Lawsuit Seeks Data On BOP, CIA Detention Site

By Steve Rensberry
   (RPC) - 4/28/2016 - Although it has received scant attention in the news, The American Civil Liberties Union filed a lawsuit this past month against the Federal Bureau of Prisons, citing the bureau's failure to comply with a Freedom of Information Act request involving documents pertaining to a 2002 visit to a CIA detention site in Afghanistan, code-named COBALT. The operation and site, also known as “the Salt Pit,” was used to confine and torture terrorism suspects, according to the declassified torture report provided to the U.S. Senate Intelligence Committee in 2014. Although the practices described in the report were referred to as “not inhumane,” it nevertheless was a shock to the senses for many of those who read it.
   The ACLU's initial Freedom of Information Act request, filed in 2015, was brushed aside by prisons officials, who claimed that “no records exist" -- a response which the civil rights organization has questions.
   “What business did the Bureau of Prisons have with a torture site in Afghanistan?” ACLU National Prison Project Staff Attorney Carl Takei stated in a recent news release. “The bureau controls conditions for the 200,000 federal prisoners in the United States while teaching its methods to jails and state prisons around the country. We have to wonder why a team from that institution would give its approval to a place where prisoners are kept in solitary confinement in near-total darkness 24-7, shackled to the wall standing up, and with a bucket for human waste.”
   The ACLU's suit was filed on April 14, 2016. A link to an executive summary of the report on the CIA's Detention and Interrogation Program, given to the Senate Select Committee on Intelligence on December 9, 2014, is available here:
   The executive summary is 525 pages long, and the full committee study is 6,700 pages in length.
   As stated in the forward to the summary, written by Committee Chairman Dianne Feinstein: “The full report has been provided to the White House, the CIA, the Department of Justice, the Department of Defense, the Department of State, and the Office of the Director of National Intelligence in the hopes that it will prevent further coercive interrogation practices and inform the management of covert action programs.”
   Recalling the days after 9-11, when political leaders and the public felt the impulse to do whatever it could to stop another attack, Feinstein said that such pressure and fear did no “justify, temper, or excuse improper actions taken by individuals or organizations in the name of national security.”
   Feinstein referred to the lessons of history and the need to subject decisions to internal and external review, then lambasted those who oversaw the COBALT operation.
   “Instead, CIA personnel, aided by two outside contractors, decided to initiate a program of indefinite secret detention and the of brutal interrogation techniques in violation of U.S. law, treaty obligations, and our values,” Feinstein wrote.
    Her statement begs the question: If such techniques were in violation of U.S. law and treaty obligations, why has no one connected with such abuse been prosecuted?
   The short answer is because those doing the prosecuting, that is, the Justice Department, would indirectly be prosecuting themselves. The Justice Department cited in its investigation the advice given by the Office of Legal Council, which itself is part of the U.S. Justice Department. Both are part of the executive branch of the U.S. government. Together with the attorney general, both groups provide advice and guidance to the president and all other executive branch agencies, including the C.I.A.
   Following the release of the 2014 report, justice department spokespersons and the administration have remained unified and steadfast in their redirection of the subject, not surprisingly, with President Obama citing a desire to "look forward, not backward," and the justice department citing the fact that such interrogation techniques had been fully reviewed and considered legal under the previous administration. In other words, it goes all the way to the top.
   One of the most damning assessments of the administration's failure to prosecute those responsible has come from the organization Human Rights Watch, and from UN Special Rapporteur on Counterterrorism Ben Emmerson.
   The Human Rights Watch report can be found here:
   To quote: “As set out in this report, Human Rights Watch concludes there is substantial evidence to support the opening of new investigations into allegations of criminal offenses by numerous US officials and agents in connection with the CIA program. These include torture, assault, sexual abuse, war crimes, and conspiracy to commit such crimes. In reaching this conclusion, we have drawn on our own investigations, media and other public reports, and the declassified information in the Senate Summary. But more evidence exists that has yet to be made public. . . . US officials who played a role in the process of creating, authorizing, and implementing the CIA program should be among those investigated for conspiracy to torture as well as other crimes. They include: Acting CIA General Counsel John Rizzo, Assistant Attorney General for Office of Legal Counsel (OLC) Jay Bybee, OLC Deputy Assistant Attorney General John Yoo, an individual identified as “CTC Legal” in the Senate Summary, CIA Director George Tenet, National Security Legal Advisor John Bellinger, Attorney General John Ashcroft, White House Counsel Legal Advisor Alberto Gonzales, Counsel to the Vice President David Addington, Deputy White House Counsel Timothy Flanigan, National Security Advisor Condoleezza Rice, Defense Department General Counsel William Haynes II, Vice President Dick Cheney, and President George W. Bush. In addition, James Mitchell and Bruce Jessen, CIA psychologist contractors who devised the program, proposed it to the CIA, and helped carry it out, should also be investigated for their role in the initial conspiracy.”
   In a surprise ruling, Federal Judge Justin L. Quackenbush denied on April 22, 2016, a motion to dismiss a suit brought against psychologists James Mitchell and Bruce Jessen, who aided in the CIA's torture practices and COBALT operation, and for which they were paid $81 million. More about the case and ruling can be found here:

Report: Medical Errors Injure Upwards Of 488,900

By Steve Rensberry
   (RPC) - 2/19/2016 - A recent report by the Heartland Health Research Institute estimates that between 281,000 and 488,900 patients in Illinois hospitals are injured each year to do preventable medical errors or events. The estimate nationally is between 6.6 million and 11.5 million patients.
Preventable injuries occurring in Illinois hospitals.
    “If the Centers for Disease Control (CDC) were to include preventable medical errors in U.S. hospitals as a category, it would be the third leading cause of death in the United States, behind heart disease and cancer,” an HHRI press release about the report states.
   Fatalities occur in Illinois hospitals due to preventable adverse events (PAE) at an estimated rate of about 1 death for every 139 hospital admissions. By comparison, 11 patients die in hospitals from such errors for every vehicle fatality, 15 patients die for every murder committed in the state, and altogether nearly 3 percent of the state's entire population is harmed each year by PAEs. The frequency and volume translates into about one fatality every 50 minutes in the state due to such errors.
   The annual cost of such errors? The HHRI report estimates that in Illinois the annual social cost of such fatalities is about $5.2 billion. Nationally the cost is estimated between $23.1 billion and $103.4 billion. The number of injured patients annually in Illinois, based on the most common types of preventable medical errors, is as follows: adverse drug events (72,600 patients); venous thromboembolisms/, VTEs – blood clots that form within a vein (48,800); decubitus ulcers, bed soars (36,400); catheter-related urinary tract infections (17,500); falls in the hospital (16,200); nosocomial pneumonia (12,600); catheter, related bloodstream infections (6,300).  
   "Preventable medical errors in our hospitals is clearly alarming, both in the number of lives affected and in cost." Heartland Health Research Institute President David Lind stated. "Is Illinois making progress on preventable medical errors? The quick answer is, we don't really know because reporting yields a healthy dose of under-counting and under-reporting of medical errors. Without having stringently-coordinated regulations and policies that effectively hold providers accountable through transparent reporting, medical errors will continue and the public will remain in the dark. The Federal Aviation Administration has such regulations - shouldn't our safety be just as important when we enter a hospital as it is when we board an airplane? The public deserves transparency and accountability on this issue."
   A study by USA Today in 2013, using data from the National Practitioner Data Bank and other sources, point to an additional worry for potential patients – unnecessary surgeries, which the article states might account for as much as 10-20 percent of all operations in some specialties. Cites are cardiac procedures such as stents, angioplasty and pacemaker implants, spinal surgeries, hysterectomies, cesarean sections, and knee replacements.
   “Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary,” authors Peter Eisler and Barbara Hensen write.
   What makes the size of the problem difficult to calculate is that only the worse cases are likely to become public knowledge, and if a surgery by chance takes care of a problem that could have been alleviated with lesser therapy or a non-surgical procedure, little suspicion is raised because the problem is gone.
   “Hospitals around the country do not report PAEs accurately and consistently - if at all,” the HHRI report states. “National experts acknowledge that most PAEs are either under reported or unreported. The Department of Health and Human Services Office of Inspector General issued a report in 2012 stating, 'Hospital staff did not report 86 percent of [patient harm] events to incident reporting systems, partly because of staff misperceptions about what constitutes patient harm.' This behavior reflects our culture of silence.”
   An October 27, 2015 Harvard Business Review report, written by Rebecca Wentraub, Yannis K. Valtis and Peter Bonis, claims there are many as 44,000 deaths in the Unites States each year due to preventable medical errors, with a price tag of roughly $17 billion.

U.S. Health Insurers Eye Bigger Profits In 2016

By Steve Rensberry
   (RPC) - 2/12/2016 - The Affordable Care Act not withstanding, health insurance companies across the United States have been seeking to raise their rates. Some companies, such as Blue Cross and Blue Shield of Minnesota, have sought increases of more than 50 percent in recent months. (1)
   In a Jan. 26 commentary written by CIGNA executive Wendell Porter and published by the Center for Public Integrity, that author notes that the nation's largest health insurer, UnitedHeathCare, posted profits of $10.3 billion in 2014, against revenues of $130.5 billion -- pushing its share price to $113.85. This is in sharp contract to a price of $30.40 in March of 2010.
   UnitedHealthCare isn't alone.
   “Every one of the big six saw their shares reach or come close to reaching historic highs. Although they haven’t done quite as well as United, the other five have seen the price of their stock more than double or triple. Health Net’s share price has increased 224 percent since March 2010. Anthem’s is up 238 percent over the same time period. Aetna’s 290 percent. Cigna’s 305 percent. And Humana’s 309 percent,” Porter writes. He cites the industry practice of purging unprofitable accounts--in particular small business accounts--as a contributing factor. (2)
   A Jan. 21 story by Paul R. La Monica, published by CNN and entitled “Thanks, Obamacare! Health insurer stocks soar,” cites the same record highs. “Many health care companies have yields that are significantly higher than the puny yields investors get from buying long-term U.S. Treasury bonds,” La Monica writes. (3)
   Kevin McCoy of USA Today suggests in a February 2 story that Aetna's fourth-quarter profits beat Wall Street forecasts, in part, because of an increase in the number of Medicare and Medicaid health plans it sells. (4)
   “The company said net income for the October -December quarter rose 38 percent to $320.8 million, or 91 cents a share,” McCoy writes. “That was up from $232 million, or 65 cents a share, for the same period last year.”
   New profits from Cigna Corp, meanwhile, were down 9 percent in the first quarter of 2015 (Mara Lee, Hartford Courant, Feb. 4), with the company citing higher costs associated with individual health insurance plans as one reason for the drop. A $48 million purchase by Anthem, announced last summer, is pending.
   Bob Herman, writing for Modern Healthcare, highlights other movements in the industry after years of uncertainty toward government programs and other types of investments, apart from traditional health plans. He cites data from Securities and Exchange Commission filings which show the percentage of UnitedHealthCare revenue from Medicare and Medicaid in 2009 at 49 percent, and it's share of commercial plan revenue at 50 percent, compared to 2014 revenues of 59 percent and 36 percent respectively. Aetna derived 24 percent of its profits from Medicare and Medicaid in 2009, and 76 percent from commercial accounts, compared to 42 percent and 58 percent in 2014 respectively. (5)
   “Federal spending on healthcare surpassed Social Security for the first time in 2015, thanks in large part to Medicaid expansion and the ACA's public exchanges, according to the Congressional Budget Office. Investor-owned HMOs that focus almost exclusively on outsourced Medicaid—such as Centene Corp. and Molina Healthcare—have thrived,” Heman states. “Medicare Advantage, perhaps more than any other federal program, has attracted the most interest because of the substantial revenue prospects from the growing numbers of baby boomers becoming Medicare-eligible. Almost 18 million people have a private Medicare Advantage plan, up from 10.5 million in 2009.”
   An analysis of 2016 premium changes and insurer participation in the Affordable Care Act's Health Insurance Marketplace, conducted by the Kaiser Family Foundation, looked at changes in the two lowest-priced Silver Plans for 11 major metropolitan areas and found an average, pre-tax credit increase of 4.4 percent. Those cities were: Portland, Oregon; Albuquerque, New Mexico; Richmond, Virginia; Burlington, Vermont; Baltimore, Maryland; Portland, Maine; Washington D.C.; Hartford, Connecticut; New York City, NY; Detroit, Michigan; and Seattle, Washington.
   “Our analysis is based on the 10 states plus the District of Columbia where we were able to find comprehensive filings or other information about the rates of the lowest-cost plans. Other states have released summary information, but not sufficient detail to identify the lowest-cost silver plans. In many cases, premiums are still under review by insurance departments and may change prior to the start of open enrollment,” the KFF report stated.

Photo by Steve Rensberry (c) 2014