Category Archives: Health care reform

How can I miss you when you won’t go away?

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Audio accompaniment to this blogpost:

Well, good ol’ “Bitter Bob” Hartwell, outgoing Republicrat Senator from Bennington, has left his fellow Senators a parting gift: the op-ed equivalent of a flaming bag of poo, entitled “What Senate Democrats Must Do.”

Hartwell’s public statements have shifted to the right in recent months, starting with his infamous skepticism about climate change and continuing through his comments to VTDigger last week that the Democrats have gone too far to the left:

“There’s too much spending, there’s too much social engineering, going on. Our party is getting out of line,” he said.

His opinion piece is more of the same. It reads as though it comes, not from the moderate Democrat he claims to be, but from somewhere to the right of Phil Scott. Indeed, it’s a big fat sloppy wet kiss to the Republican Party, delivered one week before Election Day. I’m sure the timing is coincidental, cough, hack, choke.

Bitter Bob, doing research for his opinion piece.

Bitter Bob, doing research for his opinion piece.

He accuses the Democratic Party of becoming “more ideological and, therefore, less effective and more poorly focused on the real issues.” By which he means, the “real issues” that concern Bitter Bob Hartwell.

He then slaps around Democrats and the Shumlin Administration for the “poor rollout of Vermont Health Connect” and says “The Legislature must determine to put an end to the single payer scheme unless it can clearly show significant savings…”

A reminder: There are two goals in advancing single-payer. One is to bend the cost curve, and the other is to provide universal access to health care. If Bob is only interested in the former, well, I’m glad he will no longer represent the Democratic Party in the new biennium.

Then he gets to property taxes and school funding, which “inexcusably, the Legislature has done virtually nothing to control…” Remind me: wasn’t Bob Hartwell in the Legislature himself?

Also, in one badly-written sentence, he appears to endorse Scott Milne’s proposal for a freeze on property taxes.

Then he takes a dump on the Senate Education Committee for “a most unacceptable performance” in failing to address the issue to Hartwell’s satisfaction. He’s talkin’ to you, Dick McCormack, Don Collins, Phil Baruth, Bill Doyle and David Zuckerman.

Somehow I don’t think Bitter Bob was talking to his colleagues this way when the Senate was still in session and his words could have had some impact. Indeed, it’s hard to tell from this essay that Hartwell was a fairly influential member of the Senate majority instead of an innocent bystander.

He then slams “Vermont’s intoxication with large scale renewable energy,” which fits in with his doubts about climate change. It also buttresses his self-congratulatory impulses, as he upbraids the Senate for refusing to pass his bills to create new obstacles in the path of renewable energy.

After that, it’s on to the core Republican talking point: “Vermont continues to spend too much money,” especially on social services programs, and bitches about “throwing money at problems” in a way that’s straight out of the Angry Jack Lindley playbook.

Hmm. Angry Jack and Bitter Bob. The worst Vaudeville act ever.

And then Hartwell rants about something that’s only a major issue in his own mind: the legislature’s failure to repeal the Bottle Bill, which, he says, wastes money, contributes to carbon pollution*, and “shoves businesses… into New Hampshire.” And he takes a gratuitous slap at VPIRG — or, as Hartwell puts it, “one so-called ‘research’ group.”

* Which, according to Bob himself, isn’t really a problem.

The “get off my lawn” ranting continues for several more paragraphs, in which he bemoans the fact that nobody in the Senate is as wise as Bob Hartwell and unleashes a bunch of howlers, including:

— The Senate fails to act “as a team,” and instead pursues “the interests of each committee with little understanding of the effect… on the state as a whole.” Considering his hijacking of the Natural Resources Committee in pursuit of his favored hobbyhorses, that’s pretty rich.

— Vermont should be more like New Hampshire.

— Our economic doldrums have nothing to do with national trends, “but rather by policies internal to Vermont.”

— Dean Corren is a liar.

Yeah, that’s one huge stinking flaming bag of poo. Thanks, Bitter Bob, for giving us a farewell gesture that reminds us all how lucky we are that you’ve decided to get outta Dodge.

Don’t let the door hit you on the way out.

Pfft! There goes another conservative talking point

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Vermont conservatrives have been making some hay lately by raising fears about Medicare. The idea is that Governor Shumlin is plotting to take over Medicare, and who knows what will happen to your benefits after that.

Well, first of all, Medicare benefits are protected in federal law.

But more importantly, here comes a tidbit from VTDigger’s Anne Galloway: 

Two recent stories about the relationship between Medicare and Green Mountain Care, the state’s planned universal publicly financed health care program – often called single-payer – were inaccurate. The stories were based on statutes on the Legislature’s website that had not been updated.

The stories outlined accusations made by Libertarian gubernatorial candidate Dan Feliciano and Orange County Senatorial candidate Bob Frenier. The same charge has been made in a radio ad produced by the Ethan Allen Institute.

As Galloway explains, the legislature amended the health care law earlier this year, removing the section calling for state oversight of Medicare. And, she says,

State officials have said they are no longer seeking to administer Medicare as part of Green Mountain Care, and the law reflects that change.

The problem, apparently, is that the legislature’s website was not properly updated and still contains the old version of the law. And, as Galloway concludes, the charges about a state takeover of Medicare are “inaccurate.”

This should clear things up, but somehow I can’t see the conservatives dropping a nice juicy talking point just because it happens to be wrong.

Dear Shumlin Administration: Please heed the words of Uncle Barack

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President Obama got in a brief tick of turmoil a while back when his approach to foreign policy was summarized as “Don’t do stupid shit.” Which, as the political equivalent of the Hippocratic Oath, makes a world of sense to me.

And I wish our leaders in Montpelier would frame it and hang it over their desks, because it sure would come in handy when dealing with Vermont Health Connect. The latest, ICYMI:

Thousands of Vermont Health Connect customers who signed up to pay health care premiums online recently received email notices directing them to pay through a website that is offline.

Vermont took down its health exchange Web portal Sept. 14…  But the state and its contractors apparently forgot during the intervening three weeks to cancel an automated email blast that directed roughly 6,500 people who signed up to make payments online. Those people, about 20 percent of the website’s commercial customers, were directed to visit vermonthealthconnect.gov to view their premium invoice.

(ahem.)

NNNNNOOOOOOOOOOOOO!!!! 

Stop it! Just stop it!

Stop doing stupid shit!

“Apparently forgot,” eh? Maybe some of you should come to work tomorrow and find that your keys no longer work because your bosses “apparently forgot” to let you know about your change in employment status.

This bout of apparent forgetfulness happened under the new contractor, Optum, and under the revamped administrative team of Harry Chen and Lawrence Miller, so we can’t blame this on the dearly departed (CGI, Doug Racine) and the recently rendered invisible (Mark Larson).

I’m a strong supporter of the current iteration of health care reform, and I have high hopes for single-payer. As a result, I’ve too readily accepted Administration assurances that they’ve learned their lessons, they’re working hard, they’ve got a handle on it, and they’ll fix it.

This time, as Bullwinkle T. Moose used to say, for sure.

But I am getting tired of defending the Governor and getting the ground cut out from under me. Maybe that’s why a new poll shows him with a 45% favorable rating against 41% unfavorable. In spite of the fact that he’s running for re-election against the legendary comedy team of Mr. Blandy and Mr. Fringey.

So, Shumlin team, please tell me there won’t be any more screwups, revelations of past blunders, delays, or embarrassing emails to the very constituents who (a) were in line to benefit from Vermont Health Connect and would love to see it work, and (b) now have every reason to be royally pissed off at the authors of this reform.

A protest vote for Doug Racine is startin’ to look awfully tempting.

El Jefe brings a chicken to the doctor

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Sometimes I wonder if John McClaughry is serious, or if he’s just trolling us all.

I don’t comment on his opinion pieces very often, because he’s so far beyond the pale that it’d be kind of like commenting on an alien civilization. One that considers Ayn Rand a creeping pinko.

Well, this time I’m pretty sure that El Jefe General is under the bridge, snickering. Because his latest effort, dutifully posted by VTDigger, betrays a woeful ignorance of our history. Or at best, a view of our history through coke-bottle-thick rose-colored glasses.

Screen Shot 2013-11-08 at 1.01.59 PMIn it, El Jefe calls for a return to those Good Old Days when health care was a matter of mutual aid instead of government intervention.

We’re not talking the days before Obamacare, or the days before Medicare. We’re talking pre-Franklin Delano Roosevelt. Because as we all know, FDR ushered in the decline and fall of True America. Take it away, El Jefe…

Health care a century ago relied largely on “friendly societies,” that first appeared in the UK as early as 1793. These were self-governing mutual aid societies that promoted ethical behavior, healthy lifestyles, and “the temperate interchange of social feeling” for the afflicted. They also provided medical care, sick pay, and funeral arrangements for members and their families.

… In the U.S. clones of the friendly societies began to appear in the early 1800s under the name “fraternal organizations,” exemplified by the Odd Fellows and the Loyal Order of Moose. These lodges established orphanages, hospitals, banks, schools, retirement homes, newspapers and insurance companies. They sponsored “lodge practice,” where the local lodge members selected and employed a doctor.

Ah yes, the Good Old Days, when all you had to do is join — freely, without a hint of coercion — with your fellows to ensure that all your needs would be met. McClaughry bemoans the repression of these free movements at the hands of the medical establishment, insurance companies, and, of course, the Big Bad Government.

El Jefe paints an attractive picture. Too bad it’s conveniently incomplete. If you were subject to the tender mercies of a “lodge doctor,” before the days of medical regulation and licensing, your life and health were probably in the hands of a quack or a well-meaning tradesman with little or no training.

Let’s just imagine a “lodge doctor,” even a well-intentioned one, trying to cope with the complexities and marvels of modern medicine. (Hey, let’s put him in charge of Ebola containment!)

For more, let us turn to one of my favorite texts: “The Good Old Days — They Were Terrible!” by noted historian/archivist Otto Bettmann, founder of the Bettmann Archives. Published in 1974 and still in print, it’s a breezy, compact deflation of cherished myths about the olden times. Many of which are dearly held by El Jefe.

“The country doctor of old… was actually no more than a venturesome prescriber. Because his diagnosis was based on guesswork his therapy was totally unreliable. Sometimes it cured — often it killed. …general practice in the United States was backward, commercial and often fraudulent.

“The lack of education and proper licensing exposed the sick to hordes of ignoramuses masquerading as doctors. More a trade than a profession, medicine attracted not the sons of the elite — who preferred law or theology — but mediocrities who saw a chance to get rich quickly.” 

Many of America’s “medical schools” were little more than diploma mills, offering a sheepskin after a few months of training.

“Doctors had little professional prestige; indeed many were considered ‘crude, coarse and ignorant, contributing to social butchery by keeping their patients ill.'”

This was American medical care during John McLaughry’s Golden Age of unfettered liberty. Considering all of that, I guess it’s no wonder that John’s little boys’ club, the Ethan Allen Institute, hasn’t hired its own lodge doctor.

Honestly, McClaughry’s essay makes Sue “chicken to the doctor” Lowden look like Anya Rader-Wallack.

 

Health care reform: the election issue with no teeth?

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Interesting thing happened last week. Vermont CURE, an advocacy group for single-payer health care reform, cut ties with Tess Taylor, the former House Assistant Majority Leader who resigned from the Legislature to sign on with CURE only about six months ago. In the middle of the 2014 legislative session.

Taylor had been brought on board in the expectation that there’d be some heavy lifting to do in the 2014 campaign, and her political chops would come in handy. Seemed like a good bet at the time, and an even better one after a spring and summer full of trouble for Vermont Health Connect. Surely, went the conventional thinking, the failures of VHC would mean trouble for Governor Shumlin.

Well, maybe not. Bram Kleppner, chairman of the V-CURE board, speaking with VPR’s Peter Hirschfeld: 

“We were expecting a strong candidate to oppose Gov. Shumlin. We were expecting a wave of strong  candidates coming in to run against supporters of (single-payer). So we brought Tess on, obviously because of her deep expertise in the Vermont political process,” Kleppner says. “But it became clear to us after the primaries that that political and legislative opposition that we were expecting really just hadn’t materialized.”

So, rather than a campaigning challenge, V-CURE will focus on a PR effort to convince the general public that single-payer is the best way forward. Taylor’s experience is less germane to that.

This ties in with an email chat I recently had with fellow blogger (and former Burlington City Councilor) Ed Adrian. He wanted to know how my blogposts about health care reform were doing in terms of readership. He’d noticed that anytime he wrote about health care reform, his numbers were “dismal.”

So I checked my numbers and found that, for whatever it’s worth, the same is true for theVPO. Health care stories just don’t attract many pageviews.

Now, theVPO’s audience is a very select, and self-selected, slice of the general public: those with a strong interest in Vermont politics. You can’t safely generalize from them to the entire electorate.

But you’d think that, if anything, my readers would be more interested in health care than everybody else.

Ed pointed out that a sizable majority of Vermonters have never had to interact with Vermont Health Connect because they get their health insurance elsewhere. For them, VHC’s failings are basically an abstract concern.

I wouldn’t have placed much value in the pageviews of a couple of blogs. But combine it with V-CURE’s move, and i have to wonder: is health care reform a lot more sizzle than steak? Is it mainly of interest to insiders and the political media?

It’s hard to tell from the course of the campaign to date. Scott MIlne hasn’t made a dent in Governor Shumlin’s armor with his attacks on VHC incompetence; but is that because of the issue, or because of his terrible campaign?

Then there’s Dan Feliciano, who’s gotten a lot of insider buzz with his devout opposition to single-payer. But his fundraising has been terrible and his 48-hour fundraising blitz came and went without any news — which has to mean it was a complete failure. Is he getting anywhere with a frontal attack on single-payer? It’s impossible to tell, since he hasn’t been included in recent polls. But his fundraising numbers certainly don’t reveal any groundswell of support.

There’s reason to believe that the failures of VHC may not be that politically harmful to Shumlin. I suspect that property taxes would have been a better issue for the Republicans. They still wouldn’t have beaten the Governor; but only a small portion of Vermonters have interacted with VHC, while pretty much everybody pays property taxes, either directly or indirectly.

It’s worth pondering, anyway.

Why state IT projects fail: a much-overlooked factor

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Oliver Olsen, the once and (perhaps) future State Representative from southern Vermont, recently wrote an essay entitled “Why IT projects fail.” It was, more specifically, about why state-contracted IT projects fail.

Olsen began with the question, why can’t we bulid a software system when we manage to build large-scale complicated stuff like highways, bridges, and suchlike. His explanation: while the basics of civil engineering have been in place for quite a while, the world of high technology is young and ever-changing. And it’s harder to deal with the intangible world of IT than with the steel-and-concrete world of construction.

Good enough, as far as it goes, and I recommend reading the piece.

But I’d add one big factor that no one else seems to have noticed.

One of the problems throughout the history of the Affordable Care Act and Vermont Health Connect is a lack of competition for IT contracts. CGI was the big dog, by a long shot. Vermont chose CGI in large part because it had won so many other ACA contracts that it seemed the clear choice. Turned out, of course, that CGI wasn’t really up to the job. And when Vermont went to find a replacement, the only real choice was Optum, upon which our hopes are now pinned.

So the question: Computers and software are huge growth industries, and the US excels at both. Why can’t we get more, and smarter, companies to bid for health care exchange contracts?

I’d turn that question around: why are so many high-tech companies staying away?

Could it be because public-sector projects are complicated, fraught with peril, and more likely to yield failure than success?

Just looking at how the market moves, I have to conclude that it’s a lot more profitable to build newfangled gadgets, computer games, and smartphone apps. And the cost of failure is a whole lot lower: you put out a device or a game or an app. If it fails, you move on to the next one and write off the development costs. If you’re trying to build a health care exchange, you’d better damn well get it right. You can’t just walk away in the middle, and you can’t unilaterally postpone the launch.

Also, whereas a game or an app is pretty much a stand-alone item (as long as it plays nice with the operating system), public-sector IT projects are complicated systems that have to interface with other complicated systems.

There are lots of things IT experts can do that are higher-return and lower-risk than public-sector IT projects. Which is why most of them stay away from the business, and the public sector is left with a relative handful of bidders.

And somehow I doubt that those bidders represent the best and the brightest of the IT world.

The universal Milne

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The Scott Milne campaign has a number of albatrosses around its neck.There’s the newbie candidate’s inept performances on the stump and in debates. There’s his apparent allergy to fundraising. There was, of course, his late start. There’s the devastated, improverished infrastructure of the Vermont Republican Party. (Tickets Still Available for the Congressman Peter King fundraiser tonight!) (Please buy a ticket!) (Pretty please?) There’s the fact that he still hasn’t managed to articulate actual positions on the issues.

And on top of all that, there’s his remarkably incoherent political positioning. Because, you see, Scott Milne is trying to be all things to all people. He’s simultaneously opening his big-tent flap to conservatives, moderates, and even liberals.

Scott MilneLiberals?

Yup.

He’s trying to present himself as a thoughful, moderate leader who will consider all points of view, including the most progressive. He’s depicting Governor Shumlin as a bad manager; his pitch to liberals is, “If you replace Shumlin, state government will work better and you’ll see more of your policy dreams come true.”

It’s an impossible balancing act to maintain. And Scott Milne is definitely not the man for the job.

Look at his runaround on the GMO labeling bill during this week’s debate.

First, he said the GMO bill was “a good example of the radical, progressive management of a bill by this Administration.” Then he said he wouldn’t repeal it. Then he couldn’t say whether he would have vetoed it if he’d been Governor. And finally, he returned to the theme of “managing the bill,” saying that if Shumlin hadn’t been so ham-fisted about it, the bill could have been passed “in a much more business-friendly way.”

To sum up: the bill itself isn’t necessarily bad. In fact, it could even be a positive. But Shumlin’s “management of the bill,” whatever the hell that means, was the problem.

If only Scott Milne had been Governor, we would have gotten the same outcome with completely different results. The liberals would have gotten their way, but we would have remained somehow “business-friendly.” Or something like that.

My theory also explains his odd stance on health care reform. Vermont Health Connect was a radical, progressive program — but single-payer health care is NOT necessarily radical. It could turn out to be the best option. Milne ain’t saying.

What he is trying to say to us liberals is, Shumlin’s made a mess of Vermont Health Connect. Elect me, and I’ll make it work so smoothly that it’ll pave the way to single-payer. Maybe.

On issue after issue, Scott Milne is trying to appeal to everybody at the same time. On school funding, he wants to cut costs but he also wants to retain local control. He wants a freeze on the statewide property tax, but he apparently doesn’t want schools to suffer any cuts. And he’s unwilling to even hint at a new school-funding plan. Because he doesn’t want to lose a single vote.

Many issues are simply too “complicated,” and all he promises is to work with the Democratic Legislature on the details. To conservatives, the message is: I’ll hold the line. To liberals, it’s I’ll let you have your way a lot of the time. Somehow he’s not convincing any of us.

Most telling of all is his stance on legalizing marijuana, which sounds like it came from a chronic doper:

“It is a bad idea but if I get a bill, I’ll sign it.”

In the words of the candidate himself, Holy Shamoley.

I realize the man thinks he is “Gandhi-like,” but even the original Mahatma couldn’t have pulled this off.

 

VHC and the NFL

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The National Football League, the unstoppable beast of modern sports, is having a bad time of it. Commissioner Roger Goodell, team owners, and players are under scrutiny for what appears to be an epidemic of bad behavior toward women and children, and a casual attitude toward violent offenders.

In actual fact, there are no more or fewer incidents than there have ever been. The problem is the league’s hypocrisy, backtracking, dishonesty, and double-dealing. Or, as we learned from the Watergate scandal — well, we should have learned it — it’s not the crime that gets you, it’s the cover-up. If the NFL had gotten out in front and taken plausibly strong action, its current PR crisis would never have happened.

Which brings me to Vermont Health Connect, our long-troubled and (temporarily?) sidelined health care exchange. And particularly the need for a heavy dose of the best disinfectant: sunshine.

To begin with the takeaway: Please, let there be no more surprises. If there are unrevealed problems, call a news conference ASAP and get all the bad stuff out in the open at once. No more dribs and drabs, no more Friday afternoon newsdumps; just a public accounting for everything. Take heed of the NFL’s tribulations, made worse every time new information comes out or a prominent figure sticks his foot in his mouth.

Maybe there’s no bad news left. Maybe we know it all. That would be great, if true. But the Administration’s recent track record doesn’t fill me with confidence.

Go back, first of all, to the Friday afternoon newsdump to end all Friday afternoon newsdumps: the release of the Optum report detailing serious problems with the state’s oversight of the VHC website’s construction. Not problems with the technology or software; but serious management shortcomings by Shumlin Administration officials. The report was released the Friday before Labor Day, so maybe you missed it.

At the time, the words of responsible officials were not reassuring. Health care reform chief Lawurence Miller said the Optum report would help chart “the best way forward,” which seemed to preclude any accounting for past maladministration. And Health Access Commissioner Mark Larson, who has since been sidelined from VHC oversight, allowed as to how his takeaway from the report was that “we have worked hard with our vendor partners.”

Well, yeah, hard. But not effectively.

On September 15 came the temporary VHC shutdown. It was first announced as a way to streamline repairs and upgrades in advance of the next open enrollment period. It made sense, and I praised it at the time: stop futzing around, get it fixed, and set the stage for the single-payer debate.

Since then, a couple things have happened that cast doubt on my sunny interpretation. A few days later, VTDigger’s Morgan True reported that the VHC shutdown had as much to do with a site-security crisis as with a sudden onset of managerial diligence.

Over the summer the federal government provided a timeline for reducing security risks, which expired 10 days ago…

Miller and Harry Chen, the secretary of the Agency of Human Services, decided to take down the website last weekend because the state was unable to meet a Sept. 8 federal deadline for security controls; the determination was not the result of a security breach or a specific threat.

“Rather than asking for more time, we decided to disconnect from the federal hub,” Miller said.

Miller could not rule out the possibility that the feds might have ordered a VHC shutdown if the state had failed to act.

Which puts quite a different complexion on the shutdown. And Miller didn’t reassure much when, speaking about security issues, he had trouble with verb tenses:

… it needs to be a high priority; it needed to be a higher priority than it was.

A curiously passive tone, methinks.

The very next day, we learned that top state lawmakers were displeased that they learned of the VHC shutdown through the media. Sen. Ginny Lyons, chair of the Senate Health Care Oversight Committee, said “We’re legislators, so we need to know.” Miller’s response? Officials kept it quiet for security reasons.

“The nature of the announcement was also an abundance of caution. Security advisers say when you’re going to do something for security reasons you do not telegraph that ahead of time.”

Uh, sorry, but no.

The federal government has crafted ways to share top-secret information about things like war, terrorism, and intelligence with appropriate members of Congress. I think Shumlin’s people could have passed a quiet word to, say, legislative leadership and the chairs of the health care committees. I think those people could have been trusted to keep a secret, for a couple of days, for good reason.

Miller’s explanation, of course, implies that lawmakers cannot be trusted. I think if I were Ginny Lyons or Mike Fisher, I’d be insulted by that.

And next winter, when Shumlin starts the push for single-payer, he’s going to need the support, good will, and trust of those leaders. Well, Miller as much as said he didn’t trust them.

I sincerely hope we’ve emptied out the Pandora’s Box of VHC. If there are still some dark, unexamined corners and crevices, then I implore the Administration to throw open the lid and let the sun shine in.

The most significant thing about Governor Shumlin’s first TV ad of 2014

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The Shumlin campaign has taken to the airwaves with a 30-second commercial that features real-life Vermonters who have benefited from Shumlin initiatives. The aim of the ad is to remind viewers of the administration’s many accomplishments — to counteract the stream of bad news about Vermont Health Connect and the Department of Children and Families, and to remind liberal voters that the Governor has, indeed, delivered on many of his promises.

All he needs is rainbows and unicorns.

All he needs is rainbows and unicorns.

Pretty standard stuff, and it’s been duly reported in the media. But they haven’t noticed* the most significant thing about the launch: its timing.

*Correction: All but one of them failed to notice. Sevan Days’ Paul Heintz reported it two days before I did. That’s why they call him The Huntsman.

In 2012, the Shumlin campaign didn’t take to the airwaves until roughly two weeks before Election Day.

This year, the campaign hits your TV screens almost a full month earlier.

According to campaign finance reports, the Shumlin camp spent $125,000 on ad buys in 2012. Campaign manager Scott Coriell isn’t saying how much they’ll spend this year, but it figures to be a lot more.  They’ll be filling airtime for six weeks instead of two, so it’s fair to guess that they’ll triple their spending this year. Or more.

So, why?

In 2012 Shumlin faced an underfunded, underorganized, mismanaged opponent. Shumiin’s re-election was never in doubt. This year, he faces one opponent who’s far worse in all three categories, and another who represents a fringe viewpoint with a proven track record of appealing to a sliver of the electorate. Recent polls (and deeply flawed polls at that) notwithstanding, his re-election is once again in the bag.

But the Governor isn’t aiming his campaign at the broad electorate. He’s trying to pump up the base and generate higher turnout by core Democratic voters. Hence the reminders of popular Democratic initiatives.

If he can get a pure majority of the vote — at least 50% plus one — he’ll have a lot of political capital to spend in next year’s debate over single-payer health care.

But if he wins with a plurality and, worse case, he gets fewer votes than the Republican and Libertarian candidates combined, he’ll have a lot less pull with the Legislature. And right now, he’s polling in the mid-40s. He needs a boost.

Plus, of course, the higher his vote total, the more Dems and Progs will ride his coattails to victory. And he’ll need every liberal vote he can get, if single-payer is to pass next year.

That’s the significance of the early TV launch this year.