Tag Archives: Lawrence Miller

Lie down with dogs, get up with fleas — UPDATED with more fleas

Hey, you know about the Mylan controversy? Yeah, the company that bought the rights to the EpiPen and then jacked up the price by several gazillion percent? It now charges nearly $500 for a gizmo that probably cost them about three bucks to make.

Well, I’d managed to forget, or suppress, its Vermont connection until I was reminded by recent accounts in VTDigger and the Burlington Free Press. To wit, the Shumlin administration arranged a peculiar land swap in St. Albans to facilitate an expansion of Mylan’s operations here.

A land swap that costs the General Fund about a half million dollars a year.

(That’s about the price tag we “couldn’t afford” to spend on an Ethics Commission. Just sayin’.)

UPDATE: As Auditor Doug Hoffer points out, Mylan is also a beneficiary of the Vermont Employment Growth Initiative (VEGI) program to the tune of $5.7 million. More on this below.

I won’t rehash all the details here; you can check out VTDigger’s 2013 story, which lays it all out in excruciating detail.  I will note one thing before moving on: this turd blossom featured the guy I’m beginning to think of as the Joe Btfsplk of the Shumlin administration.

The idea… was largely the brainchild of Lawrence Miller, the Commerce Secretary.

Mmmyeah, EB-5, the endless Vermont Health Connect reboot, and now Mylan. Quite the resume you’re building, Mr. Miller.

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Shoot the Messenger

As its final months drag onward, the Shumlin administration is remaining true to one of its core principles: Shoot the messenger. We have two prime examples of this time-tested strategery today: a top state official slams a respected media outlet, a move that has backfired big-time in the past; and the administration puts a big fat price tag on transparency.

First, Lawrence Miller, Vermont Health Connect czar, has beef with VTDigger.

[Miller] testified Wednesday in the House and challenged the veracity of a VTDigger story that said the state has been unhappy with its current Vermont Health Connect contractor and is negotiating with another company.

… [Miller said] that any frustration he expressed in emails was a normal part of negotiations.

Digger’s earlier story had quoted emails from a state official expressing dissatisfaction with VHC contractor Optum. Which would be noteworthy, since Optum was supposedly the savior of Vermont Health Connect. Miller pooh-poohed the story’s assertion, saying that a certain amount of “friction” is a normal part of the process.

Maybe that’s true, but here’s the problem. This is the same “Lawrence Miller” who was in charge of the Agency for Commerce and Community Development when it was happily attempting to both promote and regulate the ill-fated EB-5 program. He headed ACCD from 2011 to 2014, when he was tasked with cleaning up the Vermont Health Connect mess.

In other words, Miller has been hip-deep in two of the Shumlin administration’s signature disasters. Is it possible he negotiated Shumlin’s original land deal with jerry Dodge?

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Another nail in Vermont Health Connect’s coffin

The vultures are circling. The wolves are howling. The diminished corpus of Vermont Health Connect is crawling across a pitiless landscape; every time an oasis appears, it turns out to be a mirage.

Things aren’t lookin’ good.

I’ve been a strong supporter of Governor Shumlin’s health care reform plan — hopefully as a first step toward single payer, or at least universal coverage of some kind. I have bought and consumed every confident reassurance ever issued by the Governor and his minions. I have, unfairly in retrospect, mocked his critics as mindless partisans. I have allowed my hope to be renewed by fresh reassurances, most recently last fall, when the administration announced that VHC had met its performance benchmarks.

Today, not so much. Today I’ve turned a corner. I remain hopeful, but the confidence is gone.

The last straw was yesterday’s article by VTDigger’s Erin Mansfield, which began like this:

An independent expert on health care strategy advised the state to spend as little money as possible on Vermont Health Connect technology in the immediate future and instead use resources to evaluate alternatives to the exchange.

Frank Petrus, a senior managing partner at Connecticut-based Gartner Inc., told lawmakers the state should stop spending money to build new Vermont Health Connect technology, try to leverage investments it has already made, and commission a study that would take three to four months.

Basically, he wants to put VHC into hospice care. Stop trying to fix it, just help it “limp along a little while longer.”

Ugh. Yeesh. Aaaaaarrrrrgh.

This isn’t coming from a free-market ideologue, but a guy with unimpeachable bona fides:

Gartner has consulted for several state health exchanges, including Vermont Health Connect, and has a great deal of experience in public sector human services.

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Mr. Miller has a hissy fit

Here’s a new one in Vermont governance: a top state official refusing to “work with” a reporter who covers his beat. Strange but true. And he put it in writing!

Dramatis personae: Lawrence Miller, chief of health care reform; and Erin Mansfield, health care reporter for VTDigger. Miller wrote a hot blast of an opinion piece in response to Mansfield’s recent article about the latest wave of problems with Vermont Health Connect, and here’s the opening paragraph:

The most recent exchange story is an extremely slanted piece of journalism. It does not tell the whole story of Vermont Health Connect, accuses me of lying, and creates an inaccurate perception. This particular column follows repeated factual inaccuracies by VTDigger’s health reporter, adding the new feature of character assassination. I give up. I will not work with her anymore.

Digger, for its part, “stands behind the accuracy” of Mansfield’s story.

I don’t know who’s right and wrong here. Maybe she overemphasized the negative, which is often the case in journalism. Non-news is, by its nature, not news. When something works, we don’t write a screaming headline about it.

But Miller’s version doesn’t pass the smell test.

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Vermont Health Connect: a very conditional victory

So the Governor and a full brace of minions came out Monday morning to announce that Vermont Health Connect had met the first of his two deadlines, or milestones, or benchmarks: the implementation of a change of circumstance feature.

This, after VHC was taken offline for the weekend to install upgrades, a move that prompted premature glee among reform opponents like State Rep. Heidi Scheuermann.

Yeah, not so much.

But the declaration of victory, though sounded loud and clear, came with a handful of asterisks. The Vermont Press Bureau’s Neal Goswami:

The upgrade, which is still being phased in by the administration, will allow customer service representatives to make changes to consumers’ accounts in an automated way.

“Still being phased in.” Got it. And…

“It means that we now have the capability, the tool, to be able to change your circumstance when things change for your insurance. And the outcome of that, as we get it up and running, will be a much smoother system that has been evading us since we launched,” Shumlin said.

“… as we get it up and running…” Hmm.

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Is this the end of Rico?

Well, if this isn’t the mother of all Friday newsdumps.

After 18 months of headaches caused by Vermont Health Connect, Gov. Peter Shumlin announced Friday that he’s prepared to replace the online health insurance marketplace if it fails to meet two new deadlines.

(Note: According to VTDigger, Shumlin first made his announcement on WDEV’s Mark Johnson Show. Credit where it’s due.)

Yeezus. I make a little day trip to New Hampshire, and this is what happens? I may never leave Vermont again.

“This is not an attractive option,” Shumlin’s chief of health care reform, Lawrence Miller, said at the press conference.

Miller added that “bubonic plague can ruin your day, and zombies are bad news.”

In the past I have occasionally been guilty of hyperbole, so it’s understandable if you take this with a grain of salt, but…

This doesn't end well.

This doesn’t end well.

If Vermont Health Connect fails, it is the end of Peter Shumlin’s political career.

It wouldn’t be the last act; he’d still remain governor for another year and a half. But the abandonment of VHC would be a death blow to whatever’s left of his reputation for managerial competence. And trustworthiness. He will have a simple, stark choice: Serve out his term as best he can, step aside with grace and dignity (and hopefully a big show of unity with a consensus candidate for the Democratic nomination)… or go down in a metaphorical burst of tommygun fire.

Mind, all this is contingent on the failure of VHC, which is far from a sure thing. But given its track record (and the Governor’s), today’s announcement has to send shivers down the spines of everyone who’s invested political capital in the Shumlin Growth Fund.

The song goes like this: assurances of success; bumps in the road; conditional assurances of success; postponements; failures; promises to learn lessons and do better; new plans with later deadlines; fresh assurances; lather, rinse, repeat.

We have just gone from “assurances of success” to “conditional assurances.”

The fallback plan, should VHC again fail to meet functionality targets, is a hybrid marketplace: federally supported but state-regulated. It’s not a terrible Plan B, but it would put the lie to every assurance Governor Shumlin has made about Vermont Health Connect since its launch. It would hand the Republicans a huge quantity of ammunition, and it would permanently sink Shumlin’s managerial reputation.

The Governor’s new timeline:

Shumlin said he would only deploy the contingency plan if Vermont Health Connect is unable to automatically process changes in account information by May or if it’s unable to smoothly reenroll users by October. Even then, the state would not adopt the new system until October 2016, in time for the 2017 open-enrollment period.

Oh great. So if VHC isn’t working by October, then we’ll be activating Plan B right in the middle of the next gubernatorial campaign.

And what if anything — at all — goes wrong? It drags on until after the election. If that happens, it may not matter who the Democrats nominate.

If all that happens, Peter Shumlin will not only go down in history as a failure. He’ll also be the guy who squandered a king’s ransom in political capital for his Democratic Party.

Gruber contract officially downsized

One argument the Republicans have made in their desperate effort to fan the flickering flames of Grubermania is that, although Gov. Shumlin cut off Jonathan Gruber’s pay, his contract remained intact and would require a formal rewrite.

Well, mission accomplished, per the Mitchell Family Organ:

State officials released an amended contract with MIT economist Jonathan Gruber Tuesday evening, lowering the maximum amount payable to $280,000.

… Some Republicans had maintained that the original contract required official changes, and said Gruber’s “handshake agreement” with Lawrence Miller, Shumlin’s chief of health care reform, was not sufficient.

The amended contract reflects the change in pay for Gruber.

The full contract can be viewed at the link above.

I’m sure the Republicans will come up with fresh rationales for their obsession. But the contract can no longer be cited as an issue. And if they possess a shred of intellectual honesty, they’ll stop referring to the Gruber contract as a $450,000 deal and adopt the true figure, $280,000.

Ball’s in your court, guys.

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.

 

Dear Shumlin Administration: Please heed the words of Uncle Barack

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.

VHC and the NFL

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.