EVIDENCE-BASED FOR PROFITS VS EVIDENCE BASED FOR PUBLIC INTEREST. AFFORDABLE CARE ACT ENDS 'DO NO HARM' IN HEALTH CARE.
WHO DETERMINES THAT THE END IS POSITIVE FOR WE THE PEOPLE? The same bunch of health industry executives having spent these few decades fleecing our Medicare and Medicaid trusts with fraud and profiteering to enrich themselves MAKING AMERICAN HEALTH OUTCOMES THE WORST IN DEVELOPED NATIONS.
Below we see what is called PUBLIC HEALTH ORGANIZATION saying it promotes Affordable Care Act and if we look at the public health issues it fails to identify any of the policies or health goals preventing the achievement of public health. If we look at WHAT IS PUBLIC HEALTH----
We posted from a friend how citizens are dying from infections caused by failing to clean tops of aluminum drink cans because warehouses with mice are allowing mice droppings and then stores are simply placing these cans on shelves. SANITATION we see below is public health. US cities deemed Foreign Economic Zones like Baltimore completely dismantled public health and made it simply an agency that collects data. Do you have public health if staffing is so low no hope of actually performing assigned tasks can occur? OF COURSE NOT---again, throwing a few million at public health while handing the bulk of funding to global health corporations to expand overseas is not AMERICAN PUBLIC HEALTH.
If an organization promotes ACA-----when everyone knows it is far-right global Wall Street and global health insurance killing our US public health system-----look elsewhere for information--create a REAL public health organization in communities. Climate change was supersized by the same Congressional pols and Obama who created Affordable Care Act---would this organization tell us that? NO.
Our CDC has been so defunded and dismantled we no longer have an effective national structure for addressing major communicable disease vector outbreaks---does this organization tell us that? NO
What is Public Health?
Public health promotes and protects the health of people and the communities where they live, learn, work and play.
While a doctor treats people who are sick, those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors.
From conducting scientific research to educating about health, people in the field of public health work to assure the conditions in which people can be healthy. That can mean vaccinating children and adults to prevent the spread of disease. Or educating people about the risks of alcohol and tobacco. Public health sets safety standards to protect workers and develops school nutrition programs to ensure kids have access to healthy food.
Public health works to track disease outbreaks, prevent injuries and shed light on why some of us are more likely to suffer from poor health than others. The many facets of public health include speaking out for laws that promote smoke-free indoor air and seatbelts, spreading the word about ways to stay healthy and giving science-based solutions to problems.
Public health saves money, improves our quality of life, helps children thrive and reduces human suffering.
Public Health is...
Some examples of the many fields of public health:
- First responders
- Restaurant inspectors
- Health educators
- Scientists and researchers
- Community planners
- Social workers
- Public health physicians
- Public health nurses
- Occupational health and safety professionals
- Public policymakers
Any REAL public health organization would have been shouting that the MASTER PLAN of US cities as Foreign Economic Zones bringing global campuses and global factories to our US cities was ANTI-PUBLIC HEALTH. It would be shouting against this 4TH INDUSTRIAL REVOLUTION of technology from super-sized computer infrastructure bringing the most toxic of hardware and its manufacturing as with this virtual reality economy killing REAL public health and security. Instead what we see from these corporate public health organizations is the PRETENSE OF PUBLIC HEALTH----they pretend the US is still working to create safe environments for its citizens while being silent as public policy installs the opposite.
It is our local public health agencies that would have worked hard to stop health industry frauds and government corruption but of course the leadership is appointed by those very corrupt pols. It would be that non-profit public health organization which would out all of this but of course these are led by global Wall Street players simply selling bad health policy as good for WE THE PEOPLE----as with MARYLAND HEALTH CARE FOR ALL being the driver of Affordable Care Act.
WE MUST HAVE 99% OF CITIZENS COMING TOGETHER TO FIGHT AGAINST WHAT IS BEING SOLD AS PUBLIC HEALTH.
This video is about public health but it does not promote policies good for public health---it sells global Wall Street policies pretending they will be good for 99%---please stop allowing 5% GLOBAL WALL STREET PLAYERS BE OUR VOICE FOR REAL PUBLIC HEALTH.
The 4th Industrial Revolution is NOT GREEN ----it is not DEMOCRATIZING public health-----it is killing what was the strongest and best in world history US public health and bringing it down to what is basic developing nation health structures. This harms not only WE THE PEOPLE it kills all opportunity for third world global citizens to ever experience the quality of life developed nations built these few centuries.
What Is The Fourth Industrial Revolution?
Jacob Morgan ,
You may have heard of the fourth Industrial Revolution, but what exactly is it? It's definitely a topic that has been talked about over the past few years but gained even more prominence after it became a focal point of conversation at the recent World Economic Forum. The first Industrial Revolution was characterized by steam and water. The second Industrial Revolution was the introduction of electricity to mass produce things. The third is characterized by the internet, communication technologies, and the digitalization of everything. The fourth Industrial Revolution is the concept of blurring the real world with the technological world.
Here's a great visual from the WEF.
Photo: World Economic Forum
We can see this happening in several areas already. Virtual reality that allows us to transport to new worlds or consume and interact with information in new ways, robots and software working side-by-side with humans, nano-bots that could one day be injected into your blood stream to cure you of an illness, 3D printing tools and limbs, voice controlling your house, tools like IBM Watson being used to help a doctor diagnose you, and that's just for starters! We also have to consider things such as the internet of everything and big data.
The blurring of technology into every part of our lives is becoming the norm. However, the impact that the fourth Industrial Revolution will have or the direction it will take are not yet known. A wave of technology is now crashing into our personal and professional lives like a ton of bricks. So the question becomes, when technology fuses with people, how does that impact and change our lives? How will the way we work change? How is the fourth Industrial Revolution going to alter the way you work and live?
What do you think? Leave a comment below and subscribe to the YouTube channel for more videos if interested.
The Affordable Care Act not only deregulated our public health system it privatized what was still standing albeit those structures were not enforcing public interest protecting through these few decades. Our social work agencies were so underfunded as to be unable to perform services to community but now our social work agencies have been outsourced and privatized to global health corporations meaning they get their marching orders from global Wall Street and not our local public health structures.
We are moving from a once highly functioning public health structure----I understand Republican states may never have allowed these structures to operate but across the nation our local public health structures did operate effectively and efficiently before CLINTON/BUSH/OBAMA defunded them----allowed for no enforcement of Federal public health protections these few decades breaking down what citizens had seen as a social safety net. The Affordable Care Act creates that global corporate health structure where social workers-----A DEVIATION from public interest are dispensed into communities with a goal of creating societal structures for GLOBAL CORPORATE CAMPUS SUSTAINABILITY----meaning making society work for most profitability.
THIS IS A DEVIATION ------NOT A LOGICAL PROGRESSION UNLESS YOU ARE THAT FAR-RIGHT, AUTHORITARIAN, PRAGMATIC NILIST.
Below we see an article originating from NYC's global IVY LEAGUE COLUMBIA UNIVERSITY--telling us these issues are being discussed and debated but that discussion is only happening on these global IVY LEAGUE campuses. WE THE PEOPLE are not in those discussions=====and our voices are not the ones global Wall Street pols and players install as policies. This is what we must reverse---these discussions occur in our communities---our public universities would be center for our voices not partnered with global IVY LEAGUES as has happened in Baltimore.
The Privatization of Social Work: A Deviation or a Logical Progression?
Since the 1980s, social workers have increasingly left the service of the public sector and entered into private practice. A substantial number of today’s social workers practice for-proﬁt client-based therapy rather than agency-based public service. These recent changes are causing critics to question whether social work’s new focus on for-proﬁt services has deviated from social work’s original purpose to forge allegiances with the poor, the disadvantaged, and the oppressed. Is this change in focus an abandonment of social work’s historical principles? Or is it simply a modern and logical evolution? This paper examines the debate between private and public social work practice. It describes how social work historically emerged and evolved on two interconnected fronts, one with a focus on change at the community level, and one with a focus on change at the individual level. This paper posits that the two approaches are not irreconcilable and that healthy debate has led, and continues to lead, the profession forward.
This work is licensed under a Creative Commons Attribution-NonCommercial License (CC-BY-NC).
Published in partnership with
Center For Digital Research & Scholarship
Columbia University Libraries/Information Services
Columbia University School of Social Work
ISSN (Print): 2372-255X
ISSN (Online): 2164-1250
All articles licensed Creative Commons (CC-BY) License unless otherwise stated.
As with THE URBAN LEAGUE -----the URBAN INSTITUTE again ties itself with global IVY LEAGUE institutions for these societal discussions so when we are told these issues are being discussed----they never reach our communities and the 99% of people----the entire structure of academic discussion is now controlled within these global IVY LEAGUE structures.
Below we see the boards of URBAN INSTITUTE look just like the GLOBAL WALL STREET BALTIMORE DEVELOPMENT CORPORATION which is an extension of global JOHNS HOPKINS. So we are not getting meaningful discussion of these vital public health issues from WE THE PEOPLE. These are that 5% to the 1% serving a CLINTON/BUSH/OBAMA tied to health institutions enriched by hundreds of billions of dollars in health industry frauds of our Federal, state, and local health agencies.
WE REVERSE MOVING FORWARD ONE WORLD ONE WORLD HEALTH ORGANIZATION BY GETTING GLOBAL WALL STREET POLS OUT OF OFFICE AND REBUILDING OUR LOCAL PUBLIC HEALTH AGENCY STRUCTURES.
This report written by CLINTON/BUSH/OBAMA INSIDERS tells us what global Wall Street thinks is public health.
About the Urban Institute
Urban's mission is to open minds, shape decisions, and offer solutions through economic and social policy research.
We believe in the power of evidence to improve lives and strengthen communities. Public policies work best when they are rooted in facts, and our research sparks solutions in programs and practice. Our analyses and recommendations help expand opportunities for all people, reduce hardship among the most vulnerable, and strengthen the fiscal health of governments and effectiveness of public policies.
How We Work
We conduct sophisticated research to understand and solve real-world challenges in a rapidly urbanizing environment. Our work engages communities at multiple levels—city, state, and country—as we gather data and evaluate programs. Urban Institute scholars blend academic rigor with on-the-ground collaboration, teaming with policymakers, community leaders, practitioners, and the private sector to diagnose problems and find solutions.
Founded in 1968 to understand the problems facing America’s cities and assess the programs of the War on Poverty, the Urban Institute brings decades of objective analysis and expertise to policy debates—in city halls and state houses, Congress and the White House, and emerging democracies around the world. Today, our research portfolio ranges from the social safety net to health and tax policies; the well-being of families and neighborhoods; and trends in work, earnings, and wealth building. Our scholars have a distinguished track record of turning evidence into solutions.
As an organization, the Urban Institute does not take positions on issues. Scholars are independent and empowered to share their evidence-based views and recommendations shaped by research.
Our work environment encourages intellectual honesty, innovation, diversity, and mutual respect. Our analysis elevates debate, wherever it takes place.
Board of Trustees
View Executive Leadership
Jamie S. Gorelick (chair)
Gorelick is a lawyer with high-level government experience. A former member of the National Commission on Terrorist Attacks upon the United States, she has also been deputy attorney general of the United States and general counsel of the Department of Defense.
Freeman A. Hrabowski III (vice chair)
President, University of Maryland, Baltimore County
Hrabowski is an expert on science and math performance, specializing in minority participation and performance in these fields. He currently advises the National Science Foundation, the US Department of Education, and schools and universities nationwide. In 2012, he was named one of Time’s "100 Most Influential People in the World."
Jeremy Travis (vice chair)
President, John Jay College of Criminal Justice at the City University of New York
Travis is a national expert on criminal justice, a lawyer, an educator, and a public servant. He has launched a national research program on prisoner reentry at the Urban Institute, directed the National Institute of Justice, held high-level positions in the New York City Police Department and the Mayor's office, clerked for Judge Ruth Bader Ginsburg on the US Court of Appeals, and worked for the Vera Institute of Justice. He served as chair of the National Academy of Sciences consensus panel that produced The Growth of Incarceration in the United States: Exploring Causes and Consequences. In 2014, he received the Distinguished Achievement Award from the Center for Evidence-Based Crime Policy at George Mason University.
J. Adam Abram
President and CEO, James River Group Inc.; Chairman, Franklin Holdings Ltd.; Chairman, Piedmont Community Banking Holdings Inc.
Abram has founded and directed four companies in financial services and real estate: Adaron Group Inc.; Front Royal Inc.; James River Group Inc.; and, most recently, Piedmont Community Bank Holdings Inc., a federally chartered bank holding company with plans to create a community bank to serve southern Virginia, North Carolina, and parts of South Carolina.
Professor of Economics and Associate Chair of the Department of Economics, Massachusetts Institute of Technology
Autor is professor of economics and associate chair of the Massachusetts Institute of Technology's department of economics. His fields of specialization include human capital, skill supply and demand, and earnings inequality; labor market impacts of technological change and globalization; disability insurance and labor force participation; and contingent and intermediated work arrangements. Autor is the codirector of the MIT School Effectiveness and Inequality Initiative and, since 2009, the editor of the Journal of Economic Perspectives.
Donald A. Baer
Worldwide Chairman and CEO of the Strategic Communications Firm Burson-Marsteller; Chairman of the Research Firm Penn, Schoen & Berland
Baer has been a leader and executive in media and communications for a wide range of business, government, and nonprofit organizations. In 2014, he was elected chair of the PBS board of directors and to the board of directors at Meredith, a major media company. From 1998 to 2007, he was Discovery Communications' senior vice president for strategy and development. He was a senior adviser to President Bill Clinton, including stints as his director of strategic planning and communications and as chief speechwriter/director of speechwriting and research. A former media lawyer, reporter, and magazine editor, Baer has won two Writers Guild of America awards for his work on the annual Kennedy Center Honors TV production. He also led the creation of Silverdocs, the American Film Institute and Discovery Communications' annual documentary festival.
President Emeritus, University of North Carolina
Bowles, president of the University of North Carolina from 2006 to 2010, cochaired President Barack Obama's bipartisan National Commission on Fiscal Responsibility and Reform. A former member of the National Economic Council and National Security Council, he served as President Bill Clinton's chief of staff, deputy chief of staff, and director of the Small Business Administration. The founder and former chairman and CEO of the Charlotte investment banking firm that became Bowles Hollowell Connor & Co., Bowles was previously a general partner of Forstmann Little, a New York private equity firm.
Founder and Executive Chairman, CityView
Cisneros is founder and executive chairman of CityView, one of the nation's premier institutional investment firms focused on urban real estate, in-city housing, and metropolitan infrastructure. He served as president and COO for the Spanish-language network Univision from 1997 to 2000 and as secretary of the US Department of Housing and Urban Development from 1993 to 1997 under President Bill Clinton. Before his cabinet position, Cisneros was the four-term mayor of San Antonio, Texas, from 1981 to 1989.
Mitchell E. Daniels Jr.
President, Purdue University
Daniels served as governor of Indiana from 2005 to 2013. He directed the Office of Management and Budget under President George W. Bush from 2001 to 2003, served as president of Eli Lilly North America in the 1990s, and was CEO of the Hudson Institute from 1987 to 1990. He is author of Keeping the Republic: Saving America by Trusting Americans.
President and CEO, JPMorgan Chase Institute
Farrell is a former McKinsey & Company director and global head of the McKinsey Center for Government and the McKinsey Global Institute. She served as deputy director of the White House’s National Economic Council and as President Barack Obama’s deputy assistant on economic policy from 2009 to 2011.
Margaret A. Hamburg
Foreign Secretary, National Academy of Medicine
Hamburg headed the Food and Drug Administration from 2009 to 2015. She was the Nuclear Threat Initiative’s vice president for biological programs from 2001 to 2005 and its senior scientist from 2005 to 2009. Hamburg was assistant secretary for policy evaluation at the US Department of Health and Human Services from 1997 to 2001 and commissioner of the New York City Department of Health and Mental Hygiene from 1991 to 1997.
Terrence P. Laughlin
Vice Chairman and Head of Global Wealth and Investment Management, Bank of America
Laughlin is vice chairman of Bank of America and a member of the company’s executive management team. His responsibilities include oversight of the company’s Global Wealth and Investment Management division. Previously, Laughlin was president of strategic initiatives for Bank of America, responsible for global corporate strategy. He also established and led Bank of America’s legacy asset servicing. Before joining Bank of America, Laughlin was president and chief executive officer of OneWest Bank and held various senior leadership positions with Merrill Lynch and FleetBoston Financial. He is a member of the board of the Bank of America Merchant Services (a joint venture with First Data Corporation) and the board of trustees at the University of Pittsburgh, where he serves on its executive, investment, and institutional advancement committees.
Marne L. Levine
Chief Operating Officer, Instagram
Levine is chief operating officer of Instagram. She joined Instagram from Facebook, where she served as vice president of global public policy from 2010 to 2014. Before Facebook, Levine served as chief of staff of the National Economic Council at the White House and special assistant to the president for economic policy. Previously, Levine was director of product management for Revolution Money and chief of staff for Harvard University President Larry Summers. She began her career in 1993 at the US Department of the Treasury under President Bill Clinton, where she held a number of leadership positions.
Eugene A. Ludwig
Founder and Chief Executive Officer, Promontory Financial Group LLC
As CEO of a premier strategy, risk management, regulatory, and compliance consulting firm, Ludwig is a trusted adviser to the world's leading financial companies. He is recognized as a farsighted thinker on the most pressing issues confronting financial services. Before founding Promontory, Ludwig served under President Bill Clinton as comptroller of the currency, head of the agency responsible for supervising the preponderance of US banking assets. He later became vice chairman and senior control officer of Bankers Trust/Deutsche Bank.
N. Gregory Mankiw
Professor of Economics, Harvard University
Mankiw, a Harvard University professor of economics since 1987, has extensively researched price adjustment, consumer behavior, financial markets, monetary and fiscal policy, and economic growth. A prolific writer, he has also written two popular textbooks: Principles of Economics, which has sold over two million copies and been translated into over 20 languages, and Macroeconomics. He has been a research associate at the National Bureau of Economic Research and an adviser to the Federal Reserve Banks of Boston and New York and the Congressional Budget Office. From 2003 to 2005, he served as chairman of President George W. Bush's Council of Economic Advisers.
Mary J. Miller
Former Under Secretary for Domestic Finance, US Department of the Treasury
Miller was the under secretary for domestic finance (2012–14) and the assistant secretary for financial markets (2010–12) at the Treasury. She played a key role in overseeing US debt issuance and the financial regulatory overhaul. Before joining Treasury, she spent 26 years at Baltimore-based asset manager T. Rowe Price Group Inc., including as director of the fixed income division and a member of the firm’s management committee. She was a research associate at the Urban Institute from 1980 to 1983.
Annette L. Nazareth
Partner, Davis Polk & Wardwell LLP
Nazareth is a lawyer and a former policymaker. She served as a commissioner of the US Securities and Exchange Commission and as the director of the Securities and Exchange Commission's division of trading and markets. She has also held senior legal positions in the investment banking industry.
Managing Director, Bain Capital
Patrick was governor of Massachusetts from 2007 to 2015. Before holding public office, he was executive vice president and general counsel of the Coca-Cola Company. Patrick served in the same role at Texaco, Inc., from 1999 to 2001. From 1994 to 1997, he served as assistant attorney general overseeing the civil rights division of the US Department of Justice.
Charles H. Ramsey
Former Philadelphia Police Commissioner
Ramsey is the former Police Commissioner of the Philadelphia Police Department, the fourth largest in the nation. An internationally-recognized practitioner and educator with forty-six years of law enforcement experience, he is the former chief of the Metropolitan Police Department (DC) and past president of both the Police Executive Research Forum and the Major Cities Chiefs Association. He also served as co-chair of President Obama’s Task Force on 21st Century Policing.
John Wallis Rowe
Julius B. Richmond Professor of Health Policy and Aging, Mailman School of Public Health, Columbia University
Rowe was chairman and CEO of Aetna, Inc., from 2000 to 2006. He was president and CEO of Mount Sinai–New York University Medical Center and Health System from 1998 to 2000. Earlier in his career, Rowe was the founding director of Harvard Medical School’s Division on Aging and was chief of gerontology at Beth Israel Hospital in Boston.
J. Ron Terwilliger
Chairman Emeritus, Trammell Crow Residential
Terwilliger is Chairman Emeritus of Trammell Crow Residential, the largest developer of multifamily housing in the U.S. during his tenure as CEO. Since his retirement he has focused on philanthropy; largely on housing. He serves as Chairman Emeritus of the board of Habitat for Humanity International. He also established and funds the J. Ronald Terwilliger Foundation for Housing America’s Families to address the nation’s critical affordable housing challenges.
Sarah Rosen Wartell
President, Urban Institute
Wartell became the third president of the Urban Institute in February 2012. A public policy executive and housing markets expert, Wartell was President Bill Clinton's deputy assistant for economic policy and the deputy director of his National Economic Council. At the Department of Housing and Urban Development from 1993 to 1998, she advised the federal housing commissioner on housing finance, mortgage markets, and consumer protection. Read more about Wartell on her biography page.
Anthony A. Williams
Chief Executive Officer, Federal City Council
Williams's career spans public service, real estate development, and teaching. He has been mayor of the District of Columbia; CFO for the District; CEO of Ramsey Group Inc.; and an executive in many federal, state, and municipal agencies. Williams also teaches at Harvard University's John F. Kennedy School of Government.
Here is the position paper from an URBAN INSTITUTE----a Clinton global Wall Street think tank on privatizing our public health and social services. Baltimore dismantled its public health decades ago and it is now listed as third world in its public health outcomes. This happened because global Wall Street and Johns Hopkins corporation decided it was better to grow globally than take care of public health. That will always be the decision with privatized health care.
Even right wing Republicans are now sick and tired of OUTSOURCED GOVERNMENT AGENCIES with the fraud and corruption once going to small businesses now going into the pockets of global corporations still corrupting our local politicians and creating Wall Street Baltimore Development 'labor and justice' organizations to promote Wall Street health policies.
THIS IS WHAT CHANGES WHEN WE GET RID OF GLOBAL WALL STREET POLS AND PLAYERS----ALL THESE GOVERNMENT TIES TO CORPORATIONS FALLS AWAY AND OUR BALTIMORE PUBLIC HEALTH AGENCY IS REBUILT INTO OUR COMMUNITIES LISTENING TO THE NEEDS OF CITIZENS.
Privatization is encouraged in Reinventing Government
, but Osborne and Gaebler, like other analysts, caution
that "[p]rivatization is one answer, not the
answer...Services can be contracted out or turned over to the private sector. But governance cannot..." (Osborne and Gaebler, 1992, p. 45) "There is no inherent reason why for-profit firms could not compete for most, if not all, social service delivery activities." (Hatry and
But the government is responsible for assuring that public services are effective, whether or not the services are publicly delivered. Public decision-makers need to look at the long-term capacity of government agencies to monitor and the costs of monitoring. They need an objective way to assign criteria to determine appropriate cost--the public sector does not know how to determine cost and does not understand
well how the concept of risk relates to the private sector's incentives and disincentives in business ventures.
The limited empirical research comparing the effectiveness of service provision by the public and private sectors suggests a few conclusions:
There is no empirical evidence that the service provided by private contractors is inadequate.
There is some evidence from research studies that the quality of services may be higher in private service
delivery systems than in public systems, but very mixed evidence on whether the private sector is more
cost-efficient. However, for many reasons, the findings may be biased in favor of the private sector.
When public services are privatized, there is a reduction in the number of public employees, but there is not necessarily a reduction in total employment nor are workers always worse off.
There are success stories and examples of failure in all sectors--public, non-profit, and private. No one
model is inherently "better" than another. The key factor is whether there is clear accountability for
results, clear criteria for performance, and clear public objectives.
Privatization is a way to bring the advantages of competition and flexibility to the delivery of public services.
These advantages include greater efficiency, increased responsiveness to the needs of customers, and
encouraging innovation. These advantages are more difficult (but not impossible) to achieve within
government due to restrictions on hiring public employees and budgeting issues related to capital
As Rainey (1991) points out, "The nature of public organizations, their public character, often
subjects them to more external intervention and constraint. In turn, this often imposes on them greater
challenges in trying to perform efficiently and effectively."
While there is clear potential for improved efficiency, privatization also involves risk and requires careful
management on the part of the public agency. The research reviewed emphasizes the importance of clear
goals and accountability. Some of the highly visible problems recently encountered in large system-wide
contracts probably at least partly reflect lack of accountability and performance criteria . Effectiveness tends to be very situational--it depends on the implementation of the contracting process, the contract itself, performance criteria, and ongoing monitoring.
To achieve the potential benefits of privatization, public agencies will need to clearly specify the roles of
contractors, determine appropriate costs, and develop performance criteria that are tailored to the client
population being addressed. Public agencies will need to consider their long-term capacity to structure and
monitor privatization initiatives in order assure cost effectiveness and quality in the delivery of publicly funded
This article shows that State of Vermont with a GOVERNOR MALLOY who posed left social progressive by supporting MEDICARE FOR ALL when in the end he simply installed the same state private health system attached to Affordable Care Act. He never intended to install Medicare for All----
Here is that same progression from a public agency being taken to private corporate non-profit then simply privatized to global corporations---it happens with every agency taken to privatization as is happening now with our public K-12----and here is our public health and human services undergoing that same non-profit now moving to private corporation process.
A global Wall Street Clinton neo-liberal like MALLOY will pretend to protect against privatization but being far-right wing will move to this same privatization promoted by URBAN INSTITUTE and seen in Baltimore these few decades.
As McKinney states non-profits historically are under funded because when outsourcing occurs most of what was public funds for services is lost to PAY-TO-PLAY, FRAUD, AND CORRUPTION.
'McKinney said the nonprofits have historically been underfunded–something he attributed to the legislature being more willing to fund state programs because they employ state workers–and said privatization would have to include increasing their funding'.
Privatization could challenge social services nonprofits
By: Arielle Levin Becker | June 29, 2011
As the Malloy administration prepares to cut spending in social service agencies–part of the plan the governor released Tuesday and wants the legislature to approve today–the nonprofits that provide many safety net services for low-income and disabled residents are wondering what the changes could mean for them and their clients.
People who work with nonprofits say they could take over some state services, particularly group homes and local mental health authorities, which provide theraputic and crisis intervention programs. Private providers already operate some of both.
But some cautioned that the nonprofits themselves are in precarious financial positions and would need more state funding to take on additional responsibilities. And nonprofit leaders worry that the budget cuts could instead mean cuts in the rates private providers are paid by the state.
Terry Edelstein, president and CEO of the Connecticut Community Providers Association, said there is “unlimited capacity” among nonprofits to absorb state services–as long as there is funding for it. State funding for private providers has not increased in the past three years, and remains flat in the upcoming two-year budget.
“We’re cost-effective, we’re efficient, it costs us less to provide services than the state,” she said. “But that doesn’t mean that we’re happy with what will be five years of no increases in funding…We don’t want to do this on the backs of our employees, either.”
Officials in Gov. Dannel P. Malloy’s administration said Wednesday that it’s too soon to say which services would be privatized as a result of the $1.6 billion in cuts needed to fill the two-year budget gap stemming from state employee unions failing to ratify a concession deal.
But when asked whether the cuts would increase the state’s reliance on private nonprofit human service providers for things the state does now, budget director Benjamin Barnes said, “I expect that they will.”
Barnes added that there are constraints on the state’s ability to privatize social service functions in a short period of time, including collective bargaining and practical restrictions on relocating individuals. He said it was premature to discuss details of privatization.
In budget cuts released Tuesday, the Malloy administration assigned each state agency a financial target and suggested number of layoffs to achieve it. If the cuts come from layoffs, the Department of Developmental Services would lose 540 workers, or 14.9 percent of its workforce. The Department of Mental Health and Addiction Services would lose 486 positions, and the Department of Children and Families would lose 359.
Those types of position cuts wouldn’t be possible without affecting the direct services the agencies provide, said Deborah Chernoff, spokeswoman for New England Health Care Employees Union, District 1199, which represents 7,700 state employees. That could mean reducing the level of services and staffing, transferring clients to private providers, or making program eligibility more stringent so fewer people get served, she said.
A report released in March by the state Commission on Nonprofit Health and Human Services detailed significant differences in wages and benefits between the public and private sector.
Group home workers in the private sector, for example, made $10.91 less per hour than their state-employed counterparts; over a year of fulltime work, that would amount to a $22,693 difference.
But the report also noted that less than one in five nonprofit providers had at least one month’s expenses on hand, and said many are “operating dangerously close to their margins,” and likely to be unable to handle unforeseen increases in expenses.
“To add on to that sort of weak foundation would not necessarily be a good thing,” said Ron Cretaro, executive director of the Connecticut Association of Nonprofits.
If the administration wants to privatize social services, he said, “We essentially need to be at the table and talking to them about what financial resources would be needed.”
Nora Duncan, a public affairs professional with expertise in nonprofits, noted that many nonprofits’ missions are to serve vulnerable people, and said they would be happy to step up, if they receive appropriate funding and time to do it.
“The nonprofit world can’t just do it because they’re good citizens,” she said. “They have to actually have the money to build, staff, license, et cetera.”
Any privatization of social services wouldn’t likely be able to happen immediately.
If nonprofits need to develop new group homes, rather than take over existing ones, it could take time to find sites for them, Duncan and Edelstein said. Although state law requires group homes funded by some state agencies to be treated like single family homes for zoning purposes, some proposed group homes have drawn staunch opposition from neighbors, and some legislators have pushed for public hearings on their siting.
And the state’s flexibility in replacing social service workers with lower-paid employees could be limited, at least for the next fiscal year. District 1199’s contract with the state includes protections for employees in the departments of developmental services and mental health and addiction services if the workforce is reduced because of a change to community-based programs. Affected employees would be offered employment in the same or comparable classification, at no reduction in salary grade, as long as they worked at the departments as of July 1, 2009. The contract expires July 1, 2012.
But, Chernoff said, “This language was not created with the idea that there would be massive layoffs across a whole spectrum of work titles.”
Chernoff said privatization has always been a concern for the union. While people often talk about the private sector being more efficient or effective, or able to focus on particular areas of expertise, she said, “Most of that is really just disguised for ‘They can do it cheaper because they pay people less and they don’t give them health insurance or they give them health insurance that’s so expensive that they can’t afford it.'”
Many private agencies have more turnover than the state, Chernoff added, which can lead to a decline in consistency and continuity of care. Agencies also might not invest in training because of a lack of adequate funding from the state to support it, she said.
But Senate Minority Leader John McKinney, R-Fairfield, said the overlap between social services provided by the state and the private sector makes privatization of almost any social service function possible.
McKinney said the nonprofits have historically been underfunded–something he attributed to the legislature being more willing to fund state programs because they employ state workers–and said privatization would have to include increasing their funding.
“But obviously the trade-off is the state’s costs go down significantly,” he said. “You use some of that savings to properly fund your nonprofit providers so that they can provide the services.”
'who suggested that the true result of a pro-plaintiff decision will be a "two-tier health-care system," like what we've seen with Medicaid expansion'.
This is indeed where Affordable Care Act takes us-----what is wealth inequity now becomes health care inequity with what was our hospital and clinic system for all now breaking into GLOBAL HEALTH TOURISM DESIGNER HEALTH CARE naked capitalism global market prices will have only the global 1% and their 2% accessing. We have shouted that the 99% will fall into that second tier---GUTTED OF FUNDING MEDICAID FOR ALL. That is to where we are going as more and more Americans are pushed off developed nation health plans. As we see already the bulk of what was Federal public health funding from research and development to Medicare and Medicaid public hospitals and clinics are now going to subsidize that upper-tier global corporate health. That was the goal of Affordable Care Act.
This means that second tier---for the 99% must be administered as cheaply as possible---as with Race to the Top creating the cheapest education platform for K-career for the 99%. When all avenues of health care are privatized and outsourced breaking down all oversight and accountability ----WE THE PEOPLE AS HUMAN CAPITAL become sources to increase those global corporate health profits---ergo, we can be used for research and experiment---our body can be seen as parts which can be sold or used to enhance profit----the innovative PHARMA and medical procedures can be applied without trials---and all private social services will not be advocating for justice ----they will be tasked with keeping the 99% restrained and complacent.
So an URBAN INSTITUTE is discussing policy towards these goals---it is that gutted of funding MEDICAID that is now being sold as UNIVERSAL/SINGLE PAYER -----and all of that is OPPOSITE of what we want as American quality care for all. As with all global Wall Street almost all of Federal funding will subsidize that upper--tier for a very, very small group of global citizens.
Snapshot of a two-tiered health system: How Medicaid enrollment varies across state linesMar 2, 2015, 2:51pm CST
Eleanor Kennedy Staff Reporter Nashville Business JournalIt's King v. Burwell week in Washington, with the U.S. Supreme Court slated to hear oral arguments in the case challenging the legitimacy of subsidies offered through the federal insurance marketplace this Wednesday.
And even though we likely won't learn the court's decision until June, plenty of people are weighing in on how the government might cope with a pro-plaintiff decision. That list includes Tennessee Republican Sen. Lamar Alexander, who co-authored an op-ed in the Washington Post with Sen. Orrin Hatch (R-Utah) and John Barrasso (R-Wyo.) outlining the conservative plan to "to protect Americans harmed by the administration's actions."
The senators' plan, which includes financial assistance to those who lose subsidies during the transition and increased flexibility for states creating health insurance markets, was met by some skepticism from political blogger Ezra Klein, who suggested that the true result of a pro-plaintiff decision will be a "two-tier health-care system," like what we've seen with Medicaid expansion.
So what has the result of that two-tiered system been in the year since some states decided to expand Medicaid coverage while others, like Tennessee, chose not to? According to data recently released by the Department of Health and Human Services, states where Medicaid was expanded have seen a 27 percent increase in enrollment in the program, compared to a 7 percent increase in states that did not.
In Tennessee, where Gov. Bill Haslam's unique plan for expansion died in the Legislature last month, 1.4 million people had enrolled in traditional coverage as of the end of December. That's nearly a 14 percent increase from enrollment totals prior to the health care act's rollout, according to HHS.
But Kentucky, a state controlled by a Republican governor that nonetheless built its own marketplace and did expand Medicaid, Medicaid enrollment has increased 76 percent since the ACA, the largest gain in the country.