Greed’s far-reaching impact

Medicaid clients, providers hurt by corruption scandal

Ask an animator about whether small changes can lead to big effects. Their entire careers rely on the principle that tiny shifts in position will result in an appearance of motion. Put enough — say 1,500 — of the small variations together and an animator might end up with one minute of a TV show or movie.

It’s a Hollywood version of the socalled butterfly effect, the scientific theory that suggests something as tiny as a butterfly flapping its wings may eventually influence the trajectory of a tornado or hurricane on the other side of the planet.

Little on this planet functions in truly independent fashion. Investigators in Thursday evening’s tragic amphibious vehicle sinking near Branson, Mo., will undoubtedly pinpoint a primary cause, but how many separate decisions and conditions led to that awful moment for the operators and 31 passengers? No one could have imagined booking a vacation to Branson two or three months ago would become a first step toward tragedy, but the dots can be connected in hindsight.

Other actions, however, have far more predictable outcomes. A lobbyist and executive for a Medicaid-funded provider of counseling and other services for troubled young people and adults in Arkansas set in motion a multimillion-dollar bribery scheme to buy influence with legislators. Lawmakers accept bribes or kickbacks to ensure the provider, called Preferred Family Healthcare, continues getting millions of dollars in state support to grow that business. As the evidence of public corruption continues to widen, Arkansas cuts its ties with the firm and sends the system of care it supported into chaos.

Preferred Family Health reported it had more than 25,000 clients receiving mental and behavioral health services in Arkansas last year. About 3,300 received substance abuse treatment. As reported in last Sunday’s Northwest Arkansas Democrat-Gazette, Preferred Family and a number of its affiliates in Arkansas saw receipts from Medicaid and other state-administered health care programs rise from about $24 million to about $43 million from 2013 to 2018, state finance records show.

The illicit behaviors at the heart of the scandal were born as sinister ideas. Greed is their root. Practitioners of corruption are willing actors in schemes that, absent the corrosive effects of that greed, can easily be seen as destructive to the very system they are abusing. It is not hard to anticipate a home supported by termite-infested piers will eventually come crashing down. And yes, we’re comparing people who sought and accepted the public’s trust then used that authority to serve themselves to termites.

Every few days brings new revelations about the number of conspirators and how far they were willing to go to enrich themselves. For every individual engaged in illegal behaviors, there are dozens, perhaps hundreds, of Arkansans whose lives have been turned upside down. They’re conscientious employees of Preferred Family Healthcare now looking for jobs. They are other service providers, who long felt they were at a competitive disadvantage but only now fully understand why and are now scrambling to deliver services to more people. They are patients who relied on the Medicaid-supported system to help guide them through troubling times.

It’s not hard to imagine a lawmaker, in the early days of this scheme, convincing himself the money he was skimming would be insignificant compared to the millions of Medicaid dollars being spent. Maybe he asked, “Who’s going to get hurt?”

We know the answer now: Thousands of Arkansans in their hour of need. Not to mention the damage all this dishonesty has done to the public’s faith in our government leaders. This isn’t just political insiders lining their pockets at the expense of taxpayers. The greed on display in these criminal prosecutions has disrupted the lives of thousands of Arkansans for whom lawmakers and care providers have a serious responsibility to serve.

Bribes, kickbacks and deception are far from victimless crimes. We hope judges and, if necessary, juries remember the far-reaching effects when it comes time for sentencing. Public corruption creates a lot of collateral damage.

Kudos to those other organizations out there working hard to meet the needs of patients and fill the gaps left with the removal of Preferred Family Healthcare. As usual, it’s left to those who did nothing wrong to clean up the mess.

We hope our justice system can give those involved in public corruption a lot of time to think about what they’ve done.