“Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files,” investigative journalists Patrick Rucker, Maya Miller, and David Armstrong reported at ProPublica on March 25. “A Cigna algorithm flags mismatches between diagnoses and what the company considers acceptable tests and procedures for those ailments. Company doctors then sign off on the denials in batches …”

There are many structural defects in an American HMO/PPO/prepaid care system that masquerades as “insurance.” One of them is a tendency to mask outright fraud. If ProPublica’s reporting is accurate, Cigna’s practices are an example of that defect.

While Cigna implemented its “review system” — which sounds more like an “automatic denial of purchased benefits” system — more than a decade ago, legal thriller writer John Grisham described it in his 1995 novel The Rainmaker.

In the novel (subsequently made into a film starring Matt Damon), an “insurance” company refuses to pay for a leukemia patient’s bone marrow transplant on the pretense that such transplants are “experimental.”

A young lawyer eventually discovers that the company’s policy is to simply reject claims, knowing most patients won’t fight for the benefits they’re entitled to. High legal drama ensues.

If you purchased an item from me, and I failed to hand over the item after receiving payment, you’d know darn well I’d defrauded you. You wouldn’t do business with me again, and might even sue me.

But suppose I’m a $150 billion company with 18 million “customers,” most of whom receive my services in the form of employment benefits with limited (if any) ability to withdraw their patronage from, or stop payment to, me.

That kind of arrangement makes it a lot easier for a business to get up to shenanigans.

While I’m on record as thinking that “single payer healthcare,” for all its problems, might work better than the current Rube Goldberg healthcare apparatus, “single payer” wouldn’t solve this particular structural problem: A captive “customer” base at the mercy of a large, opaque bureaucratic apparatus.

The solution to this problem is finding a way to sever the linkage between employment and health coverage, which originated as a way of getting around World War 2 salary caps with “fringe benefits.”

Direct — and stoppable — payment from actual consumers would force Cigna and other “insurance” companies to cater to those consumers, or lose business to companies that don’t treat defrauding the customer as a viable element of a legitimate business plan.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY

In 1960, with assistance from the United Church of Christ, civic leaders launched New College — a private liberal arts institution with an initial student body of 101.

By the 1970s, that enrollment had swelled to more than 500. With nearly $4 million in debt rather than a fat and growing endowment, New College made a deal with the devil: It sold itself off to the Florida’s government-operated university system.

In terms of curriculum and educational approach, “New College of Florida” was allowed to largely operate as it had before … until earlier this year, when governor Ron DeSantis appointed six new members to its board of trustees in an effort to, as his chief of staff put it, turn the school into a “Hillsdale of the South.”

If that goal sounds somewhat perverse, it is.

The distinguishing characteristic of Hillsdale College is not that it’s “conservative.” What sets it apart is that it’s one of a handful of truly private US colleges which decline government financial support — student loans, Pell Grants, GI Bill benefits, etc. — and the strings that come with that support.

If DeSantis wanted New College to become a “Hillsdale of the South,” the correct approach would have been to sell it off (or donate it to) “conservative” private sector operators.

Instead, he did exactly what he (and other “conservatives”) constantly accuse “the left” of doing, and have been doing themselves for decades: He imposed his own political viewpoint on a state-operated school.

Establishment politicians of all stripes constantly bemoan the “politicization” of “public” education, while constantly engaging in their own preferred “politicization.”

“Politicization” is baked into the whole idea of “public” education. It can’t be any other way.

When schools are operated by appointed government bureaucrats who answer to elected government officials, schools will necessarily be expected to serve the goals of those bureaucrats and those officials.

Electing different officials who appoint new bureaucrats doesn’t solve the problem, it just changes the direction the “politicization” runs in.

Nor is “school choice” — allowing parents to spend taxpayer money at private schools or send their students to tax-financed government “charter” schools — a solution to the problem. That money inevitably comes with conditions that turn formerly private schools into de facto government schools. Which is precisely why Hillsdale refuses such funding.

The choices are: Complete separation of school and state, or political indoctrination of your kids by and for whoever won the most recent election.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY

In March of 2003, the United States launched an illegal war of aggression against Iraq.

The US regime promoted that illegal war of aggression, starting well in advance, through the manufacture and repetition of  falsehoods for the purpose of cultivating fear over non-existent threats, and loathing over non-existent connections between the Iraqi regime an the perpetrators of the 9/11 attacks.

In the execution of that illegal war of aggression, thousands of American troops and hundreds of thousands of Iraqis died.

Twenty years later, none of the American culprits in that deadly deception operation have been brought to justice. Some — for example, secretary of defense Donald Rumsfeld and secretary of state Colin Powell — have since died. Others — for example, president George W. Bush,  and national security advisor Condoleeza Rice — remain not just alive and at large, but even prominent, influential, and widely respected.

As for “opinion leaders” who supported the war because they believed the US regime’s falsehoods, there’s a split.

Some have openly admitted their error and apologized for it; among those, some have even managed to resist subsequent temptations to support American military adventurism abroad.

Others, while admitting they were fooled by specific falsehoods, have continued to defend the war as justified because, simply put, Saddam Hussein was a bad man. Most of those commentators have subsequently supported other US military misadventures in the name of “defending democracy,” etc.

And still others continue to defend the falsehoods themselves. For example, despite a grand total of zero post-1991 chemical weapons, and zero chemical weapons demonstrably controlled by Saddam after 1991, ever being recovered — Bush himself joked about that later — some insist that the weapons were there and that they and the equipment used to make them were spirited away in truck convoys to Syria even as US aircraft flew over, and US troops converged on, the sites where they were supposedly manufactured and stored.

Some were fooled, eventually noticed, and resolved to never get fooled again. Some were fooled, eventually noticed, but were gullible enough to fall for the same tricks again and again. Some were fooled and remain fooled to this day.

That’s how it goes, I guess.

But it’s incumbent upon that first group, and on those who were never fooled in the first place, to take George W. Bush’s words to heart:

“There’s an old saying in Tennessee — I know it’s in Texas, probably in Tennessee — that says, fool me once, shame on — shame on you. Fool me — you can’t get fooled again.”

And, having taken Bush’s malapropic advice,  to pass it on to subsequent generations by continually asserting and insisting on the irrefutable historical fact:

In March of 2003, the United States launched an illegal war of aggression against Iraq.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

PUBLICATION/CITATION HISTORY