Monthly Archives: June 2024

Supreme Court Decision in Loper Bright Enterprises v. Raimondo:  A Blow to Americans’ Health & Our Democracy as We Know It.

Posted on by

By:

Dave Kingsley

Free Rein for the Increasingly Powerful Insurance Industry in the Increasingly Privatized Medicare & Medicaid Programs

    Make no mistake about it, the Supreme Court this week in Loper Bright Enterprises v. Raimondo and Relentless v. Department of Commerce [1] handed over supreme power to the corporations of America.  These decisions didn’t just weaken federal agencies, they gutted them. OSHA, CMS, EPA, NLRB and other major regulatory agencies have been incrementally weakened for decades through legislation and raw political power. These cases are the coup de grace for our mortally wounded regulatory agencies.

    In the massive healthcare sector of our economy – funded mostly by taxpayers – major corporations will now be able to ride roughshod over the rights and needs of beneficiaries who have paid for and earned qualification for benefits.  For instance, UnitedHealth, which has exploded to the top of the Fortune 500 in a mere two decades and other insurance behemoths can continue their takeover of Medicare and Medicaid, reduce care, increase cash flow, and ignore attempts by HHS to rein them in.

    Any attempt at regulation by CMS will be challenged in court.  It is likely that regulators will lose.  No matter how rational, technical and scientific the agencies’ arguments are, the Supreme Court will have the final say.  Although nine justices on the court do not have the expertise, the resources, or the time to make appropriate decisions that congress and the courts have historically left to qualified experts in agencies, this Supreme Court will hand down decisions based on the majority’s perverse right-wing, religious ideology.   As Justice Kagan wrote in her dissent:

    “Its justification comes down, in the end, to this: Courts must have more say over regula­tion—over the provision of health care, the protection of the environment, the safety of consumer products, the efficacy of transportation systems, and so on. A longstanding prec­edent at the crux of administrative governance thus falls victim to a bald assertion of judicial authority. The major­ity disdains restraint, and grasps for power.”

    Make no mistake about it, that power will be exercised on behalf of UnitedHealth, CVS, Cigna, Molina, the Ensign Group and any other corporation wanting relief from government oversight.  We are already seeing this in the American Healthcare Association’s judge shopping suit against CMS for regulations requiring adequate staffing in nursing homes (through their Texas affiliate).

The Philosophy and Structure of the U.S. Constitution Provides Ultimate Power to the People – not to the Biggest Corporations & Six Ideologues on the Supreme Court.

    The people pay the taxes to fund government healthcare and elect representatives to enact and implement programs such as Medicaid and Medicare.  And I believe we the people still have the power – if we are willing to exercise it. Last week I was speaking to the National Association of Attorney’s General/Medicaid Fraud Control Units Association in San Diego.  My evaluation of the nursing home industry is not complimentary to say the least. At the end of my talk, I was asked what could be done about the scurrilousness of this industry.  My answer to that is first things first: expose them. Expose them to the media, expose them to legislators, expose them to colleagues, friends, and neighbors.  The American Healthcare Association (AHCA) and LeadingAge perpetually lie and propagandize about finance.  In my view, the pushback on their claims about low nets and thin margins needs to be stepped up. 

    Anyone can see the income statement, cash flow statement, and balance sheet of the Ensign Group – it is public.  Attorney General Jame’s suit in New York exposes a cabal of investors who are not required to disclose their consolidated financial statements.  The Ensign Group has over $500 million setting on their balance sheet – that is double what they had a couple of years ago.[2] The New York AG’s suit against Comprehensive at Orleans indicates cash extraction of 22% on $86.4 million in revenue over approximately three years.[3]

    Does anyone seriously doubt that these examples are exceptions in the whole scheme of things?  They are not.  We have plenty of other evidence to undermine the lies of AHCA and LA.  We need to put that in the face of legislators.  Organize, organize, organize, and relentlessly shove information at Senators and Congresspersons.  No doubt, the majority on the Supreme Court will do what we know they will do.  It will be ugly.  But they need public support to remain legitimate and survive as a credible juristic institution.  If the court continues down its current path, the citizens will eventually change the court.

[1] 22-451_7m58.pdf (supremecourt.gov)

[2] See their 2024 10K filing with the S.E.C. here: https://investor.ensigngroup.net/financials/sec-filings/default.aspx

[3] https://ag.ny.gov/press-release/2022/attorney-general-james-sues-orleans-county-nursing-home-years-fraud-and-resident

The Choice between a Humane Health Care System or an Industrialized Medical System for the Benefit of Shareholders & Executives: What would the People Choose?

Posted on by

By:

Dave Kingsley

    Elites sneer at the idea that people in general are intelligent enough to make good decisions in democratic elections. This is a disgusting and ill-informed attitude mostly aimed at the middle- and lower-income classes. But historical evidence indicates that people en masse are not as dumb as the self-anointed educated class and the mainstream media would have us believe. 

    Hubris and ignorance on the part of political elites and the intelligentsia have led pollster charlatans, journalists, bureaucrats, and politicians to assume that public opinion is little more than clueless folderol, rife with nonsensical conspiracy theories.  In so many ways, the “people” are viewed by the affluent and college educated classes and opinion influencers in the media as “lesser thans” and “lower types.”

    Machiavelli knew better. As he wrote in Discourses on Livy, “But as for prudence and stability, I say that the people are more prudent, more stable, and better judges than a prince. And not without reason is the voice of the people compared to that of God, for popular opinion has been seen to predict things in such a marvelous way that it is as if some occult power[virtu] enables it to foresee the evil and the good that may befall it.”[1]

    Harry Truman knew better. Among other issues, he ran on the principle of universal, single payor health care and won. Elites, pollsters, and journalists predicted that he would lose in a landslide.   We didn’t get the health care – thanks to the bigotry of Southern Democrats – but we got the people’s opinion about government’s role in medicine for the masses. There is no evidence that it has changed.[2] 

    Women fighting for reproductive rights know better and are winning ballot measures to enshrine those rights in state constitutions across the U.S. Extremist conservative legislators are consistently trying to undermine the efforts of citizens for a “right of choice” through anti-democratic legislative maneuvers.

    In Missouri, where I live and where the Republican majority in the legislature has gone extremist right-wing bonkers, Medicaid expansion was passed by “the people” through a referendum.  Ballot measures on reproductive rights and a minimum wage will be on the ballot in November and will likely pass.

    Oracles from left-to-center-to-right elitist political ingroups were shocked when voters from so-called “red states” voted to enshrine reproductive rights of women in state constitutions.  The media – all the media from right to left – would have you believe that we are a “divided nation.”  We aren’t. But that story is good fodder for television and newspapers.  The truth is most Americans share the same values and want the same things from government.  The broad middle (the overwhelming majority) of the voting public can best be described as ambivalent with some conservative views and some liberal views – mostly commonsensical views.

    I will stipulate that a pathological, narcissistic-sadistic fascist was able to win the electoral college and become president – but like every other Republican since George H.W. Bush he didn’t win the popular vote. He lost by an even wider margin in 2020.  Furthermore, many counties in states like Pennsylvania that Barack Obama won in 2012 by an overwhelming margin flipped to Trump by a wide margin in 2016.  I believe there is an explanation for that – which is ignored by the media and political intelligentsia.

In this Age of Show Business, the Role of Media is to Entertain You – Not Inform You.

    No doubt, in a country with a population of 334 million people (231 million are 18 and older) [3] and 161.42[4] million registered voters, an unstable tyrant can round up tens of millions of ardent, true believer followers. Given the spread of mental illness, fractured egos, instability, financial stress, and other psychologically damaging stresses of toxic capitalism, it should come as no surprise that a demagogue could and would come along and with the help of the MSM drive the electoral process into nonsense and chaos. 

    This should be even less surprising when the demagogue’s persona is the creation of NBC, which is owned by Comcast, one of the most powerful corporations in the oligopolistic media industry. It was, therefore, the mainstream media that led a significant mass of busy stressed-out people into believing that Trump was a kick ass, savvy businessman who could and would straighten things out and lessen their pain.  For years, he was a corporate created caricature foisted onto unwitting and economically hurting television viewers looking for escape. 

    Since 2015 when Trump descended on the escalator in Trump Tower – and after setting up Mexican immigrants as America’s enemy – the media has feasted on his burlesque politics.  Nothing attracts attention like dangerous cartoonish politicians with slapstickish, outrageous performances.  For nearly a decade, Trump has been a prop for feeding the much needed noisy, shallow product on cable channels, morning talk-entertainment shows, and nightly news. Although we “have nothing to fear but fear itself,” fear plus titillation keeps people tuned in.  The corporate need to enhance and protect shareholder value enhances the value of all Trump all the time on cable political entertainment channels such as CNN, FOX, and MSNBC plus all of the NBC, CBS, ABC, and FOX Sunday talk shows.

    The media is responsible for Trump – not public stupidity.  The media has a vested interest in keeping him going.  The public does not. 

Venal Media & Political Forces with Dangerous, Self Interest Designs Have Hijacked Political Narratives through Propaganda, Chutzpah, and Manipulation

    As we have learned from history, industrialists, media, and other powerful institutions (think religion) with the intent to install a strong man and a fascist movement in power for their own benefit, have the capability to misinform the public about real conditions and move them to participate in their own destruction. Once falsehoods are instilled in desperate and unwitting citizens, it is very difficult to tear them down.   

    As the American people are subjected to another round of election time insanity, the MSM is at it again – minimizing the severe pathologies and dangers of Trump and magnifying real and imagined negatives of President Biden.  In their stressful, busy attempts at survival, ordinary people naturally and unconsciously process signals – memes and narratives sometimes subtle, sometimes not so subtle.  It is to the benefit of media corporations to create and maintain an appearance of normality and a “horse race” so that their customers don’t lose interest.  As former President Obama said last week “behavior that used to be disqualifying is now normal.”

Let “We the People” have Honest Information – not Propaganda – and then Let Us Decide

    U.S. leadership values have dragged mass culture downhill since the post World War II robust and optimistic middle-class and Golden Age of Capitalism (circa 1945-1975). Since that time, the former Republican Party has degenerated into a full-blown fascist movement – a phenomenon filtered out of MSM narratives. It is dangerous for the media to ignore the resilience of fascism [5] and concentration of wealth and power in mammoth corporations and super-rich individuals/families.

    The fascists have clearly laid out their agenda. The MAGA Project 2025 will take the American people to a place where an overwhelming majority does not want to go.  It is a blueprint for dismantling the administrative state, stacking the courts, white supremacist rule, repression of dissent, and oppression of the middle and lower classes.  The healthcare program is misogynistic, religiously fundamentalist, and identitarian.[6]

    None of the theocratically fascist program offered to the American people by the fanatics of a movement that could gain control of government in a few months would pass muster in a referendum on healthcare or any of the other scary elements of Project 2025.  The cruelty of the current healthcare system would become cruel in spades.  I believe that the media should be less sanguine about rising fascism for the sake of appeasing shareholders and provide truth instead of pablum to consumers of television and print publications. 

    Furthermore, the Democratic Party should stop its political poll idolatry and naïve idealism about “working across the aisle” and wage a more robust fight.  The overwhelming majority of the American people can see through all of this political theatre and are disgusted.  Why don’t we just have a national referendum on what the people want?

[1] Niccolo Machiavelli (2003) The Prince and Other Writings.  New York:  Barnes & Noble Books, 182.

[2] David McCullough (1992) Truman. New York: Simon & Schuster, p. 532. It is widely believed by historians and social scientists that the American Medical Association blocked Truman’s single-payer, universal, healthcare program by convincing the American people that it was a slippery slope into socialism.  That’s false.  Southern Democrats killed Truman’s proposal for a national health insurance program that would look like the “Medicare for All” proposals devised by progressive Democrats.  The Democrats with a majority in Congress could have passed Truman’s plan and the AMA could not have stopped it.  However, Senators and Congressmen from the former Confederate States had to power to block any legislation that would threaten the racial hierarchy and plantation capitalism of the South.  When it came to healthcare, he American people in general did not share the Jim Crow agenda of the Southern Delegation. 

[3] National Population by Characteristics: 2020-2023 (census.gov)

[4] Number of registered voters U.S. 2022 | Statista

[5] The Allies defeated Hitler and  Mussolini, but fascism has been quite robust and is now more potent than ever. Consider the strength of Marine LePen’s National Front in France and the results of the recent EU elections.  See also: Richard Wolin (2004) The Seduction of Unreason:  The Intellectual Romance with Fascism from Nietzsche to Postmodernism.  Princeton, N.J.: Princeton University Press.

[6] Project 2025 – Wikipedia:

“Project 2025 accuses the Biden administration of undermining the traditional nuclear family and wants to reform the Department of Health and Human Services (DHHS) so that this household structure is promoted.[18] According to Project 2025, state governments should have the authority impose stricter work requirements for beneficiaries of Medicaid,[23] the federal government should promote the Medicare Advantage program, which consists of private insurance plans,[56]: 464–65  federal healthcare providers should deny gender-affirming care to transgender people, and eliminate insurance coverage of the morning-after-pill Ella required by the Affordable Care Act of 2010 (Obamacare).[18] Project 2025’s healthcare plan would also remove Medicare‘s ability to negotiate drug prices.[18]

Project 2025 aims at dramatically reforming the National Institutes of Health (NIH) by making it easier to fire employees and to remove DEI programs. Conservatives consider the NIH to be corrupt and politically biased.[15]

Project 2025 accuses social media networks—directly naming Facebook, Instagram, Twitter, and TikTok—of jeopardizing the mental health and social ties of young Americans by creating a form of addiction. “Federal policy cannot allow this to continue,” it states.”[56]: 5–6 

If We Forget Our COVID Pandemic History, We Will be Forced to Relive it.

Posted on by

By:

Dave Kingsley

The COVID Tragedy Was System Failure that Didn’t Need to Happen

    The U.S. health care system, which includes preventative and public health, is complex and dynamic. Unfortunately, this necessary and critical system for the good of the public interest has been declining into catastrophic failure mode for at least two decades. We struggled to manage and survive a systemic collapse of the economy along with medical systems due to an inept response to a deadly pandemic during 2020 and 2021.

    Because private interests had taken precedence over the health needs of the public, approximately 2000 nursing home patients and employees had died of COVID by April of 2022.[1] They are victims of industry greed and neglect, government deregulation, and venal, corrupt, and indifferent politicians.  Given the lack of Trump Administration concern and preparation and given what happened in the Senate Intelligence Committee discussed below, it should come as no surprise that dangerous and destructive conspiracy theories abound. How easy it is to see why government failure has inflamed cynicism among such a widespread number of Americans.

    The previous administration, bureaucrats, and legislators knew that the probability of a plague was high but did not have the capacity to respond when it did happen. Successful response to a rapidly moving scourge requires: (1) a plan, (2) a strategy, (3) adequate equipment/supplies, (4) technology (5) trained personnel, and (6) and competent, honest leadership willing to implement the plan.

    The consequence of a blasé attitude on the part of government in January of 2020 was devastating. There was no plan, no strategy, adequate personal protective gear, enough ventilators, bed capacity and other equipment and supplies needed in a pandemic. 

    The question is why? Public health and infectious disease experts had been warning for decades that pandemics would grow more severe and more frequent (In 1993, global public health expert Laurie Garrett warned us of that in The Coming Plague). Indeed, since the 1980s, we have seen HIV, H1N1, SARS, and Ebola outbreaks spread across the planet. It is not as if there have not been dire health scares in our past that could have informed us of the critical need for preparedness in the future.

Who Knew What and When Did they Know it?

    The CIA was aware of something serious going on in China in December of 2019. The Chinese economy was practically brought to a halt and serious isolation practices were implemented as only an authoritarian government can implement population control. The disease quickly spread to other Asian countries. Singapore, South Korea, Taiwan, and Japan implemented extensive organized and effective prevention efforts. Singapore, South Korea, and Taiwan had prior experience with the SARS epidemic and undertook impressive campaigns to keep the outbreak from overwhelming their medical systems. They succeeded.

  Why were administration officials in the United States so sanguine about a novel virus that prompted massive public health efforts in China and other Asian nations? Even after it was known that a case of COVID had been discovered in a Washington state nursing home, the U.S. government remained unconcerned. Or did it?

    Former Senator Richard Burr, Chair of the Senate Intelligence Committee, was a leading legislative figure in the development of a national plan to thwart pandemics. He was not a neophyte in public health policy. Nevertheless, having been present at a “closed door” COVID19 briefing presented by the Trump Administration National Security Council on January 24th of 2020, he announced to the public that the virus would be contained and that grave worries about a pandemic weren’t justified.  

    By late February, Senator Burr had dumped stock worth between $628,000 and $1.7 million.. Intelligence Committee Members Feinstein, Loeffler, Purdue, Inhofe, and Johnson also unloaded a considerable amount of stock.[2]  The public was not immediately aware of these financial transactions.  The contents of the briefing have never been disclosed to the public. In a search of the Senate Intelligence Committee website, no evidence could be found that a meeting regarding COVID 19 was held.[3]

    Journalists uncovered an audio recording of Senator Richard Burr, Republican chair of the Senate Intelligence Committee, telling some donors in a private meeting that the coming pandemic could be as serious as the global flu pandemic of 1918. He was not at all as laid back and buoyant as he was in public at that time. The donor meeting occurred on February 27th.[4] 

     At the time Senator Burr was not expressing the same alarm in public he imparted to his close political allies, the President of the United States declared at a South Carolina rally on February 28th – one day after Burr’s ominous statements caught on audio – that the corona virus was a Democratic Party hoax.

    Throughout February and most of the month of March, Trump and his powerful propaganda machine consisting of Fox News, an assortment of well-funded and well-organized Christian nationalist organizations, and most of the Republican Party repeated the corona virus hoax lie. A phalanx of right-wing virus deniers, conspiracy theorists, and Fox bloviators were egged on by the president who at best was recognizing that the disease did exist, but claimed that it was primarily China’s problem and wouldn’t amount to much in the U.S.

Minimizing by the CDC, NIH, HHS, and the FDA at Senate Health, Education, Labor, & Pensions Committee Hearing

    On March 3rd, Trump Administration officials responsible for pandemic preparedness, presented their views on potential threats to public health from the COVID19 outbreak at an open hearing held by the Senate Health, Education, Labor, & Pensions Committee. Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response, HHS stated that, “The potential global public health threat posed by this virus is high, but right now, the immediate risk to most Americans is low. The greater risk is for people who have recently traveled to an affected country or been exposed to someone with COVID19.”

    After the SARS epidemic, Asian countries developed pandemic guidelines for nursing homes. The nursing home industry and HHS/CMS were totally indifferent to the steps taken by countries affected by SARS to prepare for the eventuality of another plague.[5]

Will Our Government Fail Us the Next Time?

    Over a million Americans died during the raging Covid19 pandemic. Nursing homes have been disproportionally affected. Over four years after the outbreak, two major nursing home commissions have avoided direct confrontation with the industry and CMS over lack of preparation prior to COVID and misfeasance and nonfeasance during the Pandemic. Little to no attention has been devoted to the issue of responsibility. As has become a normal response to serious negligence and consequent damage to the public by industry and government inaction, no entities or persons have been held accountable.

    The behavior of U.S. Senators privy to information not available to the public and acting on that information in their interests and to the detriment of the public is disgusting. It is in fact criminal. A flurry of activity by the DOJ, SEC, and Senate Ethics Committee was initiated and then dropped.  No one was held accountable. The government failed the American people, Senators behaved criminally, responsible parties escaped accountability, and the country moved on.

    It is delusional to believe that another scourge is not likely.  Advocates need to begin asking questions about protocols in nursing homes, stockpiling of personal protective equipment, and responsibility of the industry for preparation and administration of facilities during a pandemic.  We are dealing with an industry in which shareholders have intrinsic value and patients have instrumental value. Investors’ mission is to maximize cash flow.  To do that, they will naturally minimize care.  That is immoral and medically unethical.

[1] Over 200,000 Residents and Staff in Long-Term Care Facilities Have Died From COVID-19 | KFF

[2] The Senator Who Dumped His Stocks Before the Coronavirus Crash Has Asked Ethics Officials for a “Complete Review” — ProPublica.  Senator Feinstein sold stock worth $7 million dollars.

[3] https://www.intelligence.senate.gov/, “HEARINGS” tab.  I checked this URL in the Spring of 2020 and could not find any information about the hearing.

[4] The audio of the Senator warning his wealthy supporters about the coming plague can be heard at https://media.crooksandliars.com/2020/03/44593.mp3_standard.mp3. 

[5] (2) Care homes and COVID-19 in Hong Kong: how the lessons from SARS were used to good effect (researchgate.net); see also: https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(23)00062-4/fulltext