LANSING, MI – For year, private health insurance companies have been pressing state officials to hand Michigan’s $3 billion a year mental health system to them.
Now, it looks like they just might get their wish — and those who are most concerned with the plight of the mentally ill are deeply worried. Michigan Senate Majority Leader Mike Shirkey, a Republican from Jackson County, has been talking about a proposal that would privatize mental health care in the state.
Tom Watkins is not happy about this. Watkins was deputy director, then director of what was then called the state department of mental health from 1983 to 1990; he later ran the Detroit-Wayne County Mental Health Authority for four years, till 2017.
“This is a plan to transfer $3 billion annually from the public system to insurance companies that are designed to provide profit, not care,” he said. “Public systems get maligned, and they do have inefficiencies, but they provide much more accountability.”
He is far from alone. Other health care advocates were also upset. Kevin Fischer, executive director of the Michigan chapter of the National Alliance on Mental Illness, or NAMI, told reporters it was nothing more than a “money grab by the (private) health plans.”
Most Republicans disagree. They note that physical care for many Medicaid recipients has already been contracted out to private health care plans. They say that doing the same for mental health care would make for efficiencies and likely save costs.
That argument causes Watkins to roll his eyes. There’s nothing wrong with seeking efficiencies (finding ways to cut costs.) When I was running the Detroit-Wayne County system we did that as often as we could. But we used the money we saved to provide a $2 an hour raise to the direct care staff. That’s not likely here.
“At a private health care firm, too often the CEO is making $20 million and the person who is bathing your grandma is making minimum wage.”
The details of Shirkey’s proposal, which has yet to be formally introduced, are still murky. But documents being circulated in Lansing indicate he intends to push legislation that would affect those who rely on Medicaid and have mental illness, developmental disabilities or severe drug or substance abuse problems.
Republicans have long been in favor of more privatization of mental health care programs, which currently serve an estimated 300,000 Michiganders. Five years ago, Gov. Rick Snyder proposed turning over Medicaid funding to 13 managed care plans, and set up a number of “Section 298” pilot programs to test the idea.
But nobody could agree on just how to do that; problems constantly developed, and Gov. Gretchen Whitmer, a Democrat, ended funding for the proposals soon after she took office in 2019.
There clearly is big money behind the latest privatization push. The Michigan Campaign Finance Network (MCFN), a non-profit, non-partisan watchdog group, has revealed that private health care plans have contributed more than $1 million to the campaigns of legislators who will decide whether to privatize mental health care.
Not surprisingly, Shirkey got more — $76,250 — than anyone else. His political action committee got $25,000 alone from one Jon Cotton, the former president of Meridian, one of the private health care plans which would stand to gain.
According to MCFN, Cotton’s family has given more than $356,000 to various Michigan lawmakers in recent years.
Watkins is very dubious about the propriety of all this – and thinks he has a clear idea of what would happen if state mental health care was essentially farmed out to private interests.
“Public systems have accountability, even if it hasn’t always been perfect. “They provide a system and a clear way you can get answers. But if you have a problem with the XYZ private health care system you have to go to some corporate headquarters and try to confront their CEO. Good luck getting past the security guard.”
He added, “Look. Do you think Congress imagined when they created Medicare and Medicaid that they were creating a system to create millionaires and billionaires in the private insurance sector?
Now living in Costa Rica, the former health care director has had personal experience with the pain mental illness can cause; he had two brothers who committed suicide.
“What we need to ask ourselves is this: At the end of the day, who would you trust to make decisions about the care of 300,000 citizens of the state of Michigan – the public sector, where there is oversight and accountability, or a for-profit insurance company?”
And he added that eventually, the choice is bound to “impact someone you know and love, a mother, father, sister, child.”
Enthusiasm for privatizing state services may have been somewhat dampened in Michigan by Gov. Rick Snyder’s disastrous attempt to privatize food services in Michigan’s prisons.
Yet regardless of sentiment, Republicans still have solid majorities in both houses of Michigan’s legislature, and can likely pass anything they want to. They do not, however, have enough votes to override the governor’s veto, if she were to issue one.
But would Gretchen Whitmer veto any law privatizing state mental health care?
“If the decision is made on the basis of accountability and transparency and public oversight of public dollars, she will,” he said, before adding “sometimes, decisions are made for other reasons.”
Watkins did not mention that last month, the governor got into political hot water for not disclosing a trip she had made to Florida to see her ailing father. She flew on a private corporate jet partly owned by the family of private health care czar Jon you Cotton.
Stay tuned.
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