No foolin’ As the world turns, Oklahoma’s high stakes Managed Care fight sparks tension

No foolin’ As the world turns, Oklahoma’s high stakes Managed Care fight sparks tension

Patrick B. McGuigan, Writer, The Metropolis Sentinel

Evaluation for The Southwest Ledger

Pat McGuigan 

Oklahoma Metropolis, April 1, 2021 – Within the public sq., every main coverage confrontation has distinctive facets.

Occasions and personalities inside anybody legislative combat (or election) can by no means be completely equated with these in one other.

Nonetheless, within the examine of coverage and politics, as in historical past, there are classes.

Journalists and historians – like sages and philosophers – usually make factors by telling tales. This essay shares a couple of tales meant to offer context for an necessary well being coverage debate on the Capitol in Oklahoma Metropolis.

Wilson: Not an amazing president, however he stated this … 

As a wee lad, I believed Woodrow Wilson (1856-1924) was an amazing U.S. president.

My evaluation of him grew strongly adverse as I studied historical past in additional depth. Nonetheless, there may be an American political adage, typically attributed to Wilson, distilled right here in my very own phrases, which appears apt.

After eight years as president of Princeton College, Wilson served a mere two years as governor of New Jersey. As he transitioned from academia to the world of state governance – so the story goes – a smart previous Democratic Solon warned him how harsh and mean-spirited issues may very well be on the capitol constructing in Trenton.

Wilson, it’s stated, advised the gray-head to avoid wasting his breath, saying, “The rationale educational politics is so vicious is that the stakes are so extremely low.”

As soon as upon a time, the “low stakes” sketch might need been correct. Today, increasingly nonconforming conservatives and Libertarians face “cancel tradition” pressures for his or her reasoned deviations from the dominant left-of-center synergy in greater training. It appears improper to explain penalties for modern scholarly free thinkers as “low stakes.”

Nonetheless, the Wilson story is shared as a result of, assuming there may be reality within the commentary that low stakes fights might be brutal, it isn’t exhausting to agree that prime stakes battles are sometimes extra so.

One other story follows. 

We have already got socialized medication’ 

I labored at The Oklahoman for Edward L. Gaylord (1919- 2003) for 12 years (1990- 2002), first as an editorial author then because the newspaper’s opinion editor.

His steerage to editors was most frequently nuanced and broad, and gently provided.

For a while in the course of the Clinton Administration (1993-2001), I crafted frequent and passionate editorials in regards to the financial sins of proposed modifications to American well being care rapidly dubbed “HillaryCare” (named for then-First Woman Hilary Clinton).

I reasoned her push would lead the nation to socialized medication, which I opposed.

One morning, sitting at morning espresso with Mr. Gaylord and political cartoonist Jim Lange, the boss was in a considerate temper.

Responding to considered one of my printed “HillaryCare” blasts, Gaylord stated phrases to this impact to me, “Pat, we have already got socialized medication. It began lengthy earlier than Medicare. What we have to do is encourage methods to make the socialized medication we have now higher for folks, and decelerate the methods it quickens the expansion of presidency.”

His feedback remodeled the way in which I’ve handled well being care points ever since.

A Large … Deal 

Which brings me again to the proposed Managed Care method for voter-mandated Medicaid Growth in Oklahoma.

Unveiled to the general public in late January, the hassle from Gov. Kevin Stitt and the management of the Oklahoma Well being Care Authority is attentive to well being outcomes and likewise goals to direct value elements in a optimistic path.

This can be a good factor, as a result of together with training and corrections, all issues regarding authorities involvement in well being coverage quantity to, as the present president of the US stated in a previous section of his profession, “a giant f—ing deal.”

Certainly, as a journalist I respect (Ray Carter) wrote just lately: “From 1999 to 2019, whole expenditures on Medicaid in Oklahoma — adjusted for inflation and together with each state-and-federal {dollars} — surged from $2.33 billion to $5.6 billion.”

(Memorably, the Late U.S. Senator Everett Dirksen of Illinois (1896-1969), each a politician and a sage, as soon as mirrored ruefully, after years within the nation’s capital, “A billion right here, and a billion there, and fairly quickly you’re speaking actual cash.” (Today he would probably amend the sum to “trillions.”)

So: the stakes are excessive, not low – each in fiscal phrases (the broad need to handle the spiraling prices of tax-financed well being care applications for Oklahoma authorities) and in programmatic phrases (the impact of well being care evolution on the lives of actual human beings – sufferers, pharmacists, nurses, medical doctors, and different medical personnel.

Price understanding is the affect battles like this have on the political class – Republicans and Democrats, conservatives of all stripes, liberals of all nuances and people more and more uncomfortable with conventional designations.

Any one of many sketched classes of these governing us deserve no less than some understanding, appreciation and even tolerance as they stroll via the Medicaid Growth combat on the state Capitol, throughout the authorized system and all through Oklahoma’s massive (and ever-growing) taxpayer-financed authorities.

Republicans Disagreeing Amongst Themselves

The steadiness of this commentary is generally targeted on two conservative Republicans.

They share many views about public coverage, however are clashing memorably over Managed Care.

State Senator Kim David of Porter has characterised the governor’s imaginative and prescient as a well timed resolution about “coordinated care.”

State Senator Rob Standridge of Norman, in distinction, agrees with the state medical institution’s current assaults on the Stitt proposal. Standridge’s allies have described Stitt’s plans for SoonerSelect as a “Well being Care Holdup.”

Senator David was described in a Learn Frontier story (January 29) as “a longtime proponent of managed care.” And: “[David] stated she had no considerations that the Legislature and critics inside it may block this system. She stated the state query that positioned Medicaid enlargement within the structure assured it.”

In line with that story a couple of press convention by which Sen. David participated, “She stated that critics within the Legislature merely don’t perceive the coverage, or that they’re looking for particular pursuits that profit underneath the established order.”

The report straight quoted Sen. David as saying, “I believe numerous numerous members — a few of those that have been outspoken about it — don’t perceive precisely what the idea is.”

And: “They know what they’ve been advised, and so they know they need to be afraid. After which I’ve a number of who stand to achieve by protecting the system the way in which it’s.”

Once in a while, particularly in public life, stating the plain is an act of braveness.

Put mildly, this model of bravery can get an individual in bother.

The response throughout the Senate Republican caucus was reportedly intense.

Sen. David accepted from the President Professional Tempore of the Senate a one-week censure.

She later stated in a letter to colleagues, “I respect his resolution and can study from this second. My feedback had been by no means meant to place Sen. Deal with or my colleagues in a adverse mild.”

She reasserted passionate advocacy for knowledge in Medicaid administration, going ahead: “Solely a handful of states do not need third-party managed Medicaid. In reality, 40 states do, with confirmed outcomes.” 

As this disagreement heated up, The Norman Transcript reported — regarding two pharmacies that Senator Standridge owns: “Blanchard Drug & Present and LegendCare Pharmacy — that had been reimbursed greater than $3.4 million from 2017 to 2020 by the state Medicaid system, in line with Oklahoma Well being Care Authority information that was obtained via an Open Information Request.”

Additional particulars: “The sum of the annual common pharmacy reimbursements over these 4 years was over $2.1 million. Blanchard Drug & Present, situated in Blanchard, was reimbursed $1.02 million throughout that point interval, whereas LegendCare pharmacy, situated in Norman, was reimbursed greater than $2.38 million.”

Standridge advised his hometown newspaper, “Actually some might disagree with me on managed care, however primarily based on what I’ve studied and noticed in surrounding states which have applied managed care on this manner it’s neither higher for the state nor for our most weak residents it’s meant to assist. Nevertheless, if it will definitely turns into the system by which we ship Medicaid, I’ll proceed to work to ensure the supply of care is the most effective that it may be.”

Politics and males named Paul 

Sketching this disagreement (I share Sen. David’s coverage desire) brings me again to issues I discovered whereas working for the late Paul M. Weyrich (1942-2008) throughout my sojourn in Washington, D.C.

Weyrich was, like many individuals in public life, far more than the sum of his information clippings (which had been prodigious). Amongst different issues, his first actual job was in radio journalism.

And, I heard him say greater than as soon as that politics is to not be confused with theology:

In bringing somebody to religion, you search an individual’s conversion – one hundred pc. In politics, anybody curious about gratifying outcomes ought to perceive that the elected official who agrees with you greater than half of the time on the large stuff is your ally, not your enemy.”

After all, Paul believed that some points are extra vital than others. The issues he fought for nonetheless depend.

However as time goes by, his adage about politics, and his habits towards no less than a lot of his coverage adversaries, involves thoughts.

He bequeathed to me friendships with, amongst others, the Rev. Jesse Jackson, and the late U.S. Senators Paul Tsongasof Massachusetts and Paul Simon of Illinois.

Additional, there’s this little bit of knowledge. which Weyrich believed:

[N]ow these three stay: religion, hope and love. However the biggest of those is love.” (1 Corinthians 13: 13).

Maybe there’s something in regards to the identify, “Paul.”

One other Paul co-wrote a preferred tune again within the day, with this memorable repetitive refrain:

“We are able to work it out.”

Maybe, no less than in Oklahoma, we will handle that.

Notice: McGuigan’s evaluation first appeared within the Southwest Ledger, April 1, 2021 print version and on-line:  Southwest Ledger, 7602 US Freeway 277, Elgin, OK 73538, (580) 350-1111. It’s reposted right here with permission.

Oklahoma state Senator Rob Strandridge, R-Norman, is strongly against Managed Care of Medicaid Growth. 
The writer of this evaluation spent a decade working for the late Paul M. Weyrich (1942-2008). File Picture. 
The Rev. Jesse Jackson and the late Paul M. Weyrich, a conservative chief primarily based in Washington, D.C., had been associates for a few years. On this picture, Jackson is proven with the writer’s son, Josef, throughout a go to to Oklahoma in 1991. McGuigan Household Picture. 
2010 picture: Patrick B. McGuigan is a journalist and educator primarily based in Oklahoma. He’s the writer of three books and the editor of seven, together with ‘Crime and Punishment in Trendy America’ (Free Congress/United Press of America). 

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