Hawaii elects Republican congressman amidst federal investigations into Republican-mastered Medicaid program

On Saturday, Hawaii elected the state's first Republican congressman to Washington in more than two decades.  In his first published comment after the election, Charles Djou said "I think we sent a clear message to Washington, D.C., that we are spending too much money and that we need more fiscal responsibility, and I look forward to going to Washington, D.C., and Congress to do exactly that."

Djou's words come in the wake of recent revelations that the state's one-year-old Medicaid managed care system may be under investigation by the FBI as well as the Office for Civil Rights of DHHS and CMS, the Medicaid regulatory arm of DHHS.  The investigations are all related to cuts in services to the state's disabled and elderly population that have reportedly, in some cases, led to injury and even death.

In fact, from last week until yesterday, eight different families who have experienced personal tragedy due to these service cuts have offered to be interviewed by the press.  The story that came out in this morning's Honolulu Advertiser made no mention of any of these families, nor of the published fact that the death rate among Medicaid enrollees in Hawaii has jumped 36% since this new managed care program went into effect.

This system was conceived under the leadership of Hawaii Governor Linda Lingle, a Republican. Since Lingle's election in 2002, the out-sourcing of Hawaii services has taken some interesting turns:

Hawaii is the only state in the country that pays another state to be its Medicaid fiscal agent.  Hawaii pays Arizona about $9 million a year for the services, which is on top of the contract the state has with ACS to handle the billing put through the Arizona-owned system.  An interesting caveat to this is that ACS cannot perform any on-site maintenance of the system.

Hawaii has been paying the University of Massachusetts Medical School since 2006 to handle federal reimbursements due the state for Medicaid expenditures made by DOE.  As of July 1, 2009, they company still had not got around to getting every potential Medicaid-covered child into the system.  Reimbursements are therefore running about $1.3 million a year, even though DOE generates at least $80 million a year in Medicaid-billable expenses.

Hawaii has paid a Washington, D.C. law firm $5.25 million to write, re-write and legally defend the state's contract between UnitedHealth and Wellcare for the Medicaid services which are bringing all the afore-mentioned federal investigators to our islands.

Hawaii's contracts with UnitedHealth and Wellcare take about $300 million off the top out of Hawaii.  That doesn't include profits generated by denying services that could be covered under the per enrollee payment the companies get every month from the state.  Nor does it include the employment lost as state workers are laid off and replaced by corporate employees, or the local jobs lost as home support services have been cut.

"Fiscal responsibility" seems to have a different definition for me than it does for Mr. Djou.  His political party has favored the rape and pillage of the state's economy by fat profit-making companies for the past eight years.  It's the people who suffer when the state's budget for things like education and medical care has been gutted in order to make way for corporate profit.  The windfall profits these companies had to get by accessing the state's federal stimulus funds is incalculable.  Money that was supposed to help people has gone to make profits.

This is not responsible government.  At least not a government that is responsible to the people who elect it.