Category Archives: Money in politics

COPN Monopolies Depress Income for Virginia Healthcare Professionals Without Lowering Costs

The Business of Healthcare

by James C. Sherlock

Virginia is among the richest states in the country.  

We are ranked ninth among states with the highest median household income in the 2019 (latest) Census Bureau American Community Survey. Virginia median household income was $74,222 and the U.S. as a whole was $62,843.

But Virginia has a Certificate of Public Need (COPN) law among the most stifling of competition in the nation. The law itself and the regional monopolies created combine to suppress both opportunity and income for healthcare professionals.  

The monopolies don’t just control the healthcare delivery market, they also control the labor market.  

This essay will illustrate the effects of COPN and COPN-generated monopolies in depressing wages, and thus on the willingness of medical professionals to practice here. And then show you those lower wages don’t save consumers a dime. Continue reading

Medicaid and Medicaid Rate Increases Boost Virginia Hospital Profitability

The Business of Healthcare

by James C. Sherlock

Virginia in 2018 both expanded Medicaid and increased Medicaid reimbursement rates.  

Those changes orchestrated by Virginia hospitals took effect in 2019 and resulted in a major financial windfall to those same hospitals.

I have compared the 2018 and 2019 Hospitals Operating and Total Margins spreadsheets published by the state through its contractor vhi.org. They provide detailed financial performance information for every hospital in Virginia. The 105 hospitals in 2019 included acute care, rural critical access hospitals, children’s, psychiatric, rehabilitation and sub-acute hospitals.

We will see that when the Medicaid changes kicked in in 2019, Virginia’s wealthy urban hospital systems got richer.  

But we will also see that those same changes rescued the rural hospitals from barely breaking even in 2018 and enabled them as a class to book extraordinary profits in 2019.

We will ask at the end of the discussion whether the state-provided outsized profitability of Virginia’s untaxed non-profit hospital systems may warrant a re-examination of their tax exemptions. Continue reading

COPN – Don’t Leave Home Without It

by James C. Sherlock

Sometimes I think we don’t personalize the effects of Virginia’s Certificate of Public Need (COPN) program on individual Virginians in ways that are relatable. Nor do many understand the power of the hospital monopolies.

Many readers here have followed the progress of our reporting of the increasing and relentless suppression of competition in healthcare by COPN. I will offer in this essay a single example that may personalize it.

In 2009, the regulation, not the law, that defined the radius from your home of facilities that would be considered when seeing whether you are adequately served by existing open heart surgery facilities was changed as follows:

Title 12. Health » Agency 5. Department Of Health » Chapter 230. State Medical Facilities Plan » Part IV. Cardiac Services

Article 2
Criteria and Standards for Open Heart Surgery

12VAC5-230-440. Accessibility Travel time.

A. Open heart surgery services should be within 30 60 minutes driving time one way, under normal conditions, of 95% of the population of a the [ health ] planning district [ using mapping software as determined by the commissioner ].

Simple change. Thirty minutes was changed to 60 minutes. You surely did not notice. You were meant not to notice. And your elected representatives were not asked to vote on it. Continue reading

Buy Bacon’s Book

By Peter Galuszka

This is a shameless advertisement. Jim has written an excellent book and you should buy it and review it.

While some of Jim’s focus is at odds with a similar book I wrote eight years ago, “Maverick Miner” is a really well put together effort at research and writing.

In my reporting, I asked many people, mostly miners, what they thought about E. Morgan Massey. The response: tough on unions but good guy. I heard this over and over. I was told that if rank and file miners had a serious problem, they could call Morgan and he’d come to the mountains to work things out. I heard this a lot and it gives credence to Jim’s book.

You should buy the book, read it, and like it or not, post something on Amazon. Here’s something I did:

“In this book, Jim Bacon, a Richmond journalist, tells a fascinating story about 94-year-old E. Morgan Massey, the former head of coal company that would become highly controversial. Massey paid Bacon to write a private narrative about the Massey family and agreed to let Bacon write his own unabridged account. Taken as a biography and while understanding that this is from Massey’s viewpoint, the result works very well. Massey explains why he hired Donald L. Blankenship, who achieved remarkable notoriety as the boss of Massey Energy, a company spinoff. He ended up in federal prison. The book underestimates the human and environmental cost of coal mining in the Central Appalachians. It also takes Massey’s side in dissecting what caused the April 5, 2010 explosion that killed 29 miners – the worst such U.S. coal disaster in 40 years. Even so, Bacon’s access to internal sources and records is a welcome contribution to understanding a great story.

Peter Galuszka is author of “Thunder on the Mountain: Death At Massey and the Dirty Secrets Behind Big Coal.” (St. Martin’s Press, 2012)

What Texas’s Crisis Means for Virginia

by Peter Galuszka

The Texas freeze and ensuing energy disaster has clear lessons for Virginia as it sorts out its energy future.

Yet much of the media coverage in Virginia and certainly on Bacon’s Rebellion conveniently leaves out pertinent observations.

The statewide freeze in Texas completely fouled up the entire energy infrastructure as natural gas pipelines and oil wells stopped working, coal at generating plants iced over and wind turbines stopped working.

Making matters much worse, Texas opted not to have power links with other states. Its “free market” system of purchasing power meant utilities skimped on maintenance and adding weather-relative preventive measures such as making sure key generation components were weatherproof.

The result? Scores dead and millions without electricity. Here are more points worth considering in Virginia:

Climate Change is For Real

It is a shame that so much comment in Bacon’s Rebellion is propaganda from people who are or were paid, either directly or indirectly, by the fossil fuel industry. Thus, the blog diminishes the importance of dealing with climate change in a progressive way.  Continue reading

Bacon Bits: Fear and Loathing at Every Turn

Minutes away from monthslong blackouts. Partisans and their friends in the media will debate forever how to apportion the blame between renewables, natural gas and other factors in the rolling blackouts in Texas. What the situation in the Lone Star State indisputably does do, however, is drive home the absolute necessity of maintaining an electric grid that can withstand rare but extreme weather events. As terrible as conditions are now, with people now going without water and power, it could have been worse. According to officials with the Electric Reliability Council of Texas or ERCOT, the power grid was “seconds and minutes” away from catastrophic failure that could have left Texans in the dark for months, reports The Texas Tribune. Anyone who does not think the same thing could happen in Virginia as we hurtle toward a zero-carbon (and potentially zer0-nuclear) energy grid is homicidally naive.

More news you’ll never read in a Virginia news outlet. We have to rely upon New York-based National Review magazine for this revelation: “While Virginia’s teachers unions have been vocal regarding their worries about returning to school, and their disapproval of the school reopening bill (SB 1303), new documents obtained by National Review show the unions also have engaged in an intense behind-the-scenes pressure campaign to influence Democratic state lawmakers over the reopening issue. Over just the past few months, the unions have combined to send thousands of emails to Democratic House delegates about school-reopening plans. And so far, the lawmakers have refused to release the vast majority of the emails, citing a state law that allows them to shield their correspondence from the public.” (Hat tip: TooManyTaxes)

Healthcare consolidation continues apace. Bacon’s Rebellion is the only publication in Virginia that is worried about the ongoing consolidation of the healthcare industry. The public doesn’t seem to care either, but we’re going to document the trend anyway. The latest news is that the University of Virginia Health System has signed a letter of intent to buy out Novant Health U.Va. Health System, a Northern Virginia regional health system owned and operated by the two companies since 2016. Winston-Salem, N.C.,-based Novant owns 60% of the health system. Under the deal, UVa Health, which owns 40%, will own the whole kit and caboodle. Continue reading

Baby Steps Toward Campaign Finance Reform

Del. Marcus Simon
Photo credit: Bob Brown/AP

By Dick Hall-Sizemore

Virginia law prohibits a candidate for public office from converting “excess” campaign funds to her personal use when closing out her campaign finance account. However, there is nothing to prevent a candidate from using campaign funds for personal, non-campaign related, purposes during a campaign.

Ever since his first General Assembly session (2014), Del. Marcus Simon, D-Falls Church, has introduced legislation to prohibit any personal use of campaign funds. Year after year, the bill died, with no recorded vote, until the 2019 session, when subcommittee votes were required to be recorded. That year, the bill died, 4-3, in subcommittee, with the four votes against it cast by Republicans. Last year, the bill was carried over again. Continue reading

The Democratic Coalition’s Conflicts of Interest Cause Much Political Scrambling

by James C. Sherlock

It is tough to be a Democratic politician in Richmond or Washington. Now that they govern, they find it one big game of coalition whack-a-mole.

I have written today of the conflicts between the interests of teachers unions and those of parents playing out in the Virginia General Assembly. That vital Democratic suburban women demo is in play.

That is the tip of the iceberg for Democrats. They have assembled a coalition whose interests are fundamentally opposed. Those fissures are only fully exposed when they have unfettered governance, which they have now both in Richmond and Washington.

The only things they seem to agree on are big government, free money and government regulation and control of nearly everything except their own interests.

After that, it gets dicey. Continue reading

Business as Usual in the Virginia Senate – “Dominion Dick” Saslaw Delivers

Sen. Dick Saslaw (D)

by James C. Sherlock

Associate Press headline Feb. 15: “Virginia Senate Democrats kill electric rate reform bills.”

Fish gotta swim, Senator Richard L. “Dominion Dick” Saslaw gotta be Senate Majority Leader and Chairman of the Virginia Senate Commerce and Labor Committee.

Saslaw has received nearly a half million dollars in campaign donations from Dominion Energy and its previous CEO, Thomas Farrell. The Chairman literally would be cheap at ten times the price.

From the AP:

“The Senate Commerce and Labor Committee on Monday swiftly killed the last of more than half a dozen bills this session that aimed to reform Virginia’s system of electric utility rate review, which is seen by Wall Street investors as favorable to the utilities and by critics as an example of legislative capture by companies with an outsize influence over the General Assembly.”

Dominion sweeping all before it actually gives some sense of stability to the General Assembly.

Below is a list of campaign donations by Dominion Energy and Tom Farrell to the Senators who voted with Dominion on the closest vote, 8-7 to table Virginia HB1132 Electric utility regulation; initial triennial review, requirements, sponsored by Del. Jay Jones (D). Continue reading

Virginia’s Physicians and Nurses Must Take – Yes, Take – More Influence Over Virginia Health Policy

Virginia Health Service Areas and Health Districts

by James C. Sherlock

As I have studied and reported upon Virginia’s struggles in COVID response, many things have come into focus that need to be done better in healthcare. I have reported on a lot of them here and called for changes.

One major, overarching flaw needs attention.  

Virginia’s physicians and nurses do not have sufficient influence over health laws, policy, regulations, Department of Health oversight or health programs.  Physicians and nurses as organized groups largely were neither consulted or listened to in COVID response policy. If you doubt it, ask them. They are beyond frustrated.  

When you needed a COVID vaccination, were you able to get one from your doctor or nurse practitioner? Didn’t think so.

I will recommend here a way to change the balance of influence. It is important to all Virginians that it indeed be altered. Continue reading

Probably a Coincidence – COPN, the Monopolization of Health Care and the Marginalization of the Poor

by James C. Sherlock

The Business of Healthcare in Virginia

I have been asked many times about how freer markets in healthcare can coexist with our need to treat the poor. I will try to briefly cover some of the complexities of the answer to that question.

And I will show that of all of the government healthcare control systems, COPN is the only one that has proven to disproportionally hurt poor and minority populations by its decisions and their effects.  

And it does so by design. Continue reading

COPN Scores a Kill

by James C. Sherlock

More than eleven months ago I wrote an essay titled, “The Legal Corruption of (Virginia’s Certificate of Public Need) COPN.” That system needs overhaul, not adjustment, and the people of Hampton Roads need help.  The Governor needs to lead in both efforts.

Today I offer the third in a series (first two here and here ) of essays providing background and potential future solutions to the closure of Bon Secours DePaul Hospital in Norfolk.

This is the story of the public, state-sponsored execution of DePaul and a simultaneous attempt to create a bleak future for Bon Secours in Hampton Roads.

COPN mortally wounded that hospital in 2008. It lasted until now as Sentara gnawed away at it  Its death was announced this past week. Pending is how Bon Secours will look at its future in Hampton Roads.

Continue reading

Dominion $$ Overwhelm Clean VA’s in Committees

Click for clear view. Dominion Energy Virginia donations to legislators on the House Labor and Commerce Committee, compiled by Energy and Policy Institute from VPAP reports.

by Steve Haner

The first major showdown over last-ditch efforts to change the rules on the coming Dominion Energy Virginia rate case occurs Monday in a subcommittee where six delegates received a total of $80,000 from the utility in 2020, and four received $67,500 from its self-appointed watchdog Clean Virginia.

The chair of the subcommittee, Del. Richard “Rip” Sullivan of Arlington, received $15,000 from Clean Virginia, but the chair of the full Labor and Commerce Committee, Del. Jeion Ward of Newport News, might sit in the meeting, as is within her authority. Dominion contributed $50,000 to her campaign in 2020. Both are Democrats. (If Ward is there, the total Dominion donations in the room will reach $130,000.)  Continue reading

Charter Schools and How Things Work in Virginia

Sen. Dick Saslaw (D) Springfield – Official photo

by James C. Sherlock

As an object lesson on how things work in Virginia, I’ll relate a story of campaign donations, the Virginia Education Association, a Democratic Governor, a Republican Senator, Democratic Senator Dick Saslaw, his wife Eleanor and charter schools.

The Virginia Education Association

The Virginia Education Association has given nearly $1.8 million in campaign donations to Virginia state candidates over the years, nearly all of it to Democrats. The VEA, like the National Education Association and its smaller rival, the American Federation of Teachers, hates charter schools for reasons — both actual reasons and those stated by the unions — that we have detailed here in the past.

Dick Saslaw. The Virginia Senate’s most prominent opponent of charter schools has been Sen. Dick Saslaw, D-Springfield.

From a newspaper report on January 28 of 2013:

The Virginia Senate narrowly killed a pair of constitutional amendments dealing with two perennial Republican favorites: right-to-work and charter schools.

Democrats helped defeat a constitutional amendment from Sen. Mark Obenshain, R-Harrisonburg, that would have created more opportunities to open charter schools in the state.

Continue reading

Liberty’s Curious “Think Tank”

By Peter Galuszka

Imagine there is a “think tank” at a private, non-profit university. It produces no academic papers and does no peer-reviewed research. Instead, it holds podcasts, seminars and buys ads on Facebook that obviously promote a political party and president.

Would that be a “think tank” or a political action committee?

That about sums up the situation involving Falkirk Center at Liberty University in Lynchburg, according to Politico, a Washington-based news outlet.

True, Liberty is a private, conservative religious institution. But that does not mean it can do what it wants.

“Universities are not allowed to back candidates or be involved in elections because of their status as 501c(3) nonprofits, which exempts institutions like Liberty from paying income tax and allows donors to deduct their donations from their taxes,” according to Politico. Continue reading