Civic Engagement COVID-19 Medicaid The Patriarchy

Killing Nebraskans for a Profit

In his daily briefing last Friday, Ricketts joined Scott Frakes in assuring the public that our overcrowded prisons are, despite the recent positive coronavirus test of a corrections employee at NSP, safe spaces for the incarcerated members of our community.  According to Frakes, the inmates receive health care that is “better than what many Nebraskans have access to”.

Correction Director and face of pure evil, Scott Frakes, who was appointed to his position in 2015 by Pete Ricketts, and who just received a 30% raise, presumably for continuing to fight the ACLU on Pete’s behalf..

Talk about a low bar.  Many Nebraskans in fact have no health insurance and therefore receive almost no health care, because a trip to the doctor or to the pharmacy would mean no food or rent or electricity that month.  Instead, they work through it—through the pain, the disabling symptoms, the infection—until they recover or end up in the hospital, at which point they will incur so much debt that they will likely have to join the 530,000 Americans who declare medical-debt related bankruptcy each year.  The men and women incarcerated in our prison system may have to suffer with little to no care until something catastrophic happens, but at least they don’t have to pay for it. 

The spread of COVID-19 hasn’t changed any of these basic dynamics in our health “care” system, it has just increased the number of people suffering so dramatically and over such a short period of time that we’re not able to ignore them.

The situation at Carter Place in Blair and other nursing homes and long-term care facilities across Nebraska points to one of the major flaws in the system.  The assholes in charge of Carter Place and other assisted living homes owned by the company Enlivant (mostly rich white men – and one rich white woman, you know, for equality – who list their former jobs by the NYSE stock abbreviation and how many billions in assets that company has) specialize in taking charge of “underperforming” nursing homes and turning them around.  Your average person might think that “underperforming” referred to the level of care given to the residents in the home.  The idea that Dan Guill (President and Chief Operating Officer of Enlivant) comes into places with substandard care and whips them into shape makes him sound like a great guy.  But “underperforming” doesn’t mean that the home is failing in the task for which it is ostensibly designed—the long term care of elderly or disabled members of our community—it means that the home has been acquired by a for-profit corporation that thinks more money can be squeezed out of this institution and sent to its stockholders or given to its CEOs as bonuses or used to buy back its stock and drive up its share price on the stock market.  To be blunt—Enlivant thought more money could be demanded from families paying for the care of their loved ones, more money could be shaved off the salaries and benefits of the Nebraskans employed to do the care, and cheaper food, furniture, cleaning products, protection equipment, etc. could be purchased in place of the higher quality materials previously being used in the home.  So they sent in Dan Guill. Dan Guill is a specialist in finding out those things, and making the changes necessary to funnel money upwards from hard working Nebraska families to Enlivant’s wealthy CEOs and investors who are likely not even living in the state.  He’s been doing that for a while, leading to substandard materials and exploited employees who were exploited even more callously after the outbreak, all so Enlivant could make more money. Good job, asshole!

Enlivant is successful at turning “underperforming” facilities around that it runs them in 27 states, and has four other facilities in Nebraska. Including the facility in Blair, they also have facilities in Columbus, Fremont, Nebraska City, and Seward.

Something similar has been happening for a long time at our hospitals.  There’s a reason that everyone is obsessing over the number of beds available, and wringing their hands that our state, like every other, is destined to fall so far short of what will be needed.  The philosophy of “just-in-time” capitalism rules the number of beds in a given space.  To be profitable, hospitals need to keep every bed filled for as many hours of each day as possible.  Empty beds are dollars not being made.  Stockpiled supplies are just money off the balance sheet.  So beds and supplies are reduced to as close to the exact number likely to be needed at a given time as possible in an effort to reduce all that “waste”, i.e. money not being made.  But when a pandemic hits, and supply lines break down or are manipulated by unscrupulous dealers (which now apparently includes the federal government under Trump), then we’re all screwed.  Hospitals that “perform” well in a for-profit system are not run to preserve or restore the community’s health. 

So it shouldn’t be surprising to hear that inmates get care much the same or better than those of us on the outside.  As Scott Frakes stated in the briefing, “prisons are a business”—not a place where we confine those who have broken our society’s laws in order (depending on your view) to serve as punishment, to force reflection and reformation, and/or to keep them from harming others on the outside.  No, prison is now where we make money off of people who have broken our society’s laws, just as hospitals are a place where the rich make money off of the sick, just as nursing homes are facilities where the rich make money off of the weakness of the elderly. 

Something has gone terribly wrong here, and that something is called privatization.  Ricketts and the other oligarchs who are on the receiving end of all that money being squeezed out of the imprisoned, the sick, and the elderly swear up and down that “business” provides services more “efficiently” than the government.  But the only thing they are efficient at doing is what they are made to do: make money.  Of course Ricketts is fighting tooth and nail to avoid expanding Medicaid—that’s dollars out of his rich buddies’ pockets.  But one thing this pandemic has made glaringly, painfully obvious is that Ricketts can promote all the “amazing” companies he wants in his daily briefings.  As our illustrious president once said (before taking it back and changing his mind for the third time): we are at war.  And those companies, which are gobbling up our hospitals, our prisons, our nursing homes, and are trying to swallow public education whole, are the shock troops of class warfare, one that is being waged against the working poor and the middle class.  As Nebraska’s own Warren Buffet correctly said, “There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning.”

Maybe now that the bodies are literally piling up in the fields, we’ll recognize that fact and start fighting back.

Top Executives at Enlivant. You can see the whole list here.

CEO of Enlivant
Dan Guill, President and COO of Enlivant, and the guy who made sure your granny was exploited for the highest possible dollar amount
Chief Human Resources Officer at Enlivant, presumably the guy who mandated that sick workers in Blair must continue coming to work or get fired.
CFO of Enlivant
Chief Information Officer at Enlivent
Mr. Thurlow is responsible for day to day operations in the West Division of Enlivant, which includes the facilities in Nebraska.