Another Black Eye For Indiana

A reader of this blog recently sent me a research report from Ball State. In this study, the author, Michael Hicks, confirms conclusions reached by other solid researchers.

One such conclusion: sick people in Indiana are being fleeced by hospitals that are supposedly “nonprofit.”

Hicks began by admitting his preconceptions:

Several weeks ago, a concerned citizen sent me a financial summary of Indiana’s not-for-profit hospitals. He asked that I look into the issue of excessive profits by these systems. I was skeptical that the issue would be relevant. Profits are critical to an economy; they serve as a guide to pricing and investment decisions and reward the men and women who create value. The demonization of profits is a sure sign of unformed thought. Moreover, not-for-profit hospitals have explicitly chosen to forgo profits as part of their operations, so I doubted the financial summary would reveal anything important. I was mistaken.

What he found shocked him–and should shock us.

It turns out the not-for-profit hospital industry and their network of clinics is the single most profitable industry in Indiana. These profits are so large that when accumulated, they account for roughly 9 percent of the state’s total economy. As of 2017, this industry had accrued more than $27 billion, yes billion. Yet, the not-for-profit industry in Indiana pays virtually no taxes and invests almost none of those profits locally. That money is invested in Wall Street, not Main Street. However, they do charge Hoosiers a premium to access healthcare.

The numbers come from a Rand Corporation study conducted earlier this year that found  hospitals in Indiana charging among the highest prices in the nation. Hicks noted that he had confirmed Rand’s data, and had compared the results with with the lack of competition in each healthcare market.

In places where there is little competition, such as Fort Wayne, consumers pay more than twice the cost for a typical medical treatment as they do in places with the most competition. This is how these hospitals accrued excess profits that are roughly 12 times larger than the entire state of Indiana’s Rainy Day Fund.

Hicks says that Hoosiers pay $819 more per person per year than the average American, and attributes that premium to the growth of monopoly power among the state’s not-for-profit hospitals.  And he provides examples.

Parkview Hospital is the most blatant example. In one recent year, Parkview Hospital in Wabash earned a 48 percent profit rate. By comparison, Walmart, which also has a store in Wabash, had a profit rate of 3.12 percent that year. Parkview Hospital’s profit absorbed a full 4.1 percent of the county’s GDP (gross domestic product).

Using data from a ProPublica investigative website, I found IU Ball Memorial Hospital enjoyed a lavish 23.8 percent profits in that year. This was more than $100 million, or a full 2.5 percent of the county’s GDP. Despite this, the president of IU/BMH recently begged the city of Muncie to subsidize new luxury apartments so his doctors could live downtown. That subsidy will cost Muncie Community Schools more than $2 million, which just so happens to be about two days of profits at the not-for-profit IU Ball Memorial Hospital. There are literally dozens of other outrageous examples reflecting an appalling lack of governance at not-for-profit hospitals.

This situation is particularly hurtful for local governments that are already reeling from Mitch Daniels’ politically-brilliant and governmentally-destructive constitutionalization of  property tax caps. As Hicks rightfully notes,

Local governments are also victims. The most profitable industry in our state pays no property tax and no income tax, but overcharges schools, city and county governments for healthcare.

Hicks ends his article with a warning to profiteering organizations–it can’t go on like this for much longer. As he says, it’s an open invitation to plaintiffs attorneys and politicians alike.

To place this in historical context, the profit rates at Indiana’s not-for-profit hospitals are larger than anything the Gilded Age robber barons were able to secure. In this observation is a final lesson. In the process of vetting this study with several colleagues, I shared it with one lifetime Republican and veteran of two GOP administrations. His response was simply that this is the single best argument for Warren/Sanders healthcare reform he had ever seen. He is not wrong, and that alone should prompt quick legislative, regulatory and legal action.

I wouldn’t bet on it.

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A Step Too Far

The modern-day version of the Golden Rule is apparently: “He who has the gold, rules.”

Today, I’d like to consider the application of that axiom to institutions of higher education, and the donors they solicit.

People give money to colleges and universities for a number of reasons, and many of those reasons are laudable. University research is responsible for curing diseases, explicating history and developing philosophies, among many other things. University classrooms introduce students to great literature and art, help them develop critical skills, and deepen their understanding of the world. Making a gift to support those activities is a welcome expression of philanthropic generosity.

Then, of course, there are people like the Koch brothers, whose “gifts” generally come with rather disquieting strings. 

FAIRFAX, Va. — Virginia’s largest public university granted the conservative Charles Koch Foundation a say in the hiring and firing of professors in exchange for millions of dollars in donations, according to newly released documents.

The release of donor agreements between George Mason University and the foundation follows years of denials by university administrators that Koch foundation donations inhibit academic freedom.

University President Angel Cabrera wrote a note to faculty Friday night saying the agreements “fall short of the standards of academic independence I expect any gift to meet.” The admission came three days after a judge scrutinized the university’s earlier refusal to release any documents.

The report from the New York Times, from which the above paragraphs were taken, confirms a  widespread suspicion among academics. There have been rumors about George Mason University for years; those rumors have cast a shadow over the school’s reputation and that of its scholars. When people believe a donor’s “generosity” has purchased a desired research result, the research results will–properly– get discounted.

When it appears that a faculty member has been added not because a search committee, operating under standard academic procedures, determined that the person hired was the most accomplished applicant, but because s/he was the preferred choice of a donor–especially a donor like Koch– looking askance at that new hire shouldn’t be surprising.

The newly released agreements spell out million-dollar deals in which the Koch Foundation endows a fund to pay the salary of one or more professors at the university’s Mercatus Center, a free-market think tank. The agreements require creation of five-member selection committees to choose the professors and grant the donors the right to name two of the committee members.

The Koch Foundation enjoyed similar appointment rights to advisory boards that had the right under the agreements to recommend firing a professor who failed to live up to standards.

To label this state of affairs “unacceptable” is to state the obvious. It’s hard enough, in today’s toxic and polarized environment, to find sources of unbiased information. The reputation of a university is inextricably tied to its demonstrated  intellectual honesty. That doesn’t mean that all of its research results are sound, or all of its teaching Socratic, but it does mean that the inevitable flaws and missteps are honest errors, not purchased propaganda.

The activist group UnKoch My Campus noted that the George Mason documents evidencing the arrangement are strikingly similar to agreements the Koch Foundation made with Florida State University–agreements that recently caused an uproar at that institution. (There’s a lesson here for Ball State University, here in Indiana,  which has  accepted Koch dollars to establish an economic Institute.)

Cabrera’s admission that the agreements fall short of standards for academic independence is a stark departure from his earlier statements on the issue. In a 2014 blog post on the issue, he wrote that donors don’t get to decide who is hired and that “these rules are an essential part of our academic integrity. If these rules are not acceptable, we simply don’t accept the gift. Academic freedom is never for sale. Period.”

In 2016, in an interview with The Associated Press, he denied that the Koch donations restricted academic independence and said Koch’s status as a lightning rod for his support of Republican candidates is the only reason people question the donations.

Right. And if you believe that, I have some underwater land in Florida to sell you. It’s going to take some time and effort to restore the reputation of George Mason University–assuming it can wean itself away from the “gold” that has ruled it.

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One of the Many Reasons Elections Matter

Yesterday’s post focusing on GLBT rights reminded me that we’re heading toward June and Gay Pride. As we prepare for the annual Pride celebrations, two things are clear: 1) GLBT Americans are winning the fight for civic equality, and 2) the nature of the remaining threat to that equality has changed.

I won’t belabor the first observation; anyone reading this blog can recite the “wins.” Same-sex marriage is recognized in more and more states, Fortune 500 companies are falling over themselves to be welcoming–to extend benefits and institute policies mandating fair treatment. Popular culture and even pro sports are accepting their no-longer-closeted celebrities.

All of these indicators point to a sea change in the attitudes of average Americans, and that change is confirmed by survey research. The days when coming out meant risking ostracism from friends and families, or difficulty getting a job, aren’t altogether over, but we’re getting close.

The threat today comes from the Neanderthals we keep electing–the theocrats who insist that America is a “Christian Nation,” who reject science, who believe women should be “subservient,” barefoot and pregnant, and that GLBT folks should be closeted (or worse).

Just a couple of examples:

A couple of days ago, the Indianapolis Star revisited a controversy that arose a couple of years back over allegations that a Ball State University Assistant Professor was teaching creationism, aka “intelligent design.” BSU’s President, JoAnn Gora–somewhat belatedly–issued a letter confirming the institution’s commitment to science, and its recognition that intelligent design is religious dogma, not science. (To do otherwise would have massively degraded the value of a BSU degree.)

Subsequently, the Indiana legislature’s God Squad made threatening noises; the explicit message was that requiring faculty to teach real science in science classes “violated Academic Freedom” (!) and the implicit message was that it would cost the University when the time for state appropriations rolled around. Last week, the Star reported that the professor involved was promoted. Whether he is still teaching Intelligent Design is unclear.

Indiana’s legislators aren’t the only ones waging war against genuine academic freedom, diversity and modernity generally. South Carolina’s not-ready-for-this-century lawmakers voted to slash funding for two of the state’s largest public colleges in retaliation for the introduction of books with gay themes into the schools’ freshman reading programs.

In February, the South Carolina House of Representatives voted to cut $70,000 — the entire cost of the offending programs — from the College of Charleston and the University of South Carolina Upstate.

These two incidents—which, unfortunately, are anything but isolated—should sound alarm bells.

Red state legislatures are dominated by frightened old heterosexual white guys whose unspoken motto is “Stop changing the world, I want to get off.” The broader society is making its peace with complexity, diversity and inclusion, but these lawmakers, and the Rabid Righteous base that elects them, is waging a last-ditch effort to turn back the clock.

These guys—and they are almost always guys—are able to be elected thanks to a combination of voter apathy, vote suppression and gerrymandering. Those who go to the polls in states like Indiana and South Carolina are opting for candidates who reject science, progress and inclusion in favor of a constricted and literalist religiosity.

In 1966, Richard Hofstadter wrote Anti-Intellectualism in American Life. That anti-intellectualism–characterized by the elevation of sloganeering over analysis and “biblical truth” over complexity, evidence and education—is  still with us; it characterizes the Tea Party and too much of today’s GOP.

It poses a threat not just to GLBT folks, but to all of us; it’s a formidable barrier to our ability to create a sane and tolerant society.

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A Welcome Statement

A couple of weeks ago, I criticized Ball State University for hiring a prominent creationist to teach science courses. Coming after complaints alleging that another science faculty member had taught a course from an “intelligent design” perspective, the hire raised troubling questions about the quality of scholarship at the University.

Yesterday, a friend on the BSU faculty shared with me a strong statement on the controversy just issued by President JoAnn Gora.

The money quote:

As this coverage has unfolded, some have asked if teaching intelligent design in a science course is a matter of academic freedom. On this point, I want to be very clear. Teaching intelligent design as a scientific theory is not a matter of academic freedom – it is an issue of academic integrity. As I noted, the scientific community has overwhelmingly rejected intelligent design as a scientific theory. Therefore, it does not represent the best standards of the discipline as determined by the scholars of those disciplines. Said simply, to allow intelligent design to be presented to science students as a valid scientific theory would violate the academic integrity of the course as it would fail to accurately represent the consensus of science scholars.

Precisely.

The statement made no reference to the prominent creationist who was hired, but it was unambiguous in recognizing that “intelligent design” is neither academically appropriate nor scientifically accepted, and assuring the faculty and alumni that religious doctrine will not be taught in science classes at Ball State.

A failure to clarify its continued commitment to intellectual integrity would have significantly diminished BSU’s academic reputation, so the issuance of this statement was a welcome relief (if unaccountably tardy).

But better late than never.

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Education Redefined

When I was a young girl growing up in Anderson, Indiana (circa Ice Age), Ball State University, located in nearby Muncie, was sort of a joke. It was a “Teachers’ College,” attended by kids who didn’t have the grades to get into more rigorous or respectable schools.

Over the years, Ball State’s reputation has improved tremendously. It is no longer just a teachers’ college enrolling substandard students. It has become a respectable and respected University.

Or so I thought.

Suddenly, Ball State’s motto–“Education Redefined”–has taken on a whole new meaning. A recent news item was nothing short of appalling.

Ball State University has hired a controversial astronomer who is a national leader in the intelligent design movement (Slabaugh, Muncie Star Press). President Jo Ann Gora approved the hiring of Guillermo Gonzalez as an assistant professor in the department of physics and astronomy on June 12 at a salary of $57,000. He will start teaching at BSU in August. The hiring occurred after Ball State had launched an investigation into a complaint that another assistant professor in the same department, Eric Hedin, was promoting intelligent design in a science class…

Every court that has considered the propriety of teaching “creationism” or “intelligent design” (interchangable terms, no matter how desperately their proponents claim otherwise) in public school science classes has concluded that intelligent design is religion, not science. That includes Republican judges appointed by conservative Republican Presidents. Among scientists, intelligent design is a joke–not because it postulates the existence of God (many scientists believe in God), but because it is not science. Intelligent design or creationism can be taught in a class on comparative religion, but it simply cannot be taught as science.

Let’s talk about what science is.

Science is the pursuit of knowledge and understanding of the natural and social world following a systematic methodology based on evidence. It requires the observation, identification, description, experimental investigation, and theoretical explanation of natural phenomena. Science is characterized by empirical inquiry.

The scientific method begins with the identification of a question or problem, after which relevant data are gathered, a hypothesis is formulated based upon that data, and the hypothesis is then subject to additional empirical testing.

Development of a scientific theory is a part of the scientific method. It involves summarizing a group of hypotheses that have been successfully and repeatedly tested.  Once enough empirical evidence accumulates to support a hypothesis, a theory is developed, and that theory becomes accepted as a valid explanation of a particular phenomenon.

In the scientific method, a clear distinction is drawn between facts, which can be observed and/or measured, and theories, which are scientists’ explanations and interpretations of those facts. Scientists can draw various interpretations from their observations, or from the results of their experiments, but the facts, which have been called the cornerstone of the scientific method, do not change. A scientific theory is not the end result of the scientific method; theories are constantly supported or rejected, improved or modified as more information is gathered so that the accuracy of the prediction becomes greater over time.

Nonscientists use the word theory to mean speculation, or guess—“I have a theory about that.” When we fail to distinguish between our casual use of the term and its very different scientific meaning, we confuse discussions of science education. This has been particularly true of arguments surrounding Darwin’s Theory of Evolution. Some religious people (certainly not all) believe that the theory of evolution is inconsistent with a belief in God, and they challenge the teaching of evolution in biology classes because they believe that it is “just a theory.”

In order to be scientific, hypotheses and theories must be subject to falsification.

A falsifiable assertion is one that can be empirically refuted or disproved.

Observing that a woman or a sunset is beautiful, asserting that you feel sad, declaring that you are in love and similar statements may be very true, but they aren’t science, because they can be neither empirically proved nor disproved. Similarly, God may exist, but that existence is not falsifiable—God cannot be dragged into a laboratory and tested. One either believes in His existence or not. (That’s why religious belief is called faith.)

It’s unfortunate that so many people don’t understand the difference between science and religion, but it is inconceivable that an institution of higher education would confuse the two, or allow religious doctrine to be taught as science.

I don’t know what’s going on at Ball State, but apparently that institution is “redefining education” in ways that will return it to its previous status as a third-rate institution.

Jo Ann Gora should be embarrassed, and Ball State alumni–who are seeing their credentials devalued–should be furious.

 

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