KUFM Commentaries - 1997-1998
Return To All Commentaries
(Links to all titles coming soon)

Veterans' Day: We Won't Forget Our Debts (November 11, 1997)
The Miracle of Managed Care: A Fable for Our Times (December 9, 1997)
Chamber of Commerce: Bearing Gifts For You? (January 6, 1998)

"... The Whole Nation Is Degraded ..." (February 3, 1998)
The More Things Change, The More They Stay The Same (March 3, 1998 )
Managed Care's April Fools (March 31, 1998)
Tobacco Companies: "Poor Babies" (April 28, 1998)
Responsible Legislation to Curb HMO Abuses (May 26, 1998)
Injured Workers Betrayed By Workers' Compenstion System (July 21, 1998)
People Over Profits (August 18, 1998)
Auto No-fault Is No Choice (September 15, 1998)
Good Hands, Good Neighbors? (October 13, 1998)

Get The Facts On Tort Reform (November 10, 1998)
Toy Safety (December 8, 1998)



Veterans' Day: We Won't Forget Our Debts
(November 11, 1997)


The eleventh hour, of the eleventh day, of the eleventh month, in 1918, Armistice Day. The day and time that signaled the end of the "War to end all Wars". The horrors that war inflicted upon combatants and civilians did not prevent future wars, but the date does serve as a reminder. A reminder that we now call Veterans Day.

Veterans Day is the day that we as a nation, and as a people, remember all of the men and women who have served our country in the armed forces. On Veterans’ Day we fly the flag, march in or watch parades, make and listen to speeches and dedicate monuments and memorials to Veterans. Veterans Day is also a day to remember the debt that we owe to Veterans — our brothers and sisters, our fathers and mothers, our sons and daughters, our grand and great grandparents, our neighbors and friends.

It is easy to remember, and to be thankful, that Veterans have defended our country and our freedom. It is harder to remember, that remembrance and gratitude alone do not fully pay our debt to Veterans.

We, as a people, are comfortable with remembering Veterans and acknowledging our debt to them this one day a year. The rest of the year we leave our debt to be paid through our government. Like any other government function these days, the quantity and quality of Veterans services is driven by dollars. Veterans do not automatically receive the quality and quantity of services that we can provide, or, at the least, that we should provide. We must let our government know that we are prepared to provide the money to pay our debt to Veterans.

Recent news stories point out that we, through our government, do not always pay our debt to Veterans, either fully or on time.

A survey was conducted in late October by the International Union of Gospel Missions of 58 homeless missions across the country. The survey revealed that 32 percent of the homeless in these missions were Veterans. However, only about 19 percent of the overall male population in this country are Veterans.

It is striking that 62% of the Veterans surveyed in homeless shelters served in war, either in Korea (10%), Vietnam (42%) or the Persian Gulf (10%). Common sense shows an indisputable link between service in war and the many factors that lead to homelessness.

What were these Veterans like when they left the service? Were they [quote]"lazy or crazy" [unquote], as the rhetorical stereotypes of the homeless we are bombarded with would lead us to believe? No, of the Veterans in this survey: 71 percent reported receiving an honorable discharge; 17 percent received general discharges; only 7 percent received medical discharges; and only 5 percent received dishonorable discharges.

Are we, through our government, doing all we can, or all we should, to pay our debt to those now homeless Veterans who served our country? Given the disproportionate number of Veterans in homeless shelters, the answer must be no. There are a number of private sector organizations and charities that provide services for homeless Veterans. Despite the efforts of these groups, there are still too many homeless Veterans. This is a debt that we have not paid.

The "War to End All Wars" ushered in the use of, and exposure of combatants to, a multitude of chemical agents on the battlefield. Veterans are still dealing with the results of their exposures in Vietnam to Agent Orange and other chemicals.

It is nearly seven years since the Gulf War, yet, we continue to deny benefits to Gulf War Veterans who are suffering and severely ill from exposures to chemicals during that war. The Presidential Advisory Committee on Gulf War Veterans’ Illnesses recently issued their final report. It, like earlier reports of the Committee, was extremely critical of the Pentagon’s actions in investigating chemical exposures of troops during the Gulf War. It would seem that the Pentagon did not learn from the Agent Orange disaster. Veterans have once again been denied timely benefits to address the injuries they received while serving our country.

  This is Al Smith for the Montana Trial Lawyers Association.

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The Miracle of Managed Care: A Fable for Our Times
(December 9, 1997)

Remember the miracle of the fishes and loaves? Christ takes finite resources, a few fish and a few loaves of bread, and through a miracle he feeds the multitude, meeting the needs of all the people gathered.


The Racicot administration is attempting to perform a similar miracle in this state. Acting on the advice of Racicot’s administration, the legislature in 1995 took the first step towards turning Montana’s public mental health system over to a private managed care company. This was but one of Montana’s steps to join the current fad to privatize core governmental services.


The miracle idea was pitched by Racicot’s administration to the legislature in a simple and enticing way. First step, present an inefficient and unaccountable government program and artificially inflate its rate of spending increase. Second step, promise that a private company could manage the program to provide current services better than the state could. Third step, promise that a private company could also provide more services than were currently provided. Fourth step, promise that the resulting privately managed program would do all this more efficiently political jargon for more cheaply. The private sector would do it all – for less cost to the state AND still make a profit. Truly a miracle for the ages!


It is not surprising that nearly everyone bought the miracle pitch. Mental health was a program that had big problems. Everyone could agree on that. Everyone, including consumers of mental health services and their families, mental health advocates, mental health providers, legislators and mental health bureaucrats, --- they all agreed public mental health services were not efficient. And they all agreed the services provided did not meet the needs of the people who needed them, or the needs of the state. People wanted to believe in a miracle

The decision was made that the state would pursue the miracle, and the public mental health system was to be given over to privatized managed care through a contract for services. Then came a Request for Proposal, an RFP, that set out what miracle services the state would expect a company to provide under the contract. The result, while imperfect, offered hope for better and more appropriate services for consumers. 
 
Ah, but which miracle worker to pick? Which managed care sect offered the best miracle for the least cost? Last fall, CMG of Maryland was ordained as the chosen one. Though it mattered little, as within a year’s time three of the four sects vying to perform the miracle were merged into the larger sect of Humana, the largest of the managed care denominations.

In January, the legislature discovered that the state had miscalculated how much it could pay for this miracle when it offered the contract. The miracle would have to be performed for seven million dollars less than expected. CMG cried foul, they were good they said, but what did the state expect – a true miracle?

CMG agreed to go forward with its work, as its contract required. From its April beginning, the performance of the miracle has been troubled.

Rather than more mental health services being offered, there were less services. Rather than new services being provided, services that had been previously provided were no longer available. Rather than services being easier to apply for, the application was harder. Rather than services being provided in less time, it took more time to receive services. Rather than being more efficient, CMG was less efficient in providing timely payment to mental health service providers.

Consumers and family members complain that they are not getting the services they need when they need them. Providers complain that they are not getting paid for the services that they have provided.

Consumers warn of impending human tragedies if the miracle does not come to fruition soon. Providers warn they will go broke and no longer be able to provide any services.

The people are told by the managed care companies and the Racicot administration that it is not easy to perform miracles, it takes time. They tell us to give them more time. We are not to fear, they tell us. The miracle will come they promise. Continue to believe and you will experience the miracle.

Last week state legislators heard more palliative excuses from managed care and the Racicot administration. More promises. More requests to be patient and to believe in the miracle. Senator Chuck Swysgood of Dillon, still wanting to believe, was quoted as "hoping to God" that the problems can be remedied. Perhaps we should do more than hope. We may now need to pray for a true miracle.

Despite the promises, there has been no managed care miracle in Montana. The paid miracle workers have been exposed as charlatans and money changers. Rather than receiving a miracle, the people of Montana have been taken in a con game by the salesmen of the snake oil called managed care. Or, perhaps, we were sold a fairy tale -- one comes to mind – perhaps you’ve heard of it: The Emperor Has No Clothes.

This is Al Smith for the Montana Trial Lawyers Association. 

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