Tonight, I am in San Antonio Texas at Ft. Sam Houston. I am teaching for the last time a course for military doctors and surgeons that I have been part of since 1983. We have military and civilian instructors. Several of the instructors work full time for the Center for Disease Control (CDC) and the National Institute for Health (NIH) and have been involved at the ground level with the Federal Covid response. One of these physicians has been around the world over the past two years integrating logistical networks and helping with policy in over 20 countries. After listening to his stories, I told him he should write a book. His response was surprising to me: “No way, if I did I would go to jail” I don’t believe that is true, but his point is that over the past two years the use of executive orders, and the bureaucratic bullying that occurred because of Federally incentivized Crises Standards of Care (CSC) and draconian mitigation strategies, economic incentives that resulted in over $6 trillion of unaccounted Federal Covid spending over two years. During that time Federal spending went from 25% to 45% of GDP. Revenues to the Federal Treasury of $4.5 trillion with outlays of over $10 trillion. There have been beneficiaries in all this—large hospital providers, insurance companies and big pharma.
Two stories that I found very interesting are worth repeating. He provided consultative visits to many hospitals from level 1 University teaching hospitals to a small rural hospital in New Mexico. His visit to Connecticut where Yale University is located demonstrated that within a few miles of each other there were two 1000 bed hospitals with all the ventilators, nurses, and doctors that they needed. One of these facilities had 4 hospitals on a forty-acre campus. On that campus there were more people and logistical support systems than there were in 4 Western States combined.
Another facility that he looked at was a small rural hospital in New Mexico with no ICUs, 30 total beds and two Licensed Practical Nurses (LPNs) who were managing intubated patients on pressors. No doctors, PA’s or FNPs the protocols being used in both instances were the same! ICU attending and Fellows and nurses with master’s degrees at Yale, and the (LPN’s) in New Mexico. One size fit all
During his informal out brief with me he admitted that the cultural differences—ethnic, racial, (rural vs Urban) were mishandled miserably by the experts acting under the authority of Federal regulations, executive orders, and bureaucratic leverage from Washington DC
The suspension of eligibility verification in Federally subsidized programs ranging from Medicaid, Insurance Exchanges, and Covid specific funds to providers (large hospitals systems received far more that the rural Level 3 facilities) because they had “back-office expertise” that the smaller rural facilities didn’t have.
My friend believes that both operational and financial audits of agencies that were involved in the distribution of these funds is desperately needed at both the State and Federal levels. In his opinion these should be outside audits done by large national auditing firms. I mentioned to him about the reports in several journals about Idaho being the fourth worse state in the country regarding Medicaid fraud with 39% false billings and false claims. He knew of our state’s problems but asked that he not be quoted regarding his feelings about Idaho and several other States.
What are our legislators and Governor hiding? Are they protecting special interest groups like the IMA/IHA who fund their campaigns? The Joint Finance and Accounting Committee spends all their time allocating scarce resources without ever addressing the issue of costs and possible corruption. A proper reckoning of costs needs to be addressed by those in positions of responsibility in State government. Every family and small businessperson in our State goes through that same process several times a year.
Before ever taking over a large government agency like the Department of Health and Welfare (DHW) a new director should insist on an outside signed partner’s audit of that organization. The cost would be worth the savings. The problem is that people in that organization over past several administrations have come directly from the ranks of major insurance carriers. In addition to that the Governor’s former legal counsel now is a vice president of one of the Blue(s). This same insurance company competes for contracts with State employees and teachers! Corruption doesn’t have to be illegal to hurt people, but it often is. The symbiotic relationship between Idaho government agencies and organizations in the public sector needs to be examined. Sometimes good people for so many years have been caught up in a corrupt system that they don’t even see it for what it is. This lack of awareness can be contagious. Little corruptions can grow, big corruptions can become standard operating procedure, and We the People who pay taxes and ever-increasing insurance premiums, watch the value of the fruits of our labor (wages) shrink because of the inflation caused by government overspending. The money supply has almost doubled over the past 4 years while production—both goods and services has shrunk (manufacturing) or is just now returning to pre Covid levels (services). More money chasing fewer goods and services equals inflation. At the current price of diesel filling a 300-gallon fuel tank on a semi-tractor cost $1400 to fill up. What does anyone consume that doesn’t need a truck to transport it somewhere along the supply line?
If government at any level continues to grow it will cost more. And taxpayers are footing the bill with dollars that are worth less.
We need accountability in our state government now. We should make corruption in Idaho State government the issue in both the primary and general elections this year.