Fudge expected to announce support for FitzGerald-Kearney today

Fudge expected to endorse FitzGerald for Governor today

There has been an inordinate amount of chatter around town about the dismal prospects of presumptive Democratic gubernatorial candidate Ed FitzGerald. Much of it turns on rumors that he is hostile or insensitive to various unidentified black interests. Some go so far as to accuse him of being racist, claiming animus in his tenure as Lakewood mayor or his work to date as Cuyahoga County’s first-ever County Executive. And they top it off by citing the indifference of our area’s two most prominent black elected officials, Congresswoman Marcia Fudge and Cleveland mayor Frank Jackson.

We thought the evidence was scant for these claims even before it was announced that Fudge would join FitzGerald this morning for a “major” campaign event that is all but certain to be her endorsement of the FitzGerald-Kearney ticket. * And we would bet a reasonable sum that Jackson will endorse the ticket as well, though probably not before 2014 actually arrives.

Politics is fascinating because it often confounds linear models except when they count the ballots. The Republicans are favored in all of next year’s statewide races and they should be. They have the advantages of incumbency, will likely raise more money, and will be running against a ticket of newcomers to statewide elections. These are huge factors. But there are always wild cards. How the economy is performing is certainly key. Creeping unemployment is a potent threat to Gov. Kasich’s claim of Ohio’s miraculous economic recovery, which if it has occurred at all, has been neither wide, nor deep, nor lasting.

A second wild card is likely to be the status of the Affordable Health Care Act next fall. Will voters be totally turned off by the administration of this historic legislation? Or will they in sufficient numbers come to appreciate the beginnings of a new health care system that promises to be more rational and equitable than the old regime? Will Kasich be able to use his Medicaid expansion leadership to make headway with black voters? Or will they instead remember the draconian cuts to local schools and services occasioned by his state budget cuts, and his overreach in support of labor union strangulation?

And the biggest wild card of all may be Ohio’s antediluvian Tea Party. Will they support the GOP ticket, sit on their hands, or find a third alternative?

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* The FitzGerald-Fudge event is scheduled to start at 10AM at the Memorial-Nottingham branch of the Cleveland Public Library, 17109 Lake Shore Blvd Cleveland, Ohio 44110.

Health Watch Wednesdays | Give Kasich his due on Medicaid Expansion

Ohio's Governor follows President's lead with positive reforms of his own

We have lived with Gov. John Kasich long enough to know the good and the bad. We can’t forget his heartless balancing of the state budget on the backs of local municipalities and school districts. Indelible also was his ruthless attempt to squash working men and women who choose to be unionized.

Alongside these substantial negative markers must now be placed his leadership in securing Medicaid expansion in Ohio. We were among those skeptics who thought he might be content to be on record in favor of expansion, while allowing the Neanderthal Republicans to strangle Medicaid expansion by bogus “reform” initiatives.

Today we listened to Greg Moody, the director of the governor’s Office of Health Transformation address a select group of health industry providers and advocates. He was speaking at the Cleveland Clinic as keynote for the final installment of the Center for Community Solutions’ 2013 Health and Human Services Institute. The event was in Bunts Auditorium on the Clinic’s main campus.

 Asking the question, “Why do we pay for more and more and more instead of better and better and better?” Moody laid out a convincing presentation of the Kasich administration’s efforts to reform Ohio’s horrific healthcare system. Dubbed the Ohio Health and Human Services Transformation Plan, Moody presented the critical path approach to modernize Ohio’s Medicaid regime, streamline the state’s health and human services, and to establish a closer and more rational relationship between the cost of health care services and the value of the services rendered.

“We pay for individual units of service so we get a lot of individual units of service,” Moody said, “whether they improve health outcomes or not.” Moody was recruited to Ohio by Kasich to lead efforts to rationalize Ohio’s health care policies, reform the labyrinthine paths by which such healthcare is delivered, and to correlate cost to value.

One desired goal of this effort is to improve Ohio’s dismal standing as a state with relatively high per capital health care costs while having being in the bottom quartile in terms of health outcomes.

 

States listed L to R in order of best health outcomes. Ohio is in red.

Moody effectively drove home the Governor’s commitment to a sounder health care system when he showed a slide that depicted all of Kasich’s top aides focusing on strategies to secure a favorable ruling on Medicaid expansion from the state’s Board of Control. That outcome came late last month after what Moody depicted as an intense two-month effort ordered by Kasich to secure such a ruling.

Of course, nowhere in Moody’s presentation, or even in the panel discussion that followed, was there any direct mention of the Affordable Health Care Act, sometimes referred to as Obamacare, much less any acknowledgement that this historic legislation was a catalyst to the state’s reform efforts, or the reform efforts of the healthcare industry in general.

Moody did acknowledge “poverty is highly correlated” to all kinds of negative health outcomes, and flatly declared that addressing poverty is the surest way to improve the health of Ohioans.

Most interesting to us in the panel discussion that riffed on Moody’s mood was the common sense assertion by Thom Craig that “mental health care should be integrated into regular health care system.” Craig, the senior program officer for mental health of the Margaret Clark Morgan Foundation, said that “we are all a little bit mentally ill and we are all a little bit mentally well.”

Rita Horwitz, Better Health Greater Cleveland

Michael McMillan, Cleveland Clinic

Thom Craig, Margaret Clark Morgan Foundation

Also on the panel were Rita Horwitz, RN, the director of business development and operations for Better Health Greater Cleveland, and Michael McMillan, executive director of market and network services for the Cleveland Clinic.

Is Bowing to Shutdown Boehner's way of being Biblical?

Negos[1] Fiddle while DC is frozen: no health care for Jesus

I came across the following political cartoon shortly after a colleague recently solicited my views regarding the current government shutdown. It succinctly expresses my assessment of who is responsible for the present impasse.

A fuller answer would address the question how and why this shutdown came to be. Here goes.

Tea Partiers comprise about a tenth of the House of Representatives and roughly 20% of the Republican House majority. The political cowardice of the GOP leadership to confront its most reactionary wing time and again leads Speaker Boehner’s team to abdicate control of the People’s House to this tiny minority of Congressmen. Rather than marginalize these bullies through an act of leadership and statesmanship, the Speaker chooses capitulation time and again so as to avoid provoking primary challenges. He apparently does not apprehend that virtually all of the Tea Party representatives come from heavily gerrymandered districts that have been largely scrubbed of nonwhite voters. It would be hard for most states to create more of such districts in the next redistricting go-around, and increasingly impossible to maintain such districts in view of the country’s present demographic trends. But short-term expediency is breeding big-time, long-term adverse consequences for both the nation [certainly] and the GOP [probably].

While I have mentioned the racial composition of the districts of which the Tea Party has secured present political control, I have not spoken of the racial animus of its members and its policies. To do so usually provokes irrational and cynical nonsense about “playing the race card”.  But let us consider these few facts drawn from the historical record.

1.    Affirmative action has always been a part of America’s history. Until the Civil Rights Movement the primary benefits of affirmative action were white men. This is incontrovertible before the New Deal of the 1930s. But even New Deal legislation reinforced favoritism based on race. One example of many: Social Security legislation was drawn to exclude those occupations to which most black people, especially black women, were relegated. This was a political compromise by the Franklin Roosevelt administration to achieve the greater good. Black people paid the lion’s share of the cost at the time and still do. [Not unlike that 3/5 of a person compromise that made possible the birth of a nation. Who benefited from that? Who paid the price of that ticket?].

2.   The primary beneficiaries of modern civil rights legislation have been white women. Not begrudging them. I’m just saying. Tens of millions of black people have benefited from the legislation. Over a hundred million white women have benefited from it. Of course, the real beneficiary has been the entire nation.

3.   A higher percentage of black people has been uninsured than white people. The black community needs the Affordable Care Act. But, just as in the preceding paragraph, more white Americans will benefit from the ACA than black folk. No problem. The whole nation benefits.

And while we’re on this point, I would venture that Tea Partiers are among the most vociferous defenders of the claim that the USA is the greatest nation on earth, [with the best health care system, the purest foreign policy, the most valorous military, etc.] But how do they explain that the US lags virtually the industrial world in enacting universal health care? Or that our pre-ACA system has led to the world’s most expensive system while simultaneously being one of the world’s most inequitable? [Check out this eight-minute video on health care costs in America.]

So why this excursion into talk of race? I personally lost interest long ago in calling people racist for their actions or beliefs. I think we need a new way of talking about issues of race that permits us to address causes and conditions and remedies without making accusations or assigning individual blame. Nevertheless, it is appropriate to point out that certain people consistently adopt positions that have disproportionately negative consequences for people of color. And when the Speaker of the House, a la Pontius Pilate, throws up his hands and lets the mad crowd have its blood, he can’t claim clean hands.

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[1] When I was in prep school,  “nego” was a term applied to people who were consistent naysayers, for whom opposition seemed a natural reflex.