Tag Archives: Affordable Care Act

Big Greenwashing

Dartmouth College has announced a new, lavishly-funded institute to study energy issues. Or, as the PR bumpf puts it, the institute’s purpose is “ato advance the understanding and knowledge of a resource that powers modern life and is directly related to society’s standard of living and success.”

Great news, right?

Well, not everybody thinks so. As the Valley News reports, “environmentalists within the Dartmouth community described [the institute] as a ‘horrific’ example of influence-peddling.”

See, the full name of the new body is the Arthur L. Irving Institute for Energy and Society. That’s “Irving” as in Irving Oil, one of New England’s leading distributors of fossil fuel. The Irving family donated $80 million — roughly half the estimated cost of the thing, including a shiny new building to be erected on campus — in exchange for the naming rights and, some fear, a measure of influence on what exactly is studied.

This is a growing trend on college and university campuses: rich people with axes to grind putting up scads of dough to establish “institutes” devoted to studying questions of their choosing. And churning out “research” that, mirabile dictu, supports conservative and pro-business points of view.

Continue reading

Advertisements

Gnats to Fart in Windstorm

Oh look, a bunch of Republican lawmakers are belatedly getting off the pot.

Vermont state Rep. Kurt Wright, R-Burlington, says approximately 30 Republican lawmakers will endorse Marco Rubio for president on Thursday.

… “He’s the last best chance,” Wright said. “I think the window’s beginning to close.”

Err, “beginning” to close? More like “coming down like a well-greased guillotine.”

Presumably, at least some of these 30 Bravehearts also attended the John Kasich Town Hall last Saturday. None endorsed him, although they were all very happy to be on hand. But I guess they realize that Foxy Grandpa’s window was never open, let alone “beginning to close.” It’ll be interesting to see how many top Republicans show up at the just-anounced Kasich Town Hall on Monday at Castleton University.

The Rubot also got the coveted (cough, choke) endorsement of former Lt. Gov. Brian Dubie, who praised Florida’s Usually Absentee Senator as a “strong conservative” with “bold conservative ideas.”

Yeah, that’ll move the needle. Look out, Trump: Brian Dubie is comin’ to get ya!

Also, gosh, I didn’t realize Dubie was such a fan of strong conservatism. I guess that Jim-Douglas-without-the-charm act he pulled in 2010 was just a load of horse hockey.

Continue reading

Woolf’s Duplicitous Delicatessen

Our Motto: “Where There’s Always a Thumb on the Scale”

It’s been a while since I chronicled the dishonest commentary of Art Woolf, a.k.a. Vermont’s Loudest Economist. Every Thursday, he blesses us with a few hundred words of pro-business bumpf salted with carefully chosen figures designed to conceal the flaws in his reasoning.

Heck, I could easily write a riposte every week, but that gets old after a while.

However, the two most recent entries in the Woolf oeuvre merit scrutiny, because they touch on significant public policy debates: taxes and health care reform.

His November 5 missive revisits one of his favorite themes: Vermont’s taxes are too damn high. Well, he doesn’t say so exactly; but he presents an array of misleading statistics to bolster that popular conservative argument.

Continue reading

Don Turner phones it in

House Republicans have apparently decided it’s time to pay some lip service to the idea of health care reform.

Emphasis on “little.”

Under the very generous headline “House Republicans Develop Alternative to Shumlin’s Payroll Tax Proposal,” VPR’s Bob Kinzel outlines a half-assed Republican idea that would, at best, produce a fraction of the benefits of Shumlin’s plan. At worst, it’d be a huge step backward for health care access in Vermont.

The Governor has proposed a payroll tax of 0.7%, with the proceeds going to shore up Vermont’s embarrassingly low Medicaid reimbursement rate. Since Medicaid services are now indirectly subsidized through higher charges to non-Medicaid payers, increasing the state’s reimbursement rate should lead to lower insurance premiums for everybody else. Shumlin says the net drop in premiums would more than make up for the new tax, and he would task the Green Mountain Care Board with making sure the premiums go down.

Also, the reimbursement system would be, y’know, fairer.

House Minority Leader (and king of the kneejerk conservative response) Don Turner isn’t buying it. Funny thing: he doesn’t argue against the tax itself. Instead, he invokes the long-discredited Domino Theory.

“It seems like a little number, but you’ve opened the door,” Turner says.

So he’s not arguing against the tax, just the imaginary consequences of the tax.

His big idea? The state should ditch Vermont Health Connect and opt for the federal exchange. Turner figgers we could save $20 million, which could go toward raising Medicaid reimbursements. Even by his perfunctory standards, this is awfully lame. Transparent, even.

Three problems (at least).

— His $20 million estimate is contested by administration officials. And, as I understand it, a lot of the money spent on VHC is actually federal money. How much of Turner’s reputed $20 million is actually Vermont’s money?

— Shumlin’s tax plan would raise $90 million annually, enough to close the Medicaid reimbursement gap by half. Turner’s $20 million would accomplish slightly more than Jack Diddly Squat.

— Worst of all, the US Supreme Court is considering a case that could end federal health care subsidies for states that use the federal exchange. Turner doesn’t give a rat’s.

“We understand there may be a potential for Vermonters to lose federal subsidies,” Turner says. “However, 35 other states are in the same boat.”

We’ve cut the number of uninsured Vermonters in half, and Turner’s response? “Ehh, easy come, easy go.”

Also, about one-third of the payroll tax revenue would allow the state to expand Medicaid to 20,000 more Vermonters. There’s nothing like that in Turner’s “plan,” and he couldn’t care less. As Kinzel reports, Turner “says he’s not convinced that this expansion is a good idea.”

I guess he’s fine with tens of thousands of Vermonters having no health insurance. Or at least he’d rather have that, than a small payroll tax hike that would be more than compensated for by lower insurance premiums.

Here’s something Governor Shumlin should stop saying

Ever since last Thursday’s inaugural ceremonies, Gov. Shumlin has been telling anyone who will listen that he was “saddened” by the presence of protesters. Like other Democrats, he singles out the one protester who crossed the line by singing during the benediction.

He has to highlight that one moron because otherwise, the demonstrators were not disruptive or offensive. They followed the rules of civil protest. The inauguration proceeded as scheduled until the very end.

Of course, what really offends the governor is that they dared to crash his coronation. The Vermont Press Bureau:

“The inauguration is an opportunity where we all say, ‘Let’s roll up our sleeves, cut out all this party stuff and get to work,’” the governor said. “And I just don’t think that they did their cause… much good by the kind of tactics they employed…”

Or in Brill Building terms: “It’s My Party and I’ll Cry if I Want To.”

The whingeing is excessive and self-centered. But I’d like to focus on one thing the Governor is saying, over and over again, that hurts his credibility. It goes something like this:

“I was really saddened by what happened yesterday, because I’m as frustrated as anyone with our health care system, and there’s no one that wants to see the goal of universal access as much as I do,” he said.

That’s from Saturday’s Burlington Free Press, but he’s been spouting variations on that theme in other outlets.

And he needs to stop. Now.

For one thing, it’s false. For another, it’s a two-sided statement: Shumlin is trying to emphasize his own political pain and loss — but at the same time, he’s downgrading everyone else’s.

Is there really no one who is more frustrated by Shumlin’s abandonment of single-payer? Is there really no one who more ardently wants to see universal access?

Of course there is.

Start within the administration itself. Are Robin Lunge or Mark Larson less disappointed than Shumlin? How about Anya Rader Wallack? Or Jonathan Gruber, who’s become a national laughingstock and has now lost his best chance to enact single-payer? There must be, at minimum, dozens of staffers and contractors who’ve put their heart and soul into Vermont’s single-payer initiative. That’s not to mention the single-payer advocates like Deb Richter and Peter Sterling, who served on the Governor’s Consumer Advisory Council and had the rug pulled out from under them.

Widening our scope, how about the entire Progressive Party, which put its own gubernatorial ambitions on hold for three straight election cycles in order to give Shumlin a free hand on single-payer? Might they be more frustrated than the Governor?

Which is not to overlook Democrats who’ve fought for single-payer. Maybe ex-Rep. Mike Fisher feels a bit of disappointment after losing his bid for re-election and then the cause he’d worked so hard for.

Finally, let’s not forget the tens of thousands of Vermonters who still don’t have health insurance, and the additional tens of thousands who still struggle to pay their premiums, in spite of the Affordable Care Act’s advancements. They are directly impacted by Shumlin’s decision in ways that he will never, ever be. He’s a millionaire who can afford any kind of health coverage he wants, up to and including concierge medicine from the Mayo Clinic.

That’s a partial list, but a substantial one. I think it’s safe to say that there is at least one person more frustrated and more disappointed than Governor Shumlin.

Whether he intends it or not, the Governor slights the feelings and experiences of all those people  when he claims special status as the number-one victim of single-payer’s demise.

As for what he should say instead, here’s a suggestion:

“My decision not to pursue single-payer health care has caused a lot of anger and frustration, and disappointed a lot of people, including many who have supported me politically. Our inability to move forward on single-payer has brought pain to thousands of Vermonters who are still without health insurance. 

“I apologize to each and every one of them. My commitment to universal access is as strong as ever, and as long as I am Governor, I will strive to advance the cause of universal access to the best of my ability.” 

There. That’s not too hard, is it?

Why state IT projects fail: a much-overlooked factor

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.