Chad Selweski covered state and regional politics for The Macomb Daily for nearly 30 years, earning numerous awards. He is a regular contributor to Deadline Detroit.
By Chad Selweski
In his zeal to reform state government in a business-like manner, Gov. Rick Snyder has relied on favorite buzz words and phrases to reflect his approach toward governing.
Relentless positive action. Reinventing Michigan.
Gov. Rick Snyder
In his January 2015 State of the State address, Snyder said the state would provide a “river of opportunity” for its citizens. A year later, after belatedly declaring an emergency in Flint, his political persona was drowning in a river of denial.
Snyder’s determination to treat those who use government services (essentially all of us) as “customers” and to run government like a business has now produced four spectacular failures: the privatization of prison food services through Aramark; the state-run attempt to turn around the financially and physically crumbling Detroit Public Schools; the outsourced health care imposed at the state’s Grand Rapids nursing home for military veterans; and, of course, the Flint water crisis.
In each case, the expected savings proved largely illusory while the quality of services dropped precipitously, even tragically.
Now, the governor eyes a new target for the privatization of government: the state’s $2.4 billion mental health care system. Snyder’s proposed budget blueprint introduced last month calls for turning over a large portion of the funding to private insurance companies.
Jeopardizing Care for Scant Savings
In a familiar refrain, critics warn that the potential financial gains would be minimal while care would suffer for many of Michigan’s most vulnerable: the mentally ill, those with behavioral disorders, autistic children, and those with developmental disabilities or chronic substance abuse problems.
The Snyder plan has been dubbed an attempt to “profitize” mental health care in Michigan. Medicaid money would flow through HMOs rather than directly to community mental health departments that operate in the open and have overhead costs that are half that of private insurers.
A key concern is that in Michigan, the Medicaid HMOs that would swoop in, such as those associated with Blue Cross/Blue Shield, Molina Healthcare, Meridian Health Plan and United Healthcare, lack sufficient experience and expertise in the mental health field.
As a result, insurance coverage could shrink and quality of care would suffer. The effects, by far, would be felt most directly in the Detroit area where most the of the state’s 300,000 people suffering from mental health problems live.
Lt. Gov. Brian Calley
With angry parents of mentally ill children rising up in loud opposition, Lt. Gov. Brian Calley jumped into the political fray last week and promised to forge a compromise by working with mental health providers, advocacy groups, insurers and parents.
'Dumbest Damn Thing'
A key legislator followed suit by agreeing to set aside the privatization language within the budget bill.
With the Snyder administration facing wilting criticism on so many fronts due to ham-handed attempts at cutting corners, legislators seem eager to avoid another high-profile confrontation with the public. One frustrated lawmaker says privately: “This is the dumbest damn thing I’ve ever seen.”
For Snyder, the CPA-turned-government-CEO, his biggest flaw -- his bottom-line mentality -- was amply described recently by one of his former senior advisers, Dennis Schornak, who also served as a longtime policy adviser to governor John Engler.
“Government is not a business … and it cannot be run like one,” Schornak said in an interview with the Detroit Free Press. “The people of Flint got stuck on the losing end of decisions driven by spreadsheets instead of water quality and public health.”
Tom Watkins
Tom Watkins, CEO of the Detroit Wayne Mental Health Authority, confidently believes that the so-called work group being formed by Calley will reject privatization in favor of a comprehensive reorganization of the system. A concerted effort would keep mental health services at the local level and they would continue to be overseen by local mental health boards, not corporate boards who meet behind closed doors.
“We’ve won a battle but we haven’t won the war,” said Watkins, a highly respected administrator in state and local government for many years. “This … needs to be done in the light of day, not in the dark of night.”
In other cases of privatization going haywire, the practice of putting profits and politics over people remained hidden until they were exposed by whistleblowers and government audits.
Aramark’s infamous tour of duty in Michigan prisons featured maggots and rats in food service areas and sexual trysts and drug smuggling between Aramark employees and inmates. An audit last December concluded that Aramark may have overcharged the state $3.4 million for meals that were apparently never served.
If Compromise Fails
In Grand Rapids, the outsourcing of nursing assistants to a vendor, J2S, resulted in chronic short-staffing, according to an auditor general's report. Only half of required room checks were performed, records were doctored, and complaints of abuse and neglect of veterans were routinely ignored.
As for the proposed privatization of mental health care, if the Calley compromise fails, the lack of specialization by the HMOs could have a disastrous effect. John Kinch, director of the Macomb County Community Mental Health Department, said his agency’s $220 million budget provides customized coverage for autism, cerebral palsy, bipolar disorders, group home treatment and multiple health issues such as a schizophrenic mom with a problem pregnancy.
In addition, many families could lose their therapist or psychiatrist as the HMOs take over.
If a privatized funding system gains traction in the Legislature, the governor will be hearing from protesters about Flint water and Detroit schools, as well as from families across the state that deal with mental illness.
“Hell hath no fury,” Watkins said, “like a scorned parent of a child with a disability.”
