMS data set of Medicare-certified hospices.</a> Chart by Lena Groeger.)This chart represents Medicare hospices — it does not include the dizzying rise in state licenses — and therefore undercounts the total explosion in end-of-life care providers. (Hospices must first obtain a state license before they can be certified to bill Medicare for their services.) Federal data, for instance, shows just 22 Medicare-certified hospices packed into a building on Friar Street in Los Angeles, but California’s data reveals an additional 107 state hospice licenses registered at the same address. (Although California’s moratorium bars new providers, it does not stop the thousand-plus owners already in possession of state licenses from obtaining Medicare certification and billing the government.)
Industry leaders have expressed alarm about the loopholes in the state and federal certification process that enable sudden clusters of for-profit providers to materialize. A ProPublica review of hospice data in Phoenix showed that a raft of new entities shared the same addresses and network of owners. Some of the Arizona entrepreneurs already operate several hospices in Los Angeles, including out of the building on Friar Street. “These small entities aren’t required to publicly report quality of care data, are often not audited and, because of how the per diem is set up, it’s a gold mine,” said Larry Atkins, the chief policy officer of the National Partnership for Healthcare and Hospice Innovation. “You could very quickly figure out whether a hospice is a real place or a mill that’s simply signing up and burning through patients to bill Medicare. But no one is really doing that.”
Eric Rubenstein, who worked as a special agent at the Department of Health and Human Services’ Office of Inspector General until 2019, said that the Centers for Medicare and Medicaid Services and its contractors are often focused on auditing bigger billers. For the “smaller circuses and clowns,” the government’s lax payment system can be easy to exploit. “The demand for these licenses is predicated on the fact that there’s a huge amount of money to be made quickly in hospice fraud,” he said.
CMS said in a statement to ProPublica that the agency “is aware of the increase in the number of new hospices” requesting Medicare certification, and is “working to ensure they meet all applicable requirements for participation in the Medicare program.”
Last month, four national hospice associations banded together to ask CMS to enact targeted moratoriums in high-growth regions. “In addition to action at the state level, increased federal oversight is needed to protect hospice patients and their families,” they wrote. The groups are currently scheduling a meeting with CMS to discuss their concerns.
This post was originally published on Articles and Investigations – ProPublica.
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Tens of thousands of nurses across the United Kingdom are set to walk off the job Thursday in what’s been described as the largest-ever strike by National Health Service workers, who said they were forced to act after the government refused to negotiate over pay amid painfully high inflation. The walkout represents NHS nurses’ first national strike, and it comes as U.K. rail and postal workers are…
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In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud. Medicare had paid the Blue Cross plan more than $20,000 to cover the care of 11 patients seen by Aggeus Healthcare, a chain of podiatry clinics, in 2011. Blue Cross said it couldn’t locate…
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New York Attorney General Letitia James recently filed a lawsuit against The Villages, a nursing home in Albion, New York, for years of financial fraud that resulted in the abandonment of the “most basic functions of care” for the nursing home’s residents. An investigation conducted by the Office of the Attorney General found that from 2015 to 2021, the facility’s owners received $86.4…
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Paid sick leave policy was brought to the forefront of U.S. public discourse this past week after President Biden and congressional leaders moved to block a nationwide rail strike over union workers’ objections to the lack of sick leave policies in their contract. Under the imposed deal, workers receive no paid sick days. Four unions had already voted against the contract. Congress’s move to block…
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On October 11, prison organizer Dawn Brooks’s phone began ringing off the hook. Within three days, she received 50 calls. Colitha Bush, a Texas mother who had been released from federal prison under COVID measures in mid-September, was one of the callers. She had spent 14 days at a halfway house before being released to home confinement at her sister’s house. On October 12…
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Senate Majority Leader Chuck Schumer and a handful of other Democrats sent shockwaves across social media on Tuesday after apparently voting with Republicans to terminate the COVID-19 national emergency declared by former President Donald Trump in March 2020 as the virus shuttered the nation and much of the world. Schumer’s office later told reporters that his “yea” vote was mistakenly recorded — including on his own website — and his vote was actually a “nay.” Other top Democrats still voted with the GOP.
In a 61-37 vote, 11 Democrats joined 49 Republicans in voting for a joint resolution to bring the pandemic national emergency declaration to an end. Unless there were other “mistakes,” the Democrats voting with Republicans include Sen. Amy Klobuchar (Minnesota), Sen. Tim Kaine (Virginia) and others. Progressive observers were outraged, arguing the pandemic is far from over with winter threatening a surge in COVID cases along with other respiratory illnesses that could destabilize an already stressed health care system.
However, there appears to be some confusion not only over who voted for what, but also over two different declarations. Trump reluctantly declared a “national emergency” in March 2020 after the World Health Organization designated COVID a global pandemic, but an earlier order signed by Trump’s health czar at the Department of Health and Human Services declared a “public health emergency” in January 2020 as the virus threatened to sweep across the United States. Both declarations give the federal government emergency powers to intervene in state policy in order to meet urgent medical needs.
The Senate’s joint resolution would only affect the national emergency declared by Trump and was passed by simple majority under the Senate’s executive oversight rules. The Biden administration recently announced another 60-day extension of the public health emergency, which gives the federal government power to expand Medicaid coverage, nutrition assistance, and other benefits often provided by state governments for the duration of the pandemic.
The White House also said President Joe Biden would veto the Senate resolution to terminate the national emergency declaration, and House Democrats may choose to ignore the resolution for the remainder of their term in the majority. In a statement, the White House said the national emergency provides the federal government with authority ensure that “necessary supplies” are readily available as winter approaches and the health care system remains under stress. The order allows millions of people to receive free tests, treatments and vaccines through federal and state programs.
“Strengthened by the ongoing declaration of national emergency, the federal response to COVID19 continues to save lives, improve health outcomes, and support the American economy,” the White House Office of Management and Budget statement said, adding that terminating the national emergency “abruptly and prematurely would be a reckless and costly mistake.”
Last month, Biden extended the national emergency indefinitely before it will finally expire on March 1, 2023, according to Fierce Healthcare. The declaration allows for waivers that expanded the use of telehealth services and loosen regulations to allow for innovative public health programs, such as federally supported COVID testing sites.
The administration has also drawn authority from both emergency declarations to expand nutrition benefits for low-income families and to bolster programs such as Medicaid and Medicare to protect people from losing health coverage during a pandemic. Removing the public health emergency order in particular could open up federal pandemic efforts to challenges from conservative states.
Kansas Republican Sen. Roger Marshall introduced the joint resolution to terminate the national emergency declaration on Tuesday, citing a CBS interview with Biden in September, when the president said the “pandemic is over.” Some observers saw the statement as a gaffe after administration officials walked it back. On the Senate floor, Marshall argued that COVID cases, deaths and hospitalizations are down, and the administration is “manipulating” policy in order to “super-size” government power and enact a federal “spending spree.”
On the floor, Sen. Ron Wyden (D-Oregon) noted that it was the third time the Senate debated Marshall’s resolution and warned it was a “recipe for chaos” in the health care system as winter brings COVID, flu, and other viruses. The resolution would create “red tape” and make it harder to for federal agencies to keep waivers on the books that have kept hospitals staffed and supplied, and allowed for flexibility in programs such as Medicaid, which provides health coverage to millions of lower-income people.
“Congress ought to be looking here to support medical workers and protect our health care system from becoming totally overwhelmed by viruses,” Wyden said, adding the resolution was dead on arrival in the House. “The Marshall resolution and this broader Republican effort we have been hearing about on the floor to eliminate health care flexibilities does the opposite.”
However, leading Democrats, such as former presidential hopeful Amy Klobuchar of Minnesota, voted with Republicans to pass the resolution in the Senate. Press offices for both Senators Schumer and Klobuchar did not respond to several inquiries from Truthout.
The resolution is unlikely to be taken up by the House while Democrats remain in charge, but leading Democrats may be signaling to the Biden administration that it should start preparing for an “end” to the pandemic, or at least to the emergency powers granted to his administration. With a closely divided Senate and the GOP expected to have a slim House majority next year, the senators may be warning Biden that patience is limited among lawmakers and the public alike, and Congress is expected to fiercely debate the issue.
While the resolution did not address the January 2020 public health emergency order from the Department of Health and Human Services, that authorization will also likely be a target for Republicans. If the public health emergency order is revoked or expires in March, the administration’s pandemic powers would begin to unravel, including a requirement that states do not remove people from Medicaid rolls. If the public health order expires during the winter and GOP-led states begin dropping people from Medicaid, experts warn that struggling hospitals could face a financial and logistical disaster.
This post was originally published on Latest – Truthout.
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Major medical groups say that the loss of federal abortion protections has diminished access to pregnancy care such as treatment for ectopic pregnancies and miscarriages. The groups are sounding the alarm that racial gaps in pregnancy-related deaths will be exacerbated, according to a new Senate report first shared with The 19th.
The analysis comes on the heels of preliminary data suggesting that in the first two months since the ruling in Dobbs v. Jackson Women’s Health Organization — a case that eliminated federal abortion rights and opened the door for states to ban abortions entirely — abortions fell by about 6 percent, or about 10,000 abortions, across the country. So far, abortion is entirely or almost entirely illegal in 13 states. In Georgia, it is banned for people after six weeks of pregnancy. Bans in other states, including North Dakota, Indiana and Ohio, are currently being blocked by courts. In Florida and Arizona, abortion is prohibited after 15 weeks of pregnancy.
The report was compiled by four Democratic senators: Elizabeth Warren of Massachusetts, Tammy Duckworth of Illinois, Mazie Hirono of Hawaii and Tina Smith of Minnesota. It contains responses to letters Warren sent to the American Medical Association, National Nurses United, the American Pharmacists Association, the American Hospital Association, and Physicians for Reproductive Health, asking them to track how the Supreme Court’s June 24 decision has affected access to pregnancy-related care. The report also cites a public letter from the American College of Obstetricians and Gynecologists.
All five organizations expressed concerns that these abortion bans would result in higher pregnancy-related death rates. Currently, federal data shows that Black and Indigenous pregnant people are two to three times more likely to die from pregnancy than White ones. That racial gap is likely to grow, medical groups fear.
“Restrictions on access to abortion and related care will worsen existing gaps in health disparities and outcomes,” a letter from the AMA read.
Even when state abortion bans have exceptions to save someone’s life or health, the language is often vague enough that physicians aren’t sure if the patient qualifies. Several groups raised concerns about the bans’ impact on people with dangerous health conditions. Already, many physicians in states with abortion bans are delaying treating ectopic pregnancies, which can quickly become fatal and are treated by terminating the pregnancy, until patients are on the verge of death.
Patients experiencing other potentially life-threatening health concerns such as hemorrhaging, preeclampsia and intrauterine infections are now facing similar risks, the medical groups told the senators.
Ohio’s six-week abortion ban required doctors to meet with a pregnant person “at least 24 hours prior to the performance or inducement of the abortion.” Since a spontaneous miscarriage is treated with the same medications as an abortion, the state’s Cleveland Clinic Emergency Department interpreted that stipulation as applying to pregnancy loss treatment as well. (Ohio’s six-week abortion ban is currently blocked by state courts.)
Medical providers are “being forced to wait to intervene until their patient’s condition worsens because of uncertainty around what is ‘sick enough’ to qualify for an exception,” according to the letter from Physicians for Reproductive Health.
The AMA also singled out other concerns for patients experiencing spontaneous miscarriages, making it harder to access the appropriate treatment. Ahead of the Dobbs decision, many physicians and reproductive health advocates expressed concern that abortion bans might create a chillling effect, discouraging medical providers from prescribing the pills — mifepristone and misoprostol — or making them harder to find.
That now appears to be happening. Specifically, many doctors are reporting difficulties finding mifepristone for patients who experience miscarriage. While miscarriages can be managed using just misoprostol, the medication regimen is far more effective when both drugs are available.
“Limiting access to mifepristone has serious consequences for treatment of these conditions,” the AMA said.
The report also found that as more people travel out of state for abortions, wait times have grown substantially at clinics in states where abortion remains legal. In New Mexico, which saw a 12 percent increase in abortions between June and August of this year, wait times at most clinics are now at least three weeks. That can be enough to push someone into a subsequent trimester, requiring more advanced care and potentially an abortion that takes two days instead of one.
It’s not clear how many more states will enact and enforce abortion prohibitions. Currently, eight state bans are being blocked by courts. Lawmakers in other states, including Nebraska and Florida, are expected to pursue harsher abortion restrictions in the coming year, though it’s an open question as to how many will pass.
Sen. Lindsey Graham, a Republican from South Carolina, introduced a bill earlier this fall that would ban most abortions after 15 weeks. The bill currently does not have the votes to pass, and other Republican senators were quick to distance themselves from the proposal. But it’s not clear if such a ban might gain more traction if Republicans took control of Congress.
If enacted, such a law could have stark consequences, all of the medical groups warned.
“The effects of this type of federal abortion ban would be devastating to the health and well-being of individuals and families across the country,” ACOG wrote.
Among the consequences, per National Nurses United: “severe symptoms, illness, and even death.”
This post was originally published on Latest – Truthout.
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Crystal Muñoz was four months pregnant when federal agents knocked on her door. They assured the Texas mother that she wasn’t in any trouble; they just wanted to know about a map she had drawn for some people two years earlier. Little did she know that talking with them would lead to a 20-year prison sentence — and delivering her baby with her wrist and ankle cuffed to a hospital bed.
Federal agents arrested Muñoz for conspiracy to distribute marijuana. The courts allowed her to stay at home with her husband and months-old daughter until the end of her trial. When a jury convicted her in October 2007, she was sent to the Ector County Detention Center to await sentencing. By then, she was in her last trimester.
“It was horrible to be in there at all,” Muñoz told Truthout, “but to be pregnant [in that jail] was super-awful.”
She recalled being handcuffed and shackled — with cuffs around her wrists and ankles — when she was brought to an outside hospital for prenatal visits. Depending on the officer, she might also have a metal chain wrapped around her waist.
Each day brought the same meal — beans, cornbread and bologna, even though lunch meats can cause listeria in pregnant people and result in serious illness for fetuses. Muñoz requested extra fruits and vegetables to no avail. The jail did not supply prenatal vitamins. Her husband attempted to navigate the jail bureaucracy to bring her a bottle, but despite his efforts, the vitamins never reached her.
The American College of Obstetricians and Gynecologists states that pregnant people should drink eight to twelve cups of water each day, but Muñoz recalled that meals were the only times that the jail provided drinking water. Otherwise, women would have to drink water from the bathroom sink, the same sink where people brushed their teeth, washed their hands and washed their panties. “And it’s right by the toilet,” Muñoz added.
Not wanting to risk bacteria, Muñoz hid empty potato chip and snack bags, filled them with ice, then drank the contents.
The day after Christmas, Muñoz went into labor. She was brought to the hospital, where officers secured her left wrist and left ankle to the bed posts. Although the attending doctor ordered the officers to remove the restraints, they did so slowly — first freeing Munoz’s ankle and, when she began birthing her baby, her wrist.
“I was super-healthy, so she came out super-healthy,” Muñoz said, recalling that her baby was the same size as her first daughter. But if she had had a more difficult pregnancy, or preexisting health conditions, her pregnancy and birth might have been much worse.
Now, federal lawmakers are seeking to improve pregnancy care in the federal prison system.
In October, Senators Amy Klobuchar (D-Minnesota) and Susan Collins (R-Maine) introduced the Protecting the Health and Wellness of Babies and Pregnant Women in Custody Act. Rep. Karen Bass (D-California) introduced a similar House bill in March.
The legislation bans restraints during pregnancy, a prohibition already enacted by the 2018 First Step Act. It also prohibits placing pregnant people in solitary confinement during their third trimester.
The bill also directs the Bureau of Prisons, which oversees all federal prisons, to provide regular access to water and bathrooms, nutritionally adequate diets, prenatal vitamins as well as information about parental rights and lactation. These protections would only apply to pregnant people in federal jails and prisons.
Data Show Thousands of Pregnant People in Prisons, But Mostly in State Prisons
Carolyn Sufrin is a medical anthropologist, OB-GYN and an assistant professor at Johns Hopkins University School of Medicine. She is also the founder of the organization Advocacy and Research on Reproductive Wellness of Incarcerated People (AARWIP), which researches reproductive health care behind bars. During a 12-month period between 2016 and 2017, ARRWIP found that approximately 4 percent of people entering state and federal prisons and 3 percent of people entering jails were pregnant.
“The vast majority of pregnant people who are incarcerated are not in the federal system,” Sufrin told Truthout. During ARRWIP’s 12-month data collection, there were 172 pregnant people in federal women’s prisons, comprising 0.3 percent of the federal women’s prison population. Since then, those numbers have not increased significantly.
In addition to prohibiting shackling during pregnancy, the 2018 First Step Act instituted data collection on pregnancy and pregnancy outcomes in federal prisons. In 2019, federal authorities reported that 180 pregnant people had been incarcerated in federal facilities that year. Ninety-four gave birth while incarcerated. Federal authorities reported one instance of handcuffing a pregnant person, allegedly for disruptive behavior.
The following year, as COVID-19 began spreading across the country, 91 pregnant people were incarcerated in federal facilities. Thirty-nine were released before giving birth; of the 52 who remained, 50 had live births, one had a stillbirth and there was one maternal death. There were no reports of restraints of pregnant people.
Many states do not collect or report pregnancies or pregnancy outcomes in their prisons or jails. The new federal bill would alleviate that black hole by directing the Bureau of Justice Statistics, which collects and publishes data about incarcerated people in the United States, to include information about pregnancy, pregnancy-related care and the use of solitary confinement during pregnancy.
Legislation Is Not Always Enough to Ensure Humane Treatment
The bill comes too late to help Muñoz, who was granted clemency by then-President Donald Trump and reunited with her now-teenage daughters in February 2020.
But even for future people who are pregnant behind bars, legislation doesn’t necessarily ensure that prison or jail officials will follow the new measures. In 2009, formerly incarcerated mothers and their allies succeeded in passing legislation in New York to end shackling during labor, delivery and postpartum recovery. But despite the law, as late as 2014, prison officials continued to clap pregnant people in handcuffs, leg irons and belly chains when transporting them to outside medical visits — and even restrained them in the hospital hours after they had given birth.
In 2018, Maryland passed a law requiring jails and prisons not only to have written policies to address pregnancy and child placement, but to provide incarcerated people with these policies. In 2019, the state also passed a law prohibiting jails and prisons from placing pregnant people in solitary confinement.
Kimberly Haven, the executive director of Reproductive Justice Inside, helped draft both bills and has been monitoring implementation. She noted that in July 2021, two years after the prohibition of solitary confinement for pregnant people, Jazmin Valentine was placed in solitary after being arrested on an alleged probation violation. She gave birth alone in her jail cell after jail staff and nurses ignored her pleas for help, telling her over the course of six hours that she was merely withdrawing from drugs, not in labor.
“The reason we wrote this bill was just for this reason,” Haven told Truthout. “We came to them [Maryland’s jails and prisons], offered our trainings and training materials, and we were rebuffed.”
While the federal bill allows for the use of restraints or solitary confinement under extreme circumstances, it requires federal jails and prisons to review their use every few hours and report any such use.
But, noted Sufrin, “those [reporting requirements] are after the fact. There are no mandatory sets of health care standards or system of oversight or accountability to entice jails and prisons to follow the standards.”
Ultimately, said Sufrin, the solution to inadequate and terrible pregnancy and postpartum care “is not to incarcerate pregnant people in the first place and to invest in access to adequate pregnancy and postpartum care in the community.” But, she added, “that’s going to take a long time. We need some mandatory standards and systems of oversight and accountability.”
This post was originally published on Latest – Truthout.
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On Wednesday, Kentucky’s Democratic governor announced a plan to expand the state’s Medicaid program to include dental, vision and hearing care for adults.
Gov. Andy Beshear’s plan to expand the services available under Medicaid in Kentucky will impact around 900,000 adults enrolled in the program. New benefits will go into effect on January 1, 2023.
Medicaid is a joint state- and federally-funded program that provides medical coverage to individuals and families with low incomes across the U.S. In Kentucky, a single adult is only eligible for the program if they earn less than $18,075 per year; for families of four, adults are eligible if the household income is below $36,908.
The changes will allow low-income adults in the state to access necessary care that was previously out of reach. (Children in the state are already eligible for dental, vision and hearing care if they receive Medicaid.)
Beshear assured residents that the changes won’t have a major effect on state spending, pointing out that Kentucky already has a healthy Medicaid budget and that federal funding will pay for most of the costs associated with expanding coverage.
Federal dollars will account for 90 percent of the expansion, which will cost an estimated $36 million annually. Kentucky will cover the remaining 10 percent of yearly costs, which amount to around $3.6 million per year — equivalent to approximately 8.5 percent of the state’s total government spending in fiscal year 2022.
“It will have no significant impact on Kentucky’s budget. It will require no changes to our budget in this next session,” Beshear said. “In other words, it is easily affordable, which means we absolutely should do it.”
Beshear touted the changes as being beneficial to workers across Kentucky.
“If you can’t see, it’s really hard to work,” Beshear said. “If you can’t hear the instructions that you’re getting, it’s really hard to work. If you have massive dental problems that are creating major pain or other complications, it’s really hard to work.”
Beshear’s announcement was praised by analysts in the state.
“This is a big deal!” tweeted Dustin Pugel of the Kentucky Center for Economic Policy. “Kentucky Medicaid has long offered vision and dental, but they offered scant services — for example you could get an eye exam, but not glasses. And it has never offered hearing benefits. Good on [the Cabinet for Health and Family Services] for implementing these long-overdue benefits.”
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In what advocates call a “grotesque display of corporate profiteering,” the health insurance giant formerly known as Anthem reported making $2.3 billion in net profit off its policyholders over the past three months as analysts predict a dramatic spike in the cost of health insurance premiums in 2023.
Elevance Health, the largest for-profit company within the Blue Cross Blue Shield Association, surpassed Wall Street expectations on Wednesday and reported nearly $40 billion in revenue during the third quarter of 2022. Returns to shareholders increased by 7 percent, generating $1.6 billion in profits for investors. Elevance provides health coverage for 118 million people across multiple states.
Elevance claims its profits are the result of offering more service to more customers. However, health care activists who help patients fight for coverage from their insurance providers say a chunk of this profit undoubtably comes from denying insurance claims from sick people who cannot afford proper care otherwise. Denying claims, they say, is a “regular business practice” for squeezing out extra profits. Insurers know the vast majority of patients do not exercise their right to appeal when claims are denied and are often unsure how to do so.
“Part of this money is made denying claims,” said Aija Nemer-Aanerud, Health Care For All campaign director at People’s Action, in an interview. “How many surgeries, medications and doctor visits would $2.3 billion amount to if we didn’t live under a for-profit system set up to advance the interests of greedy corporations instead of actually care for people?”
A spokesperson for Elevance did not respond to an email requesting internal data that would show whether the company is turning profits by denying health insurance claims, but organizers have gathered horror stories from patients across the country. The six largest private health care insurers enjoyed a combined $41 billion in profits in 2021, and in 2020, private insurers denied more than 42 million in-network claims from patients covered by Affordable Care Act (ACA) marketplace plans, according to People’s Action and the Kaiser Family Foundation.
Thanks to federal transparency requirements tied to ACA subsidies, we know that means nearly one in five claims under ACA marketplace plans were denied by private insurers in 2020. This figure only includes federally subsidized ACA plans, not the private plans provided by employers that many people have. Eleana Molise, a neighborhood organizer with ONE Northside in Chicago, said one in seven of all medical claims are estimated to be denied nationally.
“This especially affects Black and Brown people who are sold the worst insurance, and people in rural America, where you get fewer or no health care providers, or they are ‘out-of-network,’ meaning you get stuck with the bill,” Molise said in a livestream Tuesday with health care advocates, impacted patients and Sen. Bernie Sanders (I-Vermont).
“A rational health care system is a system that guarantees health care for all as a human right, and it is s system that is cost effective, a system that is comprehensive … it is not a system designed to make private health insurance companies huge profits,” Sanders said, repeating his call for universal public health insurance known as Medicare for All.
Private health insurers will often refuse to pay for medical care under the rules baked into insurance plans — deductibles must be met, doctors must be within the insurer’s network, and any drugs prescribed must be on the insurer’s approved list of medications.
However, advocates report that people are often stuck with massive bills for medical care that is rightfully covered under their plans, forcing them to pay out-of-pocket or challenge the insurer under complicated and frustrating appeals processes handled by the company itself.
“The wolf is guarding the henhouse,” said Ken Whittaker, executive director of the social justice group Michigan United. “They know most people don’t know you can appeal your claim, and less than 1 percent appeal claims when they are denied … and that’s more money for CEOs and Wall Street investors.”
While it’s unclear just how much profit is raised by denying insurance claims, advocates say the industry’s behavior leaves little doubt that private insurers are gouging patients and public health care programs. For example, an Elevance CEO took home $17 million in salary and bonuses in 2020, the same year Elevance and other Blue Cross Blue Shield companies agreed to pay a $2.67 billion settlement in a major antitrust case filed on behalf of policyholders.
A recent New York Times investigation found that private insurance companies exploited Medicare Advantage, which provides private health coverage for people 65 and older but is paid for by the federal government, to rake in billions of dollars from taxpayers. The majority of large insurers sent the government inflated bills, and Elevance and other companies face federal lawsuits for elaborate schemes to inflate profits. As The Times notes:
Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.
Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.
Medical bills that the insurance company refuses to pay after an emergency room visit or a major illness are the most common form of claim denial, Nemer-Aanerud said, but millions of uninsured and underinsured people are unable to afford basic preventative care that would help them stay healthy long-term — and keep costs down for everyone else. Coverage of lifesaving treatments and prescriptions are also denied by insurers, often the result of secret kick-back agreements made with pharmaceutical companies that drive up drug prices and determine which medications are covered for patients.
Callie Gibson, whose husband Mark Hall was denied access to proper medication for a chronic digestive disease, said the issue is affecting her family right now, but health coverage denial can happen to any of us. Hall was on medication that worked for years, but after switching from Medicaid to a private employer’s plan through Cigna Health, he was forced to switch to a biosimilar despite an appeal from his doctor. Even after taking higher doses, the new drug does not adequately control digestive bleeding and other painful symptoms, preventing Hall from living his daily life.
“Because ultimately, the insurance companies don’t care about you as an individual,” Gibson said during the livestream with Sanders, reflecting on the couple’s experience with Cigna. “They care about their shareholders, the people who are making money off this company, and they are not going to take action as long as they are continue to make money, and until we hold them accountable for what they are doing.”
The Health Care For All campaign is helping people fight for their claims through the appeals process, and anyone who has been denied health coverage is encouraged to contact the campaign.
This post was originally published on Latest – Truthout.
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The multibillion-dollar National Football League (NFL) is locked in an extremely divisive controversy that can only be solved with a simple, but controversial, sandlot solution — a flag stuck in the back of the quarterback’s pants… and then of all ball carriers and receivers.
Though the solution may seem silly to those with no interest in or tolerance for professional football, the problem cuts to the core of a significant health and labor issue facing NFL athletes.
Much of the progress toward understanding the seriousness of the concussion problem has come from the football players’ union, the NFL Players Association (NFLPA), and from an organization of former players including retired running back Ken Jenkins.
“We’ve come a long way since I played,” says Jenkins, who retired in 1987. “You were supposed to be able to shake off a little stinger or dinger or a small concussion or a bell rung. That was expected back then. And, if you didn’t … it was almost like, ‘Well, he’s not tough.’ Now we know that a concussion can cause problems down the road and even lead to death. It has opened our eyes and created a cascade of safety measures to be put in place that have helped our game, especially for the youth coming up.”
Pioneered by former Colts player John Mackey in the 1970s, the NFLPA struggled long and hard against the billionaire owners who still view “their” players as dispensable employees. Over the decades, led later by former player Gene Upshaw and attorney Ed Garvey, the union faced almost impossible odds, fighting through brutal battles over pay, working conditions, free agency and collusion, and more. Gradually, the union built immense clout through organizing.
But perhaps the union’s biggest fight has centered on the discovery that many players have been suffering a previously undiagnosed form of brain damage called chronic traumatic encephalopathy (CTE). First identified by a Nigerian-born coroner in Pittsburgh, Bennett Omalu, the problem surfaced with the death of former Pittsburgh Steelers and Kansas City Chiefs superstar center Mike Webster.
Webster played from 1974 to 1990, entering the Pro Football Hall of Fame with a reputation for violent outbursts. Eventually Webster came to live with depression and mental illness, struggling with drug addiction and exhibiting erratic behaviors. At age 50, he died suddenly. According to The Atlantic, while the hospital report said Webster had died at Allegheny General Hospital from a heart attack, he also “suffered from ‘depression secondary to post-concussion syndrome,’ suggesting the syndrome was a contributory factor to his death, thus making it accidental.”
When Omalu used his personal funds to examine Webster’s brain tissue, he discovered a previously unknown syndrome of cell damage caused by the repeated trauma that is at the core of tackle football. Soon, with NFLPA support, the syndrome was confirmed in other dead and dying retired players.
Like the tobacco industry denying a connection between cigarettes and lung cancer, or the nuclear power industry whitewashing the dangers of atomic radiation, the NFL and its super-rich owners went into deep denial. They viciously attacked Omalu and his supporters, vehemently denying their immensely profitable sport could cause any lasting harm.
But the NFLPA took Omalu’s findings into the public mainstream. The union gradually organized retired players and their families — many of who continue to struggle with players’ high rates of depression, domestic violence and suicide. Ultimately, the union sued the NFL on behalf of its stricken veterans and their too-often abused spouses and children. A preliminary 2013 court settlement of $765 million opened the door to a long series of legal battles.
The union has also battled the league over funding for medical studies. Meanwhile, the 2015 film, Concussion, starring Will Smith and focused on Omalu and his research brought a new level of public attention to the situation. After Junior Seau, another beloved Hall of Famer, committed suicide at 43, medical researchers found that his brain exhibited “cellular changes consistent with CTE.” The findings deeply impacted public opinion.
The NFL and other major sports leagues have long been criticized by legendary consumer advocate Ralph Nader, among others. Much of his critique has focused on the ability of professional teams’ wealthy owners to gouge the public for huge sums of money to build enormous stadiums that only benefit the rich. But Nader has also skewered contact sports like hockey and football for promoting and marketing the brutal physical contact that results in CTE and other serious injuries.
In recent years, controversies have erupted over “race-based adjustments in dementia testing that critics said made it difficult for Black retirees to qualify for awards in the $1 billion settlement of concussion claims,” the Associated Press reported. The testing procedures, which the NFL agreed to end in 2021, had caused complex conflicts within the players’ union.
But the union and the league are continuing to battle over the brain damage issue. It’s been generally assumed that football is the United States’ most popular sport, in large part because its most loyal viewers love the violence itself. Promoted in part by the macho rantings of Donald Trump, who once owned a non-NFL professional football team (and the contract of running back Herschel Walker, the GOP’s far right candidate for Senate from Georgia), harm done to players has been considered “part of the game.”
The current uproar stems from two seemingly opposite situations — the disturbing concussive damage done to a young Miami Dolphins’ quarterback, and an overly protective penalty called in favor of an aging veteran QB.
The more serious side of the controversy surrounds Tua Tagovailoa, Miami’s 24-year-old star passer. In successive games Tagovailoa suffered head injuries that may have permanently threatened his health.
Under intense pressure from the players’ union and public advocates like Nader, the NFL has instituted some protocols to protect its most valuable assets: its star quarterbacks. Rules now in place, about how badly QBs can be hit by defensive players, and when quarterbacks must be substituted out after suffering obvious trauma, have somewhat mitigated risks. But the protocols are deeply flawed and seriously contradictory.
Tagovailoa was slammed to the ground on September 25, 2022, and experienced a concussion. But the Dolphins claimed he’d suffered a “back injury” and put him back in. Then, on September 29, 2022, he suffered yet another serious hit. According to People: “While lying on the field, Tagovailoa’s raised his hands and arms above him and appeared to be unable to control their movement, and medical assistance was called. Tagovailoa remained motionless on the field for around 10 minutes before being carried out in a stretcher.”
Despite the obvious trauma, Tagovailoa was allowed to play the next week and was hit yet again in ways too devastating to ignore. Commentators have voiced outrage that the life and future health of a player in his twenties could be so cavalierly risked for a mere ball game.
Ironically, when Tagovailoa was made to sit out the next game, his replacement — Teddy Bridgewater — was himself on the very first play hit too hard to continue. Miami’s third-string passer then led the team — which had been streaking — to an abysmal defeat.
The futures of Tagovailoa, Bridgewater and the Dolphins themselves are now all up in the air. The angry, divisive and often confusing debate about when concussed QBs should play and when they should be pulled has no clear resolution.
But the flip side of the debate reared its ugly hammered head in a marquee game between the Tampa Bay Buccaneers and Atlanta Falcons when legendary Buccaneers quarterback Tom Brady was sacked. The hit was routine and showed no signs of excess within the league’s protocols. Brady appeared uninjured.
But as one of the NFL’s all-time leading passers, Brady had license to jump up and down with theatrical complaints. The referees granted him a very dubious penalty, which probably decided the game in the Bucs’ favor.
In response, one of U.S. sports’ most popular commentators, Stephen A. Smith, made what could be a definitive suggestion. While expressing his outrage at Brady’s antics, he argued that a flag should be stuck in the back of the quarterback’s pants… and then of all ball carriers and pass receivers. Instead of letting these key players get smashed and thrown to the ground by massive pass rushers, the flag could merely be pulled, ending the play. The extreme violence and tangible damage suffered in this pivotal part of any football game would thus be avoided.
The suggestion to use flags in professional football may have been first discussed in public as a “serious cultural issue” 10 days prior by four former players on this writer’s weekly Green Grassroots Emergency Protection Zoom call and Progressive Radio Network’s “Solartopia” radio show.
“He [Tagovailoa] had a concussion from four days earlier and they let him play,” said former player Dan Sheehan. “It was just bizarre.”
The suggestion to use a cloth strip to be pulled and thrown to the ground is a throwback to “flag football,” the sandlot version of the sport played by millions of amateurs in parks throughout the country. In this more pacific version of the game, there’s no tackling. Each play ends with the ball carrier’s flag — rather than the players themselves — being thrown to the ground.
Such a version of the game is of course viewed as “wimpy” by Trumpian fans, most of whom have never played the sport
themselves, but who pay the big bucks to see hired gladiators (most of them Black) smashing each other’s brains to oblivion on the field.
For all the focus on rules surrounding quarterbacks, the essence of the game at all positions remains embedded in its violence, with the expectation of injury being virtually universal.
In the long run, going to flags — and not just for quarterbacks — may be the game’s only hope.
While European “football” — what people in the U.S. know as soccer — has grown exponentially, tackle football in the U.S. is tanking among young people. A new study suggests that half of adults in the U.S. disagree with the idea that tackle football is an “appropriate sport for kids to play.” Fearing injuries, lawsuits and a spreading revulsion against violence, high schools and colleges around the country are dropping the sport altogether.
As early as 2003, a major orthopedic study showed as many as 350,000 high school football players were being injured every year. And while the NFL gorges on high ratings and gargantuan profits, it cannot continue without a constant flow of young players.
For the league, a good quarterback is vital to the game’s allure. Tagovailoa has a multimillion-dollar four-year contract. The Kansas City Chiefs’ quarterback Patrick Mahomes recently signed a long-term deal for a half-billion dollars.
As we have seen in Miami, a team led by a mediocre quarterback is barely worth watching, even for the game’s most devoted fans. The quality of the NFL’s “product” is degraded every time a star QB is forced to sit out a game.
In the short term, protecting the quarterback, runners and pass catchers with a flag protocol rather than murky, hard-to-define concussive protocols should be — forgive the pun — a no-brainer.
The violence lovers will whine that the sport is going “wimpy.” But in the long term, the whole game must be overhauled and made less brutal. The grotesque parade of seriously harmed young stars being carted off the field is not sustainable. For the NFL, there can be no greater threat than the wise decision of young athletes to choose other sports.
Will making professional football less violent affect American culture? Realistically, it’s hard to think otherwise.
Football is the nation’s premier spectator sport, watched weekly by tens of millions. The Super Bowl is the most watched annual sporting event in the world.
A packed weekend of often horrifying blood sport can do the American psyche no good. Taming it down to the beautiful nonviolent ballet it really should be could constitute a great leap forward for the nation’s cultural mindset, and for the health of its athletes.
We won’t know for sure until we try. But common sense should tell us that when it comes to tackle football, flags are the better option.
Please write me directly via solartopia@gmail.com to help make it happen.
This post was originally published on Latest – Truthout.
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New research unveiled Monday estimates that around 1.3 million U.S. adults with diabetes either skipped entire insulin doses, took less than needed, or put off purchases of the medicine over the past year due to its high cost, a striking indictment of a healthcare system that allows profit-seeking pharmaceutical companies to drive up prices at will.
The authors of the new study, published in the Annals of Internal Medicine, analyzed data from the 2021 National Health Interview Survey, examining a sample representative of 1.4 million U.S. adults with type 1 diabetes and 5.8 million with type 2 diabetes.
The results indicate that 16.5% of all adult insulin users across the U.S. rationed insulin in some way in the past year, with rationing more common among those with type 1 diabetes than type 2.
“Universal access to insulin, without cost barriers, is urgently needed,” Adam Gaffney, an ICU doctor at the Cambridge Health Alliance and the lead author of the study, told NBC News. “We have allowed pharmaceutical companies to set the agenda, and that is coming at the cost to our patients.”
Gaffney, an outspoken advocate of Medicare for All, said he has personally “cared for patients who have life-threatening complications of diabetes because they couldn’t afford this life-saving drug.”
BREAKING: We found 1,300,000 Americans with diabetes ration insulin due to cost.
Those without insurance had the highest rates of rationing at 30%.
This isn’t some awful phenomenon. This is a policy failure.https://t.co/SG5ntSDApe
— Public Citizen (@Public_Citizen) October 17, 2022
The high price of insulin has long been a scandal in the U.S., where the list costs of the cheap-to-produce medicine are often up to 10 times higher than in other countries.
Sen. Bernie Sanders (I-Vt.) has famously led caravans of people with diabetes into neighboring Canada to spotlight the shocking price of insulin in the U.S., which does little to regulate the pharmaceutical industry’s price-setting power.
One recent report by Human Rights Watch (HRW) described insulin access in the U.S. as “a privilege that many cannot afford,” noting that “soaring medicine prices and inadequate health insurance coverage can result in unaffordable out-of-pocket costs that undermine the right to health, drive people into financial distress and debt, and disproportionately impact people who are socially and economically marginalized, reinforcing existing forms of structural discrimination.”
The new study, co-authored by David Himmelstein and Steffie Woolhandler, echoed those findings, pointing out that people without health insurance “had the highest rate of rationing… followed by those with private insurance.” People on Medicaid and Medicare reported the lowest rate of insulin rationing.
“Several factors likely underlie our findings,” the authors note. “Insulin prices in the United States are far higher than in other nations. Moreover, pharmaceutical firms have increased insulin prices year upon year, even for products that remain unchanged.”
According to public data spotlighted by HRW, Eli Lilly has hiked the list price of the commonly used insulin product Humalog by an inflation-adjusted 680% since it started selling the drug in 1996.
Gaffney, Himmelstein, and Woolhandler note that the recently enacted Inflation Reduction Act includes a provision limiting insulin copays to $35 per month for those on Medicare, a change that “may improve insulin access for seniors, who experienced substantial rationing in our study.”
But they lament that Senate Republicans stripped out an insulin copay cap for those with private insurance.
“Further reform,” the trio writes, “could improve access to insulin for all Americans.”
In July, California Gov. Gavin Newsom announced that the state would soon move to produce its own insulin in an effort to provide a lower-cost alternative to Big Pharma’s products.
At the national level, HRW has called on Congress to “consider legislation to provide insulin to all insulin-dependent individuals in the country free-of-cost.”
“People who need insulin shouldn’t have to break the bank just to survive,” said Matt McConnell, economic justice and rights researcher at HRW, “but in the U.S. they often do.”
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In an early August press conference, Florida Gov. Ron DeSantis delivered a shocking announcement: He was abruptly suspending Andrew Warren, the elected chief prosecutor for Hillsborough County (Tampa) and an outspoken critic of the governor. Warren, who was given no warning, was escorted from his office by an armed deputy.
In an accompanying executive order, DeSantis accused Warren of “incompetence and willful defiance of his duties.” Although county prosecutors in Florida are elected and do not answer to the governor, DeSantis pointed to a statute in the Florida State Constitution that allows a governor to suspend elected officials “for reasons of misfeasance, malfeasance, neglect of duty, drunkenness, incompetence, permanent inability to perform official duties, or commission of a felony.” Historically, this power has almost exclusively been used to remove officials charged with felonies.
To support his claims, the governor pointed to two joint statements signed by Warren and other prosecutors around the country: a June 2022 pledge not to use their offices’ “limited resources” to prosecute those who seek or provide abortion care, and a 2021 pledge not to criminalize transgender people or gender-affirming health care. DeSantis also noted a policy Warren implemented against bringing charges in cases that stem from police stops of pedestrians and cyclists; this was intended to end the high number of “biking while Black” bike-stop charges in Tampa.
All three of Warren’s opinions cited by DeSantis — his support for access to legal abortion, the right to gender-affirming care and reducing unnecessary and racist policing — stand in direct opposition to the governor’s political goals. The two public officials have clashed over these and other issues repeatedly over the past several years.
After removing Warren from his elected office, DeSantis immediately appointed Susan Lopez as his replacement, a conservative Hillsborough County judge and member of the Federalist Society, a conservative legal organization that believes in a literal interpretation of the U.S. Constitution, and whose membership includes all six Republicans on the Supreme Court. Lopez has already repealed some of Warren’s reforms, including the bike-stop policy.
But Warren is not going down without a fight. In an ongoing federal lawsuit seeking his reinstatement, he argues that his suspension violates his First Amendment rights and oversteps the powers granted to DeSantis under the Florida Constitution. The current suit has since been limited to the First Amendment question, which is within the realm of federal court. A trial is set for November 29.
In his complaint, Warren points out that DeSantis has not identified a single case that he declined to prosecute: His office had not received any cases regarding abortion, and Florida does not currently criminalize transgender medical care.
Warren also argues that his removal violates the will of Tampa voters who elected him in 2016 and 2020. These voters were further disenfranchised when his replacement was handpicked by DeSantis, who lost Hillsborough County by a nine-point margin in the last gubernatorial election.
“If DeSantis can arbitrarily suspend an elected official without one shred of evidence they have done anything wrong, how far will he go to punish anyone else who disagrees with him?” Warren wrote in an op-ed in the Tampa Bay Times. “This abuse of power should shock every business owner, teacher, doctor, public servant — and every voter.”
So far, Warren has already received one favorable ruling: When DeSantis moved for dismissal, arguing that First Amendment protections do not apply, U.S. District Judge Robert L. Hinkle disagreed, allowing the case to move forward.
Meanwhile, the Florida State Senate, which is responsible for deciding whether to reinstate or permanently remove suspended officials, has halted hearings regarding Warren’s case, citing the ongoing lawsuit.
DeSantis Uses His Power to Stifle Dissent
“It’s a very unusual case. And it’s a problematic case,” Bruce Green, director of the Louis Stein Center for Law and Ethics at Fordham University School of Law, told Truthout. Green is a lead signatory on one of several amicus briefs filed in support of Warren. Green’s brief was signed by 115 legal scholars whose work focuses on legal ethics, professional responsibility and criminal procedure.
“The concern is that prosecutors are going to have trouble, at least in Florida, exercising the independent, professional judgment and discretion that they were elected to exercise,” said Green. “Because they have a governor who is looking over their shoulder, and is potentially going to remove them from office if he doesn’t like the way they’re making decisions. And it certainly chills them from being candid with their electorates and with the public about how they view things.”
The brief warns that Warren’s suspension “runs counter to professional standards of conduct … usurps the will and power of the electorate, and eviscerates the carefully crafted separation of powers erected in the Florida Constitution.”
Another amicus brief in support of Warren was filed by a group of scholars of the Florida State Constitution. They note the dangerous precedent that Warren’s removal could set for voting rights if allowed to stand, warning: “If Governors were permitted to suspend State Attorneys because of their prosecutorial priorities and replace them with attorneys whose priorities mirror their own, Florida’s electoral process for the office of State Attorney — and potentially all elected state officers — would be virtually meaningless.”
That brief’s signatories include members of a committee that approved revisions to the state constitution in 1997-1998, including the constitutional statute DeSantis used to justify the suspension. They note that none of DeSantis’s claims meet the legal definition of “neglect of duty” or “incompetence.”
In fact, Warren argues his competency and fulfillment of duty had nothing to do with his suspension. Instead, he has repeatedly accused DeSantis of removing him as an attention-grabbing, partisan performance. In a statement, the ousted prosecutor wrote: “Today’s political stunt is an illegal overreach that continues a dangerous pattern by Ron DeSantis of using his office to further his own political ambition.”
In an interview with Bolts magazine, Florida Rep. Anna Eskamani, a Democrat, agreed, calling Warren’s suspension “a fascist approach to governing, if you can even call it governing.”
The evening before the suspension, DeSantis’s press secretary, Christina Pushaw, teased the announcement in a tweet, suggesting that the real intent was to stir up controversy: “MAJOR announcement tomorrow morning from @GovRonDeSantis. Prepare for the liberal media meltdown of the year. Everyone get some rest tonight.”
In recent years, Warren has increasingly criticized or attempted to mitigate DeSantis’s policies at the local level.
In 2017, for example, Floridians overwhelmingly passed a ballot initiative that restored voting rights to most people convicted of felonies after completion of their sentence. The following year, the governor signed a bill harshly limiting the initiative’s scope by requiring people to pay all court fines and fees before voting. (DeSantis is currently going even further by prosecuting Florida citizens for accidentally voting before they were eligible.) In 2019, Warren’s office responded by setting up a process to help residents apply to have their debts waived for voting purposes.
Then in March and April 2020, Warren started to bring a case against an evangelical pastor who was defying social distancing rules to hold crowded megachurch services in Tampa. DeSantis intervened by abruptly adding an exception for church services in the statewide “safer-at-home order,” which superseded any local orders. Warren criticized the action as “weak and spineless.”
And in 2021, Warren spoke out against DeSantis’s so-called “anti-rioting bill,” which created a new, broad, vague definition of rioting that could more easily be used to punish nonviolent participants. The bill denied bail for people arrested at a “riot,” gave drivers civil immunity for running over protesters, and made it more difficult for cities to reduce police funding. In response, Warren said the law “tears a couple corners off the Constitution.” The bill has also been criticized by the United Nations. (Although DeSantis signed the bill into law in August 2021, a federal judge halted major parts, including the rioting definition, earlier this year, as a lawsuit is ongoing.)
A recent article in the Orlando Sentinel pointed out yet another indication that Warren’s suspension was politically motivated: Elected sheriffs throughout the state have pledged not to enforce gun control measures, without receiving any criticism from DeSantis — let alone suspensions for “neglect of duty.”
And Warren’s ouster fits with DeSantis’s history of punishing people who disagree with his politics.
Just weeks after Warren’s suspension, DeSantis suspended and replaced four school board members from Broward County, the sixth-largest school district in the nation and the second-largest in Florida.
In this instance, DeSantis was responding to the results of a grand jury investigation he had initiated into school safety issues following the 2018 Parkland shooting at Marjory Stoneman Douglas High School. The grand jury recommended that the school board members be removed for “incompetence and neglect of duty.” But instead of allowing the vacated seats to go up for general election, DeSantis once again took the opportunity to replace the ousted members, all of whom were Democratic women, with four Republican men of his own choosing.
DeSantis has gone after others who disagree with him. In April, he and GOP legislators punished Disney for speaking out against the state’s “Don’t Say Gay” law banning discussion of sexual orientation or gender identity in schools. His department of health also suspended an Orange County health officer in January after he sent an email encouraging his staff to get vaccinated.
And back in 2019, DeSantis suspended Broward County Sheriff Scott Israel, a Democrat, for the failings of his deputies in responding to the Parkland school shooting. Although a special master appointed by the State Senate concluded there was not enough evidence to support Israel’s suspension, the Republican-controlled State Senate confirmed his removal anyway.
Reform-Minded Prosecutors Face Retaliation
Since taking office in 2016, Warren implemented policies that decreased the number of children tried as adults, gave judges more flexibility to waive excessive fines and fees, established mental health courts and created a Conviction Integrity Unit that has overturned at least 18 wrongful convictions.
After a 2016 Department of Justice investigation found that Black people made up 26 percent of the Tampa population and 73 percent of cyclists stopped by Tampa police, Warren’s office stopped bringing charges for offenses that resulted from non-criminal bike and pedestrian stops (such as “resisting without violence” charges).
These policies seem to have been popular in Hillsborough County; Warren easily beat his challenger for reelection in 2020.
But The Marshall Project outlined a concerning trend earlier this year, noting that “from Virginia to Missouri to Texas, conservatives have backed bills allowing the state to take over cases local district attorneys choose not to pursue, undermining the ability of elected prosecutors to carry out reforms that led voters to support them in the first place.”
By removing Warren directly, DeSantis has taken this attack to a new level. His appointed replacement, Susan Lopez, immediately began rolling back Warren’s reforms, including the bike-stop policy. She also reversed his decision to not pursue the death penalty in a pending murder case.
For now, Warren’s chances of reinstatement hang on the federal lawsuit. Other chief prosecutors and elected officials throughout Florida will be watching closely.
“Governors do not have the authority to disregard the autonomy and independence of prosecutors, nor are they entitled to undermine the will of the voters,” argued dozens of dozens of former judges and law enforcement officials, including three retired Florida Supreme Court justices, in yet another amicus brief in support of Warren’s lawsuit.
“Allowing governors to do so would upset the careful balance of roles and responsibilities delegated to local as well as state actors by state constitution, delegitimize our justice system, and erode public confidence in the operation of government and the integrity of the election process.”
This post was originally published on Latest – Truthout.
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Updated: Sheikh Abduljalil Al-Muqdad is a prominent 64-year-old Bahraini religious cleric and political opposition leader and activist. He has been serving a life sentence at Jau Prison since 2011 following his warrantless and violent arrest in relation to pro-democracy demonstrations in the country. During his detention, he has been subjected to torture, religion-based insults, enforced disappearance, an unfair trial, reprisal, and medical neglect. On 16 November 2023, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion concerning four elderly Bahraini opposition leaders, including Sheikh Al-Muqdad, concluding that their detention was arbitrary and calling for their immediate and unconditional release, as well as a thorough and independent investigation into the violations of their rights.
On 27 March 2011, security officers who did not identify themselves raided Sheikh Al-Muqdad’s house at 3:00 A.M., raising their weapons at him. They took him from his room, threatened him, and tied his hands behind his back in the hall of the house while they searched it. The officers did not present arrest or search warrants. Next, they took him outside barefoot despite the pain in his left foot due to an injury. Sheikh Al-Muqdad was placed in the car, blindfolded, and taken to an unknown location.
When he was taken out of the car, he was slapped, and then officers interrogated him late into the night. In the morning, they brought him to Al-Qurain Prison. He was not permitted to contact a lawyer and was only allowed to call his family for new clothes.
At the prison and during interrogation, officers brutally tortured Sheikh Al-Muqdad. They beat him, insulted him, put him on the ground, and whipped him with a leather belt or a sole after pouring water on him. One of the officers forced him to open his mouth, spat in it, and forced him to swallow. These violations continued at the Military Prosecution, where officers blindfolded him and punched him in the head. Sheikh Al-Muqdad informed the investigator at the Military Prosecution that he was subjected to torture outside the room and asked him to write that in his file and present it to the doctor; however, the investigator did not do so. He was then transferred to the National Security Agency, where officers also verbally abused him, blindfolded and sexually assaulted him, and insulted him, his family, and his religious sect.
On 22 June 2011, the National Safety Court sentenced Sheikh Al-Muqdad to life imprisonment for attempting to overthrow the regime. Both the military and civilian Courts of Appeal upheld the sentence on 28 September 2011 and 4 September 2012, respectively.
During imprisonment, officers continued their abuse, mainly through intentional medical negligence. Sheikh Al-Muqdad, still suffering from pain in his leg, has also been forced to endure back pain and has not received serious treatment or obtained an accurate diagnosis despite constant demands. Furthermore, he has suffered from severe and persistent headaches, which also have gone untreated.
In June 2022, after being denied headache treatment for four years, the Jau Prison administration took Sheikh Al-Muqdad to two appointments; however, he was denied seeing the doctor after arriving at the hospital under the pretexts of “the code has changed” and “you don’t have an appointment.”
In September 2022, Sheikh Al-Muqdad was transferred to an ophthalmologist appointment at an external medical facility to treat cataracts in his eyes. He was transferred into a small vehicle that was not equipped with air conditioning despite the extremely high temperature at the time. Consequently, he suffered from a headache, had difficulty breathing, and was on the verge of losing consciousness.
On 27 September 2022, Sheikh Al-Muqdad was due to be transferred again from Jau Prison for an external medical appointment to treat his headache, dizziness, and poor eyesight. However, just before the appointment, an officer informed him that a doctor would not be present. Consequently, Sheikh Al-Muqdad refused to go to the appointment. Officers told him that he had to sign a statement declaring that he was rejecting medical treatment, which Sheikh Al-Muqdad refused to do. His refusal was met with an aggressive response from some officers, who verbally assaulted him; approximately 4 to 5 officers attempted to beat him but were stopped by other officers. A phone call for Sheikh Al-Muqdad detailing the incident was published the following day on social media platforms. At the beginning of the call, an officer tried to interrupt it and stop Sheikh Al-Muqdad’s testimony. In this recording, Sheikh Al-Muqdad said to the officer who tried to interrupt his call “You are prohibiting me from talking about my medical situation! I’m talking about something else I’m talking about my medical treatment”. At the end of the same recording, it could be heard when Sheikh Al-Muqdad said “Notice, my brother here is prohibiting me from talking!” before the officer ended the call.
When this incident was publicized, with supporters inside and outside the prison expressing solidarity with Sheikh Al-Muqdad, authorities sought revenge against him instead of launching impartial investigations to hold the officers accountable. Sheikh Al-Muqdad was taken to the Public Prosecution Office (PPO) to be questioned. A wooden board he usually sleeps on to alleviate pain was also taken away as a form of reprisal. Additionally, the prison administration took retaliatory measures against political prisoners who protested in solidarity with Sheikh Al-Muqdad, depriving them of contact and family visits and reducing the time allowed outside their cells from 90 minutes to 45 minutes a day.
On 29 September 2022, the PPO requested an investigation based on a complaint from the Syrian officer involved in the incident, Ali Farhan and summoned Sheikh Al-Muqdad for questioning as the assailant rather than the victim. The PPO and Ombudsman subsequently fabricated a case against Sheikh Al-Muqdad, accusing him of assaulting and provoking the office.
Sheikh Al-Muqdad’s denial of medical treatment has worsened after this incident. On 9 November 2022, he underwent an eye examination, and despite having paid for the glasses from his personal account, they were not provided to him. Three weeks prior to that, he had a medical appointment outside the prison, but he was taken there in handcuffs and leg shackles despite the swelling in his feet. They placed him in the car, but when they approached the gate, they abruptly told him to get out and returned him to his cell.
On 5 April 2023, Sheikh Al-Muqdad was denied his scheduled hospital appointment, prompting him to stage a sit-in in the prison yard, where he raised a banner demanding medical treatment.
Between 16 and 20 August 2023, prominent Bahraini detained opposition figures and leaders, including Sheikh Al-Muqdad, conducted a hunger strike in solidarity with political prisoners who were also on hunger strike.
On 16 November 2023, the United Nations Working Group on Arbitrary Detention (WGAD) adopted an opinion on four elderly Bahraini opposition leaders, including Sheikh Al-Muqdad, determining their detention to be arbitrary. The Working Group urged the Bahraini government to immediately and unconditionally release all four opposition figures, conduct a comprehensive and independent investigation into the violations of their rights, and hold the perpetrators accountable.
The medical neglect policy practiced against Sheikh Al-Muqdad is still ongoing, despite his deteriorating health condition.
The warrantless arrest, torture, enforced disappearance, religious-based insults, unfair trial, reprisal, and medical negligence against opposition leader and religious cleric Sheikh Abduljalil Al-Muqdad constitute clear violations of the Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment (CAT), the International Convention on the Elimination of All Forms of Racial Discrimination (CERD), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Economic, Social and Cultural Rights (ICESCR), to which Bahrain is a party. Moreover, the violations he faced during his imprisonment, particularly medical negligence, constitute a breach of the United Nations Standard Minimum Rules for the Treatment of Prisoners, known as the Nelson Mandela Rules.
Americans for Democracy & Human Rights in Bahrain (ADHRB) calls on the Bahraini authorities to respond to the request of the UN Working Group on Arbitrary Detention opinion, by immediately and unconditionally releasing Sheikh Al-Muqdad, who was arbitrarily detained due to his peaceful activism, and all other political prisoners. ADHRB also urges the Bahraini government to investigate allegations of arbitrary arrest, torture, enforced disappearance, religious-based insults, reprisal, and medical negligence and hold perpetrators accountable. ADHRB further calls on the Bahraini government to compensate Sheikh Al-Muqdad for the violations he suffered, including serious medical negligence. ADHRB warns of Sheikh Al-Muqdad’s seriously deteriorating health condition resulting from years of medical neglect and urges the Jau Prison administration to urgently provide him with appropriate and necessary medical care, holding it responsible for any further deterioration in his health, given that he is over 64 years old. Finally, ADHRB calls on the international community to advocate further for Sheikh Al-Muqdad’s immediate and unconditional release and to call for the urgent provision of appropriate and necessary medical care for him and other elderly opposition leaders.
The post Profile in Persecution: Sheikh Abduljalil Radhi Maki (Al-Muqdad) appeared first on Americans for Democracy & Human Rights in Bahrain.
This post was originally published on Americans for Democracy & Human Rights in Bahrain.