Ya gotta be kidding me. Watch the whole thing.
Did he break anything practicing? Well, he’s in Melbourne, where they have universal coverage.
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Even while supporting universal coverage, I wrote and posted arguments against a single-payer system in June, 2005. At some point, I would expect that link to become inactive, so I’ve copied it below in its entirety. Though I might tinker with a couple of minor things, for the moment I’ll leave it as originally written. After oral argument this week before the Supreme Court on the Patient Protection and Affordable Care Act, I’ll try to synthesize what I’ve observed since, assess where we are now and where we might be headed.
Evidently, today was a pretty rough day before the Court for proponents of the PPACA. A few days ago in Universal Coverage, “Obamacare,” and the Supreme Court, I suggested that opponents of Patient Protection and Affordable Care Act (PPACA) “be careful what they wish for.” It they win in the Supreme Court, they will leave the U.S. with only one practical alternative to a fragile and failing healthcare system, single-payer, essentially a centralized, uniform system operated by the Federal government.
Anyway, here’s what a wrote seven years ago.
We do not need a single-payer system to gain universal health coverage.
Here, I made the argument for universal health coverage. For many, the solution is a single, national, governmentally sponsored, financed and administered program. I emphatically believe that this “single-payer” approach is not the solution, either programmatically or politically. Think of this notion as Medicare for all, or as Canada’s system imported to the US.
We should have universal coverage. We will never be able to eliminate many of the inefficiencies much less the inequities in today’s system unless we do. Recognizing that we might also eliminate some administrative inefficiencies with a single-payer approach, I think they’re worth the cost. Most important, the differences in access to care between those with coverage and those without are so large, so significant, and so tied to racial, ethnic and income disparities, that it raises ethical issues
that should disturb us all.
A purely market-based approach is not likely to work, and an active role for government is essential. However, a single, governmentally operated program won’t work either.
Many needlessly take for granted that universal coverage requires a single payer system. But single payer can be separated from universal coverage by distinguishing between the financing and operations of a universal coverage program, and between gathering the necessary revenues and spending them. These functions need not all be located in one governmental organization. For example, we can and do use public money to buy private insurance.
What’s wrong with the single payer proposal?
Who chooses? What choices?
Single payer systems rest on the premises that there is a uniform best health benefit plan for every individual, that public officials and organized political interests always can know what this best arrangement is, and that they uniformly will choose it. The weakness of this foundation should be argument enough against single payer.
The health care system will be even more politicized than it is today.
If the revenue of health care institutions and professionals, as well as the rules controlling the institutions and the care providers, are determined by government policies, lobbying by vested interests will be even more fierce than it is today. Key choices will be made by government, political elites and vested interests. This same political process also would determine which medical services are available, to whom and under what circumstances.
Single payer systems minimize the involvement and responsibility of individuals and families
The corollary to increasing government decision making and politicization is a diminished role and voice for individuals. In a single payer system, there is no role for the average person except to consume service. Individuals have no place in choosing systems of care and financing, little leverage over institutions that directly and significantly affect their lives, and only a faint voice when dissatisfied.
Once we establish a single payer plan, we cannot easily undo it
Some reform plans can be undone. A single payer system cannot. If we choose a single payer system, we will dismantle organizations and processes such as health insurers and plans. We will not easily or quickly rebuild them if the new system fails to satisfy us.
No guarantees on cost and quality. Some countries that have single payer systems have had lower cost-growth than the United States. However, in order to restrain cost, single payer systems require centralized government control of health care prices and use of services–and the intrusiveness that goes with it. But our experience with heavy regulation on the state level raises questions about whether central controls really are effective.
Organizational vitality and innovation
The structure of single payer systems discourages diversity and thus discourages the robustness and resilience that typically characterize diverse systems. Organizations continually must revitalize themselves lest they become moribund and bureaucratic. Diverse systems usually are better able to adapt, innovate and survive.
Organizational clumsiness
No single payer plan can centrally manage the formal or informal systems of care serving millions of people. No large centralized system can adequately tie together all of the diverse elements of a health care system on behalf of an individual. To do this we need organizations with motivation and means, and that operate at the local level. We can have a uniform system or we can have a system that is responsive to the needs of individuals, but we can’t have both simultaneously.
Locking the systems status quo into place
A single payer system would cement into place the worst and most inefficient characteristics of our health care system. It is based on a fee-for-service payment model and it relies on isolated individual institutions, agencies and professionals. The politics of universal coverage are tough enough. Why we in the United States have never adopted a system of universal coverage is worth a separate column, but it is clear that the individualist preferences embedded in the American psyche, and our ambivalence about the appropriate role of government, play a substantial role. With this as backdrop, getting agreement that everyone should be covered is tough enough. Seeking the consensus necessary to force everyone into a centralized system will leave the problem unrelieved for decades.
The ugly (political) facts of life
Even if a single payer system were ideal, we should sacrifice it in order to get even minimal coverage for those who have none.
In sum
There are other, better ways of covering everyone than to force us all into a uniform centralized system. Universal coverage does not demand a one size fits all solution, and single payer is not the answer.
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Yesterday in Once Again, Why Universal Coverge, I re-wrote what I written in 2005 and in other terms, even earlier:
Because we take the half-step of expecting the healthcare system to provide care to all, but don’t go all the way, we have instead a hidden and half-baked system. The lack of universal coverage provides an ever-ready excuse for institutional healthcare providers, most notably hospitals, for inefficient operations. Losing money? It’s bad debt and charity care. Locally, governing boards are more challenged in holding management responsible. More broadly, the numerous social systems that we have created to indirectly subsidize care have weak or no means of holding the healthcare system accountable for the money spent. Indeed, most of that spending is hidden in the inflated prices paid for those insured.
Beginning in the late 1970s, New York was inundated with hospitals crying that they were failing because they served high proportions of the uninsured poor. With great regularity, New York bailed them out. There are a variety of reasons why New York was compelled to do so:
- New York did not have data sufficient to distinguish between failure for reasons that were manageable and those outside the control of management and governing boards. Or if it did, there was no inclination to root through it.
- New York had very little, if any, political will to say “no,” especially after it said “yes” the first time.
- Directly relevant to today’s Supreme Court hearing on the Patient Protection and Affordable Care Act (PPACA), there were and are still a high number of uninsured in the communities served by many of these hospitals. High numbers of uninsured became an ever-ready excuse for extra government aid, and a mask for poor management and governance. If everyone or near everyone is covered, then failing institutions have only themselves to blame.
- Though few of these hospitals were especially large, they were able to marshall arguments that still sound very much like “too big to fail.”
Before institutionalizing the practice of subsidizing hospitals with high bad debts, New York dealt with failing hospitals on a case-by-case basis. The third case, the third hospital bailed out was Wyckoff Heights Medical Center in Brooklyn. No surprise to me, today’s New York Times has a lengthy story by Anemona Hartocollis on Wyckoff that’s enough to make one gag. Here’s how the story begins:
In recent years, Wyckoff Heights Medical Center in Brooklyn has often gone hat in hand to the city and state, lamenting cuts in government assistance and questioning whether officials truly understood the burden of running a nonprofit hospital in Bushwick, one of the city’s poorest neighborhoods.
For much of that time, Wyckoff’s chief executive was driving to work in a Bentley Continental GT, a $160,000 automobile, and at one point, the hospital paid thousands of dollars to insure the vehicle, according to hospital records and interviews. When the chief executive lost his license after an accident, hospital security guards chauffeured him and his wife around the clock in a Cadillac Escalade or a Lincoln Town Car.
The chief executive, Rajiv Garg, was not the only one who benefited from his ties with Wyckoff. One member of the hospital’s board obtained for the pharmacy that he owned the exclusive right to market prescription drugs to hospital patients. Another board member lent $2.4 million to the ailing Wyckoff at 12 percent interest, with the hospital required to put up several of its buildings as security.
Local politicians also joined in. Allies of United States Representative Edolphus Towns, Assemblyman Vito J. Lopez and Councilman Erik Martin Dilan have landed high-level positions at the hospital, despite questionable qualifications, further weakening its management. Mr. Dilan’s wife became the hospital’s director of public relations.
Many hospitals in downtrodden areas of New York City and across the state are faltering, raising concerns that a wave of closings will deprive poor people of badly needed care.
A three-month investigation by The New York Times into Wyckoff, based on dozens of interviews and an examination of internal documents, offers a sobering portrait of how one such hospital has been undermined by the very people entrusted to run it.
The hospital all but defaulted on its $109 million in state-secured bonds, forcing the taxpayers to cover $10 million due to bondholders before the state agreed in May to defer the hospital’s overdue payments.
Wyckoff no longer even carries malpractice insurance. Consumer Reports recently ranked Wyckoff among the worst hospitals in the New York region.
The stuff about the Bentley is sexier and the stuff about the pharmacy and the 12 percent loan more about the board’s blatant self-dealing, but let’s re-read those last three sentences:
The hospital all but defaulted on its $109 million in state-secured bonds, forcing the taxpayers to cover $10 million due to bondholders before the state agreed in May to defer the hospital’s overdue payments.
Wyckoff no longer even carries malpractice insurance. Consumer Reports recently ranked Wyckoff among the worst hospitals in the New York region.
The current CEO, Ramon Rodriguez, is being attacked by the hospital’s physicians, which, in cases like these, is typically a sign that he’s doing something right. But the former CEO, Rajiv Garg, had no experience managing a hospital but “he did have connections.” He also has today’s quote of the day:
There’s no intention to waste money. Sometimes it just happens.
“Sometimes it just happens.”
You can bet that for years, in addition to guaranteeing the loans, New York’s reimbursement system has been provided extra payments through its indigent care pools. And that brings us, oddly enough back to the Supreme Court, where oral argument started today on the Patient Protection and Affordable Care Act (PPACA). The PPACA was designed to radically reduce the under of people in the US without health insurance. Were there not nearly 50 million uninsured in the US and about 2.8 million in New York, we would have no need to subsidize hospitals or at least no rhetorical cover for woefully ineffective governance and management or for political favors and borderline corruption.
Of course, the immediate problems at Wyckoff Heights need to be cleaned up and cleaned out. Otherwise if it is beyond redemption, abandon it. But for the longer term, we require universal coverage and as we accomplish that, we need to wean medical institutions off their subsidies.
In today’s half-baked system, it’s as if, instead of having a Food Stamp Program, we subsidized grocery stores with the expectation that in some random way, they would give food to low income, starving people. Given the assumptions upon which they are founded and the basic structure of institutional subsidy programs inevitably are inefficient, marginally effective, unaccountable and inherently political.
Those without health insurance are not the cause of the corruption of the system and of the abysmal failures at Wyckoff Heights. They are the cover and, even more than the taxpayers, they are the victims.
Fully implementing the PPACA will allow us to provide protection to people rather than institutions. Rather than giving money to hospitals and hoping that the injured and ill can consistently get good and timely care from them, we will subsidize the coverage of individuals and families so they can get effective, accountable care when they need it. The hospitals will then figure out the rest.
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From today’s Supreme Court deliberations on the Patient Protection and Affordable Care Act (PPACA), here’s a sampler of some news and analysis.
Here’s Adam Liptak from the New York Times, Justices Hear Argument That Health Case is Premature.
For a different perspective, read Henry J. Aaron, a distinguished healthcare economist from the Brookings Institution.
Here are several posts from scotusblog, Supreme Court followers:
- Anti-Injunction Act oral argument: In Plain English by Amy Howe
- Searching for clues on the Justices’ inclinations about the constitutionality of the individual mandate by Kevin Russell
- And more links here
Here’s The Legal Surrealism of Today’s Health Care Arguments by Andrew Cohen at the Atlantic and here’s Timothy Jost at Health Affairs.
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I wrote and posted the following on my first blog on February 2, 2005. At some point, I would expect that link to become inactive, so I’ve copied it here in its entirety. I might tinker with a couple of minor things, but for the moment, choose to leave it as originally written:
Implicit in much of what I’ve written here is my strong preference for universal health coverage. It’s time to make my assumptions and preferences explicit. Let’s consider this a first draft, one that I’ll tinker with over time.
For now, I choose those words, universal coverage deliberately because they do not suggest the nature or form of the coverage, merely the goal of universality. They do not imply support or preference for a single payer or any other form of coverage. We’ll return to those questions later. Nor should readers infer that I’m using the phrase universal coverage to suggest any preference for any individual, group, or organizational rights or obligations. We’ll explore those later as well.
So let’s start with the basics. Why would some form of universal coverage be desirable? Put more pointedly, why would coverage of person A be good not just for person A, but also for person B and for person C?
- A healthy population is a more economically capable population. To the extent that there are relationships between coverage and care (imperfect, but there are) and care and health (also imperfect, but there are), then it makes economic sense for all of us to be part of a society in which we optimize the health of all its members.
- There appears to me to be a substantial, if not broad, social consensus, one that I concur with, that those who are ill or injured should not be ignored or abandoned by the medical system. I’m not going to track down public opinion polls on the issue and certainly consensus does not imply unanimity. The polls are usually too superficial or wonky on these issues. Instead, ask yourself and your neighbors questions like, "if 100 people are seriously injured in a train crash, should hospitals be expected to take care of all of them or just the 85 who have health insurance?" I’m convinced that the vast majority of Americans would answer "all of them" and would be horrified at the prospect of turning out the 15. Include me among them. That being the case, the only question that remains is is how to design a system to take care of all 100 in the most efficient and effective way possible.
- The absence of universal coverage has its own costs. No one, regardless of where they are on the political spectrum should delude themselves into thinking that a system without universal coverage is cost free. Indeed, much of the expense and inefficiency of our current healthcare system is the direct result of the lack of universal coverage. Although expanded coverage would certainly involve direct outlays, the lack of such coverage certainly involves hidden outlays, which we are paying now and will continue to pay until the problem is resolved. For example,
- Because we take the half-step of expecting the healthcare system to provide care to all (see number 2 above), but don’t go all the way, we have instead a hidden and half-baked system. The lack of universal coverage provides an ever-ready excuse for institutional healthcare providers, most notably hospitals, for inefficient operations. Losing money? It’s bad debt and charity care. Locally, governing boards are more challenged in holding management responsible. More broadly, the numerous social systems that we have created to indirectly subsidize care have weak or no means of holding the healthcare system accountable for the money spent. Indeed, most of that spending is hidden in the inflated prices paid for those insured.
- The absence of universal coverage dooms us to a system where immense amounts of resources are spent on determining which individuals have coverage and those who do not and to determining when an individual has coverage and when they do not. This spending spent leads to employment for some and, as a result, it shows up in national statistics on gross domestic product, but it’s pure administrative overhead. It produces nothing of real value.
- The current system, particularly with its employment base generates much economic rigidity and friction. Individuals suffer from "health insurance job-lock," tying themselves to jobs they would otherwise leave for another. I suspect that diminished income is less important in holding back potential new business start-ups than is the loss of employment based coverage.
- Infectious diseases do not discriminate based on insurance status. The potential of any significant infectious disease makes it vital for all of us that we are all protected. Until the beginning of the 20th century, infectious diseases were the primary cause of death. With the advent of antibiotics and other scientific and medical advances, the primary causes of death changed during the past century. But new biological threats are emerging. Hesitation in seeking care due to lack of coverage threatens not just the individual, but us all. In this case, individualism threatens all individuals.
For many, ethics and equity are the primary arguments for universal coverage. I have my own biases, but do not subscribe to the "healthcare is a right" argument. But even without such arguments, I’m convinced that there are compelling economic, social and public health arguments for universal coverage.
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Be careful what you wish for.
Coming up this week will be extensive, multi-day arguments before the US Supreme Court on the Patient Protection and Affordable Care Act (PPACA), labeled derisively by the right as “Obamacare” and perhaps increasing embraced by the Left as “Obamacare.”
As Vice President Biden said at the signing ceremony, “this is a big ______ deal.” He was right then. And, after a decision, Biden’s words could be equally well applied to what the Court does.
While I will likely point to the legal analyses and predictions of others regarding what the Court may do, my focus this week will not be on the legal analyses or the political consequences during this intensely political season generally and on the Presidential campaign specifically.
Instead, my focus will be on what it likely to happen if the Court overturns the law in some fundamental manner, particularly the so-called “individual mandate,” and also perhaps the mandates on state Medicaid programs. In particular, if the Court determines that, in imposing an “individual mandate,” Congress has exceeded its authority under the Commerce Clause of the Constitution the only alternative pathways will be further deterioration of our current system or much more governmental intrusion than even the PPACA intends.
Perhaps oversimplifying, the PPACA’s opponents are arguing that while the Commerce Clause allows the regulation of activity, it does not allow the regulation of inactivity by the forced purchase of health insurance. But that argument would not apply to the extension of Medicare, or a Medicare-like program to every citizen or resident of the entire country. And absent the current solution, the system pressure would likely find such an alternative the only outlet legally allowable.
Wouldn’t that be ironic?
The real beginning of health insurance coverage in the United States began in earnest during the Great Depression and accelerated during World War II. At some point, probably in the later 1970s or early 1980s, there was a turning point, after which the number and proportion of people without health insurance began to increase. Until enactment of the PPACA there has been no prospect for a decline in the uninsured and an increase in the insured. Absent that or some similarly sweeping law, the interactive dynamics of health insurance and healthcare would force larger and larger numbers of people to go without coverage, that is, until it stabilized with only the wealthy with protection and everyone else priced out of the market.
Beneath, great legal, technical, and financial complexities and behind political rhetoric and posturing of great variety are only four simple questions, four options, and their corollaries:
- Are we, as a society, content with a system in which people do not have medically sufficient access to health care because they have inadequate financial resources, and are we, as a society, in an age in which pathogens do not honor political or social boundaries, willing to risk our own health because someone else delayed medical care because of financial boundaries? If content with this state of affairs, then expect, increasing numbers of uninsured and expect that the healthcare system will be increasingly fragile. If the answer to number 1 is “no,” then we require some form of universal coverage, in which case we move on to question number 2.
- Would we prefer (or at least tolerate) an insurance system in which the primary entities are private but that they compete in a regulated market, in which the overall system structure is bound by government policy and in which all people must participate and all are financially enabled to participate? This is the current law. This is the PPACA, or if you prefer, “Obamacare.”
- Do we want a health insurance system that is centralized and essentially uniform, but medical care is still provided by private individuals and organizations? Call it “single-payer.” Call it “Medicare for all.” Call it whatever you like. There is no legal challenge to Medicare or Social Security for that matter. If this is the system you would prefer, stop here. However, expect that there will be some suffering and risk until your legislative goals are reached.
- Lastly, if none of the above are satisfactory, the remaining choice would be for medical professionals to be government employees and healthcare organizations to be owned by government. This would truly be “socialized medicine.”
Those are the choices. You can quibble about details. You can deny the system’s hydraulic pressures. You can pretend that those without coverage are adequately and efficiently cared for. You can hide behind the hidden subsidies of forcing hospitals and other health care organizations (also private by the way) to care for the uninsured. But you can’t avoid the basics. Those are the choices.
So for those of you who hate “Obamacare,” who wish to see the PPACA overturned, then you will be left with three options: lack of universal coverage, further growth in the uninsured population, and the attendant personal and social risks and the current system’s built in inefficiencies or a uniform, centralized governmentally operated program, one only with public insurance, but private medical organizations and professions, and the other entirely government owned and operated. For those of you who believe that anything less than single-payer is too great a compromise, keep in mind the millions of individuals who will suffer in the meantime and the risk to us all.
So to those of you who wish to not only see “Obamacare overturned,” but the legal foundation upon which it rests, pulled from underneath it, be careful what you wish for. There will be only three choices left: one of two forms of a centralized governmentally operated program, or a health care system that is increasingly fragile, which increasingly excludes millions, and which in the case of an epidemic, puts us all at risk.
So for you opponents of “Obamacare,” especially those of you who simply want it repealed or overturned, be careful what you wish for. You might just get it, but that will leave only more drastic alternatives, which you’ll like even less.
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It might not seem so to some, but compared to how much I babble about politics at home and among friends, I’ve minimized political talk on this site. (That may change later in year.)
But I couldn’t resist this piece, Newt Gingrich: Not Great With Numbers by Jesse Singal on Gingrich’s pursuit of the Republican nomination for the Presidency.
Does Gingrich understand that whether or not people come up to him on the street to implore him to stay in has very little to do with whether or not he can compete in this race? And does he understand that 176,000 divided by 300 million is—hold for a Google calculation—0.000586666667, or 0.06%?
That is to say, 176,000 is a big number, yes, but only when compared to relatively small numbers, like 1 or 15 or 256. Compared to big numbers—and there are a whole infinity of big numbers!—176,000 isn’t all that big.
You’d think this is the sort of stuff he’d have down by now. After all, the guy wants to build a moon base.
Relying on polls alone is not smart. Relying on votes to date alone is not smart. But relying on the horribly biased, subjective sample of who walks up to you on the street is really dumb. Not that I think that’s what Gingrich’s real motivation is, but don’t fool yourself and don’t try to fool us either.
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In today’s New York Times, we find State Senate Race Spotlights a Feeble Democratic Party by Michael Powell.
Powell recalls Meade Esposito, former Chair of the Thomas Jefferson Democratic Club in Southern Brooklyn which, in its good times, gave us two recent NYS Assembly Speakers. Powell’s own words are pretty good when he describes Esposito has having “capped his career with a felony.” But it’s Esposito himself who gives us the quote of the day:
Today’s reformer is tomorrow’s hack.
We’ll leave it at that.
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Talk radio is certainly not my gig. But I was asked on to a local show, Al Roney on AM 1300, this afternoon and it really forced me to do something I don’t do often, or particularly well: really simplify. As in simplify a lot. So it was an interesting and personally challenging exercise.
The topic was what are the differences in the numbers that Shawn Morse, Gary Domalewicz and others used when they disowned the numbers that are in the certificate of need application they submitted to New York State to allow Albany County to build a new nursing home. I described the issue here (not simply) and then here.
So for 15 minutes of talk radio this afternoon, I had to work really, really hard to simplify … on why one set of the Albany County Legislature’s numbers are so different from another set of their numbers. Here’s what I said:
- Well, for starters, the numbers they used are from the past, and now we’re talking about the future.
- And one thing you didn’t have in the past was a new nursing home. And when you build a new nursing home, you have to pay for the new building … DUH … The cost of paying for a new building is not the numbers that Morse’s and Domalewicz’s tried to cover their tracks with, which are all historical or current budget.
- But the proposed new building is smaller (by 20%, down from 250 to 200 beds) so there will be fewer patients and less revenue.
- More staff. Yup. More staff (about 15 as I understand it) though I don’t know for certain, probably due to a proposed new ventilator unit)
At that point, the host, Al Roney cut off the list. He asked me why those guys are doing what they’re doing, saying what they’re saying. Basically he asked why they’re lying. I took a pass on that one. I certainly have opinions but expressing them on that sort of topic in public is also generally not my gig. Roney, however, is not so shy.
Of course, the three things I mention above are far from all of it so at this moment, the temptation, the urge to expand the explanation is really, really strong. But I’m going to pass on that. Just this once, I’m going to keep it talk radio simple. The other stuff can wait until later.
But geez, “new building that you have to pay for, smaller building and thus less revenue, while adding more staff” is a pretty good start on simplification, huh?
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We said here that it seemed that the leadership of the Albany County Legislature was trying to cover their tracks by confusing everyone. Are they succeeding? Here’s the latest story from the Times Union.
We’ll get to the substance later, but at least the State Health Department isn’t buying what Shawn Morse is selling:
What’s more, a spokesman for the Health Department, Peter Constantakes, said it took the $26 million figure from the legislature’s own certificate of need application, signed by then-Chairman McCoy, who has since been elected county executive.
“It was signed off by the county legislature,” Constantakes said, adding that the county could have amended the budget after the application was submitted in late 2010.
While we’ll likely return to this story later, we just couldn’t pass up on a candidate for quote of the day. It’s from Gary Domalewicz, Chairman of the Albany County Legislature’s Nursing Home Facilities Committee in the Times Union:
Legislator Gary Domalewicz, an Albany Democrat and chairman of the Nursing Home Facilities Committee, cautioned that the legislature’s signing off on the application is not the same as endorsing the accuracy of the loss figure contained in it, which was prepared by an outside consultant.
Ah, the words just roll off the tongue and what? Dribble off into the sewer? “The legislature’s signing off on the application is not the same as endorsing the accuracy of the loss figure contained in it …”
Signing off on a document does not mean signing off on what’s in the document? Then what does it mean Mr. Domalewicz? Nothing. It means when you attest to something it means nothing. We should keep this in mind.
You’ll all understand why this quote from Andrew Lewis Carroll’s, Alice in Wonderland, comes to mind.
Humpty Dumpty: “When I use a word it means just what I choose it to mean neither more nor less.”
Alice: “The question is whether you can make words mean so many different things.”
Humpty Dumpty: “The question is which is to be master that’s all.”
Of course, we remember what happened to Humpty, don’t we?
Last November, another candidate for Humpty Dumpty was Shawn Morse. It’s probably no accident that he’s involved in this mess too.
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