That Privatizing Drive

Texas has a great reputation for doing the worst thing. Its hospital industry has already shown up as being as bad as they come. Now it looks like it's in competition with the Texas Youth Commission for which one can do the most damage.

In a series of investigations, Dallas Morning News has found multitudes of problems. Last week, the report was about privatizing.

Texas is near the bottom among the 50 states in per-capita spending on health and human services, but it is a leader in outsourcing these functions to private contractors. Since taking office in 2000, Perry has pushed some of the nation's most ambitious outsourcing endeavors, going well beyond his predecessor, George W. Bush.

"We have a leadership that believes the private sector does things better," said Celia Hagert, senior policy analyst and privatization expert at the Center for Public Policy Priorities, a nonpartisan research group in Austin.

"Whether it's ideology or philosophy – simply believing that people shouldn't be on these programs in the first place – these things have combined to create a very stingy social safety net system in Texas."

UnitedHealth caught the front end of the Texas outsourcing wave launched by Gov. Bush. Since 2003, the state has paid the company's Evercare and United Healthcare units more than $1.2 billion to provide managed care to more than 255,000 Texans under four programs.
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Since 2000, the Texas Department of Insurance has fined UnitedHealth or one of its units seven times totaling more than $10 million for violations involving claims payouts, reporting requirements and other problems.

Texas doctors have long complained about UnitedHealth and its handling of claims under employer-provided insurance plans.

"They're dishonest, and they're sneaky," said Dr. William Walton, a family doctor in North Dallas. "If you're not really on top of it, you'll lose lots of money working with United Healthcare."

The fines haven't changed UnitedHealth's way of doing business, he said, adding, "That's just a cost of business in their eyes."

In fact, UnitedHealth has amassed fines around the country.

In September 2007, the company's UnitedHealthcare unit agreed to pay $12 million to 36 states and the District of Columbia to settle complaints that it applied incorrect fee schedules and deductibles, was slow to pay claims and failed to correct problems identified by state regulators.

UnitedHealth is the target of an ongoing investigation by New York Attorney General Andrew Cuomo into allegations that its units cheated patients through artificially low reimbursement rates. Cuomo has accused UnitedHealth of maintaining "a broken reimbursement system designed to rip off patients and steer them towards in-network doctors that cost the insurer less money."

The series continued this week:

Hospital companies in Texas, many of which collect millions in state and federal funds, operate with minimal public disclosure of deficiencies. The state keeps information on complaints and inspections largely private because influential health care corporations want it that way, and Texas legislators have obliged.

As a result, it is next to impossible for the public to determine whether state enforcement works properly. "It's too difficult to get accurate information to say," said state Sen. Jane Nelson, R-Flower Mound.

Over and over again, our state government proves that the public is its last choice in who it wants to serve. It is highly inadvisable to get sick here, or for that matter, want to work. Yep, it's also a 'right to work' state, which means you have no rights unless you're the owner.

Good luck on collecting if you make the choice to get sick, or get laid off.