The Unhealthy United States Government

The Return of the Goddess Reason by Darwin Leon

THE UNHEALTHY UNITED STATES CONGRESS

BY

DAVID ARTHUR WALTERS

17 July 2017 Miami Beach


The well has been poisoned. The present government is unhealthy. It is an enemy of the people at large and a friend to the power elite. Measures can be taken to restore it to health.

The struggle by a minority of Republican Congressmen to build a slim partisan majority to repeal and replace the 2010 Affordable Health Care Act legislated by Democrats, despite the fact that the overwhelming majority or supermajority of the people oppose repeal, and also adamantly oppose replacement in the mean form proposed, exposes the naked truth about the current government, that it and its president is unpopular and therefore unstable, and is not a government by and for the people at large although they are theoretically responsible for it.

Fashions in politics can be as fickle as in clothes. Popularity is not always wonderful, for power does corrupt, wherefore majorities may be tyrannical and foster totalitarian governments.

Supermajorities protect the people against political whims in government, especially where basic human needs are at stake. The most fundamental need is health, and for that we need mutual care from birth to death.

Without health, life and liberty and property, not to mention happiness, whatever that may be, is at risk. We love our freedoms, as if we were all kings and queens in private domains. Yet those domains are by no means isolate.

Freedom is not an empty concept: We want freedom from impediments like tyranny, poverty, disease, and so on. Health care legislation is, as it were, a treaty that we as individuals have with each other, that we will come to the aid of one other when attacked by diseases, injuries, and old age.

Health is therefore not only a personal matter but is a vital collective concern. And it is so personal for everyone that the success of humanity depends on the personal health of every person. Legislation in that regard is so important that both the whole and the part should be secured by a healthy consensus so that simple slim majorities do not give things one day and take them away the next.

The United States is presently subject to a minority government that would be dismissed and a new election called for if its Constitution were amended to invoke a cabinet system of government led by a prime minister selected by the majority party or a risky coalition. That amendment would have to be proposed by either two-thirds of both houses of Congress or two-thirds of the states, and then be ratified by the legislatures or constitutional conventions of three-fourths of the states.

The drafters of the U.S. Constitution were wise to require a supermajority for fundamental acts, in this case to change the framework of the architecture for government. The Constitution also calls for a two-thirds supermajority for treaty ratification, expulsion from Congress, forgiveness of rebellions, impeachment conviction, restoration of authority to a president suspended for inability to perform his duties, and the override of a Presidential veto.

The American electorate has not been wise, however, to retain the vestiges of the tyranny against which the founders revolted, in the form of a temporary king in the president and the House of Lords in the Senate.

The mother country with its unwritten constitution has advanced since the invention of steam engines and automobiles. The Queen and Lords are respected, and at least two-thirds of subjects must have them to be British, yet Commons rules, and royalty and nobility is not an impediment to the people’s will or a check on the Commons except for the influence of respected opinions.

The United States does not need the Senate, whose members represent state elites and not the popular electorate, to check the famous madness of the members of the House of Representatives, who are supposed to represent the crowd the best they can. Under the present system they must do their best to keep the crowed deceived to maintain their seats. They too have been sickened by the poison flowing into the well from special interests.

The Senate loves to think of itself as a deliberative body of One Hundred Dignitaries, who slow things down by careful consideration based on reasoned debate, stall for amendments, or kill bills submitted by the House. That well has been polluted, not only by the almighty dollar they must constantly hustle for, but by mean partisanship sponsored by naturally selfish donors who have lots of money to invest in politics. It was thought that corruption would be more obvious in that noble house given fewer members, and it certainly is, but what are they to do for money until people can vote online so that votes and not dollars are the only political currency?

Wait a minute! What about the supermajority tradition of the Senate? What about the 60% needed to stifle the opposition from blocking bills and motions to even consider them? Forget about that. It is not yet in the Constitution or a statute. The Constitution says each house of Congress can make its own rules; they can do that at any time no matter what academics say.

The key word is “reconciliation.” There is a statute that allows for a simple majority to reconcile differences between the House and Senate in fiscal legislation. Why not stick anything which has to do with money, which is everything, into a reconciliation bill? The Byrd amendment to the statute provides that reconciliation bill may not include provisions that increase deficits ten years after the reconciliation. Senator Byrd sponsored the amendment because President Clinton wanted to rely on budget reconciliation to pass a 1993 health care plan.

Now the sponsors of the 2017 Better Care Reconciliation Act to replace the 2010 Health Care and Reconciliation Act, which was tacked onto the 2009 Service Members Home Ownership Tax Act of 2009 passed by the House 416-0 and approved 219-212 by the Senate after its health care amendment, do not want the nonpartisan budget office to review the half-baked repeal and quasi-amendment bill before voting on it—the House also skipped that input before voting on the bill it passed, and passed the buck to the Senate.

No, the Senate prefers to rely upon White House agencies for fiscal analysis including predictions of deficits. The President is pushing repeal and replace, and will be delighted to vindictively sign the legislation, cast by Democrats and some Republicans as a handout to the rich at the cost of the sick, poor, not to mention the middle class.

Many are those who are not in a charitable mood. The extent of our selfishness depends on how much we have; that is, the margin we have above our needs, and we think many of our wants are needs, say, that beer money if not the two cars in the garage. The extension of Medicare is quite frankly unpopular except among those who need it and the likes of Warren Buffet and other welfare capitalists.

To support relief to the wealthy during the currently prosperous time for them, the White House claims that the Congressional Budget Office was all wrong in its assessment of the consequences of Obamacare, that not enough have signed up for insurance under the Individual Mandate to spread the risk, so the insurance companies, to protect their vast coffers, are jacking up premiums or dropping out of the market.

The truth of the matter is that people, especially young and healthy ones, do not like to pay the fines required if they choose not to buy insurance. They would rather take the risk of an unexpected accident or illness, which might drive them into bankruptcy and force the public to pick up the medical tab anyway. Thus is the risk spread anyhow.

It is more than obvious to every logical person that the solution to this squabble, in terms of replacement, is a single-payer, Medicare-like plan, with benefits similar to those enjoyed by the Senators in their government plan. Then the United States could join other civilized countries with national health care plans. But reason goes down the drain with big deductions from earned income.

Whatever is done on the issue so vital not only to the survival of the nation but to the people should not be done lightly. That is, it should be done with their consent, and with a consensus.

Do you trust a simple majority in Congress and the President of the United States with your life in this vital matter? Only 30% do at this juncture.

Major health care legislation should be submitted to the people in a referendum that requires a supermajority. Let the people be a check on Congress in advance so they do not have to show up in the halls of Congress, as in this case, to demonstrate on crutches and in wheelchairs. Amendments to that legislation should require a 60% majority in Congress.

Why not just a simple majority in a referendum? The crowd is wise but only with experience, and we should be more certain of ourselves before getting it, because then it might be too painful for everyone concerned.

Take, for example, Great Britain’s popular 1975 decision to remain in, and then the 2017 popular decision to exit, the European commonality.

The House of Commons had voted 395-170 to continue in Common Market under new terms; that action was confirmed by a nonbinding referendum, the nation’s first ever, held 5 June 1975, with turnout of 64% and huge majority of Yeas over Nays of 8,908,508. The Question put was, “Do you think that the United Kingdom should stay in the European Community (the Common Market)?” Labour split on the issue, breaching collective Cabinet responsibility, so votes in Commons were carried only with opposition support, i.e. the issue was nonpartisan. There was a 64% turnout, with a huge majority of 8,908,508 Yeas over Nays, wherefore the referendum was hailed as the biggest support for government ever, hence popular.

Critics, however, said the nation was dead, that it had relinquished its sovereignty. A document on the discussion of sovereignty in parliament, kept secret for thirty years under the Thirty Year Rule, disclosed that Parliament thought it advisable to put consideration of Power before Sovereignty.

That makes sense. Would the people rather have the sovereignty of North Korea, or even Switzerland, or the political and economic power of the United States? After all, with or without the power, they shall still have sovereignty over their culture, still be Americans or Cosmopolitans.

The governing House of Commons considered the EU matter settled for 40 years, and then the BREXIT movement, narrowly approved in a referendum by a margin of 52% in 2016 to exit, as compared to 67% or two-thirds to remain in 1975. The turnout was 72% in 2016, considerable more than the 64% to remain in 1975, but the margin of Yeas over Nays was very slim to exit in 2016, only 1,291,501, whereas the margin to remain in 1975 was 8,908,508.

Now, then, before the feat has been fully accomplished, the British have had second thoughts due to bad experiences, foreboding even worse to come as the rest of Europe goes merrily on its way, so BREXIT may be reversed despite the strong nationalist feelings.

It is high time that the people of the United States take legislation into their own hands, purge Congress of its poison, and provide preventative, structural measures for their own sake. As it stands, almost everyone agrees that it is sick, and doom must be prophesied to invoke a cure. The cure can only come from people at large, who must themselves be healed, because the disease in their representatives begins with them.

xYx

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Healthcare and Sunshine – Congress is Critically Ill

West side view of the United States Capitol building.

HEALTHCARE AND SUNSHINE

BY

DAVID ARTHUR WALTERS

Article I, section 5 of the United States Constitution clearly states that ‘‘each House may determine the Rules of its Proceedings.’’ The senators and representatives are therefore expected to conduct the people’s business in the best manner possible, that is, efficiently and effectively in the interest of everyone concerned, and not in the special interests of factions.

It is to that end that the public business should be conducted publicly by Congress in all respects.  Yet from the time of its constitution we hear of backroom and cloakroom deals and closed committees where fundamental business is done in the dark by members who are evidently ashamed of their political factions. And we hear of working documents deliberately withheld for fear of criticism. They know that conspiring is inimical to the public interest, and that their objectives would not be realized if their behavior were transparent instead of opaque.

It is no wonder that the members of Congress, who are supposed to be representing the people at large, have established no ironclad rule or have not passed an effective law prohibiting such conduct on pain of expulsion or imprisonment unless the conspiring is justified by national security.  They are the enemy of the people as constituted. That is not to say that the people are any better at heart, for people deserve the leaders they elect.

Healthcare is vital to the public interest. Now the Democratic faction has complained that the Republican faction in the Senate secretly contrived a plan to repeal and replace so-called Obamacare with so-called Trumpcare. The plans are so-called because the members care more about the relative power of their respective parties and their prejudices than about the health and welfare of the American people.

There are admittedly problems with the Affordable Health Care Act that could be fixed in one way or another, perhaps with a single-payer, national health insurance program enjoyed by civilized nations. Otherwise the existing act could be tweaked. Most importantly, something could be done to convert mismanaged health care, conducted in the interest of providers and insurance companies, to managed health care, conducted in the interest of the human beings.

But no, Republicans, who are now in the majority, prefer to blame President Obama and his party for forcing a national health care act down their throats when they were a majority. Wherefore the House got a bill passed in public, but that bird will not fly in the Senate, so the Republican senators privately concocted their own plan, in secret, say the Democrats, along the lines of the purported theme of the Republicans ever since they eschewed Reconstruction in the South: rob the poor to pay the rich.

After the Republicans pulled the rabbit out of their top hat, Warren Buffet, the famous welfare capitalist, showed his tax return on Megyn Kelly’s new television program. He said the Republican bill would save him hundreds of thousands of dollars in one year, and he had friends who would save millions. He said he did not need the money. In fact, he claimed he likes to live in the same old house, that he could live nicely on a hundred-grand a year, and that he loves to apply his fortune to humanitarian causes rather than floating around in a multimillion-dollar super-yacht and so on.

Well, Republicans deny they are the greedy, racist party, and they make some good points about the faults in the bill they resent so much that they tried to get it repealed about fifty times. Whatever they do, let them do it publicly, and let not the pot call the kettle black because we all hail from the African continent regardless of our current birth certificates.

We recall that Republicans made the same complaint, about secret healthcare conventicles held after Barrack Obama was inaugurated in 2009.

For example, Dr. Michael C. Burgess, representing Texas, spoke at some length, on January 12 and March 10, 2010, on the lack of transparency, which he thought could be solved with a Minority Resolution of Inquiry, a tool that members have to ask for information they believe is being withheld from them needed to make an informed legislative resolution. He knew that his recommendation was futile, but he wanted to get his two cents in, and the media did take notice.

“Mr. Speaker, I would like to continue much as we have done over this past hour, talking about this same issue, the health care bill that is now before the House and Senate, even though none of us have seen the finished product, and what has happened on the issue of transparency over these past several weeks since the House adjourned in the middle of December.”

That sounds familiar today because the people have failed to discipline their senators and representatives so that all public business is conducted in public and that all documents are immediately available to anyone concerned.

“This bill has nothing to do with health care any longer…. This was, how do we get the outcome we want, which is to pass this bill? There is something wrong with the process when you say, ‘We can’t let you read it. We can’t wait. We’ve got to do it in a hurry. And oh, by the way, the benefits that are going to come to you off of this bill actually start in 2014. Your taxes will start next week….’”

Here we go again. Obviously something is wrong with the way business is conducted on Capitol Hill. The obstruction is augmented by supermajorities.

“This debate now has become an internal debate on the Democratic Party. We will continue to be blamed on the Republican side for obstructing this bill, but please understand there is nothing that we can do. We lack the numbers to stop this bill— supermajority in the House, a 60-vote majority in the Senate. All the Republicans can stay together and the bill still passes because we just simply do not have the numbers….”

The Senate is a de facto supermajoritarian institution because the rules allow that a bill can be held up forever by a filibuster unless 60 votes put an end to the delay.

The so-called nuclear option was deployed by Republicans so that the hurdle could be overcome and the nomination of Neil Gorsuch by President Trump could be confirmed by a simple majority. The nuclear exception to the 60-vote cloture rule had been created in 2013 by Democrats partly in response to Republican prejudices delaying the appointment of black judges.

The change in tradition may be a precedent for deploying the nuclear option to pass sweeping legislation such as national healthcare reform. In any event, the Senate’s structural reputation as a de facto nonpartisan institution has gone down the drain.

Arguably the supermajority rule should somehow be made permanent in such a way that it would apply to crucial public issues, such as health care bills; that is, the Republicans would not get their health care bill passed, characterized as “mean” by the President, who would not veto them no matter how mean, without a supermajority.

“The arguments that are going on right now are arguments entirely within the Democratic conference,” said Dr. Burgess. “And it is a conference committee, if you will, of the Democratic conference where they’re trying to work out the difference the Democrats have with Democrats over the bill, and ignore the Republicans—blame them, to be sure, because they’re useful to blame as being obstructionists, but realistically no Republican is obstructing or slowing down this bill. We can’t. We would like to, but we can’t.”

Dr. Burgess feared that he would not outlive the Affordable Health Care Act: “This is sweeping legislation that has a long half-life and is going to affect the way of life in this country from this day forward, really long past my time on this Earth, and I suspect a long time past the life expectancy of almost everyone who is serving in this body. So it is so important that we get this right. It is our obligation. It is the oath that we swore on this floor the early part of January of 2009 after those very famous elections, those historic elections that created the new Presidency, created a supermajority for Democrats in the House, created almost a filibuster-proof majority in the other body.”

Dr. Burgess noted that Barrack Obama’s approach sounded pretty good early on: “He said there was going to be a mandate to cover children. He said there was not going to be an employer mandate nor would there be an individual mandate, but that anyone who didn’t have insurance would be able to have insurance just as good as a Member of Congress under a program like the Federal Employee Health Benefits Program….”

But contingencies always arise that impact good intentions. The Great Recession presented huge budget problems, and then we had a flu epidemic, et cetera. A special Senate election may change the balance of votes. Coverage and cost had not been discussed during the campaign and after the inauguration, but now a cost of around a trillion dollars, was to be funded by increasing taxes on energy, and motorists back home already suffering from severe recession were outraged by expected increases in fuel costs.  There are backroom conspiracies, and the content of the bill is a mystery. After the bill is signed it will be up to an agency to make a myriad rules, and one administrator is in charge of that, yet that person has not been nominated and confirmed.

Dr. Burgess wrote a letter to President Obama on September 30, 2009, wherein he respectfully asked him for full disclosure of information on negotiations and agreements related to the national health care bill. The details would include among other things the names of the special interests.  A Resolution of Inquiry was filed on December 17, and here in January he is vainly telling the House what an important tool it is. Another important tool he and his colleagues extolled is C-SPAN. Yes, it may be boring because editors do not spin the proceedings into a story, but a free and democratic people must have public affairs aired, C-SPAN must be an option.

“The American people understand that C–SPAN is sunshine. C–SPAN represents good government. C–SPAN was the foil that the American people had against the excesses of a Presidential administration that overstepped its bounds and brought us the spectacle of Watergate and the crumbling of a Presidency. C–SPAN is the preventive medicine that keeps that from happening again in the future.”

Phil Gingrey of Georgia, speaking right before Burgess on January 12, thought he knew what the American people think about the whole affair:

“Here is what they think. I know the President knows this, and I know the Democratic majority knows this, and I know that’s why they want to pass this thing in the dark of night. They don’t want C–SPAN looking in. They don’t want Republicans looking in. They don’t want the American people looking in. They want to get out of that hole and get out of town. That’s what their plan is.”

Florence Nightingale, who was called “the prick in the side” of the power elite, would know what to do with the unhealthy Congress: she would open the windows to let in the light and fresh air, and she would scrub the place clean even though she did not believe in germs.

Michael Burgess is an obstetrician, born 1950. We hope he is not a hypocrite even though hypocrisy is the underlying crisis of humankind. Given reelection, good habits, genetics, health care, and intentions he may very well live long enough to assist the United States Congress in giving birth to a Sunshine or Open Window Law that will afford all inquirers insight into the workings of Congress. Until such a law is made, it shall remain the mortal enemy of the democratic republic.

xYx

2017 Miami Beach

Silver Sneakers Snubs South Beach Seniors

 

CRUNCH Moi

 

SILVER SNEAKERS SNUBS SOUTH BEACH SENIORS

Crunch Fitness Members Left in Lurch

Thanksgiving Day 2015

By David Arthur Walters

THE SOUTH BEACH HERALD

Shareholders can thank Healthways Silver Sneakers for dropping Crunch Fitness, the only affordable, full-service health club on South Beach, from its list of gyms available to Medicare Advantage insureds, and for attempting to deceive the hapless seniors into believing a comparable benefit would be conveniently provided.

Crunch Fitness South Beach participants were notified of the change by an undated propaganda letter shortly before Thanksgiving Day, less than two weeks before the end of the annual Medicare Advantage enrollment period.

The propaganda implied that Crunch is at fault for “no longer participating in the program,” and invited dumped seniors to enroll somewhere else “as we seek another location that will be convenient to you.” Crunch Fitness did not respond by deadline to requests for an explanation.

For seniors, many of whom are economically challenged, and who may not have a car, “somewhere else” means transportation expenses of about $5 a day, more than an hour’s drive or two hours a day on the county’s pathetic bus system.

And there will be no comparable, convenient location in South Beach as long as the tradition of pushing seniors and the working poor off the beach continues, to make way for luxury developments in accord with the political-economic program that Mayor Philip Levine, a wealthy developer, rightly called “relentless for progress” when soliciting funds from developers for a political action committee lauding him.

Crunch Fitness South Beach is the low-priced gym in South Miami Beach, at $87 per month after raising its fee this year by $3. A confidential source within the organization said it would probably gladly accept $40 from Silver Sneakers for seniors as a public service.

The only alternative full service gym on South Beach, Equinox Fitness, charges more than double Crunch’s monthly fee. Given the nature of its business, it is high improbable that Equinox would reach out with affordable fees to economically challenged persons.

David Barton’s upscale club folded on the second bankruptcy. Gold’s became South Beach Active, then folded. The problem is exorbitant real estate values fueled by surplus capital relentlessly seeking profits, cheap and often laundered money, and morally if not criminally corrupt politicians. The result has been to push working class people and retired seniors on low fixed incomes off the beach.

A Healthways propagandist refused to disclose the nature of the disagreement with Crunch because that sort of information is “proprietary.”

The proprietors certainly are not its Silver Sneakers members, who have no rights whatsoever, and must accept whatever intermediary their insurance company selects for them.

Indeed, Healthways, calling itself a “well being” management company, serves the interest of insurance companies, employers, and governments, an interest obviously superior to the well being of the ultimate consumers: the insureds, employees, and taxpayers who are not even referred to as customers in the corporate literature posted on the Internet.

And the main interest of the organization appears to be superior even to the interests of shareholders; that is, the interests of its highly paid executives. The firm, with $742 million in revenue in fiscal 2014, laid out $4.4 million dollars in the third quarter this year to get rid of its former president and CEO, and then laid 68,531 shares, today valued at $872,000, of restricted stock (HWAY) on its new president and CEO as a supposed incentive. Hedrick Smith’s national bestseller (Who Stole the American Dream?) contradicts the notion that stock incentives actually produce stellar results, except to executives. It is more than likely that public relations propaganda about expectations for the company under new management as well as the general market hype will at one time or another elevate the successor’s stock holdings regardless of his personal performance.

This badly managed health care management company has lost tens of millions of dollars, and expects twenty-five more millions to be lost in the fourth quarter for restructuring charges intended to align the interests of management with the shareholders’ interests in profits. Operations will be “decentralized” despite its current blindness to local consumer needs. Costs will be “rationalized” in order to “lower health related costs,” which probably explains why Silver Sneaker “members” with Crunch Fitness are getting the shaft on South Beach.

The total loss will exceed its retained earnings, as it gives away shares to officers pursuant to the fallacy that, by tying their interest to that of shareholders, they will have an incentive to improve performance. Will they ever learn? Well, executives have learned to line their pockets at shareholder expense despite earnings performance. Share values rise and fall with expectations. The herd has a short memory.

By the way, the third quarter loss did not include a $20 million investment loss in a joint venture with Gallup, with which Healthways partnered for 25 years in an endeavor to track and manipulate human behavior. They created the so-called Well-Being Index in 2012. The public is randomly polled with 10 questions appertaining to 5 elements, physical health being the last element on the list published on the Internet.

Physical health is the main reason people join fitness centers. Regular exercise in full-service fitness clubs reduces health care expenses. Badly managed health care management is bound to add to the cost of health care. It very well may be that private health care management intermediaries like Healthways, whose interests are aligned more with executives and shareholders than with the health of the ultimate beneficiaries, actually cost more than they are expected to save.

The choice of a convenient fitness center should be left to the consumer. The consumer should be issued the insurance company’s electronic voucher for a flat amount, determined by the average rate charged in the locality for that type of facility, to be applied to the chosen club’s monthly charge. The difference, if any, would be paid by the fitness center member. Fitness centers would be certified by an independent nonprofit entity.

In the interim, Crunch Fitness, a brand that harkens back to the good old days, would profit in several ways by offering a special senior rate to locals. The potential local market for that service is about $160,000 per month in additional revenue at $40 per senior. Seniors generally attend during off hours.

# #

Beware of Healthways Inc (HWAY)

CRUNCH Moi

BEWARE OF HEALTHWAYS

You may be left in the lurch

14 November 2015

By David Arthur Walters
THE SOUTH BEACH HERALD

Seniors, beware during this Medicare Advantage enrollment period if you believe your Healthways Silver Sneakers benefit will continue to include your favorite gym. It may no longer be on the list, and it may be too late for you to do anything about it, because the emphasis of financially strapped Healthways is return to stockholders and not benefits to its customers.

For example, Crunch Fitness South Beach, the only full service gym in South Beach besides upscale Equinox, which cannot afford to serve the entire community, was dropped by Healthways. The luxury real estate boom in South Beach has driven rents so high that GOLDS and David Barton’s were forced to close. Crunch Fitness reorganized nationwide, and its two South Beach locations are now its top producers.

I visit the Crunch gym everyday to keep myself fit and out of the hands of doctors. The reason I switched my Advantage plan from Preferred Care Partners to Care Plus last year was because Care Plus provided my gym, Crunch Fitness South Beach, as a benefit. It was not actually listed in Healthways’ Silver Sneakers directory, but I was assured by my local Crunch of its participation.

This year, I happened to check the list again because I was dissatisfied with Care Plus, which enjoys the highest Medicare rating, I believe, not because its plan is superior, but because of its bedside manner; it is good at holding the hands of disappointed seniors.

This year, Preferred Care Partners does provide the Silver Sneakers network. I resolved to dump Care Plus and return to Preferred, which is backed by United Healthcare. I discovered during my conversation with the Preferred Care Partners’ representative that my gym was not on the Silver Sneakers list.

I contacted Silver Sneakers via email, and received a response by someone who would not put his name on the communication. Crunch Fitness in area 33139 was no longer on the list:

“We anticipate being successful in our efforts and feel confident we will have alternative locations for you in the near future to continue to enjoy the Fitness, Fun and Friends you have come to expect with Silver Sneakers offered by your health plan at no additional cost.”

The fact of the matter is that there is no viable alternative location within zip code 33139 i.e. South Beach. It so happens that my primary care physician, whom I have never met and whose Care Plus optical program I found pathetic because it took his eyeglass monopoly upstairs in his clinic 7 months to get my glasses, is on the Silver Sneakers list, that being an exercise room he set up for his captive customers, the frail elderly.

Otherwise, carless seniors with the Silver Sneakers benefit can board the horrendous Miami-Dade County bus system for up to two hours a day at $5 roundtrip to go to an economy gym.

I called Michelle at Silver Sneakers to point out that there are no alternatives nor will there a viable option given local market conditions. That is, Crunch Fitness South Beach is the only option.

That was no concern of hers although she appreciated how deprived members might feel. She said a notification would be sent out, but she did not know when. She said that it is the responsibility, however, of insurance company customers to find out if they are covered. We are a nearly month into the enrollment period now, which will close on 7 December, yet Healthways has not yet provided notification to Crunch Fitness South Beach members.

I still hoped that Healthways Silver Sneakers would renegotiate the contract with Crunch, which recently raised its membership fee by about $5. I emailed Jill Myers, Healthways Press Relations Director. My plea for a response to the particular concerns was forwarded to Virginia Anderson at Allison + Partners, a strategic market public relations firm. She pasted a hackneyed PR response into her email to me:

“We are in the process of contacting Silver Sneakers members in the area to notify them of this change and encourage them to seek one of our neighboring locations, among more than 13,000 locations nationwide. We are committed to providing our members with many class and location options to suit their needs and will explore new alternatives to serve our Miami members who previously participated at the Crunch location. I understand this meets your deadline tomorrow. Thanks so much!”

When I asked what the problem with the contract was, she refused to say anything except that the information was proprietary. Neither would Crunch Fitness Corporate comment on the issue.

One can only infer from the information available that Healthways is concerned with its bottom line and not the consumers whom they would leave to suffer the conditions of a particular highly priced market.

I was obviously speaking to a machine with a broken record. A little research of Healthways financials revealed that it is a badly managed health care management company. The Nashville firm, founded in 1981, and, with $742 million in revenue in fiscal 2014, laid out $4.4 million dollars in the third quarter this year to get rid of its former president and CEO, and then laid 68,531 shares, today valued at $872,000, of restricted stock (HWAY) on its new president and CEO as a supposed incentive. Hedrick Smith’s national bestseller (Who Stole the American Dream?) contradicts the notion that stock incentives actually produce stellar results except to executives.

The company lost $15 million before taxes in the third quarter including a $10 million settlement of a contract dispute. The third quarter loss does not include a $20 million investment loss in a joint venture with Gallup.

Healthways and Gallup have partnered for 25 years in an endeavor to track and manipulate human behavior. They created the so-called Well-Being Index in 2012. The public is randomly polled with 10 questions appertaining to 5 elements, physical health being the last element.

Healthways expects to lose another $25 million in the fourth quarter for restructuring charges intended to align the interests of management with the shareholders’ interests in profits. Operations will be “decentralized” despite its current blindness to local consumer needs. Costs will be “rationalized” in order to “lower health related costs,” which probably explains why so-called Silver Sneaker members with Crunch Fitness are getting the shaft on South Beach.

Healthways will also take a hit to revenue because it is amending its contract with the Hawaii Blue, Hawaii Medical Service Association, transferring 220 of its staff to HMSA, most likely because HMSA is better managed. Hawaii pioneered prepaid health care, mandating that all employers over a small size provide coverage for each employee at its cost. I had a difference of opinion with HMSA over its marketing, and the secrecy of its formula for determining its level of benefits several years ago, but that was resolved with the assistance of the state ombudsman and two U.S. Senators.

Healthways losses will exceed its $29 million in retained earnings, and leave it with less than one dollar in current assets to satisfy each dollar in current liabilities.

Healthways rhetoric states that it is “The largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities.”

Tellingly, the ultimate consumer on which capital depends is not included in the customer list, although Healthways also says it provides “highly specific and personalized support for each individual,” which it obviously does not now do in the South Beach market.

We also read that “68 million covered lives (are) actively managed” by Healthways, meaning that individuals are deprived of choices to manage their own lives, as my example demonstrates. This is top-down, paternalistic, managed health care by a demonstrably badly managed company.

We do not need this incompetent “middle man” to manage our lives. Health club benefits should be tailored to local market conditions; some clubs cost less, some cost more; on the average the cost is reasonable. Or the insurance companies can simply pay the average cost to the clubs, and the members could pick up the difference if any.

Part of staying healthy is making individual decisions as to what health club we want to belong to. Healthways markets its Silver Sneakers on the basis that the clubs intervene in disease and promote health. We know that. And when great health clubs like Crunch Fitness are excluded from participation, we know that is unhealthy. We want our gym benefit, not public relations bullshit.

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