David Goldman/AP Photo
A resident makes his way to the dining room for lunch at a nursing home in Rockland, Massachusetts, March 6, 2020.
Wisconsin, the quintessential battleground state this year, has a long progressive legacy that can be reactivated. Under the leadership of its great Progressive Era governor and later senator, Robert La Follette, Wisconsin passed the nation’s first workers’ compensation law as well as the first state banking and railroad regulations to protect consumers. In 1932, it was the first state to enact unemployment compensation benefits, even before the New Deal did. As recently as the mid-1970s, when I worked for Sen. William Proxmire, Wisconsin regularly sent progressives to the U.S. House and Senate.
One intriguing aspect of Wisconsin’s progressive legacy is the fact that Wisconsin is one of two states (the other is New York) with a substantial number of publicly owned nursing homes. Today, 21 counties, mostly rural, own these facilities. They are generally much better than private nursing homes, and are prized by local residents.
All too predictably, for-profit nursing home operators are trying to grab these public assets, with the connivance of local MAGA Republicans, sometimes taking advantage of county budget shortfalls as the pretext. The nursing homes themselves run in the black, and typically get five-star ratings.
The push to privatize is coming from conservative county boards that have become much more right-wing over the last six years. They use closed-door meetings, trying to sell these public facilities at well below market value.
But a popular backlash against these schemes is playing to the advantage of progressives, in a year when Wisconsin’s vote for the presidency could be decided by one or two points. George Goehl, the former executive director of People’s Action who has been organizing in Wisconsin, reports that in the April election for county boards, conservatives in three counties who had pushed for selling county-owned nursing homes to private companies were ousted by voters in favor of candidates who opposed the privatization.
In those elections, Goehl recounts, Portage County Board Chair Al Haga said, “Government should not be competing with privately owned nursing homes as they have taxpayers’ money to keep it going.” Haga had been leading the push to sell the Portage County senior living facility. He and five other privatization supporters were defeated.
But that hasn’t stopped the privatization push. In September, the county board in Sauk County voted 18-13 to sell the county-owned nursing home to a notorious for-profit nursing home chain called Aria, which owns 12 nursing homes in Wisconsin and 16 overall.
Public institutions don’t take out profits, so all their revenues can go to care.
Aria’s nursing homes have all received the lowest or second-lowest ratings possible by the Centers for Medicare & Medicaid Services. A chronic issue has been unsafe staffing levels, despite large revenues.
The Centers for Medicare & Medicaid Services cited Aria’s 16 homes with 710 deficiencies, 45 infections, and $1,651,369 in fines over a three-year period. These deficiencies include failure to report suspected abuse, neglect, or theft in a timely manner, failure to provide enough food and fluids to maintain a resident’s health, and failure to honor the residents’ right to voice their grievances without discrimination or reprisal. By comparison, the publicly owned Sauk County Health Care Center received only four deficiencies in that same time frame.
In Lincoln County, where the county-owned Pine Crest Nursing Home is a five-star public facility, a group called People for Pine Crest has been fighting off privatization for about 18 months. The local newspaper, the Merrill Foto News, ran a survey asking readers if they would support a property tax increase to help keep Pine Crest county-owned. In a conservative area, 85 percent of readers said they would.
Though county board members were elected in April and will not be up in November, there could be spillover effects to the national election, as lingering feelings associate Republicans with privatization of a prized public asset.
There are several larger lessons here. First, federal and state governments have a long tradition of helping rural areas and rural people. The legacy is part of institutional memory, and it is a huge mistake to write off rural areas.
Second, public is sometimes simply better than private. Public institutions don’t take out profits, so all their revenues can go to care. And in the case of a county-owned public institution, there is direct local accountability, and personal connections between local families and valued care staff.
Third, the corrupt relationship between a tawdry for-profit nursing chain like Aria and local MAGA Republicans is a vivid example of how MAGA, despite pseudo-populist rhetoric, doesn’t serve citizens’ interests.
Populism comes in both a progressive and a right-wing form. The state that elected Bob La Follette and William Proxmire also elected the demagogue Joe McCarthy. As Wisconsin political scientist Katherine Cramer demonstrated in her insightful 2016 book, The Politics of Resentment, the loss of industry and of family farms pushed Wisconsin voters to the right. Cramer explains that as Wisconsin citizens working in the private sector suffered declining living standards, Republican Gov. Scott Walker (2011–2019) made a career of scapegoating public employees.
But as the nursing home story shows, rural progressive populism is there to be reactivated when corporate pillaging strikes close to home at the expense of valued local institutions. For that matter, given the broader debasement of for-profit nursing homes, a public option for nursing care generally is an old idea that needs new attention.
