We must earn back respect of the world
Sometimes a comedian cuts through foreign policy issues better than any diplomat. Bill Maher did that the other week with an epic rant on U.s.-china relations, nailing the most troubling contrast between the two countries: China can still get big things done. America, not so much.
For many of our political leaders, governing has become sports, entertainment or just mindless tribal warfare. No wonder China’s leaders see us as a nation in imperial decline, living off the leftover fumes of American “exceptionalism.” I wish I could say they were all wrong.
“We all know China does bad stuff,” said Maher. They break promises about Hong Kong autonomy; they put Uyghurs in camps and punish dissent. And we don’t want to be that. But it’s got to be something between authoritarian government that tells everyone what to do and a representative government that can’t do anything at all.”
Maher added: “On a national level, we’ve been having Infrastructure Week every week since 2009, but we never do anything. Half the country is having a neverending ‘woke’ competition. … The other half believes we have to stop the lizard people, because they’re eating babies. … China sees a problem and they fix it. They build a dam. We debate what to rename it.”
Yes, China has huge problems. But its leaders are focused on real metrics of success. “China’s leaders are fierce but fragile,” argues James Mcgregor, chairman of consultancy APCO Worldwide, Greater China. “Precisely because they were not elected, they wake up every day scared of their own people, and that makes them very focused on performance” — particularly around jobs, housing and clean air.
By contrast, many U.S. politicians these days are elected from safe, gerrymandered districts and seek to stay in power by just “performing” for their base with populist theatrics.
Whenever I point this out, critics on the far right or far left ridiculously respond, “Oh, so you love China.” Actually, I am not interested in China. I care about America. My goal is to frighten us out of our complacency by getting more Americans to understand that China can be really evil AND really focused on educating its people and building its infrastructure and adopting best practices in business and science and promoting government bureaucrats on merit — all at the same time. Condemning China for the former will have zero impact if we’re not its equal in all of the latter.
At last week’s Alaska meeting between the United States' and China’s top diplo
partment of Health, as well as Medicaid administration. It now also runs the state’s COVID-19 vaccine call centers. Its largest New York contracts are for the customer call centers to help people enroll in Medicaid and the Affordable Care Act. Maximus also decides whether a frail elderly person or someone with disabilities can receive home health care services under Medicaid.
Over the past decade, these contracts have ballooned in value from $340 million to over $3.6 billion, with the call center contract increasing from a five-year deal for $170 million to $2.56 billion. This outrageous cost increase for call center services is being paid for by taxpayers. It does nothing to help the clinics, hospitals or home health care providers who actually provide direct services for Medicaid recipients.
How did this happen?
In state budget negotiations, at the 11th hour when almost everything is wrapped up, the governor’s staff announces that there’s just one more thing: Let the health department extend whatever Maximus contract is expiring, without any bidding or the ordinary review or approval by the state comptroller.
The governor says put that in, or there’s no budget agreement.
The laws the governor insists on pushing aside are important safeguards against corruption and waste. What has happened with Maximus is no surprise.
A 2014 audit by the comptroller concluded that Maximus’ contract lacked detailed budgets, rate schedules, or other basic protections. Maximus was taking a profit of nearly 18 percent, charging 14 percent for “administration,” and billing the state for $500-a-night luxury hotel rooms, among other excessive costs.
But then the governor did it again: In 2016 and 2018, he inserted last-minute language into the budget to extend Maximus’ ever-expanding contracts.
Kansas recently dropped Maximus for poor performance, and Pennsylvania, Texas, and North Carolina are among states that have had significant problems with Maximus, including improperly dropping health coverage for children, failing to provide essential services for seniors and people with disabilities, wage theft, and other mistreatment of workers.
Officials must not shrug their shoulders and say the state can’t function without Maximus and there’s just no way to hold it accountable.
This is a grave risk of the massive privatizing and outsourcing we have seen in health care, social services, and other programs.
Should New York just say we’ve let Maximus grow so big that we have no choice but to leave it in charge? That is not acceptable.
It is long past time to draw the line. Right now, Cuomo may be getting ready to try to push another midnight extension of the Maximus deal, evading proper legal and financial safeguards. The Legislature must say no.