You go to the doctor, you pay in cash, you go home.
You never receive a bill or hand someone an insurance card.
That’s the way Paul McGraw, general manager at The Doctor’s Office, thinks health care should be.
The Doctor’s Office in Janesville uses a cash-only, no-insurance-accepted model, a style of health care that is nearly extinct, McGraw said.
The Doctor’s Office opened in July in the former First Choice Clinic on the city’s south side. It’s the third location in Wisconsin, the other two being in Brookfield and Darien.
The clinic does not accept insurance. Cash, debit or credit payment is required the day of service, McGraw said.
The model appeals to people who don’t have insurance or are sick of navigating health care systems that are complicated and stressful, McGraw said.
Some patients have insurance but can never meet their high deductibles in one year, so they save money by going to the cash clinic for basic preventive services, McGraw said.
A lot of people avoid preventative care or fail to get treatment for existing conditions because they cannot afford health care or do not want to deal with the hoops attached with health care, McGraw said.
Giving people another option will make for a healthier community, McGraw said.
By not accepting insurance, the clinic saves on overhead and administrative costs, McGraw said.
Services are based on what providers the clinic can bring on board. Janesville’s location offers primarily preventative care, urgent care, lab work and massage therapy. Some medications are dispensed on site.
McGraw is hoping to bring in other providers to offer a wider scope of services.
Anyone needing advanced care gets referred by a physician at the clinic, McGraw said.
The clinic hires providers as independent contractors and does not provide much oversight or regulation to how they care for patients.
The only requirements Medicraft Corporation— the company overseeing The Doctor’s Office— asks of providers is they have a state license to practice and professional malpractice insurance, McGraw said.
McGraw believes health care decisions should be made between a patient and a physician, not by “guys in suits” walking around a major hospital or health system, he said.
Cash-only clinics give freedom back to patients, McGraw said.
Health care has been a topic hotly debated by political leaders and 2020 presidential candidates.
McGraw said a cash-only model can play a role in debates on health care because it provides another option for consumers.
“I think the country is prime for a way to get patients in control of their health care,” McGraw said.
Prices for services range from $5 to $150. Appointments can be scheduled in advance or patients can walk in.
Maxine T. Cox
Margaret A. McDade
LaVon M. Milton
Ruth I. Skrede
A second whistleblower has come forward with information about President Donald Trump’s dealings with Ukraine, adding to the impeachment peril engulfing the White House and potentially providing new leads to Democrats in their unfurling investigation of Trump’s conduct.
Attorney Mark Zaid, who represents both whistleblowers, said the second person has spoken to the intelligence community’s internal watchdog and can corroborate information in the original whistleblower complaint. That document alleged that Trump pushed Ukraine’s president to investigate Democratic presidential candidate Joe Biden’s family, prompting a White House cover-up. Crucially, the new whistleblower works in the intelligence field and has “firsthand knowledge” of key events, Zaid said.
The emergence of the second whistleblower threatened to undermine arguments from Trump and his allies to discredit the original complaint. They have called it politically motivated, claimed it was filed improperly and dismissed it as unreliable because it was based on secondhand or thirdhand information.
A rough transcript of Trump’s call with Ukrainian President Volodymyr Zelenskiy, released by the White House, has already corroborated the complaint’s central claim that Trump sought to pressure Ukraine to investigate the Bidens. The push came even though there was no evidence of wrongdoing by the former vice president or his son Hunter, who served on the board of a Ukrainian gas company.
Text messages from State Department officials revealed other details, including that Ukraine was promised a visit with Trump if the government would agree to investigate the 2016 election and Ukrainian gas company Burisma—the outline of a potential quid pro quo.
Rep. Jim Himes, D-Conn., a member of the House Intelligence Committee, said word of a second whistleblower indicates a larger shift inside the government.
“The president’s real problem is that his behavior has finally gotten to a place where people are saying, ‘Enough,’” Himes said.
Democrats have zeroed in on the State Department in the opening phase of their impeachment investigation. The Intelligence, Oversight and Foreign Affairs committees have already interviewed Kurt Volker, a former special envoy to Ukraine who provided the text messages. At least two other witnesses are set for depositions this week: Gordon Sondland, the U.S. ambassador to the European Union, and Marie Yovanovitch, who was abruptly ousted as the U.S. ambassador to Ukraine in May.
Trump and his supporters deny that he did anything improper, but the White House has struggled to come up with a unified response. No administration officials appeared on the Sunday news shows to defend the president, while other Republicans focused mainly on attacking Democrats. A few Republicans suggested that Trump was only joking this past week when he publicly called on China to investigate the Bidens.
Republican Sen. Lindsey Graham of South Carolina, one of Trump’s most vocal backers, provided perhaps the strongest defense of the president. He said there was nothing wrong with Trump’s July conversation with Zelenskiy and that the accusation look like a “political setup.”
As for Trump, rather than visiting his nearby golf course in Sterling, Virginia, for a second day, he stayed at White House, where he tweeted and retweeted, with the Bidens a main target.
“The great Scam is being revealed!” Trump wrote at one point, continuing to paint himself as the victim of a “deep state” and hostile Democrats.
Additional details about the origins of Trump’s July 25 call with Zelenskiy emerged over the weekend.
Energy Secretary Rick Perry had encouraged Trump to speak with the Ukrainian leader, but on energy and economic issues, according to Perry spokeswoman Shaylyn Hynes. She said Perry’s interest in Ukraine is part of U.S. efforts to boost Western energy ties to Eastern Europe.
Trump, who has repeatedly described his conversation with Zelenskiy as “perfect,” told House Republicans on Friday night that it was Perry who teed up the July call, according to a person familiar with Trump’s comments who was granted anonymity to discuss them. The person said Trump did not suggest that Perry had anything to do with the pressure to investigate the Bidens.
As the furor over Trump’s phone call and the House’s subsequent impeachment inquiry escalated, two Republicans challenging Trump for the GOP presidential nomination engaged in a heated on-air debate over what should happen to the president. The exchange between former Reps. Mark Sanford of South Carolina and Joe Walsh of Illinois was notable, given the refusal of all but three Republican senators to criticize Trump’s conduct.
Walsh said the president deserves to be impeached. Sanford tried to make the case that moving forward with impeachment in the Democratic-run House if the Republican-controlled Senate doesn’t have the votes to convict would be counter-productive.
“This president needs to be impeached, just based on what he himself has said,” Walsh said. “And Republicans better get behind that.”
As Rudy Giuliani was pushing Ukrainian officials last spring to investigate one of Donald Trump’s main political rivals, a group of individuals with ties to the president and his personal lawyer were also active in the former Soviet republic.
Their aims were profit, not politics. This circle of businessmen and Republican donors touted connections to Giuliani and Trump while trying to install new management at the top of Ukraine’s massive state gas company. Their plan was to then steer lucrative contracts to companies controlled by Trump allies, according to two people with knowledge of their plans.
Their plan hit a snag after Ukrainian President Petro Poroshenko lost his reelection bid to Volodymyr Zelenskiy, whose conversation with Trump about former Vice President Joe Biden is now at the center of the House impeachment inquiry of Trump.
But the effort to install a friendlier management team at the helm of the gas company, Naftogaz, would soon be taken up with Ukraine’s new president by U.S. Energy Secretary Rick Perry, whose slate of candidates included a fellow Texan who is one of Perry’s past political donors.
It’s unclear if Perry’s attempts to replace board members at Naftogaz were coordinated with the Giuliani allies pushing for a similar outcome, and no one has alleged that there is criminal activity in any of these efforts. And it’s unclear what role, if any, Giuliani had in helping his clients push to get gas sales agreements with the state-owned company.
But the affair shows how those with ties to Trump and his administration were pursuing business deals in Ukraine that went far beyond advancing the president’s personal political interests. It also raises questions about whether Trump allies were mixing business and politics just as Republicans were calling for a probe of Biden and his son Hunter, who served five years on the board of another Ukrainian energy company, Burisma.
On Friday, according to the news site Axios, Trump told a group of Republican lawmakers that it had been Perry who had prompted the phone call in which Trump asked Zelenskiy for a “favor” regarding Biden. Axios cited a source saying Trump said Perry had asked Trump to make the call to discuss “something about an LNG (liquefied natural gas) plant.”
While it’s unclear whether Trump’s remark Friday referred specifically to the behind-the-scenes maneuvers this spring involving the multibillion-dollar state gas company, The Associated Press has interviewed four people with direct knowledge of the attempts to influence Naftogaz, and their accounts show Perry playing a key role in the effort.
Three of the four spoke on condition of anonymity for fear of retaliation. The fourth is an American businessman with close ties to the Ukrainian energy sector.
A spokeswoman for the U.S. Energy Department said Perry, a former Texas governor and Republican presidential candidate, was not advancing anyone’s personal interests. She said his conversations with Ukrainian officials about Naftogaz were part of his efforts to reform the country’s energy sector and create an environment where Western companies can do business.
The Trump and Giuliani allies driving the attempt to change the senior management at Naftogazt, however, appear to have had inside knowledge of the U.S. government’s plans in Ukraine. For example, they told people that Trump would replace the U.S. ambassador there months before she was actually recalled to Washington, according to three of the individuals interviewed by the AP. One of the individuals said he was so concerned by the whole affair that he reported it to a U.S. Embassy official in Ukraine months ago.
Ukraine, a resource-rich nation that sits on the geographic and symbolic border between Russia and the West, has long been plagued by corruption and government dysfunction, making it a magnet for foreign profiteers.
At the center of the Naftogaz plan, according to three individuals familiar with the details, were three such businessmen: two Soviet-born Florida real estate entrepreneurs, Lev Parnas and Igor Fruman, and an oil magnate from Boca Raton, Florida, named Harry Sargeant III.
Parnas and Fruman have made hundreds of thousands of dollars in political donations to Republicans, including $325,000 to a Trump-allied political action committee in 2018. This helped the relatively unknown entrepreneurs gain access to top levels of the Republican Party—including meetings with Trump at the White House and Mar-a-Lago.
The two have also faced lawsuits from disgruntled investors over unpaid debts. During the same period they were pursuing the Naftogaz deal, the two were coordinating with Giuliani to set up meetings with Ukrainian government officials and push for an investigation of the Bidens.
Sargeant, his wife and corporate entities tied to the family have donated at least $1.2 million to Republican campaigns and PACs over the last 20 years, including $100,000 in June to the Trump Victory Fund, according to federal and state campaign finance records. He has also served as finance chair of the Florida state GOP, and gave nearly $14,000 to Giuliani’s failed 2008 presidential campaign.
In early March, Fruman, Parnas and Sargeant were touting a plan to replace Naftogaz CEO Andriy Kobolyev with another senior executive at the company, Andrew Favorov, according to two individuals who spoke to the AP as well as a memorandum about the meeting that was later submitted to the U.S. Embassy in Kiev.
Going back to the Obama administration, the U.S. Energy Department and the State Department have long supported efforts to import American natural gas into Ukraine to reduce the country’s dependence on Russia.
The three approached Favorov with the idea while the Ukrainian executive was attending an energy industry conference in Texas. Parnas and Fruman told him they had flown in from Florida on a private jet to recruit him to be their partner in a new venture to export up to 100 tanker shipments a year of U.S. liquefied gas into Ukraine, where Naftogaz is the largest distributor, according to two people briefed on the details.
Sargeant told Favorov that he regularly meets with Trump at Mar-a-Lago and that the gas-sales plan had the president’s full support, according to the two people who said Favorov recounted the discussion to them.
These conversations were recounted to AP by Dale W. Perry, an American who is a former business partner of Favorov. He told AP in an interview that Favorov described the meeting to him soon after it happened and that Favorov perceived it to be a shakedown. Perry, who is no relation to the energy secretary, is the managing partner of Energy Resources of Ukraine, which currently has business agreements to import natural gas and electricity to Ukraine.
A second person who spoke on condition of anonymity also confirmed to the AP that Favorov had recounted details of the Houston meeting to him.
According to Dale Perry and the other person, Favorov said Parnas told him Trump planned to remove U.S. Ambassador Marie Yovanovitch and replace her with someone more open to aiding their business interests.
Dale Perry told the AP he was so concerned about the efforts to change the management at Naftogaz and to get rid of Yovanovitch that he reported what he had heard to Suriya Jayanti, a State Department foreign service officer stationed at the U.S. Embassy in Kyiv who focuses on the energy industry.
He also wrote a detailed memo about Favorov’s account, dated April 12, which was shared with another current State Department official. Perry recently provided a copy of the April memo to AP.
On March 24, Giuliani and Parnas gathered at the Trump International Hotel in Washington with Healy E. Baumgardner, a former Trump campaign adviser who once served as deputy communications director for Giuliani’s presidential campaign and as a communications official during the George W. Bush administration.
She is now listed as the CEO of 45 Energy Group, a Houston-based energy company whose website describes it as a “government relations, public affairs and business development practice group.”
This was a couple of weeks after the Houston meeting with Favorov, the Naftogaz executive. Giuliani, Parnas and Baumgardner were there to make a business pitch involving gas deals in the former Soviet bloc to a potential investor.
This time, according to Giuliani, the deals that were discussed involved Uzbekistan, not Ukraine.
“I have not pursued a deal in the Ukraine. I don’t know about a deal in the Ukraine. I would not do a deal in the Ukraine now, obviously,” said Giuliani, reached while attending a playoff baseball game between the New York Yankees and Minnesota Twins. “There is absolutely no proof that I did it, because I didn’t do it.”
During this meeting, Parnas again repeated that Yovanovitch, the U.S. ambassador in Kyiv, would soon be replaced, according to a person with direct knowledge of the gathering. She was removed two months later.
Giuliani, who serves as Trump’s personal lawyer and has no official role in government, acknowledged Friday that he was among those pushing the president to replace the ambassador, a career diplomat with a history of fighting corruption.
“The ambassador to Ukraine was replaced,” he said. “I did play a role in that.”
But Giuliani refused to discuss the details of his business dealings, or whether he helped his associates in their push to forge gas sales contracts with the Ukrainian company. He did describe Sergeant as a friend and referred to Parnas and Fruman as his clients in a tweet in May.