How can school vouchers reach a balance between serving the public interest and preserving. individual freedoms and rights?
What additional arguments can be presented for against the use of school vouchers for parochial schools?
How is the issue of school vouchers for sectarian institutions different or similar from issues surrounding prayer in school?
What are the common issues relevant to both Charter schools and voucher programs?
Since I have serious concerns regarding the long term outcomes of school choice and voucher programs, exacerbate the inequality between the rich and the poor. Since I believe that healthcare and education are both social goods, I have serious concerns about letting the free-market run amok during such a critical point in history. I do not feel it is wise to allow for-profit market forces to dictate the any public good when natural rights are at stake. The shortcomings of the Medicaid managed care programs, Medicare supplemental insurance policies, and demonstration projects such as the privatization of prisons provide sufficient evidence of the dangers of profit driven corporations in American culture. Corporate scandals with food and other suppliers contracted by the Board of Education in New York City provides an excellent example of how easy it is to manipulate funds away from the target recipients.
For example, private managed care companies offered gifts to boost enrollment by enticing desperate Medicaid recipients to join their plans. I find this marketing strategy offensive when we are dealing with a social good albeit healthcare or education. Vulnerable populations are frequently exploited through corporate contracts, and there is little reason to believe that for-profit conglomerates would treat public schools or economically disadvantaged students and families otherwise.
Arguments on both sides of the school voucher issue are very similar to those presented for and against Charter Schools and free-market school choice. Smrekar (1998) presents four key issues that have been at the center of the school choice debate: (1) economic, (2) political; (3) social justice; and (4) pedagogical.
The economic argument in favor of school choice points out that our current public education system resembles a monopoly. Proponents argue that the introduction of choice into the educational marketplace will promote competition and force schools with poor performance records to improve or close (Friedman, 1968).
The political argument is centered on the democratic ideal that the freedom to choose where your child attends school is a fundamental right. The political argument also triggers strong feelings about the role of education in a democratic society.
There are those who feel that the public school is intended, at least in part, to create a common set of core values that is best served by the public sector. At the core of the political school choice argument is a debate regarding the benefits of providing a common set of experiences in a democracy versus promoting individual choice and liberty (Smrekar, 1998). This issue, while not dead, was challenged in 1925 when the Supreme Court ruled in Pierce v. Society of Sisters (268 U.S. 510 (1925)) in favor of parents who sent their children to private school. This argument continues today and is at the center of both school choice and curriculum debates.
The social justice argument is a bit more complicated and there is little agreement on any front. Proponents argue that school choice empowers the poor to participate in the education of their children by giving them the same options available to wealthier families in the United States. According to a 1997 poll in USA Today, 47% of parents would send their children to private schools if they had the financial resources (Doyle, 1997).
Information is an essential component to any school choice program. In order to ensure social equity in school choice programs we need to be sure that the poor are fully informed of their choices and are not taken advantage of in the open market. It is believed that the act of choosing has positive effects on the school environment and promotes parental involvement in their children’s education (Doyle, 1997). Additional components of the social justice argument have focused on the nuts and bolts of choice programs, and point out how there are several different ways that choice programs may (wittingly or unwittingly) promote social inequity (Cookson, 1995). Such arguments focus on transportation problems, admissions policies, the availability of information, and how we define “choice” and implement policies regulating recruitment, enrollment and performance of participating schools, (Cookson, 1995; 1997).
The pedagogical argument points out that school choice programs are better suited for the individual needs inherent to a pluralistic society. Although some feel there is value in providing core curriculum and a common set of basic skills, there is a current trend towards specialty schools that focus on the arts and sciences, technology, vocational training, etc. Educators look towards successful magnet schools as examples of the pedagogical success that demonstrated the importance of school choice and parental involvement as indicators of educational outcomes. Some educators fear that the introduction of school choice and voucher plans would prompt the best students to leave public schools and that this would have a negative effect on the overall climate of public classrooms.
There are several different types of voucher programs, but the one which raises the most questions are voucher programs that give qualified individuals the choice to attend parochial schools. Traditional arguments against this type of school voucher program have focused on the Constitutionality of using state funds for sectarian institutions.
Historically, the church had a key role in the education of children in America. During the National Period (1780-1830), churches were used to educate children, and the King James Bible was used as a reader in these classrooms (Smrekar, 1998). Derek Neal (1997) points out that much of the current sentiment against Catholic schools is not a reflection of their excellent performance record, but rather an indication of the anti-Catholic sentiment which swept the country during the late part of the 19th Century (Neal, 1997). Neal argues that until that point, there was no contest to religious education as long as it was Protestant.
Catholic schools have traditionally served the children of the working class. They were a major socializing force earlier in the century and continue to succeed with children who might otherwise fall through the cracks in public schools. Despite tapering enrollment, Catholic schools remain a viable force in the private sector providing a reasonably priced private education to American children. Neal conducted a study that looked at the graduation rates of minority children attending Catholic schools compared with children attending public schools in the inner cities. Controlling for demographic variables, (parent’s education, parent’s occupation, family structure, and reading materials at home) closer analysis revealed graduation rates for urban minorities are 26% higher in Catholic schools compared with public schools in the same communities. Although Neal found similar benefits for whites and in suburban communities, this effect was most profound for urban minorities.
Other studies have focused on identifying the qualities that make Catholic schools successful. A number of factors have been identified by Bryk and Lee, including active parental participation and the benefits of school choice in creating an inclusive community which fosters a common set of values and ideals (Bryk & Lee, 1995). Interestingly, the very same variables found to enhance the performance of Catholic school students are remarkably similar to the reported benefits of magnet schools and choice programs. Despite the excellent performance records of Catholic schools, there are currently no voucher programs that allow parochial schools to participate in state funded voucher programs.
The reason for this is quite simple, but not necessarily correct or in the best interest of our children. The Establishment Clause of the First Amendment of the United States Constitution prohibits the use of public funds in religious institutions. However, it can also be argued that it is unconstitutional to exclude parochial schools from voucher systems because it violates the student’s free expression of religion. In addition, voucher programs require a conscious decision on the part of the student and the parent. The state does not enforce a blanket endorsement of any one religion. I use Catholic schools as an example because they represent the majority of parochial schools in urban America.
Voucher programs typically undergo strict scrutiny for all four reasons mentioned above, but this issue is especially true of any choice or voucher program that channels funds into Parochial schools. For this reason, Catholic schools and other schools with religious affiliations have been excluded from voucher plans up until this point. It is not politically viable to institute a choice or voucher program at any level (at the district, state or national level) since similar plans have historically presented long-standing, hard-fought, legal challenges to the Establishment Clause of the First Amendment of the United States Constitution.
Since the Supreme Court has not ruled on this issue, most challenges up until this point have taken place in state courts[1]. These state decisions have been split, and while there are a few voucher programs operating in Wisconsin and Ohio, neither permits sectarian schools to participate in their programs. Milwaukee designed a voucher system that included parochial schools in 1995 but later revised their proposal after the Wisconsin Supreme Court issued a temporary injunction against expansion into religious schools (Kremerer & King, 1995).
School choice programs that involve vouchers have not been tested in the Supreme Court, but there is a long history of court cases that challenge the flow of money from the public sector into private, sectarian institutions. The recent pattern of Supreme Court rulings has lead some legal scholars (Kemerer & King, 1995) to conclude that school vouchers would pass constitutional muster under the following circumstances:
Provides payments in the form of scholarships to parents of school age children
Allows parents to choose among a variety of public and private sectarian and nonsectarian schools for their children
Gives no preference to sectarian private institutions
Voucher programs up until this point have encountered substantial resistance from the legal community and a number of civil rights and political organizations. This becomes more pronounced when the voucher model includes sectarian institutions in the model plan and state court rulings have been inconsistent in decisions surrounding the constitutionality of voucher programs.
The definitive case regarding school voucher programs is Lemon v. Kurtzman (403 U.S. 602 (1971)). The Court’s ruling in Lemon was based on three components that came to be known as the “Lemon Test”. The Lemon Test applies the following to any Constitutional challenge of the Establishment Clause:
The government action must have a secular purpose
The primary effect must neither advance, nor inhibit religion
It must not result in excessive governmental entanglement with religion
Since voucher programs do not generally provide support directly to the institution, individual freedom and choice remain intact. Individual families are empowered by educational vouchers since they choose the school and religion appropriate for them. Qualified schools are not determined by religious affiliation and all schools are required to adhere to state and federal regulations which increases accountability. Similar issues came before the courts in Pierce v. Society of Sisters (268 U.S. 510 (1925)) as well, however Lemon v. Kurtzman (403 U.S. 602 (1971)) is considered to be both the landmark and test case currently before the courts.
The reason for this is quite simple, but not necessarily correct or in the best interest of our children. The Establishment Clause of the First Amendment of the United States Constitution prohibits the use of public funds in religious institutions. However, it could also be argued that it is unconstitutional to exclude parochial schools from voucher systems because it violates the free expression of religion. In addition, voucher programs require a conscious decision on the part of the student and the parent. The state does not enforce a blanket endorsement of any one religion. I use Catholic schools as an example because they represent the majority of parochial schools in urban America.
Teacher’s unions are resistant to bring in a new system that has the potential to upset their job status and security. It will likely be a number of years before we truly understand the effects of magnet schools and can evaluate the implementation of school choice programs that are already in place. Because we are dealing with such an essential human, social good, it is my recommendation that we do not implement a large scale voucher program until issues of access and equity are resolved on other public fronts. We must ensure real choices for the students and families who are not information savvy and may be limited in their ability to recognize the real value of their options. We must find a way to ensure the equitable distribution of resources so that education truly does will empower the poor.
Is the time right to apply the Lemon Test to school vouchers? You decide.
References
Cookson, P.W., Jr. (1994). School choice: The struggle for the soul of American education. New Haven: Yale University Press.
Cookson, P.W., Jr. (1995). ERIC Digests: School Choice.
Doyle, D.P. (1997). Vouchers for religious schools. Public Interest, 127, 88-95.
I do believe that if we can prove CyberBullying is a crime and that is the only reason I subject myself to the vile messages and images that make me physically ill and nightmares 5 years after it happened.
If child commits suicide, people get outraged. If aspie gets upset or develops new symptoms or is afraid to seek treatment than it is because we "misread signals" or "have higher rate of depression, anxiety and suicide?"
I call bullshit. It makes all the more reprehensible. It is criminal negligence if people do not report this kind of behavior. Especially when it is done by people who have a legal "duty to report"
Furthermore, if this causes damage to their ability to use public domain is both illegal under the Federal Communication laws, ADA and 18 USC 1027.
I lost everything.
The last 72 hours I regressed into a 22 year old who was willing to risk going blind in one eye than listen to all the morons who tried to bully me into a dangerous situation that is still volatile because it kept me from focusing on what needs to be done and my inability to stop pacing in circles until I wear myself out and fall asleep for few hours.
I realize and act like a total freak and can hear people whisper or make me feel uncomfortable stimming of repeating phrases to myself to calm prevent winding up in the hospital because I can't handle the noise or bc I don't have comfortable clothes to wear, but I had to go with my gut and realize that if I don't speak up and try to make people understand how much has been lost in that time, they. Win.
And after so many years, people see posts from five years ago and use it as justification to harass me now.
I walk a fine line every second of every day.
Yes, I would rather people see all of the wonderful articles I have written, but instead they see all of the fake d0x and embarrassing letters from my mother doing what Leah is doing to you.
I know this is long winded and hope you are following the logic, but, as a 40 year old woman with multiple degrees form the Ivy League and a pretty decent résumé my mother claimed me as a dependent on her taxes when I was living on my own for 16 years. She claimed adult dependent child and refused to amend so I could get my benefits reinstated.
Six months ago she nearly killed me in her 60,000 car and WATCHED as her new (6 foot plus militant new husband) stood over my bed and broke my only lifeline because he did not like my music or the sound of my voice.
My mother stood in corner and watched and after he leaves tells me, "I'll slap you in the fucking head if I lose my home because of you."
Then she leaves and I call two NTs in nearby and ask if I can crash for a few days at a hotel to stay safe.
"'MY SON HAS AUTISM. I CAN'T AFFORD TO blah blah blah"
In the next breath he posts my name on his website AurismAid.org so he could exploit my work and appear legitimate resource for ASD when they did nothing to help me find resources or job since that would keep me from the brilliant work I did for charity event that never even took place.
Then, I actually donated $25 to their pseudo charity (anonymous donation but I have receipt) only to find out they are exploiting others with ASD and have no 501c3, business license or accreditation to train people on anything other than how to be a shady, creepy parent who solicits donations on FaceBook for his son who is unable to speak or use toilet at 15 years old.
I was outraged. I could not believe they were taking advantage of this horrible situation to gain knout and more Leah's to keep tell me that I am the bully when I expose the scam and refuse to approve a PR stunt to gain what he *thinks" is creds and respect for being a hero dad on GMA.
Well, I don't think that makes a hero or a man if he needs to prey on the weak and the sails using MY words with Obama's face in a PSA.
I was good enough to;
do the work (for free)
Get them tons of web traffic to trend on google
Looked good on paper with letters after my name
had access to people with deep pockets and good PR
Gave them the appearance of "hiring" people with ASD so they could appeal to anti AutismSpeaks crowd
BUT, I wasn't deemed good enough to step in when Obama and Jenny McCarthy declined to make a statement to public about Autism ??
When i saw the statement that I made without permission, citation, or credit, I hit the fucking roof. I quit immediately.
Then I get flood of DMs offering everything money if I went along with the charade promising followers on twitter?
HELLO? Wake the fuck up. I don't give fuck if you have 10,000 or 200,000 followers who are willing to post bullshit and lies all over the web.
In fact, the idea that these people are SO pathetic that they need to exert their "influence" using these tactics is so much MORE pathetic, opportunistic, offensive and sad.
It is totally defeats the purpose because they use that influence to silence anyone who is either brave or stupid enough to stand refuse to comply.
This is Nazi science 101.
(Hope You are following thus far because my arms really hurt)
So, I start tweeting (thinking outlod) the way I do when I need to hear click of keyboard and heat my own voice say the words out loud as I pace until they come out sounding just right.
Gonna have to take break because I have been writing these words and concepts for years and will eventually put the pieces all together if I ever get a computer I can figure out how to use)
I waited, and waited and waited for years to see if anyone would ever see the pain and the logic of this ridiculous role I have taken on and uncover the message I am trying to put out there for future generations when they attempt to make sense out such a "virtual" reality that will either kill me or save me if I can get off this rock (or at times make it through the day without wishing I will find something to make this life worth living again.
Many people have told me that the world would be better off if I had nerve been born or I would just kill myself since they feel I am less than human and don't deserve to eat or have Internet or medical care since I am apparently THAT much of a financial burden on society.
Guess what. Yes, I want to die. Yes I am impulsive, compulsive, and self righteous BUT my logic is flawless given the right tools and opportunity to make my petty existence tolerable on the off chance that future generations or alien life forms will realize that I am different and "crazy" but one hell of a friend when the shit hits the fan.
I gotta go. I haven't slept more than 4-6 hours since my mother showed up and tried to take me to the ER so she could show off her parenting skills and have one more reason to gain sympathy and jeers from her friends or hit pay dirt and convince doctors or herself that I am causing her problems and try to stick me in a facility like Credemore so she can collect the insurance she took out on me the day before I moved in.
Better off dead? Maybe.
Willing to pull the trigger? Not on your fucking life. I would not give then the satisfaction.
And for every person who does not stand with me or will use this as more "proof" that I don't deserve to breathe or use the Internet to distract, numb, or inspire others by refusing to just disappear doesn't appreciate what I giving back to anyone who wants to know why I do what I do.
Over. And over. And over again. Until somebody listens. Or I find another way to entertain myself!!
Yes. I have video. And it ain't pretty after walking home from the hospital in 80 weather wearing black pants and the only sweater that fits.
Maybe I'll get online and order myself a pink Tank top off JadedExposure
You would think the bastard would give me one for free. But oh no. Can't have the real Elyssa on the air. It would ruin the show if they actually aired my response and statement when I answered the phone and dun. They did not even use block on caller ID.
Those bitches need to die.
That is the DailyDDoSe April 26, 2013
Just me,
e
@ELyssaD™
http://elyssadurant.com
http://powersthatbeat.com
^ed
On Apr 25, 2013, at 7:35 AM, AK wrote:
Yes, it should all be addressed legally. Leah, Heather, Ariane, Ib and others should have criminal records too. Leah should not be allowed to be a teacher running classrooms of kids. But the authorities will never get involved in blog wars and online bullying unless it turns to violent crime. I'd like to make some kind of Internet self-policing system, but I don't know how it would work. I've been so stressed from thinking about all of this that it is hard to concentrate on anything anymore. It is affecting my ability to survive, and they will never be brought to justice.
On 04/24/2013 11:24 PM, Elyssa wrote:
Just me,
e
@ELyssaD™
http://elyssadurant.com
http://powersthatbeat.com
^ed
Begin forwarded message:
From: [omjtted]
Date: April 25, 2013, 1:14:47 AM EDT
To: Elyssa
Subject: Re: Jude & Jaded
Dear ^ed,
Yeah, I've seen jaded's crap before. So sorry but this is a form of cyberbullying that should be addressed via legal channels. Ugh!
Ad hominem attacks are common amongst the idiot set. Hope all is well in your mental universe. These people are nowhere. ;) Be of good cheer?
Luv ya...
Your friends,
V & Krewe
PS: Sorry about the belated response. Haven't been to email for many a day.
Good Cop, Bad Citizen? As Cellphone Recording Increases, Officers Are Uneasy
Posted Mar 1, 2012 4:40 AM CDT By David L. Hudson Jr. from ABA Law Journal
A plainclothes Maryland state trooper approaches speeding suspect Anthony Graber, who captured the encounter with a camera atop his motorcycle helmet and later posted the video on YouTube.
Walking past Boston Common, the city’s august park, in 2007, attorney Simon Glik noticed several police officers arresting a young man. Glik heard another bystander say he thought the police were using excessive force. So he pulled out his cellphone and began shooting video of the incident.
After arresting the young man, one of the officers turned to Glik, saying, “I think you have taken enough pictures.” When the officer asked Glik whether his audio recorder was on, Glik acknowledged it was. Glik was then arrested for violating a state wiretap law and two other state offenses.
The charges were subsequently dropped, but for Glik that was just the beginning. He filed a constitutional tort suit alleging violation of his First and Fourth Amendment rights. The officers filed a motion to dismiss, contending they were entitled to qualified immunity, enabling government officials to avoid liability if they don’t violate clearly established constitutional or statutory law. But a federal district court denied the officers’ claim.
And last August, the 1st U.S. Circuit Court of Appeals at Boston ruled in Glik v. Cunniffe that the officers violated Glik’s clearly established constitutional right to video-record the police performing their duties in public.
“Our recognition that the First Amendment protects the filming of government officials in public spaces accords with the decisions of numerous circuit and district courts,” the panel wrote. The case went back to the federal district court and the parties are in discovery.
With the ubiquity of cellphones, the ease of video-recording and the availability of such websites as YouTube, people can respond quickly to police incidents and broadly circulate the recordings.
POINT AND SHOOT
“The prevalence of cellphone cameras with high enough resolutions for people to record the police and then be able to disseminate it over the Internet” is a major reason for the video-recording, says Boston attorney Jeffrey P. Hermes, director of the Citizen Media Law Project.
But law officers are often uncomfortable. “Many officers are also uncomfortable that their activities might be displayed on the Internet and otherwise widely distributed,” says Portland, Ore., lawyer Bert P. Krages, who specializes in the area. “Some also have the impression that photography presents a security risk and are acting according to a post-9/11 mentality.”
Adds Krages: “Law enforcement personnel are still grappling with the idea that ordinary citizens have the right to take images, whereas previously such photographs and videos were taken by professionals employed by traditional media companies.”
“When you talk about citizen journalists, there is also a slightly different relationship between those individuals and the police and the relationship that many mainstream journalists have with the police,” Hermes says. “Those mainstream journalists who cover the police have developed an understanding with the police that many private individuals have not.”
The 1st Circuit found it irrelevant that Glik was a private citizen rather than a professional journalist. “The proliferation of electronic devices with video-recording capability means that many of our images of current events come from bystanders with a ready cellphone or digital camera rather than a traditional film crew,” the court said. “Such developments make clear why the news-gathering protections of the First Amendment cannot turn on professional credentials or status.”
CASES IN PLAY
Glik is far from the only case. The American Civil Liberties Union of Illinois also has a case pending in the Chicago-based 7th Circuit that challenges the constitutionality of the Illinois Eavesdropping Act, as it applies to making video and audio recordings of police performing their public duties.
ACLU of Illinois v. Alvarez, filed in August 2010, claims the broad nature of the Illinois law may expose ACLU members to arrest. “The act makes audio-recording police officers in these circumstances a felony,” the complaint states. “Due to a reasonable fear of arrest and prosecution, the ACLU is restrained from engaging in this conduct.”
A federal district court dismissed the case as moot in October 2010 and the ACLU appealed. Oral argument took place in the 7th Circuit last September.
In May 2011, Emily Good was arrested in Rochester, N.Y., for taking video of police conducting a traffic stop on the street in front of her yard. According to published accounts, police told her they didn’t feel safe with her there. She was later taken into custody.
In April 2010, Anthony Graber faced an indictment in Abingdon, Md., after he recorded a state trooper giving him a ticket and then posted the video on YouTube. Graber, a 25-year-old staff sergeant for the Maryland Air National Guard, was riding his motorcycle down Interstate 95. On top of his helmet was a camera he often used to record his journeys.
The camera was rolling when an unmarked gray sedan cut him off. A man wielding a gun emerged from the driver’s side, yelling at Graber and ordering him to get off his bike. Only then did the state trooper identify himself and holster his weapon. Graber was cited for doing 80 in a 65-mph zone.
Graber accepted his ticket, then posted his video. A few weeks later, he was awakened by six officers raiding his parents’ home, where he lived with his wife and two children. He learned later that a grand jury indictment alleged he had violated state wiretap laws by recording the trooper without his consent.
“Police justifications come in a few different flavors,” Hermes says. There are security concerns and charges of violating wiretap laws, which vary by state. But police also claim they are covered by qualified immunity. The doctrine shields government officials from liability for the violation of an individual’s federal constitutional rights—so long as the official’s actions, even if later found to be unlawful, did not violate “clearly established law.”
David Milton, a Boston-based attorney who represents Glik, points to the 2010 case Kelly v. Borough of Carlisle. There the 3rd Circuit at Philadelphia granted qualified immunity to a police officer who arrested a passenger in a vehicle he had pulled over for speeding. The officer discovered the passenger was video-recording him and claimed the passenger violated Pennsylvania’s Wiretap Act. The appeals court determined that the officer was entitled to qualified immunity because he reasonably believed he had the authority to arrest the passenger.
Part of the problem, Milton says, stems from a 2009 U.S. Supreme Court decision, Pearson v. Callahan, in which the justices said lower courts had the option of deciding cases based on whether the law was clearly established, without first determining whether there had been a violation of individual constitutional rights.
But Glik altered the balance, saying there is a clearly established right to monitor the police.
“On the First Amendment issue, the concept that there is a clearly established right seems consistent with prior case law in the 1st Circuit and the experience of media recording in public as long as there have been video cameras,” Hermes says. “For decades we have had television stations recording in public and not facing sanctions.”
Adds Milton: “What is so good about the 1st Circuit decision in Glik is that the judges recognized that even though there may not be a prior case of a police officer in a park with a person on a cellphone, basic long-standing First Amendment principles clearly apply to the situation even though it involves new technology.”
Although there is no Supreme Court ruling that finds a right to record in public, Hermes says, many believe there is a clearly established constitutional right to monitor the police.
“Police serve a vital function and most law enforcement officers are very decent people who should be commended,” Krages says.
“However,” he adds, “the police are in a position to grossly abuse civil liberties, and the bad ones cause a lot of harm. In many situations, a determination of what actually happened comes down to deciding whether the officer is more credible than a suspect or citizen. Consumer-level imaging, particularly video, has captured images of officers acting very inappropriately in all sorts of situations.”
David L. Hudson Jr. is a scholar at the First Amendment Center where he writes for the Center’s website, speaks to the media and lectures on a variety of First Amendment issues. He is the author, co-author or co-editor of more than 35 books, including Let The Students Speak: A History of the Fight for Free Expression in American Schools (Beacon Press, 2011), The Encyclopedia of the First Amendment (CQ Press, 2008)(one of three co-editors), The Rehnquist Court: Understanding Its Impact and Legacy (Praeger, 2006), and The Handy Supreme Court Answer Book (Visible Ink Press, 2008). He has written several books devoted to student-speech issues and others areas of student rights. He also serves as a First Amendment contributing editor for the American Bar Association's Preview of United States Supreme Court Cases. Professor Hudson teaches First Amendment and Professional Responsibility classes at Vanderbilt.
Using TRAPWIRE to investigate misconduct in the Police State?
by Elyssa Durant, Ed.M. Policy Analyst and Citizen Journalist with a Camera Phone
I was trying to de-escalate the situation with the local Police
Department since I realize how much danger this city is in given recent
laws to persecute Muslims and people who were not born in the United
States 287(g)
However, after watching the violence erupting around me, knowing that I
am the primary target [thanks to COINTELPRO agent provocateurs] and
being questioned by the police about my twitter stream, I really don't
give a fuck.
These people have no idea how they are being manipulated by
disinformation agents, toxic living conditions and a system that is far
more corrupt than even I imagined.
The "monitor" who controls the surveillance cameras clearly has some
special deal with Metro because despite all the violence that broke out,
he finds the time to threaten, harass and stalk me ignoring the fact
that several residents threatened me after spooks came in and told
people to stay away from me or they will "get in trouble"
WHAT THE FUCK? I have no history of violence and have never even been
in a fight,I weigh 124 pounds and all these people are afraid of me? Do I
"look dangerous" because I am quite certain it won't be long before
someone makes another attempt on my life.
Much like Trayvon Martin, I was told police were on there way after a
man threw a brick through my window and then chased me down the street.
I was on the phone with 911 the whole time screaming "HELP, HELP, HELP"
yet the police claim they did not want to waste radio space to update
status of my call to a Code 3. Are you fucking kidding me?
911 told me to return to the scene of the crime where I was assaulted a
second time, and the cops didn't even bother to arrest him or take
witness statements. In fact, the officer would not even step out of the
car to speak with me because he did not like the way I was dressed.
Because no action was taken against the man that assaulted me and vowed
to kill and my father (who just happens to be a former Fed) I constantly
carry my iPhone because the cops claim they did not have enough
evidence to arrest this man. They never bothered to check the
surveillance camera and did not take statements from additional
witnesses.
They did, however take issue with the fact that I placed a video on
YouTube and were even more upset that I contacted a former colleague in
the Mayor's Office who then requested an investigation. They sent two
Lieutenants to my home; one was aggressive and disrespectful and was
more interested in what book I was reading and my website than the facts
of the case.
I was told that they would follow up with the other witnesses who would
corroborate my story, and that a Special Operations Unit and Gang Unit
would be contacted regarding the racial comments that became commonplace
every time I left the apartment.
One man hung up Nazi flags, another started praying in Muslim and all
hell broke loose in the neighborhood. I became a target because I was
white in a Black neighborhood, and apparently that alone was enough to
incite hatred among the other tenants and I feared for life each time I
left my apartment, so the police told me NOT to leave my home. THAT IS
OUTRAGEOUS.
The other tenants became more and more abusive and violent since they
now had a new sense of entitlement because they knew the police would
not take action.
It is worth noting that even after I left, the violence continued to
escalate and one women was stabbed and several other injured in fights
that broke out in the hallway. The cops still did not arrest the people
who continue to live in the neighborhood, and some of them have shown up
here at my new apartment to harass me and spread rumors.
The neighbors here have suddenly became abusive and overly concerned
with my religion and it seems the writing is on the wall. They think my
healthy paranoia is "suspicious" and I think their behavior is
outrageous.
They constantly stand outside my window and scream at me and the
"monitor" called the police on me after he threatened me and told me I
was not allowed to go near a "white car." There were SIX white cars,
two of which have no tags, so how am I to know which white car is the
one who stopped me at the mailbox and told me that two men were knocking
at my door and were here to beat me up?
I may very well be the next Treyvan Martin and if so, so be it. I am old
enough and experienced enough to know that these people do not see the
bigger picture~ that they are being used to as examples to bring down
the police state and usher in the New World Order.
I leave these notes because I do not know if I will get shot at today,
tomorrow or next week, and I think it is important to let people know
that I have spent my entire life studying gang violence, and have fought
hard against police corruption and discrimination so regardless of what
happens to me, I do not want my work (or experience) to be in vain.
I am one of the good guys, and if you can't see that by now... then take
some time to look through some of my publications which are
systematically being removed from the internet by groups like Anonymous,
Lulz, and AntiSec.
This breaks my heart, but I am fighting a losing battle. I am starting
to question my commitment and given the communities response~ I am not
sure if they are worth the sacrifice.
That's all for today. This is the Daily Dose for March 29, 2012.
Just me,
e
@ELyssaD
ANOTHER POST THE POLICE TOOK ISSUE WITH:
Metro Nashville Police Department continue to cover up crimes by failing
to follow established code of conduct in lower income neighborhoods.
Some power hungry police officer demands to search my iPhone after he
notices I am video taping the MNPD who took three hours to respond to
multiple neighbors call 911 after witnessing multiple violent assaults
against two women and one man on Monday evening.
I called 911 after two people approached my window threatening my life
for being a "cracker Jew bitch" and threw a brick through my window
where I was working on two projects about Cointelpro as a driving force
behind the Occupy movement that is being funded by The American Nazi
Party and the Lucis Trust.
I was interviewing someone who had been involved with Nazi medical
experiments and how it effected his four children who suffer with a
variety of neurological and psychological problems that are typical of
victims of Mengele's subjects.
I had just received notification from the copyright office (USTPO) in
Virginia that my submission was approved and was thrilled to learn that
my publications and identity would be protected under trademark and copyright laws
since I received several take down notices from the police and google that my site was in danger of being seized due to the number of complaints received about the content: THE TRUTH.
Ironic when I noticed which posts were
being removed due to the sensitive nature (and my vast knowledge) about
the true purpose of organized, controlled opposition as a driving force
to escalate domestic unrest designed to incite violence justifying a
Police State ushering in the New World Order.
This is not the first, second, or even third time I have been stopped by undercover police or random uniforms knocking on my door to search my cell.
One cop came running after me, demanded to see my cell phone and after
running my license to check for warrants (which seemed extreme) and
finding none, he wrote up an incident report for "suspicious behavior"
for video taping a crime scene.
He not only searched my cell phone without a warrant, but proceeded to DELETE crime scene photos.
THAT IS A VIOLATION OF BOTH THE FOURTH AND THE FOURTEENTH AMENDMENT, AND THAT'S ABOUT AS SERIOUS AS IT GETS.
RELEVANT HISTORY THAT HAS NEVER BEEN MADE PUBLIC:
Despite being a "confidential" informant in an undercover sting operation that went bad [way bad] in 2009 at the request of the Mayor's Office and several police officers not to be named at this time, I became an informant when I saw people selling prescription drugs to teenagers in DCS custody.
I wanted it to stop, and at the police sergeant's request, I agreed to work with the Crime Suppression Unit to keep these kids from inevitable path to lifelong addiction and criminal behavior.
I was instructed to report on the illegal activities, which included taking down license plates and traffic patterns indicative of illegal drug sales.
After lengthy discussions with my contact in the department, the majority of all follow up communications were via e-mail on my cell phone so my neighbors would not hear me discussing the situation.
That fateful day my cell was jammed and hacked, I was unable to receive or send critical communications to alert me that shit went bad, and my cover was blown.
None of this ever made it though the network, and the e-mails reside on a microchip that is an UNDISCLOSED LOCATION with about 40 back ups at the ACLU, FBI, and Nightly News just in case something happens to me before I transfer out of here into a safer jurisdiction.
That was the first, but not the last time my cell was jammed and hacked.
I could not receive communications or directions from the crime suppression unit, and I wound up being assaulted and hospitalized after one of the bullets hit my window.
I was promised a police escort and advanced warning, but they never showed up, until they did with automatic assault rifles at my front door.
It was too late.
I have never disclosed those emails, however they have since been accessed by hackers from Lulz, AntiSec and whoever accessed my computer when I was out of town this time last year.
How do I know? Because the PC hadn't been turned on in several years and the last ten documents opened were my detailed call records and an e-mail to a certain politician who also had his cell phone records searched and used against him in an ugly court battle and political campaign.
SO, they're you have it folks The truth, the whole truth and nothing but the truth, so help me [aliens]
Now, an obvious target by the police department, I am constantly harassed, stopped, searched, interrogated or subjected to "unofficial complaints" of harassment that always seem to follow a pattern I know all too well.
SO, when the investigator tries to tell me that I would not make a good witness since I called 911 from my closet AFTER the brick came through my window, what they mean is, we will make sure your credibility is destroyed through false reports, and constant harassment should you ever decide to sue us for police misconduct.
Well, fuck you!
After yet another incident where the police failed to respond to a life threatening situation in a timely manner, insult and intimidate me, three times in 24 hours, then ultimately release the suspect claiming there
is not enough evidence??
I CALL TRAPWIRE!!
When you refuse to take witness statements; reveal your name or badge
numbers, and another violent criminal continues to terrorize me for months on end, and the police refuse to review the live feed trapwire video that would show beyond any shadow of a doubt that this man assaulted me AND three other individuals within minutes of being released?
No evidence? Check the fucking surveillance cams just above the the scene of the crime.
Hell, check MY surveillance cam! I don't leave home without it!
Underwriting the Social Contract: Distributive Justice & Health Care Reform
The Problem Statement
As health care costs climbed exponentially in the 1980's, so did the cost of health insurance plans. As a result, employers began to enroll their employees in managed care organizations, and many Americans were forced to leave their traditional indemnity type plans. With the advent of the health maintenance organization, there is a financial incentive for the underutilization of care. (Blumstein, 1996; Davis & Shoen, 1996).
In order to reduce financial risk, health insurance companies have restricted enrollment to individuals in poor health. By covering the minimal standards of treatment and excluding high risk groups altogether, major US insurance companies have realized that the health insurance market can a be an extremely profitable industry. The public sector absorbs the cost of unreimbursed care for chronic care in America (Robert Wood Johnson Foundation, 1996). Based upon these findings, it seems clear that the money being removed from the health care marketplace is fattening the pockets of CEOs and majority stockholders.
Recent trend towards localized government leaves individuals without a financial safety net. This is the least efficient manner to handle health care costs, and evades the premise that medical care is a natural right in a civilized society. Few Americans feel secure within the current system. The rising costs of medical care contributed to the recent market changes in both the administration and delivery of health services. The financial incentive to cover only the healthiest individuals ignores the fact that medical care is a social good.
Health Insurance Portability Act of 1996
Two years after the Clinton Health Plan was defeated in Congress, Senator Ted Kennedy and Nancy Kassebaum introduced the Kennedy-Kassebaum Bill in response to growing concerns about selective enrollment procedures used by health insurance companies in the private sector. In the final version of the Bill, insurance companies must limit preexisting condition clauses to twelve months. It has been estimated that this provision of the Bill will help an estimated 150,000 Americans obtain health insurance coverage.
There are many levels of the underinsured, including those without any coverage; effective policy must address the needs of the total population without shifting costs from one disadvantaged person to another. Kennedy-Kassebaum fails to address the cost issue—the primary concern for those at risk for losing their health insurance. It does nothing to help the uninsured acquire a decent health policy, and then provides no solution to the critical issue at hand— cost
Since Kennedy-Kassebaum does nothing to control the cost of health insurance and medical care in America, the Bill fails to respond to the issue of greatest concern to the citizens of this country: the cost of medical care. The Bill looks towards the states to develop consumer protections and weakens the regulatory role of the federal government. The majority of the American public is unaware of the fancy footwork involved with this legislation, and the demographics of the population it is intended to protect. In order to assess the utility of this Bill, it is critical to identify the populations at risk for loosing health insurance coverage and the underinsured.
Kassebaum-Kennedy focuses on a slim portion of the uninsured population, and those who would be eligible for COBRA continuation (Consolidated Omnibus Reconciliation Act of 1974). Of the 41 million uninsured Americans, only about 150,000 are expected to benefit from this legislation. The Health Insurance Portability and Accountability Act of 1996 is really nothing more than smoke and mirrors since it fails to address the true issue at hand—the simple fact that the cost of quality health care in America is becoming a privilege that only the wealthy can afford.
The Cost of Care for Pre-existing Conditions
An individual with high blood pressure may just require prescription medication. Cancer patients in remission may require chemotherapy, and a person suffering with a degenerative disease may be involved in treatment studies. Each condition requires individualized treatment that cannot be based upon the simple economic/cost-benefit analysis used in the utilization review process by large insurance companies. Clearly, the most effective treatment for one patient may not be the best for another. The time required for utilization review may present additional health risks and complications to a patient suffering from a chronic health condition.
Twelve months without insurance coverage may be financially devastating to some patients, and 63% of Americans have already forgone some type of medical treatment within the last year due to financial constraints. Publicity surrounding Kennedy-Kassebaum has hailed the bill as the "be all and end all in progressive legislation, however, in actuality it will only help about 150,000 people.
Recent studies have found that the majority of the uninsured population simply cannot afford to pay the premiums (Donelan et. al., 1996; Hoffman & Rice, 1996). According to their data, only 1% of the Uninsured population is due to current health status and exclusionary preexisting clauses, yet an overwhelming number of insured respondents reported an inability to receive medical care for chronic conditions. The majority of Americans with chronic illness are covered by some type of insurance, yet they are still subject to the utilization review process and access problems that deny or delay medically necessary treatment (Donelan, et. al., Hoffman & Rice, 1996).
Underwriting the Solidarity Principle
Traditional forms of insurance underwriting required that the contract explicitly state which illness or services are not covered by the policy, in advance. If the underwriter did not specifically state a certain condition in the contract, the insurer was held to the terms of the contract and required to pay for services utilized by the policyholder (Stone, 1994, as cited in Durant, 1996).
Increasing numbers of for-profit and non-profit insurance companies began to control costs by refusing to insure individuals who they felt would utilize more services. Insurers began to require health survey status questionnaires (refer to attachment A), and even began implementing AIDS and genetic testing to identify high-risk individuals (Brunetta, as cited in Gutmann & Thompson, 1996). In the 1980s, large insurance companies began including sexual orientation as a high-risk category, by using actuarial sound criteria. Such criteria concluded that gay men were a higher risk for contracting AIDS virus and refused to write policies for anyone believed to be homosexual, (Stone, 1994 as cited in Durant, 1996).
By limiting enrollment to the healthiest members of society, selective enrollment undermines the solidarity principle of health insurance (Davis & Shoen, 1996; Snow, 1996; Stone, 1994). By eliminating those who were suspect of using more services than their healthier counterparts use, insurance companies are able to offer rock bottom prices for young, healthy individuals. By excluding preexisting conditions and requiring certain individuals to purchase high-risk policies, the number of uninsured and underinsured Americans continues to grow exponentially (Durant, 1996).
More individuals are choosing not to purchase insurance simply because they cannot afford it. Even among those with employer based health coverage, the policies frequently exclude coverage for long-term illness or care of chronic conditions (MSNBC News Forum, 1996). Without a standard definition of preexisting conditions, these clauses serve as "wildcards" since they allow insurers to deny coverage for any illness that "manifested itself before the issuing date of the policy (Stone, 1994 as cited in Durant, 1996).
This statement allows insurers to deny treatment for benefits and services for the policyholder for undiagnosed illnesses or conditions of which they were unaware. As a result, the insurers began to demand medical histories of applicants and their families in order to identify high risk individuals (please refer to attachment A).
Legitimacy of Distributive Justice
While there is a legitimate role of government to distribute scarce resources among the nation's neediest individuals, sadly this is not the cause for the mismanagement of medical dollars in the United States today. There is a big distinction between an individual being denied prescription medication at their local pharmacy due to a cost-effective formulary developed by their Managed Care Organizations (MCOs), than an individual being denied a liver transplant because healthy livers are a scarce resource. While both may have equally devastating consequences, it is more difficult to rationalize a lost life based upon rigid cost benefit analysis and utilization decisions made according to formulas and cost-benefit analysis of treatment protocols.
"The political controversy over the distribution of health care in the United States is an instructive problem in distributive justice. Good health is care is necessary for pursuing most other things in life. Yet equal access to health care would require the government to not only redistribute resources from the rich, healthy to the poor, and infirm, but also restrict the freedom of doctors and other health care providers. Such redistributions may be warranted, but to what level, and to what extent?" Gutmann & Thompson (Page 178).
Blendon and his colleagues have reported similar findings in public opinion polls from 1992 and 1994 (Blendon et. al., 1992; Blendon et. al., 1994). A recent study by the American Medical Association found cost to be of paramount concern to an overwhelming number of Americans (Donelan et. aI., 1996). Of the 40 million uninsured Americans, only 1% attributes their failure to acquire health insurance coverage to their preexisting conditions. Among the uninsured, cost is cited as the primary obstacle in obtaining health insurance coverage. Only 1% of the uninsured attributes their lack of coverage to a preexisting condition.
Based upon these democratic principles of distributive justice, consistent opinion polls demonstrate the legitimate role and public desire for government regulation of the health care industry. It has become obvious that the federal government must intervene in order to protect natural law rights, the social contract, and the Constitution of the United States. Regulation is needed to protect the individual freedoms, liberty, and the pursuit of "health, happiness, and the American Dream."
If America is to be the "Land of Opportunity," then clearly individual health and wellness should be an ideal to reach for. Current models of distributive justice emphasize public consensus as a legitimate role for government intervention. According to a number of studies by Blendon and his colleagues, the public has reported an overwhelming general concern about health care in this country, (1992, 1993, 1994, 1995, 1996).
State civil courts are backed up with cases where HMOs have violated the First Amendment (gag orders), the Fourteenth Amendment (due process), and the rights of protected classes under the Americans with Disabilities Act. Countless examples of "anecdotal" evidence appear as headlines everyday across the country. (New York Times, 1996; The New York Daily News, 1996; Long Island Newsday, 1996; LA Times, 1996; Picayne Times, 1996; Columbia Spectator, 1996; Columbia University Record, 1996; US News & World Reports, 1996; Newsweek 1996; Healthline, 1996; The Tennessean, 1996; The Albany Times, 1996; The Nashville Scene, 1996). In their entirety, these case reports represent the human tragedy that lies beneath the web of the very worst of American capitalism: corporate greed.
Identifying Populations At-Risk
A study by The Lewison Group in 1996 reveals insight into the private individual health insurance market. Clearly, individuals choosing to purchase health insurance policies for several hundred dollars each month expect their health care needs and expenditures to exceed that amount Regardless of health status, a young healthy 25 year old who purchases an individual health insurance policy can expect to pay well over $300.00 monthly for a health insurance policy with Empire Blue Shield Blue Cross (based upon 1996 rates, current rates available from the New York State Insurance Department).
Since individual policies are not addressed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), an individual policy with Blue Cross Blue Shield of Tennessee excludes preexisting conditions for 24 months (enrollment booklet available upon request). The critical markets in need of reform are the adversely selected individual insurance market, and the state's most vulnerable populations: children; the elderly; the chronically ill; the uninsured; and the underinsured.
For the millions of individuals who have lost their employer based coverage, the cost of private health insurance is prohibitively expensive. Many individuals opt out of the individual market and apply for public assistance when the need arises. Those who have retained their health insurance coverage through their employers are being moved into managed care despite their efforts to retain their indemnity style plans (Davis & Shoen, 1996; The Lewison Group, 1996).
Access to Medical Care
As routine practice, HMOs deny or delay care for all services that are not outright medically necessary. Growing numbers of individuals have suffered irreparable harm, and many have died awaiting approval from their HMO's (The New York Times, 1996; Long Island Newsday, 1996; The Tennessean, 1996; Healthline, 1996). It is hardly a secret that HMOs have fallen short of their promise to provide comprehensive health care for the "whole" individual by emphasizing preventative medicine, using medical management to coordinate care. There is substantial evidence that individuals with chronic conditions receive substandard care in HMOs.
A four-year longitudinal study of medical outcomes found that the elderly, the poor, and persons with chronic conditions were in better health when covered by fee-for-service plans compared with a control group covered in HMOs (Ware et. al., 1996). New statistics released in Washington, DC by the American Medical Association and the Robert Wood Johnson Foundation revealed the direct costs of individuals with chronic conditions account for 75% of direct medical expenditures in the United States (Hoffman & Rice, 1996; based upon the National Medical Expenditures Survey; raw data available on CD from the Department of Health and Human Services Washington, DC). 45% of the American population suffers from at least one chronic illness.
If managed healthcare has been found to deliver inadequate care to this population, then we are looking at 100 million individuals who are potentially facing personal and financial crisis as they are moved into managed care. The public already accounts for the largest payment of direct medical expenditures, which means the millions of dollars being made by for-profit insurance companies are not being circulated into the economy to assist in public health costs care. The industry made a 14.8% profit in the 3rd quarter of 1996, however these medical dollars were removed from health care and used to fatten the pockets of CEO's and majority stockholders (Healthline, 1996).
Based upon a new report from the Robert Wood Johnson Foundation, the direct costs for persons with chronic conditions represent 69.4% of national expenditures in personal health care (Robert Wood Johnson Foundation, 1996). Their direct medical costs are estimated at $4672.00 annually compared with $817.00 annually for individuals with acute illness (Hoffman & Rice, 1996; based upon National Medical Expenditures Survey 1987, not adjusted for inflation). This population is the most vulnerable to complications in their health and with their source of payment. Large insurance companies only provide adequate coverage for acute illness (Donelan et al., 1996; Hoffman et. al, 1996).
Medicaid Managed Care
Following Tennessee's lead, many states have enrolled their medically indigent populations in Medicaid Managed Care Organizations (MCOs). In Daniels v. Wadley, (926 F. Supp. 1305), the court held that TennCare violated the Due Process Clause of the Fourteenth Amendment since such procedures eliminate fair hearings and independent medical review of disputes. The court found the pattern of routine denials of care by MCOs participating in the states TennCare program to violate the Medicaid Act since it compounded the problem of institutionalized waiting periods for medical appeals pending independent review by the Medical Review Unit (MRU), (42 U.S.C. § 1396 (a)(8)).
Furthermore, the court ordered federal injunctive protection to participants and beneficiaries because no state law may preempt federal law by depriving individuals of their constitutional rights. The Department of Health and Human Services (HHS) was ordered to revise its utilization review procedures for TennCare recipients in keeping with the Medicaid Act (42 U.S.C. § 1396 (a) (8)) ensuring due process protections for all covered beneficiaries by requiring "services are provided with 'reasonable promptness,'" (926 F. Supp. 1305).
This case is one of 543 civil suits pending in the state courts for violations of the Medicaid Act (based upon a Lexis-Nexis search performed December 26, 1996). With the passing of H.R. 3507 into public law, (The Welfare Reform Bill) private citizens will find little reprieve in the federal courts, so any attempts to hold states accountable for violations of federal law will be feeble at best (Denkeret. al., 1996).
Managed care has shown itself to be a farce of "medical management" in light of all the condemning evidence to the contrary. Timothy Icenogle, a medical doctor in the state of Arizona commented in 1981, "We play sort of an advocacy role. I think the public demands something more from physicians than to just be a blob of bureaucrats, and I think we have to take a stand now and then. Our role essentially as patient advocate, is to tell them, well, just because the insurance company is not going to pay, that is not the end of all the resources," (Icenogle, as cited in Gutmann & Thompson, 1996). Never has this statement been needed more than it is today. Unfortunately, as more insurance companies refuse to pay for medical treatment, fewer resources become available for patients in desperate need of financial assistance. As Judge Kessler eloquently stated as she handed down her decision in Salazar v. District of Columbia, No. 93-452, December 11, 1996, "behind every fact found herein is a human face and the reality of being poor in the richest nation on earth, (936 F. Supp. Slip op. At 3).
Perhaps most distressing is the lack of accountability for mismanaged healthcare and improper denials of medically necessary treatment. HMOs claim immunity under ERISA, and leaving individuals without recourse in a sea contractual language and lengthy court calendars. It is evident that individuals protected under the Medicaid Act are not fundamentally different from other populations entrapped in the maze of managed care. They are simply those who have "had their day in court."
Due Process Protections
Since all Americans are theoretically entitled to due process protections under the constitution of the United States, it seems the federal courts are long overdue for making such a public statement. We are wasting precious time and losing millions in valuable human resources as we await decisions to be handed down from state courts. The Supreme Court of the United States has agreed to hear New York's request for an ERISA (Employee Retirement Income Security Act of 1985) waiver, making health maintenance organizations liable for medical malpractice in the state of New York.
When HMOs deny care from patients, it is ludicrous to hold individual physicians liable for the utilization decisions made by decentralized corporate review boards. It is time to take a serious look at tort reform, and demand action by the Supreme Court as they approach the date of New York's ERISA hearing. A blanket court ruling upholding Daniels v. Wadley, and Salazar v. District of Columbia is desperately needed to avoid an avalanche of liability suits filed in state courts. The court must uphold Daniels v. Wadley, and Salazar v. District of Columbia if further lives are to be saved in medicine rather than wasted away in the utilization review procedures. While we wait patiently for District of Columbia circuit court to order injunctive relief, the number of individuals suffering irreparable harm due to the systematic denial of medical care grows larger each day.
The history of Medicaid Managed Care does not provide a very optimistic look into the future of TennCare recipients and Medicaid beneficiaries in states around the country. Dating back to the implementation of the Arizona Health Care Cost Containment System (AHCCCS) in 1981, there are documented cases where "people reportedly died for lack of medical treatment before their eligibility was determined," (Varley, as cited in Gutman & Thompson, I 996). This leaves me to wonder why the states continue to enroll their most vulnerable populations into a system of managed care that has proven to be a disaster.
Perhaps worthy of comment is that Arizona is the only state to have voted Republican in every election since 1948—certainly provides insight into the conservative morale of the state. Although Arizona was the last state to accept the Medicaid cost sharing incentive proposed by the federal government in 1966, it was the first state to force its medically indigent population into managed care in 1981.
Violating Federal Law
Rigid pre-certification requirements and nonspecific utilization review procedures place strategic barriers to access medical treatment and services in Health Maintenance Organizations (HMOs). Pre-certification requirements are strategic barriers incorporated into the "black box" of utilization review that institutionalizes exclusionary waiting periods and routine denials of medically necessary treatment. According to federal law, "care and services are to be provided in a manner consistent with the simplicity of administration and the best interests of recipients," (42 U.S.C. § I 396a (a) (19)). Clearly, such rigid pre-certification requirements that complicate administrative processing and paperwork on the part of the enrolled beneficiaries is a violation of United States Code.
Furthermore, using primary care providers as a mechanism to limit access to specialists not only complicates administrative processing, but limits enrolled beneficiaries choice of health professionals beyond what is available to the general public in the geographic area (42 U.S.C. § 1 396a (a)(30)(A)). Certainly referral procedures do not "assure that recipients will have their choice of health professionals within the plan to the extent possible and appropriate," (42 U.S.C. § 434.29). Under this provision, it seems that any individual, especially those with chronic health conditions or disabilities should be allowed
Blumstein, J. F. (1996). Health care reform and competing visions of medical care: Antitrust and state provider cooperative legislation. Cornell Law Review,79,1459-1506.
Blumstein, J. F. (1996). The fraud and abuse statute in an evolving health care market Life in the health care speakeasy. American Journal of Law and Medicine,22(2), 205-231.
Bunis, D. (1996, July 16). Sweeping changes for health care: What it means to you. Long Island Newsday, pp. A6, A53.
Chartland, S. (1996, April 28). The changing game of health insurance. The Current York Times [On-line. Available: http://www.nytimes~com/
College of Physicians and Surgeons at Columbia-Presbyterian Medical Center Office of Public Relations. (1996, July 25) Press Release: Current York's Ivy League Medical Schools articulate first of its kind affiance.
Consumer Reports. (1996, May 31). Children and health care.
Davis, K., & Shoen, (1996, March). Health services research and the changing health care system. Unusual York: The Commonwealth Fund. Available: http://www.cmwf.org/
Donelan, K., Blendon, R. J. Hill, C.A., Hoffman, C., Rowland, D., Frankel, M., Altman, D. (1996). Whatever happened to the health insurance crisis in the United States? Journal of the American Medical Association,276(16), 1346-1350.
Durant, E.D. (1996). The New York Health Reform Act of 1996: Costs of Exclusion. (Unpublished).
Employee Benefit Research Institute. (1992). Sources of health insurance and characteristics of the uninsured. (Issue Brief No. 123). Washington, DC. Available: http://www.ebri.org/
Families USA (1996, July). HMO Consumers at risk: States to the rescue. Washington, DC: Families USA. Available: http://epn.org.families/farisk.html
Families USA (1996, June 7). New York managed care legislation: A model for other states. Washington, DC: Families USA. Available: http://epn.org/families/fastat.html
Families USA (1996, August). Kassebaum-Kennedy health insurance bill clears congress: Medicaid Saving Accounts diminutive to demonstration program. Washington, DC: Families USA. Available: http://epn.org/families/fakeka.html
Fein, E. B. (1996, July 5). For-profit hospitals: Once unthinkable, now probably inevitable. The New York Times, [On-line]. Available: http://www.nytimes.com/
Health Care Portability and Accountability Act of 1996, Pub. L. No. 104-191 (1996).
Hoffman, C., Rice, D.R., & Sung, H.Y., (1996). Persons with chronic conditions: Their prevalence and costs. Journal of the American Medical Association,276,1473-1479.
Holusha, J. (1996, August18). For doctors togetherness is the new way of life. The Unique York Times [On-line]. Available: http://www.nytimes.com/Cp960818.htfl1l
Levinson, M. (1996, June 26). As Blue Cross and Blue Shield head into the for-profit sector, it is helping to start the biggest gold rush since Sutter’s Mill. U.S.New [On-line]. Available: http:/ / www.usnews.com/
Levy, C. J. (1996, July 2). New era in Modern York hospital-rate plan. The New York Times, pp. Al.
Malpractice law evolves under managed care. Paper presented at the conference, Emerging Liability Issues in Managed Care, sponsored by the Robert Wood Johnson Foundation’s Improving Malpractice Prevention and Compensation Systems (IMPACS) program, October, 1995.
Market competition and the health care safety collect. States of Health, (December, 1996) Washington, DC: Families USA. Available: http://epn.org/families/safeflet/html
Metcalf, E. (1996, September 6). Columbia and Cornell plan alliance—2,800 physicians strong.. Columbia University Spectator, p.1.
Metcalf, E. (1996, September 27). Columbia/Cornell MD’s Ally. Columbia University Record, p. 1.
Nasr, H. (1996, July 31). Major university hospitals to merge. Columbia University Spectator, pp. 1,8.
New York Health Reform Act of 1996, NY AB 11330.
Pear, R. (1996, May 26). Two trends collide: The rise in travel and of local HMOs. The New York Times [On-line]. Available: http://www.nytimes.com/
Perrin, E. C., Newacheck, P., Pless, B. I. Drotar, D., Gortmeaker, Steven, L., Leventhal, I., Perrin, J.M.,
Stein, R.E., Walker, D.E. Weitzman, M. (1993). Issues involved in the definition and classification of chronic health conditions. Pediatrics, 91(4), 787-793.
Robert Wood Johnson Foundation (December 1995). HealthTracking: HMOs and US health care. Available: http://rwjf.org/
Robert Wood Johnson Foundation (February 1995). Market consolidation, antitrust, and public policy in the health care industry: Agenda for future research. Prepared for the council on the economic impact of health care reform (item: HTO1).
Robert Wood Johnson Foundation (December 1995). Health Tracking: HMOs and US health care. Available: http://rwjf.org/
Robert Wood Johnson Foundation (February 1995). Market consolidation, antitrust, and public policy in the health care industry: Agenda for future research. Prepared for the council on the economic impact of health care reform (item: HTO1).Robinson, R. (1993). Economic evaluation in health care: Cost-effectiveness analysis. [Education & Debate]. The British Medical Journal,307(6907), 793-795.
Robinson, R. (1993). Economic evaluation in health care: Cost-effectiveness analysis. [Education & Debate]. The British Medical Journal,307(6909), 924-926.
Rosenthal, E. (1996, July 2). Two more hospitals run to join forces: Beth Israel-Long Island Jewish Merger to do far-flung empire. The New York Times, p. B3.
Rosenthal, E. (1996, July 15). Patients say NY 1-IMOs don’t deal well with complex illnesses. The New York Times, p. Al.
Schiff, G. S. (1996, March 16). Managed care issues. Physicians for a National Health Plan. Available: pnhp@aol.com -
Selby, J. V., Fireman, B. H., & Swain, B.E. (1996). Effect of a copayment on use of the emergency department in a health maintenance organization. New England Journal of Medicine, 334,635-641.
Shaw, T. (1996, March 25). Dole’s bad medicine: health reform concept would raise costs, hurt quality. USAToday, [On-line]. Distributed by the National Center for Policy Analysis.
Smolowe, J., Perman, S., & Van Tassel,J. (1996, April 15) A healthy merger? A huge deal makes Aetna the country’s largest health-care company. Time Magazine,14(16).
Spragins, E. (1996, September 24). Special Report America’s best 1-IMOs: Rating the top managed care companies. Newsweek, pp.58-63.
Stone, D. A. (Monroe, J. A. & Beilcin, C. S. eds. 1994). The struggle for the soul of health insurance. The Politics of Health Care Reform,27-56.
Taylor, H. (1996, July 16). Health care capitalism remakes a city’s health system. The Albany Times [On-line]
Toim L (1996 July 31) Local 2110 loses its benefits Columbia University Spectator, pp 1-5
Van Duzer, K., & Nasr, H. (1996,July 31). Nurses reject final hospital’s offer, strike possible. Columbia University Spectator, pp. 1,8.
Ware, J.E., Bayliss, M.S., Rogers,W.H., Kosinski, M., Tarlov, A.R. (1996). Differences in 4-year health outcomes for elderly, dreadful, and chronically if patients treated in HMO and Fee-for-Service systems: Results form a medical outcomes study. Journal of the American Medical Association. L 1039-1047.
Williams, R. M. (1996). The cost of visits to emergency departments. New England Journal of Medicine, 334 642-646
