Monday, May 24, 2010

Fear and Loathing in Paradise: How many people have to die before anyone pays attention

It is almost as if post-Watergate investigative journalism somehow never made it to Hawaii.

In the past couple of weeks, it has come out that the FBI has been conducting criminal investigations into the deaths of people with disabiities covered by Medicaid; that the state has had a 36% increase in deaths of people covered by Medicaid in the past year; and that a shooting in Honolulu by an off-duty FBI agent was in part due to Medicaid's refusal to provide the victim with a doctor who could authorize his medications.

This all comes on top of the Office for Civil Rights of DHHS opening two investigations into civil rights violations of children with disabilities served by Medicaid, and the Center for Medicare and Medicaid Service (the federal Medicaid regulators) being in talks with Hawaii since August over the same potential civil rights violations.

The problems all derive from Hawaii's Republican-mastered Medicaid managed care system that is operated by insurance giants UnitedHealth and Wellcare.  According to year-end financial reports released by both companies it appears that their Hawaii membership of elderly and disabled people is generating profit four to five times greater than the percent of membership.  How?  By not spending the capitated insurance payments they are receiving from the state.

Last week, eight families with loved ones who have died or are dying from neglect and denials by Hawaii's two for-profit Medicaid providers got up the courage to come forward.  This is a big thing here in Hawaii.  Almost everyone has an aunty who has a friend who has a relative who works for the city or state government.  But these eight families were determined that no one else should have to go through what they have in the past year.

The names and phone numbers were all provided to a reporter at the main Hawaii newspaper, the Honolulu Advertiser.

The resulting story that appeared today could have been written by the PR people at UnitedHealth and Wellcare.  None of the families were ever contacted.  To say they feel betrayed, humiliated and angry is putting it mildly.  It is almost as if their children and parents had died again, with no one in the world caring.

The same Republican party machine responsible for outsourcing billions of dollars of Hawaii stimulus funds for Medicaid and education has just managed to get the first Republican in twenty years elected to the House.

The so-called "Health State" is slowly killing off its disabled population through neglect.  Obama's home state is sending a Republican to Congress.

There are problems here in Paradise, and they do not appear to be fixable from within.  All I can do is hope someone, somewhere pays attention and does something to bring this on-going tragedy to an end.

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.