Dewitt’s Toby Allen Lane is 31 years old. He is married. He works at Dean Robinson Seeds, and his boss considers him management material. He is a responsible, upstanding citizen. And as of last November, he couldn’t read.
As of today, he can thanks to a decision he made to seek help from the Literacy Council of Arkansas County. His tutor, Terri Cooper, says he is a motivated, goal-oriented student, which explains why he now is reading at a high middle school level.
Lane is not alone. No one knows how many adult Arkansans can’t read, but the Arkansas Literacy Councils, the state’s umbrella organization, is working to reduce the number. For two years, I was president of the board of directors, so I know a lot about its work.
It would be hard to find a more efficient organization offering more bang for the buck. Thanks to an army of 6,000 volunteer tutors, last year it helped 12,063 adults improve their reading, writing, and/or English language skills at a cost of $675,000 in state funds, plus other sources of funding. That’s $56 per student.
But it could do more. That $675,000 hasn’t been increased for decades. According to Executive Director Jennifer Holman, there are 628 adults on waiting lists. There would be more if local councils had the money to better market their services.
Arkansas has made tremendous investments in K-12 and higher education – in other words, services for people under 25. Couldn’t it do more – either publicly or privately – for the Toby Lanes of the world?
That’s the subject of my column this week for the Arkansas News Bureau.
Looking for good news in a bad economy? Medical malpractice rates have not only stabilized but are decreasing.
According to the latest available information, rates in Arkansas are down 1.3 percent since 2006 as a result of malpractice insurance companies paying out less in claims, and they appear likely to remain at low rates.
According to Lars Powell, Ph.D., Whitbeck-Beyer chair of insurance and financial services at the University of Arkansas at Little Rock College of Business, “Every new piece of information we get about claims and loss experience has been less than what we’ve seen before. So it’s possible the rates could go back up. But you would expect to see that precipitated by large losses or an increased frequency of claims, and to my knowledge, we haven’t see either one in Arkansas yet.”
The decrease follows a big run-up in rates during the first part of the 2000s, when the state Insurance Department allowed companies to have double-digit increases several straight years and turned down increase requests of as much as 100 percent.
So why are the rates going down? Primarily it’s the economy. Nationally, the Physician Insurers Association of America says claims frequency is down 25-30 percent from four or five years ago. That’s because plaintiffs’ attorneys don’t want to pay the high costs of filing suit unless they have a very good case. According to the PIAA, only 30 percent of all claims filed against doctors end up in a payment to the plaintiffs.
There are also more competitors in the marketplace. In 2004, when the dominant St. Paul Fire and Marine Insurance Company abruptly left the market, no one was offering coverage. Now there are a couple of dozen companies either renewing business or seeking new policyholders.
Other reasons: Arkansas has not had any huge verdicts in several years. Also, physicians appear to be doing a better job of applying risk management practices that reduce the potential of a lawsuit.
One factor not really affecting the rates: tort reform. Arkansas’ 2003 law has been eviscerated by the courts. Health care reform also should have little effect, good or bad, on rates.
We’re due for a comprehensive Insurance Department report that will shed more light on the subject. I will keep you posted.
D’James Rogers, who placed second in the July 12 District 54 special election to represent Crittenden County, said today that he would have joined the Democratic caucus if elected.
Rogers ran as an independent because he wanted an African-American to represent the majority-minority district rather than the eventual winner, newly sworn in Rep. Hudson Hallum (D-Marion). Hallum, who is caucasian, had defeated two African-Americans in the Democratic primary.
Hallum won the July 12 special election held after Rep. Fred Smith (D-Crawfordsville) resigned following a felony conviction.
According to unofficial returns, Hallum received 987 votes, while Rogers received 437. Republican John Greelan received 415 votes.
Rogers said that, if he had won, he would have governed as a Democrat. He has been actively working with Democrats since 2000 and was the regional field director for last year’s coordinated campaign.
Rogers said that running as an independent was difficult in a district dominated by Democrats. Naturally, he received no help from the Democratic Party and struggled to raise money. “I didn’t get any support from them,” he said. “It was like, ‘We’ll talk to you once the election is over with.’”
He campaigned with the help of family and friends and used social media to communicate his message. He said African-American leaders in the district did support him.
He said he would run again some time in the future and would do so as a Democrat.
Within hours after Yarnell’s announced it was closing shop, the Republican Party of Arkansas was ready with a press release blaming the Democrats.
This, of course, is what politicos do – play the blame game, and the Democrats are no different.
But really, it’s not Beebe’s fault, or the Republicans’ fault, that this Arkansas institution is shutting down. It’s my Mom’s fault.
Mom told me last weekend that she didn’t buy Yarnell’s for a simple reason: She didn’t like its fat-free flavors. She likes Blue Bell – you know, that Texas company.
Mom is one of millions of consumers simply making choices in a free market economy. It turns out that a lot of them – in fact, too many of them for Yarnell’s to survive – chose of their own free will to purchase another brand.
Certainly government can enact policies that make it easier for regional independents like Yarnell’s to survive – mostly by NOT enacting policies that favor big corporations. But this never-ending blame game really doesn’t solve anything.
To read more about Yarnell’s – and my mom – check out my Arkansas News Bureau column here.
The overhaul of the state’s Medicaid system will move a little more slowly than earlier anticipated, but it’s still moving.
That was one of the takeaways from a question and answer session in Little Rock attended by hundreds of medical providers and led by State DHS Director John Selig, Medicaid Director Dr. Joe Thompson, Medicaid Medical Director Dr. Bill Golden, and Steve Spaulding, vice president of enterprise networks for Blue Cross.
DHS and the Beebe administration have proposed replacing the state’s fee for service system, in which Medicaid keeps paying as long as doctors keep treating, with concepts such as “bundled payments” for “episodic care.” The state has gotten a waiver from the federal Department of Health and Human Services to try to implement the idea as a pilot project.
In other words, the state would pay a certain amount to all the providers (bundled payments) for an episode, such as an appendectomy, and no more. The idea is to give medical providers a financial incentive to provide only necessary care.
How that system will work is a topic of big concern and debate in the medical community. As originally planned, providers would decide how to divide the money for each patient. That’s still being talked about, though Selig did indicate to one questioner that Medicaid could be the decision maker. Still, it could be a mess. As David Wroten, director of the Arkansas Medical Society told me, a state is a pretty big pilot project.
The plan was to start going into effect in July 2012, and that’s still the timeline, but the presenters said the state may begin by trying to pick low-hanging fruit and roll out the changes over time. For example, an early focus area could be early delivery of babies, which data show is being done too often for convenience instead of medical necessity.
The idea is being considered because the state faces a $200 million shortfall in Medicaid in 2013, with future deficits looking even scarier. Thompson pointed out that a 5 percent savings in Medicaid’s $4 billion budget would equal $200 million.
Medicaid is the program that pays for care for the poor, the disabled, many nursing home residents and others, and you can’t reform health care without it. In Arkansas, 750,000 people are on it, and it pays for 60 percent of all childbirths.
Spaudling said Blue Cross wants to participate so it won’t be at cross purposes with the state. “The whole idea is to share information and find ways that we can both push on the same side of the rock,” he said.
I talked with Selig (above) after the meeting to get his thoughts. I have no idea why his head is so flat in the video. I promise he does not look like that in real life.
My column this week focuses on the Taxpayer Protection Pledge that 19 legislators signed before this year’s session. I don’t think they should have done so.
The pledge was pushed by Americans for Tax Reform, a Washington, D.C., outfit led by Grover Norquist that opposes all tax increases. It states that legislators will “oppose and vote against any and all efforts to increase taxes.”
My point in the column is that signing such a pledge makes legislators beholden to a special interest group like ATR and forces them into rigid ideological positions.
That dynamic was clearly at work in this session. When faced with the question of allowing Arkansans to vote on highway tax increases, at least two legislators have said that, rather than letting their consciences be their guides, they instead relied on Norquist. Moreover, the pledge forced legislators into performing all kinds of moral and mental gymnastics. Five didn’t vote for or against a $1 fee increase to fund the Arkansas State Police retirement fund. I’m pretty sure the pledge was the reason they took that somewhat wishy-washy route.
What about you? Should legislators sign such pledges before a session?
By the way, here is the list of signers.
My Arkansas News Bureau column this week discusses the Beebe administration’s Arkansas Health Transformation Initiative.
That’s a lofty-sounding title for a plan that is forming to remake Medicaid, the federal-state program that serves many lower-income Arkansans as well as Arkansans with disabilities and those in nursing homes. The initiative would “bundle” payments to groups of medical providers rather than paying each individual provider using the traditional fee-for-service method.
Why is that significant? Under fee-for-service, Medicaid keeps paying as long as doctors keep billing, so there is no incentive to cut costs. The goal is to provide that incentive before Medicaid starts running huge deficits soon.
Doctors would be paid a negotiated flat fee per episode as inducement to avoid duplicate and unnecessary care – much like you or I would pay for many other services we receive. Imagine telling a house painter that you’ll just pay him as long as he keeps painting. He might very well paint just enough to get the job done right. Or he might cover your house in layers of paint.
Lots of medical providers, of course, do not believe they should be paid like house painters, so it’s going to be a heckuva fight.
That’s the headline I couldn’t use in my column today for the Arkansas News Bureau, for obvious reasons.
The “finger” in question is the “Fayetteville Finger,” the effort by Democrats to redraw congressional maps to their advantage by creating a peninsula stretching from the Fourth District up to Fayetteville.
Their motivation is simple: Put more likely Democratic voters in the First and Fourth districts and stuff Republican voters in the Third.
It comes at the end of the state’s first ever two-party session – one that went pretty well, frankly. Aside from this stunt – and a few others – if this is Arkansas partisanship, I can live with it. It certainly works better than the kind we have seen in Washington.
The House Education Committee just passed House Bill 2010, by Rep. Jon Hubbard, that would basically remove the 350 threshold that school districts are required to maintain in order to avoid consolidation. I only heard one no vote.
Hubbard pointed to the Weiner School District, which was required to consolidate with Harrisburg even though it was performing well academically.
It now goes to the House. We’ll see.
Now Hubbard is testifying in favor of House Bill 2011 that would pay private school families and home-school families. It would have an immediate impact of more than $80 million. The parents would be reimbursed for expenses. Under questioning, he says he doesn’t have the details worked out. It would take effect next year.
Unanimously failed.
My column this week is about the prison reform bill signed by Governor Beebe into law yesterday. The law lightens certain sentences for nonviolent (and, to be honest, some not-very-violent) offenders while emphasizing parole, probation, electronic monitoring and drug courts.
Most columnists are critical of legislators most of the time, but this was a good vote. Legislators addressed a critical area of government spending growth despite this being an issue that is easily demagogued by opponents.
Few have every lost an election proclaiming the need to lock offenders up and throw away the key. But that approach is wasting a lot of taxpayer money – and a lot of lives as well. Some of those convicts can be turned around, but it makes it harder to do that if they languish in prison for years amongst the real criminals.
So while call it a first step? Because debate is beginning on another major government spending growth area – Medicaid. And that will be much more contentious. I’ll be writing a lot about that in the coming weeks.
