Recent Columns

Columns appear here a week after they're published in print.  

© 2024 NEW MEXICO NEWS SERVICES 12/16/24

Faceless flunkies making dangerous decisions

By Sherry Robinson

All She Wrote

     “Live your life in such a way that half the world isn’t dancing in the streets when some hero puts you in the forever box.”

     This meme, with a photo of United Healthcare CEO Brian Thompson, isn’t circulating in public – it’s on websites for medical professionals.

     Debates over Thompson’s assassination and the capture of his accused killer are still blazing on social media and even at Christmas parties and show no sign of letting up. The consensus is the shooting reveals a seething anger against health insurers, although most of us stop short of murder. 

     Here’s a New Mexico story: A son brought his father to the hospital slumped over and barely breathing. The man had severe COPD. A pulmonologist had prescribed oxygen equipment to help him breathe, and he was responding well. Then United Healthcare refused to cover the cost, and the man lost the life-saving equipment. He was stable for a brief time and then nearly died, generating an ER visit and hospital stay. 

     “I see this every day,” says the doctor who treated him.

     That’s the other dimension of the shooting-inspired debate. Healthcare professionals, who care deeply about patients and outcomes, witness the infuriating injustice of insurer decisions. Not only that, after investing years becoming licensed medical doctors and specialists, they’re routinely overruled by faceless flunkies making dangerous decisions.

     On YouTube, Dr. Will Flanary, an ophthalmologist better known as the doctor-comedian “Dr. Glaucomflecken” to his four million fans, has spent years providing insight into the healthcare system. While he prefers a humorous approach, he took a serious turn in responding to Thompson’s death:

     “Two things can be true: One, that murder is bad, that even bad people who do bad things don’t deserve to be executed. It can also be true that United Healthcare is an evil corporation that has caused pain and suffering to millions and millions of people over the years. This is a company that denies claims at a higher rate than every other insurer out there. It denies so many claims they have to outsource claim denial to a company that gets paid per denial… 

     “United Healthcare has vertically integrated their company to the point where they can dictate which medications patients are allowed to be on. Not doctors. This routinely leads to chronically ill patients, who are stable on a medication for years, and all of a sudden have to change medications to something that doesn’t work, all because United Healthcare got a better deal from a pharmaceutical company…

     “People are hurting. People are financially devastated by our healthcare system. They’re not able to get the treatment that their doctors recommend. So it’s not that hard to understand the social media reaction to the shooting, which I would describe as unsympathetic. All the jokes, all the snark about the shooting, it’s all a coping mechanism for a population of people who feel powerless in our healthcare system. Who are any of us to tell people how to react to this very unique situation?”

     Flanary gives us some welcome perspective on the spectacle that has fueled late night talk show riffs on the movie-star looks of the shooter, the “Free Luigi” memes, the deep distrust of the insurance industry.

     He’s adamant that violence isn’t the answer but speaking up is. He even sees an upside: “This is the first time where I’ve seen a lot of people both in healthcare and outside healthcare actually discussing harmful health insurance policy.”

     And that’s what needs to continue. His message is to stop being silent and passive.

     “So use your voice in whatever way you see fit and never forget that social media can be an incredibly powerful tool for advocacy.”   

© 2024 NEW MEXICO NEWS SERVICES  12/16/24

Join the season of giving

By Diane Denish

Corner to Corner 

     During the holiday season there is always a focus on charitable giving or philanthropy. Recently you might have been asked by your local nonprofits or organizations to give generously on Giving Tuesday. This is charitable giving. Philanthropy is something different.

     Although Giving Tuesday sometimes seems like a commercial effort, it was the brainchild of NYC 92ndStreet and its BELFOR Center for Innovation. Its original purpose was to counter the consumerism and promotion of Black Friday and Cyber Monday. Giving Tuesday hoped to inspire generosity and motivate people to do something good, for someone other than themselves. Originally it was launched in partnership with the UN Foundation, but Giving Tuesday is now a standalone non-profit with a worldwide reach, a staff of 40 and a board of prominent business and philanthropic leaders.

     This year, Giving Tuesday raised $3.6 billion, up from $3.1 billion, or 16%, in 2023, and 36.1 million Americans participated. That’s an increase of 7%. The number of volunteers increased as well by 4% to 9.2 million. All of this is good news, according to the Philanthropy Roundtable, which tracks charitable giving. 

     In recent years there has been a decline in individual giving and volunteerism. A webinar the day before Giving Tuesday, sponsored by three national organizations including the Giving Institute, identified several reasons for the decrease. Some of those reasons are social disconnection in recent years, lack of trust in organizations, economic uncertainty, and generational shifts in interests and attitudes.

     I come from a family of givers who delighted in unexpected, surprise giving, especially around the holidays. My Uncle Bill Daniels was known as a drive-by giver. Sometimes on Christmas Eve, when we would go out for breakfast at a local restaurant in Hobbs or Albuquerque, he would leave a big tip. One time when he left $200, the server chased him down and said, “I think you made a mistake.” And he said, “No, sweetie, Merry Christmas!” Stunned, she tearfully thanked him. It was now possible for her to buy her daughter a Christmas gift.

     Those kinds of experiences were an inspiration to me and my kids to continue the tradition.

     Bill later became a philanthropist. Grateful for his success in life as an entrepreneur in Cable TV, he left behind a $1 billion philanthropic fund in 2020. It has impacted hundreds of kids’ lives by providing scholarships, feeding the homeless, aiding people with disabilities, and helping to inspire entrepreneurs across New Mexico, Colorado, Utah, and Wyoming.

     Near the end of his life, he told me what he loved most about having a little extra money was his ability to be that drive-by giver. Leaving a large tip for a server, delivering an envelope of cash to someone whose story of distress appeared in a local paper or buying someone an unexpected gift they dreamed about but couldn’t afford was a joy. He loved seeing the twinkle in their eyes. 

     Not everyone can do a $200 tip or leave that envelope of cash for someone in distress. But everyone can do something. On Giving Tuesday 36.1 million generous Americans gave to the organizations they love – charitable organizations working to feed the hungry, help kids, support local news organizations, or fight for social justice. Each gift matters and hopefully will be put to good purpose.

     I opened with a reminder that charitable giving and philanthropy are different. I hope to write more about philanthropy in the future. In the meantime, make yourself and someone else feel good. Be generous, be a drive-by giver, do something unexpected in the spirit of the season and America. 

     May the joys of the season and drive-by giving be yours, New Mexico. 

Contact: diane@dianedenish.com   

© 2024 NEW MEXICO NEWS SERVICES  12-9-24

We may improve access to health care, or not

By Merilee Dannemann 

Triple Spaced Again

     To review the obvious: Most of us could not afford the financial cost of serious illness or injury. 

     We never know who’s going to be the unlucky one to become ill or injured. Health insurance was developed to share the risk. When private health insurance was not enough, government joined in with Medicare and Medicaid. One principle underlying these policies is that when more of us have access to healthcare, we are all better off. 

     I find that principle persuasive. When more people have healthcare, fewer people spread infectious diseases. Fewer people take days off work, disrupting business and public services. Fewer children stay home from school, so they have a better chance of getting an education and elevating the economy for us all.

     The United States has had a long-running argument between those who agree with that principle and those who think access to healthcare should be earned, giving preference to those who can afford to pay for the insurance or who contribute enough (however you measure that) to society. 

     We may be approaching a clash between a New Mexico policy initiative designed to expand access to healthcare and a Trump administration policy intended to restrict it. We can’t tell now how this will play out.

     The initiative is called Medicaid Forward. It has been under study for a couple of years, to expand Medicaid eligibility so that many more New Mexicans can get health coverage. 

     By New Mexico standards, this initiative is bold. Depending on which of several designs is adopted, it will increase enrollment in Medicaid between 93,000 and 326,000 new enrollees. 

     The in-depth analysis was prepared by Mercer Health and Benefits. You can read the full report on the New Mexico Health Care Authority website.

     The expansion will include people who are now in the Medicaid gap, who earn a little too much money to qualify for Medicaid by today’s rules but can’t afford other coverage. It may include people who work for small businesses where employer-provided coverage is particularly expensive. It may also include some public employees, moving them from more expensive coverage and saving state and local governments some money. 

     The plan will attempt to adjust Medicaid reimbursements to providers so that they don’t lose by treating patients under Medicaid. This is a critical component. If it works, it potentially could reduce the incentive for doctors to leave New Mexico in favor of states where reimbursement is higher.

     But here’s the kick: The federal government pays roughly 70% of the cost of Medicaid. Do I even have to tell you what’s coming next?

     The Medicaid Forward plan appears to presume that federal participation will remain stable. But we can’t count on that. 

     Project 2025, the Republican blueprint for transforming the federal government in the upcoming Trump administration, proposes adding work requirements for Medicaid and imposing lifetime caps on benefits (page 468 of the Project 2025 plan document). The American Public Health Association notes that this would “disproportionately affect… those with chronic conditions or disabilities.” 

     Medicaid itself could also be affected by the Trump-proposed Department of Government Efficiency (DOGE). One of the proposed co-heads of this department, Vivek Ramaswamy, has been saying publicly that he will fire thousands of federal employees. But the Project 2025 work requirement would require a new bureaucracy to administer the program and determine who is eligible. 

     So there’s almost surely conflict ahead. I fear the plan for Medicaid Forward might turn out to be a wasted effort. And we may continue to be stuck with an overly complicated, confusing, expensive and inefficient system that fails to cover everybody, which might get a little bit worse. 

Contact Merilee Dannemann through www.triplespacedagain.com.