Saturday, April 15, 2006

Donation Leverage Gets What Nowadays?

April 12, 2006

Dear President Bush,

The Jack Abramoff scandal shows Americans have the best government money can buy. An Abramoff e-mail makes this clear:

“We're going to seriously reconsider our priorities in the current lists I'm drafting right now if our friends don't weigh in with some juice. If leadership isn't going to cash in a chit for (easily) our most important project, then they are out of luck from here on out,"

Jack states it pretty directly, put out “the juice” or the campaign money trough on which legislators gorge will dry up.

I recently found a strange thread woven through the health care side of government. It includes members your administration, Congress and lobbyists. Bear with me, as I summarize my findings.

In August 2005 Rep. Bill Thomas of California held hearings on tax exempt standards for hospitals. As the chair of the powerful House Ways and Means Committee, Rep. Thomas has much influence over health care legislation.

Early in his career Rep. Thomas attended the American Hospital Association annual meeting, often speaking. In 1999 he also gave a talk at the Federation of American Hospitals, the trade group representing for profit hospitals. Here Bill met and worked with Tom Scully, who eventually became the head of the Centers for Medicare and Medicaid.

Since 2000 Rep. Thomas attended or spoke almost exclusively at for profit hospital meetings. His campaign contributions come mostly from health care, almost $500,000 of the $1.67 million raised in his 2004 campaign.

As I read of the hearing, I wondered why our elected officials did not frame the issue differently. The report on the hearing stated:

The Committee Chairman, Rep. Bill Thomas (R-CA), described the question as “(W)hat is the taxpayer getting in return for the tens of billions of dollars per year in tax subsidy?” Health-related entities account for almost 60% of the total revenues of Section 501(c)(3) organizations. Tax-exempt hospitals account for three quarters of the revenues of all health-related organizations.

Chairman Thomas noted the trend of the IRS to lessen the requirements for a hospital to obtain tax-exempt status. For federal tax exemption, a hospital is not required to provide charity care. In 1983, the IRS dropped the requirement to maintain an emergency room. Thus, the Committee is asking whether there really is a community service mission that differentiates tax- exempt hospitals (which seem to engage in increasingly commercial behavior) from for profit hospitals. Certainly the provision of health care is common to both types of organizations, but the charitable component has been eroded.

I thought shouldn’t they be looking into the ever increasing burden of charity care borne by non-profit hospitals? According to the AHA, uncompensated care in 2004 reached $26.7 billion and Rep. Thomas conducted a hearing on the unfair competitive advantage of non-profit hospitals?

Searching deeper into the donation record, I found possible contributing factors. In 2004 the for profit hospital trade association mentioned earlier donated $13,000. Also, Triad Healthcare, a for profit hospital company contributed $17,000. I wondered if $30,000 would buy a hearing that essentially spouts their position. Admittedly, it took a year for the hearing to happen.

The contributions being mentioned in the Abramoff case frequently are less than $10,000 and they purchased influence. Would $30,000 go even further? Of course, I have no e-mails to answer this question. But somebody might. Can you have the Justice Department look into it?

I mentioned the strange web that weaves through health care in your administration. Do you recall the flap Tom Scully had with a subordinate over the release of higher cost estimates for Medicare Part D than originally shared with the House Ways and Means Committee? Democrats asked for more figures, while Republicans and the White House remained selective about which numbers to release. Leadership shared Mr. Foster’s participation estimates, but not his cost numbers.

Guess who ran the hearing on that matter? Tom’s good friend, Rep. Bill Thomas called Mr. Foster to explore the allegations. As President of the Federation of American Hospitals, Mr. Scully developed his relationship with Chairman Thomas between 1999 and 2001. In May 2001 Tom joined the Bush administration as head of the department administering Medicare and Medicaid.

It appears Tom had a benefactor in Rep. Thomas. The powerful chairman provided cover for Mr. Scully in March of 2004 before holding his August 2005 hearing parroting the FAH position. Did Tom have more than one benefactor? One article reported that you hold Tom Scully in high regard. Is that true?

What happened to Tom post “e-mail” brouhaha? In December of 2003 Mr. Scully left his position with the federal government. His December 15th retirement announcement said he was leaving to spend more time with his children and find more lucrative work. It did not take long as the following Monday Alston & Bird issued a press release announcing their landing of the political heavyweight. It is amazing what can happen over a weekend!

PR Newswire had this to say on Dec. 18, 2003:

Tom Scully, the former Bush administration official who previously headed the Centers for Medicare & Medicaid Services (CMS), has joined Alston & Bird in the law firm's Washington, D.C. office. Scully's initial focus will be on healthcare regulatory, strategic and public policy matters. The announcement comes on the heels of the firm's appointment of Colin Roskey, the Senate Finance Committee lead staffer on the Medicare bill that was signed into law by the President on December.

Other good things happened for Tom, post CMS. A health care investment house named Mr. Scully as senior advisor. Welsh, Carson, Anderson, and Stowe historically held a strong portfolio of health care companies.

WCAS and other investment houses see your health care strategies as ripe for profit making. Did you know The Carlyle Group, for which your father worked, announced last summer a major expansion in their health care holdings? They recently shared their intent to purchase Multiplan, the largest PPO in America. That is great timing as you continue to contract out Medicare and Medicaid to private insurers.

In June 2004 Tom spoke at America’s Health Insurance Plans meeting sponsored by a WCAS affiliate. The session was promoted this way:

Attendees will hear Mr. Scully address the various opportunities and threats posed by the legislation and new prescription drug benefits for private health insurers. Discussion will also center on regional competition for market position and the interaction between HMOs, PPOs and traditional Medicare.

In November of 2005 Welsh, Carson, Anderson and Stowe made a $25 million investment in MemberHealth, one of ten national Medicare Prescription Drug plan sponsors. Tom Scully landed a position on their Board.

Now that Medicaid modernization has passed, what opportunities will open for private insurers in this area? Who else sailed through your administration only to land on the outside and benefit handsomely? What will Rep. Thomas do after his retirement? Will he pursue lobbying on behalf of his for profit healthcare benefactors?

The country recently saw one powerful Republican resign as the stain of political corruption flowed into his office. Rep. Tom Delay’s two former staffers admitted guilt in the Abramoff scandal. Many believe he too will be indicted. The Standard Times ran a column to that effect in today’s paper. This remains to be seen. What is inside of Rep. Delay’s or Rep. Thomas’ closet? Maybe nothing, but the view from here suggests something could be lurking inside.

Sorry to share such a long and convoluted story but I wanted to give you a picture of influence buying, or at least the appearance of it in our hallowed halls of government. My hunch is you are already aware.

Evidence that Dr. Jemison is Correct

April 12, 2006

Dear President Bush,

I wrote to you last September to inform you of the greatest threat to health facing the world today. Dr. Mae Jemison, physician and astronaut, shared the dirty secret at the National Association of Community Health Centers’ annual gathering in Miami Beach. Do you recall the threat?

No, it was not natural disasters, despite Hurricane Katrina’s recent strike and Hurricane Rita’s rapid strengthening as it approached South Florida.

No, it was not a flu pandemic despite world wide concern that the H5-N1 virus will evolve into a form easily passed between humans.

The answer is war, internal conflict and strife. The direct impacts from violence include death and disabilities. The indirect impacts kill far greater according the renowned physician. Access to safe water, sanitation, food, medicines, and specialized health care becomes limited, if available at all. The April 11th news from Reuters supports her assertions.

Many doctors in the area say that the local health situation has deteriorated markedly since the US-led invasion of the country in 2003. "The mortality of children in Basra has increased by nearly 30 percent compared to the Saddam Hussein era," Dr Haydar Salah, a pediatrician at the Basra Children's Hospital, pointed out. "Children are dying daily, and no one is doing anything to help them."

As a result of water-borne diseases and a lack of medical supplies, infants born in the southern city of Basra are subject to abnormally high mortality rates, say officials of an international NGO devoted to child health issues.

"For weeks, there were no I.V. fluids available in the hospitals of Basra," said Marie Fernandez, spokeswoman for European aid agency Saving Children from War. "As a consequence, many children, mainly under five-years old, died after suffering from extreme cases of diarrhea."

Fernandez went on to cite a number of problems facing local hospitals in Basra, which is located some 550km south of the capital, Baghdad. "Hospitals have no ventilators to help prematurely-born babies breathe," Fernandez said. "And there are very few nurses available, so hospitals often must allow family members to care for patients."

Just the day before Reuters ran this piece.

Doctors in Anbar governorate, particularly those in the city of Ramadi some 100km west of the capital, are urging the government to tackle the issue of the lack of medicines and essential surgical materials available in local hospitals.

"Most of our patients are being sent to the capital because we don't have enough supplies to proceed with surgical operations," complained Dr Ala'a Rabia'a of the Ramadi General Hospital.

According to Rabia'a, hospitals in neighboring cities too, including Fallujah and al-Qaim, are suffering similar shortages. "We have enough staff to help patients, but this is useless since we don't have enough material," Rabia'a explained. "We need supplies urgently to meet the needs of all hospitals and clinics in the area."

The doctor went on to explain that Ramadi General Hospital was particularly in need of emergency materials such as syringes, pain killers, plasters, antibiotics and anesthetics. "Local NGOs sometimes send us supplies, but most of them aren't appropriate to our needs," Rabia'a stressed.

Last week, a convoy laden with medicines and surgical materials, sent to Ramadi by a local NGO, was ambushed en route from the capital. All medical supplies were reportedly stolen.

Incidents of theft like these, says Rabia'a, only serve to aggravate an already desperate situation. "People are sick, especially from the bad potable water in the area," he said. "Many have cases of diarrhea and there are no drugs for it. Urgent measures must be taken."

“We broke it, we fix it” said Colin Powell prior to the invasion. The Iraqi people live the predictable consequences of that breaking daily. What did you say the other day about killing innocent women and children? Does that include those responsible for a 30% increase in infant mortality? If so, look in the mirror.

Tuesday, April 11, 2006

Texas Gubernatorial Campaign Might Reveal Stench of Corporate Welfare

Dear President Bush,

The San Angelo Standard Times ran an editorial this morning on the sweetheart deals between the State of Texas and Vought Aircraft Industries. The editor focused on a $35 million incentive for jobs creation and the questionable performance by Vought in meeting their promised obligation. He noted their plans to cut 600 jobs, primarily in Dallas.

Mr. Meighan's story reveals only the tip of the iceberg. What remains below the surface?

1) Since the original deal, the State has entered into a $65 million land deal with Vought that reduces the companies cost for land as well as their state property tax bill. In November 2005, the City of Dallas agreed to a 10 year 75% tax abatement totaling $5.6 million for Vought's expansion

2) During the land negotiation period, Vought located its new, up to 600 employee assembly plant in Charleston, South Carolina. Their CEO gave this reason for selecting South Carolina. Vought wants to locate the plant "where we think we can get assistance on the Hill for our military programs”. What can Senator Lindsey Graham deliver that Senators Cornyn and Hutcheson cannot? Is it an extra vote on the Senate Armed Services and Budget Committees?

3) The CEO understands the political game all too well as Vought is owned by The Carlyle Group, famous for it’s “A list” of insiders with strong connections to the Bush administration.

4) During the time Vought needed $100 million of state assistance, the Carlyle Group returned $2.1 billion to its investors due to the “stellar performance of its investments”. Does this sound like a group in need of corporate welfare?

5) The Carlyle Group also owns LifeCare Hospitals where 24 patients died post Hurricane Katrina. That your White House Lessons Learned report omits any mention of the company and the patient deaths is most puzzling as it mentions a nursing home where 6 or 7 patients expired. Does it benefit LifeCare and the Carlyle Group to have the federal government silent on their actions as cases enter civil court?

Those are the highlights of what might be included in future articles. Who knows how deep the iceberg goes? Do you have an idea of what lies beneath?

Saturday, April 08, 2006

“Hitleritis” Epidemic Returns to White House

April 8, 2006

Dear President Bush,

A press release from The New Yorker magazine indicates the Hitleritis epidemic that ravaged Capital Hill last summer is making a comeback.

“There is a growing conviction among members of the United States military, and in the international community, that President Bush’s ultimate goal in the nuclear confrontation with Iran is regime change.” One former senior intelligence official tells Hersh that Bush and others in the White House have come to view Iran’s President, Mahmoud Ahmadinejad, as a potential Adolf Hitler. “That’s the name they’re using,” he says. A senior Pentagon adviser on the war on terror says, “This White House believes that the only way to solve the problem is to change the power structure in Iran, and that means war.”

Please inform Mike Leavitt of this new outbreak. He may wish to quarantine the White House to prevent spread of this dangerous disease. One symptom is leaders invading sovereign countries to show their military might. Another is disregarding whole classes of people as disposable because of their religious beliefs. The world has no need for the former and much too much of the later at the moment.

In case you forgot, I wrote to you about this very topic. A copy of my correspondence is below:

"Hitler-itis" Epidemic Consumes Capital Hill
by letterstonowhere on July 18, 2005 08:42AM (CDT)
July 18, 2005

1600 Pennsylvania Avenue, N.(o) W.(here)

Dear President Bush,

I wanted to warn you about the spreading Hitleritis epidemic ravishing our nation’s Congress. As the White House is close by, I thought you should be warned. In case you are unaware of the condition, it begins with high emotions which overwhelm the nervous system. The disease then spreads to the mouth. The use of the word “Hitler” in any comparison indicates that person may be infected. People you may wish to keep your distance around include:

Congressman Frank LoBiondo, Republican, New Jersey
"Hitler, in his philosophy, was, you know, he hated Jews, he was murdering Jews, and there were some people he liked. But he never went to the level that these people are going to," LoBiondo said. Mr. LoBiondo was referencing Guantanamo detainees.

Senator Dick Durbin, Democrat, Illinois
“If I read this to you and did not tell you that it was an FBI agent describing what Americans had done to prisoners in their control, you would most certainly believe this must have been done by Nazis, Soviets in their gulags, or some mad regime--Pol Pot or others--that had no concern for human beings. Sadly, that is not the case. This was the action of Americans in the treatment of their prisoners.”

Congressman Charlie Rangel, Democrat, New York
The Iraq war "is the biggest fraud ever committed on the people of this country. . . . This is just as bad as the 6 million Jews being killed," the 74-year-old Harlem Democrat insisted during a radio appearance. "The whole world knew and they were quiet about it because it wasn't their ox being gored." When the interviewer challenged Rangel's analogy, the congressman replied: "I am saying that people's silence when they know things terrible are happening is the same thing as the Holocaust."

Senator Robert Byrd, Democrat, West Virginia
Hitler's originality lay in his realization that effective revolutions, in modern conditions, are carried out with, and not against, the power of the State: the correct order of events was first to secure access to that power and then begin his revolution. Hitler never abandoned the cloak of legality; he recognized the enormous psychological value of having the law on his side. Instead, he turned the law inside out and made illegality legal. That is what the nuclear option seeks to do to rule XXII of the Standing Rules of the Senate....

These gentlemen have been treated for the disease, as evidenced by their later apologies. They likely are no longer contagious. However, as this is a new disease, some live agents may remain in the body after treatment. The method of transmitting Hitleritis is currently unknown. It is possible that persons previously infected could be capable of passing the disease to others.

People who still have an active case of “Hitleritis” include:

Senator James Inhofe, Republican, Oklahoma
Stated the Kyote Climate Treaty "would deal a powerful blow to the whole of humanity, similar to the one humanity experienced when Nazism and Communism flourished."

Senator Jeff Sessions, Republican, Alabama
In his opposition to stem cell research said "We certainly have seen the rejections of Nazi Germany's abuses of science."

Senator Rick Santorum, Republican, Pennsylvania
Responding to Democrats in the Senate who were protesting against a potential rule change that would have killed filibusters against judicial nominations, Santorum said, "The audacity of some members to stand up and say 'How dare you break this rule' -- it's the equivalent of Adolf Hitler in 1942 saying, 'I'm in Paris. How dare you invade me. How dare you bomb my city? It's mine.'"

Senator Santorum did issue a statement that he “meant no offense”, yet he was unable to issue an apology. Mr. Santorum likely is dealing with an active disease process.

A physician noted, “The problem with so many of our leaders contracting Hitleritis at the same time is people become numb to real Hitler comparisons. It is like the boy who cried “wolf”. He cried it so many times, when the real wolf came, the town did not believe him, and they suffered for it. The modern day cry of “wolf” could become “Hitler”, with this recent rash of Hitleritis.”

Those concerned about disturbing behaviors would be better served to name those behaviors than to make comparisons to Hitler. And why stop at Hitler, why not invoke Satan or Beelzebub? Better yet, call it the will of God like a recent KKK leader. Isn’t that what Hitler really did? Blessings,

Letters to Nowhere

Wednesday, April 05, 2006

Will the FBI Investigate?

Fact: The White House Lessons Learned report omits any mention of the 24 patient deaths in a LifeCare hospital in New Orleans post Hurricane Katrina. The report explicitly mentions a nursing home where 6 or 7 patients expired.

Fact: LifeCare Hospitals was acquired by The Carlyle Group in August 2005 shortly before Hurricane Katrina struck. The Carlyle Group brags about its "insider political connections" in its news releases. The President's father has done work for the company and many of key Republican leaders currently are employed by The Carlyle Group.

Fact: Two LifeCare executives, Donald M. Boucher and David LeBlanc, have been charged with illegal campaign contributions between April 1997 and December 2002.


Questions/Need for an Investigation:

1. Why was LifeCare omitted from the Lessons Learned report?

2. Why did the report do such a poor job of identifying responsibility for pre and post hurricane patient evacuations?

3. Why did it not assess performance of those responsibilities?

4. Does LifeCare gain by the poor quality of the LL report?

5. Do they have a better chance of defending the company in any civil suits with the federal government silent on their actions?

6. If so, did any members of LifeCare, historically known for buying influence, solicit actions or omissions from federal representatives?

7. Did any members of the famously insider connected Carlyle Group do likewise?


The above information was submitted to the FBI, the Department of Justice, the NY Times, the Washington Post, the Nation and the Austin Chronicle. It is posted on Congress.org under comments to President Bush's

Tuesday, April 04, 2006

President Bush Discusses Health Care Initiatives from The Roosevelt Room

THE PRESIDENT: America needs a health care system that empowers patients to make rational and smart decisions for themselves and their families, a health care system in which the relationship between the patient and the provider are central, not a health care system where decisions are made by the federal government. Notice how I painted that into an either or? Did you hear me say we should eliminate military hospitals or Veterans Administration hospitals as those are run directly by the federal government?

What I left out is employers are bailing on health insurance and the government plans to join ‘em. Just last year Congress passed and I signed legislation that will boot 65,000 poor people off the Medicaid rolls. They will join the 5% or so of employed people tossed off their health insurance benefit as jobs are eliminated and switched to contract positions.

So we've been having a discussion here today about how to make sure our health care system meets certain objectives: one, empowering the patients; two, how do we have a system that helps control rising costs in health care? So, I am dusting off the same tired proposals I have harped on since 2002. During that time the ranks of the uninsured have swelled by some 4 million Americans. If enacted, they will not stem the flow of the rising ranks of the uninsured. And I do hope to add legions of underinsured to their numbers, which leads me to my “signature” strategerie.

And one of the interesting and innovative ways to do that is through health savings accounts. Health savings accounts are good for the uninsured, they're good for small businesses, they're good for larger corporations. Boy are they good for larger corporations and those folks, well let’s just say they donate lots of money. And it takes lots of money in the campaign trough these days to get elected. The people who allow me and other elected leaders to gorge at the money trough can save 30-40% on their health insurance benefit by switching to high deductible health plans.

And people around the table here have been sharing their experiences with how folks are saving money through health savings accounts. But they are rare, roughly 1 out of 10 people as 9 out of 10 contribute nothing to their HSA. And I would urge the small business owner or the individual who is concerned about his or her health care to take a look at a health savings account. Those of you uninsurable with a pre-existing condition, can expect to remain uninsured as HDHP’s don’t want you either. Note, that I am not making any projections as to the impact of my plans. I just tell you it’s a good deal and to go check it out. Roughly 1/3 of the uninsured have zero chance of buying a HDHP and funding their HSA. This equates to 16 million people.

How did I get my minions to draw up plans that won’t help 16 million voters? I had them lay the groundwork. Last fall, two studies were “released” that attributed the rise in the number of uninsureds to illegal immigrants. Heck, if they are here illegally we don’t want to do anything for them. So by painting the uninsured with the broad brush of illegal immigration, we remove any political will to address the problem. I won’t comment nor will Scott McClellan on who commissioned the faulty RAND Corp report. But we sure were thankful for their analysis and conclusions.

We talked about the importance of cost savings through these important products, but we also talked about how we can work with the United States Congress to strengthen them; to make them more appealing; to give people more choices in the marketplace, to say to the American people, we trust your judgment, we trust you to make the right decision for you and your families.

If you really think we trust the American people, you have been smoking something. I am proud that my administration is the most secretive one ever. My bureaucrats have been instructed not to answer questions, not to give out projections, to remain within the federal cone of silence. What we do trust, is that we can manipulate you. Like my saying my health care plans will strengthen the doctor patient relationship. Translated, it simply means you pay or you don’t go to the doctor. It will decimate the already fragile doctor patient relationships of so many Americans.

Those of you who have fond memories of the 1930’s will get to relive them. Doctors will begin collecting chickens from patients as payment for their services. The real trick will come when you need to be admitted to a hospital. My health care reforms will make hospital beds for the poor as scarce as hen’s teeth. There will still be plenty of beds for my base.

And insurance companies will continue to do well as they are the lifeblood of the health care system. Modernization of Medicare and Medicaid means contracting out government sponsored health insurance to the private sector. That fewer people can be treated is just part of the deal as those insurance companies need to cover their twice as high administrative costs and fuel their growing profit margins.

My health care reforms insure the health of insurance and for profit medicine companies. And if they are healthy so are we, as a rising tide lifts all boats. Those of you worried about our country’s response to a bird flu pandemic should ease your mind. The plans are in place to take care of all wealthy, insured politicians first. Everyone else will just have to get in line. With 44 million anti-virals and 80 million flu shots and 300 million citizens you better get in line early!

And so I want to thank you all for coming for this most interesting discussion. And I'll be glad to take a couple of questions.

Saturday, April 01, 2006

Please Tell Me It’s April Fool’s

April 1, 2006

Dear President Bush,

Did I note several ex-Nixon Administration representatives lamenting the lack of ethics and concerns over illegal actions taken by your administration? Since when is the Presidency of Richard M. Nixon held out as the high ethical standard? That these members of your own party are expressing concern is most disturbing.

Did I catch the leader of North Korea endorsing your pre-emptive strike military strategy? How many other rational sane world leaders have adopted such a position? If the answer is none, then you and Kim Jong-il are standing alone in that field together.

Did I hear you bragging about our envious economy while growth slowed and personal savings went negative? Did I hear you encouraging permanent tax cuts in the midst of high deficits and growing needs of American citizens? As business and government continue to cut health insurance programs or switch to high deductible health plans, what will that do to personal savings, even bankruptcies as high medical bills are their number one cause?

Did I hear Congress arguing over how to keep open the campaign money trough on which you and they gorge? Did I read that to avoid the new restriction on lobbyists buying expensive dinners that corporations are flying in executives to pay for the meal?

Did I read the government has agreed to settle a sexual harassment case with employees at the Denver Mint for $9,000,000? Do you expect me to believe the rationale that this would save money on attorney’s fees? Did I read that a senior NASA manager’s computer was seized because of child pornography?

Did I read Scooter Libby’s lawyers are using the full frontal attack back method to discredit Patrick Fitzgerald, the special prosecutor?

And my lingering question is yet to be answered despite contacts with the Justice Department, Homeland Security and the FBI. Why was LifeCare Hospitals, where 24 patients died post Hurricane Katrina omitted from the White House Lessons Learned report? Did it have to do with the Carlyle Group’s purchase of the company just weeks before the storm made landfall? Does it help them to have the federal government silent as they enter a courtroom for civil suits?

Please tell me it is just all a joke, that it is just an April Fool’s trick.....