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Jac Wilder VerSteeg: Gun foes should “politicize” deaths

A recent Dana Summers political cartoon in the South Florida Sun Sentinel and other Tribune newspapers depicts in its first frame a thoughtful-looking Hillary Clinton and President Barack Obama saying, “In light of the recent shootings, we need to think about guns and ask ourselves the obvious question.”

Then, in the punchline frame, Clinton and Obama, both grinning now, say, “How can we politicize this?”

It’s an intellectually lazy cartoon that does nothing more than repeat the NRA-approved response when any politician dares to notice the massacres taking place across America. When any elected official or advocacy group tries to offer gun laws that might reduce the death toll – and cites the carnage du jour – they are accused of politicizing the deaths.

The accusation implies that politicians such as Clinton and Obama don’t really care about the victims, which is a lie. And it implies that politicizing the deaths cheapens them. In fact, what cheapens the tragic deaths is ignoring them, blaming the victims (for not having guns to shoot back) and, most of all, working to perpetuate the gun culture that costs so many lives.

Plus, as is obvious to all, the NRA and its vast stable of kowtowing politicians also politicize the deaths.

But let’s take a step back and ask, is it wrong and unusual to politicize death?

Of course not. Look at almost any aspect of death – particularly violent or sudden death – and related political activity surrounds it.

You could say that, in Judeo-Christian tradition, God was the first entity to politicize death. A prohibition against homicide is included in the 10 laws He handed down to Moses.

Today, the death penalty is heavily politicized. Should we do it? When should we do it? How should we do it? Are we doing it fairly? It’s an issue in elections and in judicial appointments.

Here’s another example: Death, a major byproduct of war, is heavily politicized. Different politicians have different answers to questions about risking American lives in Iraq, Afghanistan and elsewhere. Not too long ago, a key question was whether withdrawing troops from Iraq would mean that U.S. troops killed there had died in vain. That was a blatant politicization of those deaths. “Boots on the ground” – and therefore deaths on the ground – in Syria and Iraq already are an issue in the 2016 presidential and congressional races.

Terrorism is another arena in which death is politicized. Who has protected us from terrorist deaths and who hasn’t?

Death and disease are at the center of the debate over health care in Florida and in America. Remember, in the attacks on Obamacare, the accusations about death panels? When proponents of expanding Medicaid point out that it would save lives, they are politicizing death. But so are those who turn a blind eye to the deaths that could have been prevented. Not worth the cost, is their political calculation.

Death is a topic of concern to us all, including the emerging public policy issue of doctor-assisted death. Not only is death a proper topic for politicians and politics, it is a traditional topic for politicians and politics. Death and its prevention are appropriate motivators for political action. Why would we want our politicians to ignore a serious and persistent cause of unnatural death? And that’s what guns are.

So I have no problem with politicizing death. And I favor politicians who work to find ways to reduce death, not perpetuate it.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. Column courtesy of Context Florida.

Rate of uninsured drops to 16.6 percent in Florida

The rate of Floridians without health insurance dropped to 16.6 percent this past year.

Figures released Wednesday by the U.S. Census Bureau shows that represents a drop of 3.4 percentage points from a rate of 20 percent in 2013.

Despite the drop, Florida still had the third-highest rate of residents without health insurance. Only Texas and Alaska had higher rates.

The national rate was 10.4 percent.

Officials attribute the decrease in Florida and across the country to passage of the Affordable Care Act, which expanded health insurance to millions of Americans.

The act gave states the option of expanding Medicaid. Some did so, and others like Florida chose not to do so.

Census officials say states that expanded Medicaid had bigger decreases in the uninsured rates than those that didn’t.

Republished with permission of The Associated Press.

Florida gives Medicaid insurers 7.7 percent rate increase

Florida health officials said Wednesday they would give insurers a 7.7 percent rate increase in the fledgling Medicaid managed care program, in what has been a contentious battle among Gov. Rick Scott, the insurers and hospitals.

The Republican governor lobbied hard to get federal approval for the statewide managed care program, which launched last year. He promised it would save money and improve health care for more than 3 million low-income and disabled Floridians. But now that the program seems in desperate need of additional funding, Scott has been blaming the insurance companies and hospitals.

Health insurers have lost $542 million through 2014 and said they can’t afford further losses. They asked for a $400 million raise and a 12 percent rate increase from the state. Scott’s administration had warned that any increase could negate the roughly 5 percent savings the program has generated and had previously countered with a 6.4 percent increase.

The governor strongly opposes pumping any additional state funding into the Medicaid program and wasn’t happy when state lawmakers invested $400 million earlier this year in order to help hospitals that were losing other types of federal aid.

The Agency for Health Care Administration said the 7.7 percent increase takes into account the recent legislative hospital rate increase, pharmacy trends including new drugs now on the market, and other changes. Scott’s office did not immediately comment Wednesday.

As the state and insurers have been locked in rate negotiations, Scott has repeatedly spoken out and taken action against them, including requiring that insurance company and hospitals send their contracts with each other to the states to ensure they are complying with the law. The governor had alleged that the reason the Medicaid program wasn’t saving more money was because insurers were negotiating hospital rates that were too high.

Earlier this week, Scott announced his administration would conduct random audits on hospitals. Scott has been adversarial against hospitals that receive public funds after the federal government announced deep cuts in hospital funding earlier this year. Scott, who formerly ran a chain of for-profit hospitals, has tried to show that the hospitals aren’t as bad off financially as they maintain. He has also created a commission to examine hospitals’ finances.

Insurers say higher than expected usage rates, pent-up demand among Medicaid enrollees and expensive drugs costs contributed to the losses. It’s unclear what effect the lower-than-requested rates will have on the market. It’s unlikely that insurers will drop out as there are stiff penalties for leaving, but experts say it could contribute to more market consolidation.

The Florida Association of Health Plan said the rates are a result of a collaborative dialogue between the health plans and the state.

“This a step in the right direction and the plans look forward to continuing this dialogue with the state to ensure our shared goals of providing quality health care while respecting every dollar of taxpayer funding,” said CEO Audrey Brown.

Officials estimated nearly 4.2 million will be enrolled in the Medicaid program in 2016-2017, about a 4 percent increase from the previous year.

Republished with permission of The Associated Press.

Gov. Rick Scott: Hospitals may be referred for fraud investigations

Gov. Rick Scott gave Attorney General Pam Bondi a heads up on Monday that some of the 129 hospitals being audited for Medicaid fraud or waste could be referred to her office for criminal prosecution.

Scott is on the warpath against hospitals that participate in the statewide Medicaid Managed Care program, concerned that some are over-billing the system.

Medicaid, a joint federal-state program, eats up about a third of the annual state budget.

What’s more: The state will lose about $1 billion because the federal government said it will stop paying into the Low Income Pool, a state-federal pot of money given to many hospitals to help pay for their charity care.

In a letter released to media, Scott said Agency for Health Care Administration Secretary Liz Dudek last month asked all Florida hospitals and insurance plans in the Medicaid Managed Care program to certify what they were charging.

“Unfortunately, some hospitals either completely failed to reply, replied past the deadline, or submitted information that raised additional questions and requires further review to ensure compliance with Florida law,” Scott wrote to Bondi.

Scott said he then told Dudek to start auditing hospitals. He said he plans to make sure they are “compliant with state law and (that) there are no instances of fraud or abuse.”

As a result, 129 hospitals across the state are in the process of being audited, his letter shows, from Pensacola to Miami.

“Hospitals have made a record $3.75 billion in profits according to the most recent available data,” Scott wrote.

He told Bondi that Dudek will forward the names of any facilities “where we find suspicion of fraud or abuse to your office for investigation and potential prosecution.”

“I know that protecting consumers and combating fraudulent activity are top priorities for your office and we welcome (your) assistance … to hold all entities accountable for following the law,” he said.

Who’s to blame for Florida’s rising Medicaid costs?

Florida Gov. Rick Scott is blaming rising Medicaid expanses on President Obama’s health law, even though the state’s top economist said the two are not related.

State economists estimated Tuesday that the Medicaid program will cost $577 million more in 2015-2016. That comes as health insurers are seeking a $400 million raise and a 12 percent rate increase. But The Republican governor strongly opposes pumping additional state funds into Medicaid and was not happy when state lawmakers recently invested $400 million.

In a letter Tuesday, Scott warned that health care costs are spiraling out of control. But state economists Amy Baker and others at Tuesday’s budget meeting said the Affordable Care Act was not related to the issues discussed at the conference.

The Medicaid program is finishing its first year under a new managed care structure that Scott fought vigorously for, arguing it would save the state money. But as the program seems in desperate need of additional funding, Scott is blaming the insurance companies and hospitals.

Republished with permission of the Associated Press.

Corrine Brown, Gwen Graham: On collision course?

North Florida U.S. Reps. Gwen Graham and Corrine Brown represent two distinct wings of the Democratic Party.

For one thing, if you Google “Gwen Graham Moderate,” you’ll find no shortage of results about how she’s the type of Democrat who is willing to buck the left wing of the party, on issues like the budget and the Keystone XL pipeline.

For her, it’s the “North Florida Way.”

“I promised to bring the North Florida Way to Washington — and that means working with both parties to reach common-sense solutions,” Graham told the Tampa Bay Times last year. “Now, I’m following through with that promise and focusing on creating jobs, improving education and ending the gridlock in Congress. Neither party is right 99 percent of the time, so the people of North Florida expect us to work together to get things done.”

Google “Corrine Brown Moderate,” and you find a paucity of results. Missing in them: the word “moderate.”

Representative Brown is entering her third decade in the House. Graham? In her second year now.

Despite those differences, there are some commonalities.

One such: a commitment to commemorating a half century of Medicare and Medicaid.

On Friday, Graham met with Tallahassee area seniors for said commemoration. Cake, constituent services, and quotes were served up.

“When Medicare was signed into law, 50 years ago, more than half of America’s seniors were without health insurance,” Graham said. “We’ve made great progress since then, and today, I heard from North Florida seniors who rely on the program for healthcare. I’m dedicated to protecting Medicare for them and for generations to come.”

On Monday in Jacksonville, Brown will have a Medicaid and Medicare-themed news event at the Mary Singleton Center.

The news release offers details as to the programs’ popularity. A key difference: While the Graham event did not stress Medicaid, the Brown event will, as the news release indicates:

“Many of Medicaid’s more than 71 million enrollees are children from low-income working families.  Historically, pregnant women and children have benefited tremendously from Medicaid coverage. The program covers 45 percent of births nationwide; improving health outcomes for both mother and her baby. Medicaid is also the nation’s largest payer for long-term care services and supports, including home- and community-based care as well as nursing homes,” asserts the release from Brown’s office.

The differences in presentation illustrate the differences between the two political operations. Graham’s is clearly tailored toward winning in a swing district; Brown’s can play more toward the Democratic base. It would not be such a big issue, except that redistricting later this month might cause one or both of these candidates to recalibrate.

The very real possibility that one possible redistricting outcome could put Graham and Brown into the same district bears watching. Would they run against one another? Would one run for U.S. Senate?

The conventional wisdom has suggested that if one were to run for Senate, it would be Graham. But why not Brown, if that were the case?

Much is said about the fluidity in the Republican race. But there would seem to be room to move for Representative Brown, should she want it, on the Democratic side. Neither Patrick Murphy nor Alan Grayson have prohibitive advantages. Brown, meanwhile, has hold cards to play. Presences in multiple metro areas and markers to call in across the state and the country among them.

The bulk of redistricting speculation in Northeast Florida has to do with the congresswoman’s seat. Florida Politics  will ask her about that and her plans at her Medicaid/Medicare news conference later Monday, which promises to be a lively and wide-ranging discussion between the Jacksonville media and the ever-quotable congresswoman.

Mitch Perry Report for 7.28.15 — Hillary Clinton goes green

It hasn’t been a great week for Hillary Clinton.

Forget all the hullabaloo regarding the emails she brought forward that have been found by the Inspector General to be classified, though she earlier claimed none were. That will or won’t be sorted out in due time. More troublesome are some of the numbers coming in from the NBC News/Marist Poll released Sunday, specifically her numbers in Iowa and New Hampshire. Her net favorability — those who view her positively minus those who don’t — was negative 23 and negative 20, respectively.

While the mainstream media somewhat understandably focuses on those problems, which could really drag her down as a general election candidate next year, it’s time to acknowledge that she’s been laying down some very specific ideas on the campaign trail, and Monday was another example of that. That’s where she appeared to take the challenge by Tom Steyer‘s NextGen Climate group that we reported last week, announcing that she will set a goal to produce 33 percent of the nation’s electricity from renewable sources by 2027, up from 7 percent today. That’s a higher goal than the 20 percent that President Obama has called for by 2030. She also wants a half-billion solar panels installed by 2020, and to generate enough energy from carbon-free sources within 10 years of her inauguration to power every home in the country.

NextGen Climate announced last week that all candidates or lawmakers should strive by 2030 to have 50 percent of all U.S. energy sources come from alternative sources such as wind, solar, and move away from coal and natural gas, which together comprise 66 percent of the country’s energy portfolio. Nuclear represents another 20 percent.

And did we mention that Steyer is willing to give millions to candidates who buy into his plan?

Martin O’Malley apparently has already endorsed Steyer’s goals, and the Clinton folks now believe she does, too.  Just check out this paragraph in a New York Times story today:

“Although Mrs. Clinton has emphasized fighting global warming as a priority in earlier speeches, the role of a single large donor, Mr. Steyer, in apparently influencing the details of her proposal was suggested by her press secretary, Brian Fallon. On Twitter he said, “Counting nuclear, as Steyer does, she exceeds his 50 percent goal” for 2030.”

Cynics can make of that what they will. The point is if you really care about climate change, is that this argument is only happening on one side of the aisle during this presidential campaign season.

In other news …

Jeb Bush was in Central Florida Monday. Florida Politics caught up with him in the middle of his three-city tour, where he talked up how much he loves Pope Francis and how he believes he could even have a civilized conversation with Nancy Pelosi.

• • •

Meanwhile, the Bush campaign is feeling a bit more bullish about their chances in Iowa.

• • •

The 50th anniversary of the birth of Medicare and Medicaid takes place this week, and Kathy Castor went to a senior center to mark the occasion on Monday.

• • •

Meanwhile, Castor says she’s cautiously optimistic about a conference committee salvaging a Senate committee’s passage of a bill that expands travel for Americans going to Cuba.

Debbie Wasserman Schultz calls Jeb Bush comment’s on phasing out Medicare a “massive blunder”

Democrats such as DNC Chair Debbie Wasserman Schultz are seizing on comments that Jeb Bush made Wednesday night regarding Medicare.

Speaking at an Americans for Prosperity event in New Hampshire, Bush said brought up the government run health care program for seniors by first blasting television ads back in 2012 featuring a Paul Ryan-look-a-like pushing an elderly person off the cliff in a wheelchair. That ad was in reference to the Ryan budget that called for fading Medicare out and instead make it into a voucher system.

“I think we need to be vigilant about this and persuade people that our, when your volunteers go door to door, and they talk to people, people understand this,” Bush said. “They know, and I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits,” Bush said. “But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”

“This is such a massive blunder on Jeb Bush’s part,” Democratic National Committee Chairwoman Debbie Wasserman Schultz said Thursday afternoon on a conference call. “I was outraged, but not surprised, given what I know about Jeb Bush,” she added.

“Once again, Jeb Bush has shown he just doesn’t get it when it comes to the issues that matter to middle-class families and not surprisingly, to seniors,” Wasserman Schultz continued. “Maybe Jeb Bush can afford to get by without Medicare – I’m sure the Koch Brothers would be fine too – but millions of Americans count on Medicare when they retire for access to quality affordable health care.”

Americans for Prosperity is a group funded by the Koch Brothers, a leading nemesis for Democrats nationwide.

Bush is by no means the only Republican who think Medicare is headed towards insolvency. Marco Rubio and Chris Christie have also talked about major Medicare reforms on the campaign trail. Democrats reject that theory, however, and are citing a Trustees report on the program released yesterday that shows that the system is fiscally secure through 2030.

“I’m sick and tired of Republicans who say that the only way to save Medicare is to destroy it,” Wasserman Schultz sneered.

“Jeb Bush just must be living in a Charles Dickens novel,” quipped Rich Fiesta, Executive Director of the Alliance for Retired Americans. “His behavior over the last few months towards working people and retirees has been nothing short of outrageous, if not myopic.” Fiesta brought up another recent Bush comment that Democrats seized up – his comment that Americans needed to work longer hours.

Democratic Party presidential hopeful Bernie Sanders also weighed in on the Bush comment.

“It is an indication of how far right-wing the Republican Party has become when its ‘moderate’ candidate, Jeb Bush, at a forum sponsored by the billionaire Koch brothers, is now talking about phasing out Medicare. This follows Bush’s statement that we should raise the retirement age for Social Security,” Sanders said.

All three Democrats referred to the fact that Bush’s statement comes just a week before the 50th anniversary of the creation of both Medicare and Medicaid, programs that went into effect on July 30, 1965.
The Kaiser Family Foundation recently reported that in a recent poll, by two-to-one margins, people of all political persuasions favor preserving Medicare in its current form, as opposed to replacing it with vouchers or other forms of premium support.

Gary Stein: Needle exchange is the one-buck no-brainer

Florida is not an early adapter. Most of the time, our state takes a “wait-and-see” attitude regarding nearly any health policy, social program or economic strategy that has been attempted by another state’s legislature. In some cases, no amount of positive data on a successful program is enough to convince our leadership to move in the path of innovation, regardless of the possibility of lives or money saved.

One such innovative program has saved at least hundreds of thousands of lives, millions of dollars and is older than CDs, cellphones, home computers, Katy Perry and Flo Rida, but you won’t see a statewide needle-exchange program in Florida.

It’s not for lack of trying. Bills proposing needle-exchange programs (NEPs) have been attempted for the past three years, but never got to the governor’s desk. In 2013, HB 735 (Pafford) died in the Judiciary Committee and SB 808 (Margolis) got to the Senate floor, but died on the calendar awaiting a vote.

After that session, Democrat Rep. Mark Pafford of West Palm Beach filed again, but HB 491 died in Messages at the Senate after passing the House Floor and SB 408 (Braynon) died along with it. In 2015, HB 475 (Edwards) died in Government Operations Subcommittee while SB 1040 (Braynon) died on the Senate floor calendar while the House called a premature end of session.

The real question, though, is how many Floridians have died since needle exchange programs first came to the U.S. in the 1980s?

The bills floundered, but it was not for lack of bipartisan support. After the 2013 session, Republican Health Policy Chair Aaron Bean of Fernandina Beach told the media, “We had it, we researched it. It doesn’t sound like a conservative idea — at first, but it is backed by the Florida Medical Association and would be 100 percent funded with private money, and that combination sold me.”

It may not have appeared conservative to Sen. Bean at first glance, but the concept has had conservative support from the beginning. The very first national needle-exchange program was championed by the highly conservative U.K. Prime Minister Margaret Thatcher. She looked at the data and decided the program was necessary to prevent an HIV epidemic among British addicts. In England, only 1 percent of addicts contracted HIV since the program started. Addicts in the U.S. have fared much, much worse.

Especially in Florida.

Today, there are more than 90,000 needle-drugs users, 19 percent with HIV and at least 23,000 with Hepatitis-C. Considering the lifetime healthcare cost of more than $600,000 for HIV patients and $300,000 for those with Hep-C, the burden on the state is tremendous, since street addicts rarely have health insurance and often seek treatment in emergency rooms or in Medicaid-based clinics.

Add the problem of reduced Low Income Pool funding this year and additional reductions on the horizon, and it’s not too hard to see a crisis coming to the state budget and to hospitals caring for indigent addicts.

Florida, because of its inaction, has 30 years of data and success rates across  the country and around the world to verify that needle-exchange programs work as legislators take yet another year to make a decision to start one. There are 35 states with NEPs, and they exist in one form or another in almost every country in Europe, Australia and New Zealand. They know that avoiding hundreds of thousands of dollars in health-care costs by offering a $1 syringe is a no-brainer.

Almost any question or concern can be answered by the data. For those who think that offering clean needles facilitates heroin use, there is no data that an addict ever stopped using drugs because of dirty syringes. The choice of whether or not to use while tempting HIV or Hep-C infection doesn’t seem to come up to addicts. According to a 2012 report by the Florida Department of Health’s Bureau of HIV/AIDS, 29 percent said they reuse the needles from their last injection, and 64 percent reported they had used a needle previously used by someone else.

There are even statistics about unexpected consequences. A report from the American Journal of Public Health in 2000 took notice that some states with NEP’s saw a reduction in crime.

This week, TIME magazine, a long-time conservative publication, published an article called, “Needle-Exchange Programs Could Prevent HIV Outbreaks, Experts Say.”

In 1990, I was working alongside HRS in South Florida trying to control the HIV epidemic. The idea of a needle-exchange program was batted about and then forgotten, while some activist groups actually went so far as to distribute the syringes in communities in Miami-Dade and risk arrest to save fellow Floridians. Maybe 2016 will be the year that Florida’s Legislature wakes up and smells the rationale behind the compassion of a needle-exchange program and the ability to save lives and health-care money before another year of suffering and death occurs.

It’s an idea whose time came many years ago, but it’s never too late to save lives.

Gary Stein MPH, a native Detroiter, worked for the Centers for Disease Control, landed in the Tampa Bay area to work for the State Tobacco program and is now a policy consultant, a health advocate and activist and blogger for Huffington Post. He has also been the executive director for Health Equity and Accountable Care and the Policy Director for FAAST, Inc. Column courtesy of Context Florida.

Aaron Bean and Mia Jones: “Let’s find the win-win on Medicaid expansion”

They may be on opposite sides of the aisle in Tallahassee, but State Senator Aaron Bean (R-Fernandina Beach) and State Representative Mia Jones (D-Jacksonville) say they’re on the same page when it comes to figuring out a health care funding solution for Florida the next time the Legislature meets.

“We’ve got to figure out a way to go forward,” said Bean, the Senate Health Policy Chief, during an appearance on WJCT’s First Coast Connect

After meeting in special session (because the regular session ended early in a meltdown over health care funding) lawmakers adjourned for the year without expanding Medicaid to provide health insurance for about 800,000 low-income Floridians.

However, federal funds for the Low Income Pool (LIP) that funds hospital indigent care, are expected to decline by another $400 million next year, upping the ante for an eventual fix.

“The price tag will continue to go up,” said Jones, ranking member of the House Health and Human Services Committee. “We have an opportunity for us to sit down and say, now is the time. We need to recognize that we aren’t sitting around with pots of money that are overflowing to the point that we don’t need the dollars from the federal government. Let’s come to the table again, with a true heart of saying we are going to walk away with a win-win. Unless they are willing to do that, we will end up in the same predicament we were in before.”

By “they,” Jones was ostensibly referring to the Florida House, which was not on board with Bean and the Senate’s Medicaid expansion bill known as FHIX. It had job and education requirements, and would have extended health insurance to low-income working participants for as little as $25 a month. Only four Republicans in the House voted in favor of the measure.

Bean, who had floated the idea of a joint health care committee going into the 2016 session, says until pressure mounts on House legislators, movement on the issue will be challenging. “I don’t see a change. The players are going to remain largely intact. Next year the price goes up as we wean off federal funds, it’s going to cost us three-quarters of a billion next year and the following year it’s all up to us. Maybe if the numbers change and every time we put state dollars in the pot that’s less money we can spend on projects like education or roads. The numbers will get bigger and the pressure will ratchet up, so we’ve got to come up with an idea,” he said.

Jones saluted Bean for his work on the issue, and he returned the favor, lauding her epic seven-hour debate on the House floor during the Medicaid fight.

“It was not Republican Senator Bean and Democratic Representative Jones on opposite sides, we stood together,” Jones said.

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