News item: J.D. Powers survey ranks Kansas Medicaid recipients’ satisfaction level as dead last among fifty states.
As Sam Brownback packs his bags, assessments of his tenure largely address his income tax cuts and their disastrous results. Fair enough. But Brownback leaves behind another legacy that may have a longer, more problematic impact. His administration has hollowed out government, to the point that in agency after agency Kansans experience underperformance at best and crises at worst.
This "hollowing out" has stood as administration policy from Brownback’s early days, with his appointment of Robert Seidlecki as Social and Rehabilitative Services Secretary. Seidlecki succeeded in driving out many well-qualified professionals, whose departures contributed directly to continuing crises within that crucial agency.
As veteran journalist Dave Ranney concludes, "For the past 6-and-a-half years, social services in Kansas have been governed by a belief that the best way to ‘strengthen’ low-income families is to push parents into low-wage jobs by cutting their access to public assistance. At the same time, record numbers of children have been removed from their parents’ care." All this with less funding and fewer professionals in the Department of Children and Families, the successor agency to SRS.
Then there is the Osawatomie State Hospital, a case study in state-based dysfunction. After allegations of rape and various patient-care issues, in December 2015 the hospital lost $1 million per month of federal funding. Without irony, Tim Keck, secretary of the Kansas Aging and Disability Services said, "I think getting decertified sort of opened our eyes wide to where we are." Despite some improvements, a recent survey found ongoing problems, and Osawatomie continues without certification. Tick-tock, $1 million per month.
Most recently, the corrections department has found itself short-handed, with the El Dorado prison in constant crisis. This situation is scarcely news; Kansas Organization of State Employees director Robert Choromanski has raised alarms for months. Guards were severely overworked and underpaid, as the prison population grew to dangerous levels. Last week, the corrections secretary labeled El Dorado an "emergency," but only because this designation can require guards to work 12-hour shifts.
As for health care, Governor Brownback rejected more than $30 million in federal funds to set up a state-based exchange, and he remained adamantly opposed to expanding Medicaid, even with majority support in both legislative chambers. The foregone benefits to Kansas have been enormous, approaching $1.5 billion. Moreover, as the J.D. Power survey illustrates, even our restricted, inadequate Medicaid program gets terrible reviews.
This is not just an argument between those who desire more government and those who prefer less – per health care or education or welfare. Such arguments are fundamental, and Kansas politicians have had them for more than 150 years.
Rather, Brownback and much of his administration simply do not believe that government can work. Thus, they ignore the practice of governing and administering in effective ways.
Poor governance thus becomes a self-fulfilling prophecy. Taxes should be cut because governmental spending will forever be wasteful. Bureaucrats are simply out for job security, not serving their clients. Indeed, the really talented people work in the private sector.
In the end, Kansas government employment has shrunk, as would be expected in a computer age. But smaller government does not have to mean less effective or less caring government. In Kansas, however, over the last 6 years, as measured by care for the most needy and most problematic of our citizens, that’s exactly what has happened. Just ask our Medicaid recipients.
Governing isn’t easy, but we can and must do better.
Burdett Loomis is an emeritus professor of political science at the University of Kansas.