Author Archives: John S. Walters

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About John S. Walters

Writer, editor, sometime radio personality, author of "Roads Less Traveled: Visionary New England Lives."

Trying to Remove One Hand from Our Health Care Pocket

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If you’re unfamiliar with the term, you might think “pharmacy benefit manager” is a job title for some anonymous mid-level health insurance executive. Like, say, the guy pictured above. But no, a pharmacy benefit manager is a corporation that sticks its big fat nose into the middle of America’s misbegotten prescription drug system and snorts up all the loose cash it can.

That’s my definition anyway. If you’re a high-priced lobbyist for the national PBM trade association, things look a little different. “Pharmacy benefit managers exist for one purpose: to drive down cost of prescription drugs,” said Sam Hallemeier of the Pharmaceutical Care Management Association (PCMA). PBMs, he continued, “reduce costs for insurers and consumers, reduce waste, and improve patient care.”

Wow, I hadn’t realized that PBMs are charitable enterprises that simply want to make the world a better place.

Oh wait, they’re not. The PBM marketplace is dominated by three large firms that are owned by three of America’s largest for-profit health care firms: Caremark, operated by drugstore chain CVS; Express Scripts, operated by insurance giant Cigna; and OptumRx, brought to you by insurance giant (and sworn foe of spaces between words) UnitedHealth. These mega-corporations are in business to make profits. If their PBMs are holding down costs, you can bet your life they’re doing it for their own benefit, not yours or mine.

You may wonder when I’m going to get to the Vermont political point of this. Well, the Legislature is considering a bill, H.233, that would impose substantial new restrictions on PBMs. And while our state has a track record of disappointment when it comes to health care, this thing might actually stick.

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So Why Isn’t “Lived Experience” Part of Every Legislative Process?

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The House Human Services Committee did it again Friday. They went and injected the experiences of homeless Vermonters into the normally dispassionate exercise of lawmaking. The results were, as usual, breathtaking, heartbreaking, and disruptive.

Which begs the question, why is this such an unusual event in the halls of government? Why do we rarely hear from those directly impacted by policy decisions made on high? Modest Proposal: Require every policy committee to hear “lived experience” testimony, especially those that deal with our tattered, inadequate, often cruel, social safety net. (Credit to End Homelessness Now, which has helped these folks remain housed and enabled their testimony in the Statehouse.)

Hey, maybe even we could establish “lived experience” advisory committees for the Agency of Human Services (including the Department of Corrections, you betcha). Not now, of course; it’ll have to wait until sometime after Phil Scott’s disembodied head in a jar loses its bid for a twenty-seventh term in office.

Those pesky “lived experiences” do inject a sometimes brutal dose of reality into the proceedings, making it more difficult to justify byzantine social service policies that are seemingly designed to punish participants and limit demand more than to actually address a real, tangible need.

Then again, they also display the indomitability of the human spirit, the intelligence and resourcefulness of those who live their lives on the edge. Giving them a seat at the table wouldn’t be an act of pity; it would be taking advantage of an underutilized resource.

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Phil Scott’s Big Fat Housing FAIL

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Hey, remember last fall, when the Scott administration delivered a grim assessment of Vermont’s housing crisis? Top officials outlined a dire situation with shortages in all sectors of the housing market, from shelters and subsidized rentals to single-family homes to top-end residences. In response, the administration convened an informal task force to confront Vermont’s housing crisis. A multiagency group was going to gather once a week throughout the fall to come up with big, comprehensive solutions.

Well, whatever has become of that?

Two things, and only two things, both of which completely fail to meet the moment. First, we have a joke of a temporary shelter expansion that might net a couple hundred beds for a few months. Second, we have a push for regulatory reform.

And… that’s it. No significant public investment in housing. Phil Scott is failing to address the crisis. He is failing to lead on the issue that he himself spotlighted as the state’s biggest challenge.

This has been obvious for a while, but it was hammered home during a brief legislative hearing on Friday afternoon that wasn’t even on the schedule.

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Shameless Mendacity Seems to Have Earned a Page in the Phil Scott Playbook

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I don’t know exactly when it happened, but the administration of Governor Nice Guy has developed a habit of lying. I know, I know, some of you are saying “So, what’s new, John?” But this isn’t just run-of-the-mill fudging the truth. It’s more like easily checkable whoppers emerging from the fifth floor and associated precincts with disturbing frequency.

We first take you back to mid-December, on the eve of a session in which the Legislature was set to consider a bill banning neonicotinoid pesticides. The Agency of Agriculture issued a report boasting that the number of honeybee colonies in Vermont had risen by 43% between 2016 and 2023.

Great news, right? Colony collapse might not be a problem anymore. Maybe we don’t need the ban after all.

Except that Vermont beekeepers completely disagreed. They say the report lumped together stationary and migratory hives. The latter are imported from elsewhere for the warm months. That 43% increase is due to a dramatic rise in migratory hives. Vermont’s own bees are still in trouble.

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Shock, Dismay Over Completely Predictable Consequence

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Well, it’s looking like the Legislature’s plan for extending the emergency housing program is in danger of falling apart for reasons that were pretty obvious from jump. As I put it at the time, “I’ll be pleasantly surprised if this thing actually works.”

As Carly Berlin, Designated Homelessness Correspondent for both Vermont Public and VTDigger, reports, motel owners are balking at a proposed $75 or $80 per night cap on GA housing vouchers. The former figure is in the House plan; the latter is in the version passed last week by the Senate.

As a reminder, the current average nightly voucher is $132 per night. And that figure was achieved after months and months of bargaining by the state, which was directed by the Legislature to negotiate lower rates for vouchers.

And hey, extra bonus fail points: The new cap would take effect on March 1 — a mere 15 days from now.

That bit hadn’t been reported before. Top marks to Ms. Berlin for catching it.

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The Tragedy of Stenger, Prince of Newport, As Related By Himself

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I must return to Mark Johnson’s epic interview slash psychodrama with convicted EB-5 fraudster Bill Stenger, seen here standing next to a gent whose name I cannot quite recall. This time, let’s take a look at how Stenger explains himself as a naive, trusting soul whose biggest sin was that he wanted so desperately for the projects to work that he ignored some very obvious signs of trouble.

Johnson did his level best to hold Stenger’s feet to the fire, and Stenger repeatedly responded by steering down what John Ehrlichman called the “modified limited hangout route.” Stenger admitted complicity but not criminality, depicting himself simultaneously as perpetrator and victim. Neat trick, that.

The problem is, even if you believe Stenger’s account — which would be a dangerous thing to do — he seems to be guilty of gross negligence instead of overt criminality. That’s not a great consolation prize. Neither does it make me feel sorry for him that he had to serve a short sentence in a relatively comfortable federal facility.

Which he describes, as often as not, in the second person, a subtle way of deflecting the fact that this happened to his own self. “You” reported for prison. “You” were welcomed by fellow inmates. “You” got time off for attending courses. And so on.

But that’s a minor point. Time for a deeper dive on how he describes his role in the EB-5 scandal and his timeline, which serves to make his own story less believable.

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The Great Unanswered Question About EB-5: What Did the Shumlin Administration Know and When Did They Know It? (UPDATED)

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Update below: Auditor Doug Hoffer is working on a thorough exploration of the EB-5 mess.

Mark Johnson posted a pretty incredible two-part podcast last week. In the latest installment of his “802 News” (discoverable here or Wherever You Download Your Podcasts), Johnson spent more than two hours grilling Bill Stenger, the Northeast Kingdom developer who served prison time in the EB-5 fraud case. There’s a lot to unpack about Stenger himself, but the thing that caught my attention was what he had to say about the role of the Shumlin administration. His comments tore the metaphorical scab off the unhealed wound that is EB-5, specifically the state’s role in enabling a massive fraud.

Let’s pause for a moment and posit that no one, absolutely no one, in Vermont officialdom seems the least bit interested in uncovering the whole truth about this. With each passing day, it seems less and less likely that there will ever be a full accounting for Peter Shumlin and his top officials, many of whom (coughMikePieciakcough) continue to hold positions of influence in and around state government.

To get to the key moment: By early 2015, there was plenty of smoke if not open fire around the EB-5 projects. At that point, the state had to reauthorize two of the projects, including AnC Bio Vermont, the big flashy biotech facility that was supposed to be built in The Hole, pictured above.

In Stenger’s telling, state officials knew at the time that lead investor Ariel Quiros was committing fraud, and yet they gave the green light to continue the projects. If this is true, then (as Stenger implies but doesn’t state outright), some very prominent people should have joined Stenger and Quiros in being fitted for bright orange jumpsuits.

(Those with short memories should go back and read some of VTDigger’s reporting on the scandal, spearheaded by Digger founder Anne Galloway. This story and this one for starters.)

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The Striking House/Senate Divide on Homelessness Policy

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You don’t need to know the details of what’s going on in the House and Senate to realize how different the two chambers are when it comes to providing for the homeless and creating a better social safety net. All you have to know is that last week, when the House was addressing how to fix the system, they called on expert advocates Anne Sosin (seen above) and Brenda Siegel. And when the Senate Appropriations Committee was trying to fine-tune the current program, it called on two Scott administration officials directly involved in the policy failures of the last several years.

Siegel had submitted written testimony (downloadable here) to Senate Appropriations and was present in person at the Friday hearing, and yet the committee didn’t invite her to speak. They depended instead on the architects of doom: Miranda Gray, deputy commissioner of the Department of Children and Families’ Economic Services Division, and Shayla Livingston, policy director for the Agency of Human Services.

Appropriations wrapped up its disgraceful week with a brief hearing on Friday morning, in which it quickly finalized the details of a half-assed emergency housing plan and sent it on to the full Senate, which rubber-stamped it within a half hour.

The short version of the House/Senate divide: The House is trying to build a robust bridge to a comprehensive system to help the unhoused. The Senate is patching and filling the current system with an eye more on the bottom line than the human need.

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A Stain on the Senate

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The Senate Appropriations Committee is a distillation of everything I don’t like about the Senate as a whole. It’s heavily weighted toward seniority. The senior solons get near-total deference from any junior colleague who manages to wedge their way onto the committee. Those veteran members are a knowledgeable lot — but they think they’re smarter, wiser and more knowledgeable than they actually are, and they sometimes reflect antediluvian opinions on current political issues. And they frequently express disdain, if not contempt, for the work of the House.

But the worst of the lot is Sen. Bobby Starr. He’s really been on one this week, as Appropriations considers whether to extend emergency housing programs for the well over 2,000 Vermonters who face unsheltering within the next two months. When it comes to homelessness, he crosses the line from “roguish bumpkin” to “hateful bigot.” Repeatedly.

Starr is allegedly a Democrat, and he does cast some useful votes. But the things that come out of his mouth are a stain on the Senate and on the Vermont Democratic Party, and both institutions would be better off without him. Even if his Northeast Kingdom district were to choose a conservative Republican to replace him, I’d prefer that. At least it’d be honest, and at least we wouldn’t have to deal with a Democrat displaying rank ignorance and prejudice in high office.

So what has he been up to this week? Well, let me tell you.

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Senate Committee Votes to Unshelter 1,600 Vermonters for Obscure and Arguably Bogus Process Reasons

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One of the necessary quirks of the legislative process is that almost every bill passed by a policy committee must also go through one or more “money committee” — if a bill raises revenue, it goes to House Ways & Means and Senate Finance, and if it spends a damn dime it goes through House and Senate Appropriations. If a bill both raises and spends, it must be passed by all four.

There are good reasons for this. The money committees look at the entire landscape of government spending and taxation and make sure everything fits together. They are fiscal gatekeepers, in essence.

However… these committees can also derail a good piece of legislation without serious consideration of the rationale behind it. And that’s exactly what happened yesterday afternoon in the Senate Appropriations Committee. The potential consequence is a mass unsheltering event in mid-March affecting roughly 1,600 individuals, including children, seniors, and people with disabilities.

Not that anybody noticed, because there were apparently zero reporters present. It was the latest in a series of failures by our ever-shrinking media ecosystem. But hey, let’s get on with the story.

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