Tag Archives: health care reform

Grüberdämmerung

Ah, Jonathan Gruber, the gift that keeps on taking.

The latest twist in this uncomic opera: Auditor Doug Hoffer has examined Gruber’s invoices for consulting work on behalf of the Shumlin adminstration, and found them seriously wanting.

In Hoffer’s words, his review of documents “raised questions about Dr. Gruber’s billing practices and the State’s monitoring and enforcement of particular contract provisions.” More:

Dr. Gruber’s invoices referred only to “consulting and modeling” and offered no details about specific tasks. In the broadest sense, those three words describe the work performed, but such generalities do not appear to satisfy the intent of the contract.

It’s like taking a math test where you’re asked to show your work, and you turn in a sheet with “WORK” in big letters on an otherwise blank page.

Hoffer further states that top Shumlin officials Robin Lunge and Michael Costa “were aware of the need for more details in the invoices, but approved them nonetheless. … [they] had an obligation to request additional detail from Dr. Gruber, and they failed to do so.”

Gruber’s first and second invoices raise suspicion because each showed the same round number of hours worked (100 for Gruber and 500 for research assistants). Hoffer judges the round figures, and the fact that two invoices totaled exactly the same, “implausible.” He concludes that the administration “ignored the obvious signs that something was amiss.”

To me, this is the real Gruber scandal. The conservative shitfit over a handful of intemperate remarks — made during a period of years in which Gruber must have spoken on the record hundreds of times — was nothing more than political opportunism by the opponents of health care reform. But this?

Even if Gruber was invoicing to the best of his ability, it certainly reveals shoddy management by the Shumlin administration. Which is, unfortunately, of a piece with the administration’s general performance on health care reform. Did they take a relaxed approach to spending money because so much of it came from the federal coffers? Perhaps.

Here’s another fact that reinforces my interpretation. Late last year, Gruber submitted two more invoices. In an email to Hoffer earlier this month, according to VTDigger’s Morgan True, Lunge wrote that the administration was “no longer satisfied with the level of detail provided” in those later invoices.

Why “no longer”? Because Hoffer was examining the invoices and they knew they’d be embarrassed? If there’s another explanation, I’d like to hear it.

There are other problems, as reported by True: Tax documents appear to show that Gruber actually paid his research assistant far less than the amount received from Vermont for the RA’s work. DId he pocket the rest? Did the state’s lax oversight let him get away with it?

I’m a liberal, and I’m strongly in favor of universal access to health care. Our current system is an expensive stinkin’ mess, and no amount of wrongdoing by Gruber or others will convince me that reform is a mistake. But in my book, my fandom only feeds my desire for sound management by those we’ve empowered to enact reform on our behalf, and with our dollars.

The Gruber fiasco makes me wonder about the administration’s oversight of all the other consultancies associated with the reform effort. And, for that matter, its handling of the entire process.

Hoffer has referred his findings to Attorney General Bill Sorrell, who says Gruber’s invoicing raises “major questions.” He says he will meet with administration officials to see “what evidence and records are available to justify the billing amount.”

On behalf of health care reform supporters, and those who backed Peter Shumlin because of his promises to institute unversal coverage, all I can say is I hope there are no more shoes to drop. I fear that we’re only just getting our first peek inside the closet.

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The Assassination of Mary Morrissey by the Coward Shap Smith

The Burlington Free Press doesn’t have much time for state government these days, what with the dismissal of its entire Statehouse bureau and its obvious skeleton-crewing in recent weeks.

But boy, they’ve got plenty of time to spare for the potential reassignment of a single Republican back-bencher.

[State Rep. Mary] Morrissey, [R-Bennington]… confirmed Friday she has been told that House Speaker Shap Smith, D-Morristown has plans to reassign her to a yet to be determined committee.

… Morrissey said she sees the move as an effort to silence a legislator who has been forced to ask tough questions that Democrats are not asking themselves.

Or, to put it another way, it’s a routine committee reshuffle, the kind that happens every couple of years. A whole lot of others will be shifted around in the next few days. It is within the purview of the Speaker to make committee assignments.

Morrissey and her allies are depicting this move as an effort to stymie oversight of health care reform. Which, frankly, gives a hell of a lot of credit to Morrissey. In my brief exposure to her work, she seems to be a garden-variety naysayer on health care reform, ideologically opposed to Obamacare and Shummycare under any circumstances, and not offering any special expertise on the subject.

The Speaker himself put it this way:

“I’ve spent a lot of time looking at a group of people that will work well together to come up with policy,” Smith said.

“I want to put together people who will work effectively together and don’t have baggage from past fights,” Smith said.

Since Morrissey is toting a steamer trunk full of conservative dogma, Smith seems to have reason for her removal. It has less to do with the alleged danger she poses to Democrats, and more to do with her kneejerk opposition. She’s not a watchdog, she’s a fallen tree in the roadway.

Her possible removal from the Health Care Committee is standard operating practice. And, frankly, not that big a deal. It’s not like she’s the only one who can ask inconvenient questions, and it’s not like she has special knowledge of the health care system.

Well, if she does, she hasn’t shown it.

Unwarranted outrage from your Freeploid

 

(See also addendum below: the Free Press didn’t have a reporter at one of the biggest news events in recent history!) 

Regular readers of the Burlington Free Press (all six of us) know that transparency is one of its signature causes.

(Except when it comes to the Burlington Free Press itself; there, secrecy rules the day.)

Well, this preoccupation caused Vermont’s Saddest Newspaper to leap to an unwarranted conclusion yesterday.

In the morning, the media got notice of a gubernatorial press conference to be held at 2:15 p.m. There was no mention of the subject matter.

And this caused the Freeploid to throw a nutty. It posted a short piece entitled “Secrecy surrounds Shumlin’s news conference.”

Shumlin has led the fight for government transparency, but his new press secretary, Scott Coriell, has failed to respond to questions about the topic of the governor’s meeting with the media.

Well, son of a bitch. Of course he didn’t respond.

Most gubernatorial pressers include a bit of political business — a bill signing, a new initiative, a ribbon-cutting. In those cases, the media alert will tell us what’s coming up.

But when there’s an actual policy announcement of significant magnitude? Hell no. Shumlin’s people aren’t going to upstage the announcement by providing advance information. The Freeploid is basically demanding that the administration leak its own stuff.

Particularly in this case, when the announcement was made simultaneously to the media and to those who’d been involved in the single payer work.  If Coriell had disclosed the subject matter, do you think the Free Press wouldn’t have found a way to publish the “scoop”?

The Freeploid went on to complain about changes in the time and venue for the presser. Which, c’mon, grow up. It’s not that big a deal.

I suspect the Freeploid’s real problem is that it no longer has a Statehouse bureau, and the editors had to decide whether to send a staffer down from Burlington. That’s a big deal for a paper as understaffed as the Freeploid. But that’s not the governor’s problem. And Scott Coriell shouldn’t be raked over the coals for simply doing his f’n job.

The article was slightly updated after the presser, and can be viewed by anyone who hasn’t canceled their subscription yet. The updated version mostly changes the verb tenses; the misperceptions, self-entitlement, and aspersions on Coriell remain intact. One more signpost on the Burlington Free Press’ descent into irrelevance.

 Addendum. A loyal reader pointed out that the Free Press’ main article on Shumlin’s presser was not written by a Freeploid staffer, but by the Associated Press’ Dave Gram. That’s pretty awful for a “media company” that insists it hasn’t retreated from Statehouse coverage, and whose leader has publicly slammed “rumors and speculation that we are abandoning coverage in Montpelier.” Well, sir, your absence at yesterday’s announcement is not rumor or speculation, but fact.

Presumably what happened was: the Free Press tried to find out the subject of the presser and failed. The editors then made a calculated gamble not to send a reporter — although they did send their photographer Glenn Russell. Their gamble exploded in their faces. Dave Gram’s a fine reporter, but Vermont’s largest newspaper should not be depending on the AP for coverage of a huge news story.

Here’s a pleasant surprise

I didn’t think the Governor had it in him, especially in the wake of his Election Night smackdown. But he’s not giving in to the Pitchfork Brigade’s call for the head of Jonathan Gruber. Neal Goswami of the Mitchell Family Organ:

Vermont Gov. Peter Shumlin said Monday that a state contractor under fire for derisive comments he has made about American voters and a Vermont commentator will not have his state contract terminated despite calls to do so by Republicans.

Jonathan Gruber, a Massachusetts Institute of Technology economist, has a personal services contract with Vermont that will pay him up to $400,000 to test economic models related to Shumlin’s universal, publicly-financed health care proposal, often referred to as a single payer system.

The Governor’s stand does come with strings: He will not exercise an option to extend Gruber’s contract beyond its expiration in Februiary. And he did his best to dump all over the contrator whose economic model is too valuable to do without:

…”for me it’s not just what he said, it’s that he actually thinks this stuff. It’s not the way we do things in Vermont.”

Shumlin was also careful to delineate between Gruber the technocrat and Gruber the policy advisor:

“It’s our plan, not his. It’s our policy, it’s our hope for the future and it’s our plan. We’ve used him as a calculator not a policy advisor,” Shumlin said.

Okay, fair enough. Keep him on, and do what you must to distance yourself from his arrogance. Much better than to give in to the howling mob.

Grubermania: Catch it!

Well, Vermont conservatives finally have a live one: a get-your-blood-boiling, wave-the-bloody-shirt phony “issue” of the kind that rarely presents itself in our green and pleasant land. And boy howdy, are they ever jumping on the outrage train.

Critics of the Shumlin administration are demanding the dismissal of a state consultant whose remarks about the Affordable Care Act last week went viral on Twitter and was picked up by major news outlets…

The target, of course, is Jonathan Gruber, health care expert and creator of the best economic model for health care systems. And utterer of some completely charmless comments on a handful of occasions over the past few years.

Just think, in this age of digital media, how many Young Conservatives are being gainfully employed searching through endless hours of Gruber’s public appearances, trying to locate bits of marketable outrage. Gruber’s been a high-profile figure in health care reform for many years; because of the unique usefulness of his model, he’s been hired by the feds and a whole bunch of states. He’s given testimony, he’s given speeches, he’s been on countless panels.

But never mind the inherent unfairness of tearing a man’s reputation to shreds over a few words. We’ve got some rabble-rousing to do! And our junior-league rabble-rousers are in full force: Rob Roper, Darcie Johnston*, and oh wait — here’s a new entrant to the Pitchfork Brigade: the previously cool-headed, plausibly nonpartisan Campaign for Vermont!

*And again I say, why in hell is anybody listening to Darcie Johnston after the faceplant of the Dan Feliciano campaign added another chapter to her Little Book of Failure?

Between this and CFV moneybags Bruce Lisman’s recent mouth-foamer of an opinion piece (about which more in an upcoming post), it looks like CFV is finally shedding its chrysalis of nonpartisanship and emerging as the Butterfly of Fiscal Conservatism we all suspected was in there all along.

All this Grubermania has a purpose: to toss a can of nails in the Road to Single-Payer, as VTDigger’s Anne Galloway reports:

Gov. Peter Shumlin… is moving ahead with his signature single payer health care initiative. Gruber’s work is crucial to that effort.

“Crucial” because Shumlin has to show that single-payer won’t hurt the state’s economy. Gruber’s model is by far the best tool for the job.

No Gruber, no model. And Shumlin’s task gets a little bit harder.

Now let’s see what kind of cojones the Administration has. WIll they stand by their guy in the face of grossly exaggerated attacks? Or will they toss him off the dogsled in hopes of distracting the wolves?

Based on past experience, I hope Gruber is packin’ a Bowie knife. After all, one of the great saints of Vermont liberalism, Peter Welch, fell for a similar outrage over alleged malfeasance at ACORN. Welch, you may recall, played a small and ignominious role in ACORN’s termination. Sadly, I expect nothing better of Governor Shumlin.

Time to change the subject

Huh. Day One of Vermont Health Connect 2.0 passed uneventfully, the website performing as expected with only “minor issues” that were resolved immediately.

“It was a nice, boring morning,” [chief of health care reform Lawrence] Miller said. “And that’s what we look for.”

Cool beans.

Of course, unlike last year, the site wasn’t overwhelmed by hordes of eager applicants. According to the Mitchell Family Organ, the site processed 80 new applications and 401 renewals. A nice number, but not a flood. And, we should note, some of the website’s functions are off line until after the open enrollment period ends.

So, baby steps. But so far, so good.

And as long as things are going well, we can safely ignore Republicans’ call to tear the whole thing down and join the federal exchange, complete with its lower subsidies and possible dismantling by the Supreme Court.

And now that things are looking up for VHC, must be time for Republicans to change the subject.

Oh, here we go.

A video from Vermont shows Obamacare architect Jonathan Gruber mocking a Vermonter who expressed concern about single-payer health care.

That’s better. It’s getting harder to challenge Obamacare and Shummycare on policy grounds, so let’s demonize somebody!

And filling the role, in the fine tradition of Hillary Clinton and Valerie Plame and Lois Lerner and Eric Holder and Hillary Clinton again and the hordes of illegal gangbanging youth swarming our borders (remember them?), not to mention Demon Number One, President Obama himself, is Jonathan Gruber, “architect” of Obamacare.

Let’s posit first of all that Gruber seems to be an arrogant ivory-tower type with no conception of how his ill-considered words sound in the wider world. To judge by the carefully-selected words spoken on a handful of videos trumpeted by the right, Jonathan Gruber is a proper asshole.

However…

To call Gruber the “architect” of health care reform is quite a stretch. His primary contribution was the development of an economic model that allowed the testing and comparison of possible reform measures. And from what I’ve read, the Gruber model is uniquely accurate. It’s a valuable tool, and Gruber’s been well compensated for its development and use. He’s been employed by the federal government and the Shumlin Administration (and by a whole bunch of other states) to use his model and consult on details of reform programs.

But he is not the architect of anything. Not in Washington, and not in Montpelier. He did not create the system; he was one among many. And he had nothing to do with the political strategy that led to its enactment, which makes his views on political strategy irrelevant.

You could call him the Ted Williams of health care reform. He’s a terrific power hitter. But he is not the manager or general manager, much less the owner. His thoughtless and arrogant remarks are no more relevant to health care reform than Ted Williams’ famous battles with the press were to his performance at the plate.

Convenient, isn’t it? Just when VHC is getting off the ground and Obamacare is starting its second round of successful enrollments, opponents of health care reform have “discovered” comments made by Gruber two and three years ago.

The video cited above was recorded in 2011 by the conservative website True North Reports.

And now — more than three years later — it’s the outrage du jour? How convenient.

The video’s existence was reported by Vermont’s own version of James O’Keefe, the Koch-funded Bruce Parker at Vermont Watchdog. His story was reposted by True North Reports — without comment on why a three-year-old video that True North Reports itself produced should be considered hot news today. What has TNR been doing with this video for the past three years?

By the way, the Vermonter who was mocked by Gruber in 2011?

El Jefe General John McClaughry.

As Gruber sits listening, the committee chair reads a comment from a Vermonter who expresses concern that the economist’s plan might lead to “ballooning costs, increased taxes and bureaucratic outrages,” among other things.

After hearing the Vermonter’s worries, Gruber responds, “Was this written by my adolescent children by any chance?”

El Jefe is shocked, shocked that Gruber would say such a thing. Although he’s certainly been called worse. And I myself have occasionally wondered if El Jefe’s opinion pieces might have been written in crayon.

In this particular case, McClaughry’s thunderings were so exaggerated, so over the top, that they invited mockery. And Gruber, unwisely, took the bait.

So now the Shumlin Administration is under pressure to take their irritable, impolitic slugger out of the lineup because he acted like a jerk.

Three years ago.

If you ask me, the Republicans are desperately changing the subject. They’re running out of time to undercut health care reform on its merits, so they’re demonizing one of its leading academics.

And, if you ask me, Jonathan Gruber’s remarks have no relevance to the merits of health care reform. None at all.

 

Dan, the man whose outer shell of principle conceals a melty nougat center

My man Mark Johnson hosted Dan Feliciano, Libertarian candidate for Governor, on his eponymous radio show Monday morning. And I have to say, it was a puzzling and underwhelming performance.

Feliciano proclaims himself as the candidate of principles. Those rock-solid beliefs include pulling the plug on single-payer health care, cutting state spending, and opening the public school system to competition and choice. Feliciano articulated those points clearly.

…………. But then, when it came down to details, Dan Feliciano revealed himself to be almost as soft and squishy as Scott Milne. On issue after issue, Feliciano punted on specifics. The details would be worked out later on, or he’d have to consult with these people or those people, or a new policy would be crafted through a collaborative process. It seemed to me that Feliciano was trying to preserve ties to his Libertarian/conservative base without closing the door to any centrist or independent voters.

A prime example: His two-faced response to a listener question about marijuana legalization. Feliciano began by saying “If a bill came across my desk, I would sign it.” But then he raised public-safety questions, claiming that there was no “appropriate test” for driving under the influence of marijuana.

So, he’d acquiesce to a bill that he sees as a threat to public safety. Hmm. How principled.

The question of legalizing heroin came up. This is a Libertarian principle, decriminalizing any “victimless crime.” Feliciano dodged, lamely offering that such a bill “wouldn’t pass the Legislature” and there are many other things higher on the priority list.

I am shocked, shocked, to hear such weasel words coming from a Libertarian.

Feliciano’s approach to health care reform didn’t stand up under scrutiny either. He wants to ease state regulations to entice more insurers to enter the marketplace, with the ensuing competition working its usual magic. But he’s surprisingly vague on how he’d attack the regulatory burden. He doesn’t call for the dismantling of the Green Mountain Care Board; he just wants it to be  “more of an overseer, less of a policymaker,” and that it needs to be “more accountable to the people.”

Including, perhaps, the popular election of its members.

That goes beyond lame, all the way to harebrained.

Feliciano was boxed into a corner on what regulations to cut, because he’s already been burned by questioning the community-rating system, which bars insurers from charging inflated prices to the old, sick, and high-risk. It’s a bete noire of the far right, but it’d be political poison to call for its repeal. So instead, he offers only the vague “our regulatory environment is too restrictive” and says he will “talk to insurance companies about what makes Vermont so onerous.”

Now, that’s right out of the Scott Milne playbook.

Johnson then reminded Feliciano that community rating was the single factor in driving many insurers out of Vermont. Feliciano’s response: if Vermonters want community rating we’ll keep it, but “I think there’s still opportunity — there must be something else that drove the companies out of the state.”

Oh, Dan, Dan. I thought you were a man of principle.

Later on, when the subject of health care returned, Feliciano tossed out a weak appeal to price advertising for medical services. He actually mentioned laser eye surgery as an example.

Do I have to enumerate the problems with that example? Perhaps I do. Well, laser eye surgery is a very specific and highly automated process. Unlike most medical procedures, your choice of practitioner doesn’t markedly change the odds of success.

When you get into the trenches of medical work, it’s not a matter of specific identifiable procedures; it’s a course of treatment, it’s an educated response to complications. It’s seeing the patient through to recovery. For many patients, it’s a multidisciplinary effort to combat a variety of different conditions in a single body. You can’t post that stuff on a billboard.

And Feliciano ought to know this. He’s got a special-needs daughter, and during the interview he talked about his family’s struggles to get her the best possible treatment. He praised his high-quality insurance coverage that allowed, among other things, a course of care at Johns Hopkins.

But when it comes to health care reform, he wants up-front pricing. And if you don’t want to settle for the cheapest provider, then he says, “If you want to pay a little more, you’ll have to pay something.” If I interpret that correctly, he means “you’ll pay for everything extra.”

Which doesn’t fit my definition of universal coverage, but I guess I’m just an old radical progressive softy. And to ask a hard-hearted question, if Feliciano had been seeking specialized care for his daughter under a Dan Feliciano health care system, would he have been willing to pay the extra freight? Including her treatment, fully covered by his insurance, at Johns Hopkins? That’d cost him a pretty penny under FelicianoCare.

There was also a dismal exchange on cutting the state budget. Johnson asked Feliciano for two or three examples of specific cuts.

Feliciano didn’t come up with any. He began by noting that the lion’s share of general fund spending is on Human Services and Education,  so that’s where he’d look for the biggest savings. But no specifics; just a call for a refocusing on “our core services.” As opposed to the Truffles ‘N Premium Cable Package we currently offer our welfare recipients.

And then he fell back on a truism from his days as a business turnaround specialist: “In my experience, in the private and public sectors, we can cut five to ten percent easily.”

Oh, really? He can’t offer a single line item, but it’d be easy to cut ten percent. Wow.

Things also got weird on school reform. Feliciano trotted out the school choice/voucher idea, in which “class sizes will get larger and outcomes will get bigger.” I think he meant “better,” but… how do larger class sizes, by themselves, lead to better outcomes?

But the real topper was when he said he’d “get everybody together to design a system, and if it didn’t work, we’d need an exit strategy.”

“If it didn’t work”?? You’re going to upend the entire public education system and you don’t know if it’s going to work? Good God.

In his closing response, Feliciano made a belated return to Libertarian dogma. Johnson asked him why the Democrats are so dominant in Vermont. After an unsettling series of nervous chuckles, he credited the Dems for “framing issues in terms of social problems, not individual responsibility,” and relying on “scare tactics” to induce a sense of “learned helplessness” in the hearts of We, The Sheeple.

Well, I, for one, am insulted. Am I a liberal because I’ve been brainwashed by the Democrats?  Have I abdicated my personal responsibility for some false promise of social equality?

Sorry, but no way, Jose. I am a liberal because I see the inequities and shortcomings of the free market system. And I see in government, as imperfect as it is, the only real counterweight to the raw power of capitalism. I don’t want to end capitalism, I just want to rein in its excesses. And there are lots of those.

So no, Dan, I am not a sheep. I am a person who, out of my own experience and knowledge, has freely chosen to believe in a robust role for government in our society. I’ll thank you to stop insulting me and all the other Vermonters who share my beliefs.

But I digress. Let’s just say that Dan Feliciano does best in small doses. When he has to talk at greater length, the many holes in his game become obvious. And the biggest one of all is that, when push comes to shove, he’s got the same basic ideas as Scott Milne: Elect me, and we’ll figure out the policies later.