Tag Archives: VTDigger

Vermont’s new mental health system will have more inpatient beds than the old one

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I wouldn’t blame Jay Batra if he felt personally vindicated today. Maybe even a little bit smug. VTDigger’s Morgan True: 

The state wants to replace a temporary psychiatric facility in Middlesex with a permanent structure twice the size, officials told lawmakers last week.

… Last June Vermont opened the doors of the Vermont Psychiatric Care Hospital in Berlin, but the system still lacks the capacity to keep people with acute psychiatric needs out of emergency departments.

How about that. “…the system still lacks the capacity…”

Vermont’s new, decentralized, community-oriented system currently has 45 beds: 25 at VPCH, 14 at the struggling Brattleboro Retreat, and six at Rutland Regional Medical Center. If/when the Middlesex facility is built, the system will have 59 beds.

Before Tropical Storm Irene, the Vermont State Hospital had 54 beds. After Irene, the Shumlin administration insisted, repeatedly, that if we had a more robust community-based system, we wouldn’t need that many inpatient beds. In the process, it ignored the counsel of psychiatric professionals, who said that 50 was the bare minimum.

What’s happened since then? The administration has slowly, quietly, built the system back up. And it has found that, yes indeed, those professionals knew what they were talking about.

Let’s take a trip in the Wayback Machine to Tuesday, December 13, 2011…

Gov. Peter Shumlin announced on Tuesday that his administration plans to replace the Vermont State Hospital in Waterbury with a decentralized, “community-based” plan with 40 inpatient beds in four locations around the state. …

The unveiling of Shumlin’s proposal came on the same day a top mental health psychiatrist called for almost the exact opposite of what the governor proposed. Dr. Jay Batra, medical director of the state hospital since 2009 and a professor at UVM, told lawmakers at a hearing on Tuesday that the state should have one central mental health facility serving 48 to 50 patients in order to provide the best clinical treatment and best staffing model.

That, from a lengthy VTDigger account of Shumlin’s announcement, which was made in the conspicuous absence of Dr. Batra. At the time, Shumlin was planning on a central hospital with as few as 16 beds. It was a well-intentioned effort to avoid the serious problems that had plagued VSH in the past. But it was a misdirected effort, pursued against the advice of those actually in the field.

At the time, I wrote some highly critical stuff about the administration’s plan, and I got some active pushback from administration officials who basically accused the psychiatric community of professional puffery — overstating the need for their own expertise.

Now, it’s safe to say that the administration was wrong.

Assuming the Legislature approves the $11.4 million Middlesex facility, the mental health system will have more beds than before Irene, and those beds will cost more than a similar number at a single, central State Hospital. How much more, I don’t know. But the system has had persistent problems hiring and maintaining the staff it needs for the specialized care its patients require. Those problems are exacerbated when the beds are spread among four separate facilities.

Also unknown is how much money was [mis]spent on the long and winding road to get exactly where the experts thought we should go in the first place. Plus, we are left with a system that’s almost certainly more expensive to operate and harder to administer because of its geographic spread.

One of Governor Shumlin’s great strengths is his decisiveness. He can assess a situation quickly, make a decision, and carry it through. Well, it’s a strength when he’s right. When he’s wrong, and he stubbornly insists on staying the course, that same decisiveness is one of his great weaknesses.

A little shameless, and ironic, self-promotion by the Freeploid

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Okay, so the Washington Post’s Chris Cillizza puts out a list of the best political reporters in each of the 50 states. He describes the list as a combination of reader recommendations and his own knowledge. It’s fair to assume that the farther away he gets from Washington, the more dependent he is on his readers.

Take Vermont, for instance. Cillizza’s list was sadly incomplete and, in two instances, ironically off-target.

He names four reporters. Paul Heintz of Seven Days; no problem there. Kyle Midura of WCAX; he does a fine job by TV standards.

The other two: Mike Donoghue and April Burbank of the Burlington Free Press.

Hahahahaha.

Nothing against either of them; they’re perfectly cromulent reporters. However…

— Neither is primarily a political reporter. Both are on the Freeploid’s vaguely-named Accountability Team. The Free Press draws heavily on the Associated Press for its political coverage.

— It was only a couple months ago that the Free Press jettisoned its political reporters, Terri Hallenbeck and Nancy Remsen. Both would be better choices for Cillizza’s list than Donoghue and Burbank.

The thickly-laden irony isn’t stopping the Free Press from celebrating its dubious honor. Three Freeploid functionaries have Tweeted the big news; here’s one of them.

Nice, Aki. I’m sure your former colleagues are sharing a bitter laugh.

As for Cillizza, he clearly doesn’t know much about Vermont media. He completely ignores VTDigger and VPR, two of the three best outlets for state political news. The Digger diss isn’t surprising, since he named it the Best Political Blog in Vermont two years ago. Small problem there: VTDigger isn’t a blog. It’s a professionally staffed news operation.

Cillizza does acknowledge the possible incompleteness of his list, and he has added people to it since he first posted it. I’ve sent him an email with my suggestions, and perhaps he’ll include them.

My top three noms: Anne Galloway of VTDigger, Peter Hirschfeld of VPR, and Neal Goswami of the Vermont Press Bureau. If I expanded things a bit, I’d include Dave Gram of the AP, Stuart Ledbetter of WPTZ, Bob Kinzel of VPR, and Mark Johnson of WDEV. Mark doesn’t report as such, but his daily radio show is the best single platform for discussion of state politcs and policy.

On the subject of Vermont’s true Best Political Blog, modesty forbids me.

The microfruits of capitalism

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The decrying of “burdensome regulation” is often heard in our land. It discourages entrepreneurship; it’s leaving us behind in the global economy; it raises prices on everything we buy.

All true, to some extent.

But regulations don’t just happen. They are responses to excesses in the marketplace. They are necessarily imperfect responses; bureaucracy is not a precision instrument. Dodd-Frank, whatever its flaws, would not exist if the Wizards of Wall Street had a smidgen of foresight or conscience, if they’d been able to resist the temptation to make a quick billion off toxic derivatives and Collateralized Debt Obligations.

And now we have a new exhibit in our Gallery of Free Market Excess. It’s completely unnecessary, it’s hazardous to the environment, and even industry leaders acknowledge they don’t need it.

Mmmm, fish food!

Mmmm, fish food!

I’m talking about nonbiodegradable microbeads, “barely visible plastic scrubbing grains used in personal care products.” There’s a bill before the state legislature to outlaw them. John Herrick at VTDigger:

Environmentalists and water quality advocates want them outlawed because the non-biodegradable plastic waste is washed down the drain and slips through nearly all of the state’s wastewater treatment plants.

… No studies measure quantities of microbeads in Vermont’s waterways. But scientists who study Lake Champlain say the beads can be spotted along the shores.

Marine animals consume the microbeads, which can cause internal blockages. Scientists also say that toxic pollutants “attach themselves to the plastic beads like a sticker,” and then head up the food chain.

Who the hell thought it was a good idea to put teeny-tiny nonbiodegradable plastic bits into consumer products? Why do Vermont lawmakers have to spend their time debating a bill to ban them?

Well, now you know where regulations come from.

What’s worse, the microbeads are completely superfluous, according to Martin Wolf of Seventh Generation, a Vermont company that uses natural alternatives.

“Microbeads are nonessential. Substances exist that are mineral or biodegradable, perform the same function, and have no meaningful impact on the economics of the products in which they are used,” he told the Fish and Wildlife Committee.

Mike Thompson, who put his soul in escrow to take a job representing the Personal Care Products Council, says “the industry is committed to phasing out microbeads on a timely basis.”

Of course, his definition of “timely basis” may not be yours. The Vermont bill would ban microbeads on January 1, 2017. That’s too fast for Thompson; he wants December 31, 2017, to match a law already on the books in Illinois. And Jim Harrison, the ever-vigilant head of the Vermont Retail and Grocers Association, “prefers a bill that gives retailers time to sell existing inventories.” What, two years isn’t enough?

How many bazillions of microbeads would be flushed into our rivers and lakes during the year 2017? Can’t the industry manage to make the change in two years, instead of three?

Government regulation is, at times, wasteful, inefficient, and counterproductive. The only thing worse than regulation, thanks to the madly-spinning engines of commerce, is no regulation.

Inmates aren’t people; they’re fungible assets

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For those who believe that shipping prison inmates to distant for-profit prisons is immoral (human rights), unconstitutional (judge’s decision, uncontested), or simply counterproductive (isolation may lead to recidivism), this week brought just a little bit of good news courtesy of the soon-to-depart Laura Krantz at VTDigger.

After bringing home a few dozen inmates this week, Vermont has roughly 360 inmates in a Kentucky prison and another 40 in Arizona — the lowest number in a decade.

With the good news came some bad: a provision in Vermont’s contract with the Corrections Corporation of America imposes penalties if the inmate population falls below 380. We are now very close to that figure.

Corrections Commissioner Andy Pallito admits that the provision creates a disincentive for Vermont to bring more prisoners home, even if there’s space in state prisons.

Then came the Governor’s budget address on Thursday. One of the revenue upgrades is $1.7 million from the lease of 60 inmate beds to the U.S. Marshals.

Hmmm. A lower inmate population could trigger higher payments to CCA… but now we’re leasing five dozen beds, putting the squeeze on in-state prison space… Hey presto: Synergy! We save money on CCA and we make money from the U.S. Marshals.

Fiscally, it’s a win-win.

If you don’t mind treating your inmates like commodities instead of human beings.

Don’t expect the Vermont Workers’ Center to go away anytime soon

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Those dirty hippies who made Joe Benning walk the gauntlet on Inauguration Day are most likely in this for the long haul. I say this because the Vermont Workers’ Center is a rapidly-growing organization with surprising financial muscle.

According to the nonprofit’s most recent IRS filing, VWC had revenue of nearly $680,000 in the year 2013. VWC head James Haslam told VTDigger’s Morgan True that this year, the figure will be around $800,000. As recently as 2009, its intake was less than $200,000; you do the math.

That’s pocket change in Koch World, but in Vermont it makes VWC a power to be reckoned with, beyond its ability to draw a crowd to the Statehouse.

Aside from money, it’s also tapped into a deep vein of dissatisfaction with/alienation from politics as usual. Its members are committed enough to turn out large numbers for a demonstration or flood the Statehouse hallways when needed. They are also willing to financially commit: VWC charges membership dues, and pulls in about 30% of its budget from members without much apparent effort.

My big question, when I saw VWC revenues in the high six figures, was: where is it all coming from?  Haslam:

That work is supported by a combination of foundations which, typically, is about half of our support or maybe a little bit more. The other half is from our base, which is individuals and trade unions. I think it’s something like 20% unions, 30% individuals. It fluctuates year to year, but that’s about right.

I didn’t ask him for a list of foundations; as a nonprofit, VWC is not obligated to release donor information. VTDigger’s Morgan True reports that the Ben & Jerry’s Foundation is its largest nonprofit donor, having given $50,000 this year and a total of $160,000 since 2010. True also reports that VWC has strong ties to a national network of progressive organizations; “We’re part of a broader people’s movement to turn things around for working people,” Haslam told him. Well, if its largest foundation gift was 50K and they’re pulling in 400K from foundations, then they’re drawing from a large donor pool.

One other note from Thursday’s protest. It’s been reported that five of the 29 people arrested that day were paid by VWC, which has raised some hackles. Haslam says the five are members of VWC’s ten-person staff. He says they did not receive any remuneration beyond their regular pay for taking part in the protest or for being arrested.

At a planning meeting before the protest, Haslam told me, people were asked whether they would be willing to be arrested if necessary. “We were hoping that nobody would be arrested,” he said, “but our members felt that it was important for us to take a bold stand.”

Those who volunteered for arrest, he said, “were all people who had had first-hand experience with the health care crisis.” Five of them happened to be VWC staff. “That was a voluntary act for sure,” he says. “We have a number of staff people who didn’t do it.” Including, as it happens, Haslam himself.

With a committed membership and a growing financial base, VWC shows no signs of being a flash in the pan, or some sort of Occupy movement that will burn brightly for a brief time and then flame out. They look to be in this for the long haul, on a broad variety of issues. Whether or not they continue to declare themselves at big political events, they’ll be around, promoting their causes and making it harder to ignore their issues.

A passel o’ peevishness on Inauguration Day (Part Two)

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In Part One, I mused about the overreactions and hurt fee-fees on both sides of yesterday’s Inaugural protest. Now, let’s turn our attention to the Republican reaction to Gov. Shumlin’s inaugural address.

Their main point, according to VTDigger’s Laura Krantz?

Gov. Peter Shumlin ignored the most pressing issues facing Vermont in the first speech of his third term, Republican leaders said Thursday in response to the inaugural address.

… Republicans, gathered in the Senate cloakroom, said they were disappointed Shumlin ignored property taxes and health care — two issues that topped voter concerns during the elections last fall.

The speech focused on energy and the environment, so the complaint is technically accurate. But it deliberately ignores the fact that Shumlin billed this speech as Part One of a two-part 2015 agenda. And the governor specifically said he will address the “missing” issues in next week’s budget address.

“Just because the governor has acknowledged that his plan is a failure doesn’t mean he can ignore health care. We still need to address it,” said Rep. Patti Komline, R-Dorset.

Well, he didn’t “ignore” health care. He said he’d address it next week.

Sen. Joe Benning, R-Lyndonville, said the speech focused not on saving money but on spending more.

Again, the budget address hasn’t happened yet. That’s when Shumlin promises a plan to balance the budget. And, for the fiscal conservatives among us, Shumlin’s energy/environment speech contained very little in the way of new spending. The energy part was mainly about new regulation of renewables, which doesn’t involve any state spending. The Governor did propose two fees to help fund Lake Champlain cleanup, but both are narrowly targeted on sectors that contribute heavily to Champlain’s problems — agriculture and commercial/industrial development.

Republicans said they are open to his ideas about cleaning up Lake Champlain and other waterways but those are not the big problems.

Well, actually it IS a big and urgent problem because, as they well know, the EPA is holding Vermont’s feet to the fire. If we don’t come up with a solid plan, including new funding, then the feds will come down on us hard. That makes Champlain a top priority.

Speaking of new urgency, here’s another Republican missing the point.

“It needs doing but where was he four years ago on this?” said Rep. Brian Savage, R-Swanton.

Well, he was doing the same thing Jim Douglas did before him: postponing the Day of Reckoning as long as possible. As Rep. Savage well knows, the EPA has run out of patience, so Shumlin can’t possibly put it off any longer.

Argument is an intellectual process. Contradiction is just the automatic gainsaying of anything the other person says.

“Argument is an intellectual process. Contradiction is just the automatic gainsaying of anything the other person says.”

House Minority Leader Don Turner was his usual obstructive self, strongly opposing any new taxes or fees, and even blasting Shumlin’s proposal to use the current use law as an enforcement mechanism for farmers and loggers. And he did so in a stunningly inarticulate fashion:

“I think that we know that current use is a very popular program, and it is a very expensive program. But if we want open land in Vermont its been one of those tools that has worked really well,” he said.

So wait. Current use is “very expensive,” and, in fact, Republicans have called for new limits on the program, but it’s “worked really well” and we can’t possibly do without it. You’d need a couple hours of pounding ’em back at the Capitol Plaza bar before that started to make sense.

The entire Republican response consisted of the automatic gainsaying of anything Shumlin said.

With one exception. Lt. Gov. Phil Scott released a statement that began thusly:

“I was encouraged to hear the Governor talk about economic growth. It was good to hear about the Governor’s support of research and development, especially after this important incentive was reduced last year. I hope that the Governor’s mention in his speech today is a precursor to a proposal included in the budget next week.”

Admittedly Scott sort of bent Shumlin’s message in his own direction, but look at what he did:

— He identified common ground instead of just saying “No.”

— He acknowledged that the inaugural address was Part One of Shumlin’s agenda.

A hint of politics, but overall gracious and inclusive. That’s the way you do it.

Big ol’ lead airliner

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There’s an absolutely devastating piece on VTDigger this morning. If you haven’t read it, go. Now.

For those who didn’t immediately take my advice, the story outlines the role Governor Shumlin played in holding a pillow over single payer health care’s face until it stopped breathing. Or, as the headline says, “Shumlin built ‘lead airplane’ for single payer.”

If the story is true, here’s basically what happened. At some point, the governor decided that he couldn’t win on single payer. Then, rather than face the music directly, he larded his single payer proposal with assumptions that added to its cost and suppressed its revenues. As the story says, “he cast the program in the most negative light possible.”

And then he walked away.

How did he do it?

Well, first of all, he presented only one plan, when he’d promised a menu of options.

Aside from that, his plan offered top-shelf coverage, paying for 94% of clients’ health care costs — a 94 Actuarial Value. He could have gone with a lower figure; “Act 48, Vermont’s single payer law, directed the administration to shoot for a plan that covered 87 percent of costs.”

So he ignored the law. Not much new there.

The 94 AV added $300 million a year to single payer’s cost.

He also chose to add out-of-state residents who work in Vermont, which added another $200 million. And he called for the elimination of Vermont’s provider tax, which cut $160 million in revenue.

He also chose to assume the new system would yield no administrative savings — which had been one of his big selling points for single payer.

You can see where this is going. Shumlin projected a first-year cost of $2.6 billion, but he could have brought in a perfectly acceptable plan for well under $2 billion.

And he knew it. And he chose not to tell us.

The massive report released by the administration at year’s end included not one, but 15 plans. But Shumlin chose to present only one.

Among the 15 different models in the document dump is Financing Concept 12, which uses an 87 percent actuarial value and would require $1.6 billion in state revenue for the first year.

It excludes out-of-state workers and does not offer supplemental coverage to federal employees or people with employer sponsored coverage, all of which is contained in the plan Shumlin chose.

It’s hard to read that and feel anything other than betrayal.

Maybe there were perfectly sound reasons for Shumlin’s choices, but he didn’t give them and he didn’t provide any options. Instead, he “buried” them in his pre-holiday document dump.

So, Vermont misses a chance at single payer. Even worse, the entire idea of single payer has been significantly set back, perhaps by decades. Because now we have a liberal governor, a strong advocate of single payer, concluding that it’s not practical.

This hurts.

Our still-broken inpatient psychiatric system

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One of journalism’s highest purposes is to lance the boils of society — to expose unpleasant truths that everybody is doing their best to ignore.

A prime example appears on VTDigger today: a story by Morgan True about the continuing problems in the state’s psychiatric care system, and particularly the brand shiny new state hospital in Berlin.

Among the key points:

— Even after the facility’s opening, some psychiatric patients have found themselves parked in emergency rooms for days or even weeks.

— There have been 59 documented attacks by patients on hospital staff, some resulting in significant injuries.

— The hospital houses a couple dozen of the most severely ill people in Vermont. Many have been convicted of violent felonies. One doctor told True that the hospital is “one of the most dangerous workplaces in Vermont.”

— State law strictly limits the restraint or medication of patients against their will. Even the most violent.

— In part because of this dangerous work environment, the hospital has been consistently understaffed since its opening. As a result, it has yet to operate at full capacity.

Which brings us back to point one: several months after the hospital’s opening, severely mentally ill people are still being warehoused in ERs.

This is a whole lotta bad stuff. It shows a mental health care system that’s still functioning poorly even after the Shumlin Administration’s entire plan has been put in place.

The Department of Mental Health, for its part, seems to be taking a remarkably lax and unforthcoming attitude toward the situation. DMH knows the total number of attacks on staff, but it won’t release any information on staff injuries.

And according to DMH Deputy Commissioner Frank Reed, the department “has not tried to compare the number of violent incidents at VPCH to other psychiatric hospitals.”

Well, why the hell not? I’d think you’d want to know whether our problems are unique, or simply the natural consequence of caring for the most severely mentally ill.

Reed also flunks the transparency test when it comes to waiting times in hospital emergency rooms. He says average wait times have decreased, but…

Reed was unable to provide documentation of average wait times, saying those figures are still being “pulled together.” The numbers will be presented to a legislative oversight committee in January.

Perhaps Mr. True should apologize for inquiring at an inopportune time. But it shouldn’t be that hard to assemble those numbers. Indeed, I’d expect a Department that’s doing its job to compile those figures on an ongoing basis.

In fact, I’d be very surprised if DMH doesn’t have the numbers already. It’s Management 101, isn’t it? Keep track of your most important statistical markers?

True’s report raises all kinds of questions about state law, the Shumlin Administration’s concept of a mental health care system, and how many resources were spent trying to develop a system that was undersized from the start. DMH officials are talking about supplementing the system with a new 14-bed secure residential facility, but acknowledge that it’ll be a tough sell when lawmakers are under the gun to cut the budget. DMH may have already squandered its best opportunity to create a good system.

And please don’t insult me with the “No one could have foreseen” excuse. The people responsible for inpatient care were all saying the same thing after Irene: the Shumlin Administration’s plan was so bare-bones that it was almost doomed to fail. While their advice was ignored, how many millions did the Administration spend on inadequate plans, patchwork facilities, and extra costs? (One example: according to True, the state has paid more than $1 million since 2012 for sheriff’s deputies to monitor psychiatric patients in hospital ERs.)

And it turns out, to the surprise of no one who works in the field, that a 24-bed hospital costs nearly as much to run as the old 50-bed facility, and costs more on a per-bed basis because the foundational staffing needs are so high.

And, given that the new hospital has some of the same kinds of problems as the old one, I have to ask if our laws are out of whack. I mean, look: We’re talking about the two dozen  sickest people in Vermont, many of them violently, dangerously sick. The restrictions on restraint or medication without patient approval may be the best thing for the vast majority of patients; I believe different standards should apply to the very sickest. They are the ones least capable of exercising sound judgment, and most capable of inflicting harm on staff or fellow patients.

One commonality between the old hospital and the new is our strongly patient-centric laws. It seems clear to me that those laws are on point for the vast majority of patients, but that there should be a different standard for patients in the state hospital.

Phil Scott unsubtly launches Campaign 2016

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So, whatcha gonna do to celebrate The New Biennium on January 7?

Well, if you’re Lt. Gov. Phil Scott, you’re going to do what no Lite-Guv has ever done and what he specifically has never come close to doing: you’re promoting your own policy agenda.

On the legislature’s Opening Day, when all eyes are on Montpelier, Scott is hosting a pitch session for, in the words of VTDigger’s Anne Galloway,

…business people of all stripes to pitch ideas about how to rejuvenate Vermont’s economy. Each person gets 5 minutes to tell lawmakers what they could do to help businesses thrive in Vermont.

The pitch session, billed as “Priority #1 on Day One,” will be from 4 p.m. to 5:30 p.m. at the Capitol Plaza Hotel in Montpelier and will be followed by a reception.

“A reception” at which, I’m sure, donations will be cheerfully accepted.

But beyond that, Scott is spotlighting his own prescription for what ails Vermont, and making an absolutely unapologetic pitch of his own — for the support of the state’s business community. He is positioning himself as the business community’s advocate in Montpelier.

Has he ever done anything like this before? Nope.

Is there any doubt that his decisive victory over Dean Corren and the scent of gubernatorial blood in the water has awakened Mr. Nice Guy’s inner predator? Nope.

And while “business people of all stripes” are invited (bring your checkbooks!), look at the list of business groups already lined up for five-minute pitches:

Vermont Chamber of Commerce

Lake Champlain Regional Chamber of Commerce

Vermont Technology Alliance

Vermont Retail and Grocers’ Association

Vermont Businesses for Social Responsibility

Associated Industries of Vermont

Vermont Association of Chamber of Commerce Executives

FreshTracks Capital

Vermont Sustainable Jobs Fund

Associated General Contractors

Vermont Ski Areas Association

Vermont Association of Realtors

That list includes a few good guys — VBSR, Sustainable Jobs Fund, Fresh Tracks — plus all the usual business-community power brokers. Gee, I wonder what they’ll say.

Also, there are strong signs that the “centrist” forces for growth and affordability are aligning themselves. First, although Phil Scott is the headliner, the event’s sponsor is Vision to Action Vermont, the pro-business advocacy group led by outgoing Rep. Paul Ralston (D-Middlebury) and continuing Rep. Heidi Scheuermann (R-Stowe).

(Whaddya think? Scott/Scheuermann 2016, anyone?)

The latter chimes in herself in the Comments section below Galloway’s story:

This is just the beginning, we hope, of a legislative session that will have, as its primary focus, the health of our state’s economy. …Frankly, we want all to become engaged and will provide many other opportunities to do so.

Ah. A series of dog-and-pony shows designed to highlight an alternative to the Democrats’ agenda. That’s smart politics. Much better than the formulaic naysaying of past years.

Aside from V2AVT’s sponsorship, there’s also the latest manifesto from ex-Wall Street panjandrum (and co-founder of Campaign for Vermont) Bruce Lisman, echoing the affordability call from Scott and V2AVT. In Lisman’s own self-congratulatory way.

Affordability is a renewed slogan that has recently found its way into the vocabulary of Gov. Shumlin and some members of the Legislature.

Finally, the Democrats are awakening to the wisdom of Bruce Lisman!

Uncle Brucie’s version of the affordability crisis focuses almost entirely on the perceived failings of state government. There’s some truth to that, but national factors play a much bigger role. Stuff like our putrid economic recovery, decades of stagnant purchasing power among the middle and working classes, the rapid accumulation of wealth in the top one percent.

But this post isn’t about the convenient blind spots of Bruce Lisman. It’s about the fact that the forces of “centrist” Republicanism are loudly singing the same tune: Affordability, defined primarily in terms of boosting business. Not defined in terms of using government to counteract the economic forces beating down average Vermonters and help them work their way through an economy that’s rigged against them.

One other thing: all this activity is taking place without mention of, or participation by, Scott Milne. He is, after all, still running for governor, and he technically has the support of Republican lawmakers. But as usual, when it comes to planning their agenda, Milne has no seat at the VTGOP table. He is nothing more than a convenient stick to beat the Democrats with, and he will be discarded as soon as he stops being a useful tool.

Shumlin waves the white flag

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The governor’s number-one public policy goal is no more.

At a news conference today, Governor Shumlin pulled single payer health care off the table, saying the numbers simply don’t add up. Instead, he promised a continued effort to improve access to, and lower the cost of, health care in Vermont.

“This is the greatest disappointment of my political life,” he said, and that nails it. Single payer was one of the foundations of his initial run for governor in 2010. His promise to push for single payer set him apart in a crowded Democratic field and helped overcome doubts about his liberal bona fides.  That promise kept the Progressive Party on the sidelines in 2012 and 2014.

And now, it’s not gonna happen.

Oh, he promised a continued fight for a fairer and more accessible system, starting with the 2015 legislative session. But single payer is out until further notice. When asked, “If not in 2017, when?” he only answered in generalities.

As for the timing of the announcement, only six weeks after the election, Shumlin claimed that his team had just finished working the numbers last Friday and confirmed the bad news on Monday.

The numbers were unacceptably bad. Morgan True of VTDigger had reported that the financing mechanism would be based on an 8% payroll tax and a consumer premium imposed on a sliding scale. But the way the numbers shook out, the actual payroll tax would have to be more like 11.5%, and the premiums would have to be higher than expected. The result could punish the economy and leave many Vermonters with higher health care costs.

He cited several factors that moved single payer out of reach. Federal subsidies were not going to be as generous as hoped. The sluggish economic recovery meant fewer dollars coming into the treasury. That had led to state cuts in Medicaid payments that reduced federal support.

Also, the administration had decided a three-year phase-in for small businesses that don’t currently provide insurance was necessary to cushion the shock of a payroll tax. That phase-in meant substantially lower payroll tax revenue for the first three years.

Shumlin was clearly sensitive to the concerns of the business community. That, and his woodshedding in the November election. He saw single payer as a huge gamble that he was unlikely to win, and now is not the time to stick his neck out.

He also acknowledged that the troubled rollout of Vermont Health Connect cost him credibility on building a new health care system. “We must show we can deliver,” he said. “Vermonters have reason to question us, given the troubles with Vermont Health Connect.”

He emphasized all the hard work that’s been done to create Vermont Health Connect, bend down the cost curve, and lay the groundwork for a better system. And he promised a continued, all-out effort to improve the system. But single payer was his signature deal, and now he’s had to forego it.

Even if the delay is relatively brief — say, two years — single payer is almost certainly unattainable during his tenure in office.  The failure of single payer will be a big part of his legacy, and will significantly hamstring his ability to win back liberal and Progressive voters who’ve been skeptical of him.

Fair or not, today’s announcement confirms that skepticism. Let’s accept that the numbers are honest and the timing was just the way things worked out. Even so, the optics are bad.

There are many liberals who never believed Shumlin was serious about single payer. They will see their cynicism as confirmed.

This retreat will also lend great comfort to the foes of health care reform. A determined Democratic governor, with all the resources he could want, spent three years researching single payer, only to conclude that it wouldn’t work. The revised cost estimate for single payer — $2.6 billion a year — is almost exactly what Wendy Wilton, then-Republican candidate for Treasurer, estimated two years ago.

And the abandonment of single payer strips the governor of his signature issue. Aside from Tropical Storm Irene, his administration has been marked by incremental gains on a number of issues and blocking tax hikes. There haven’t been any high-profile accomplishments — which is why one of Shumlin’s re-election ads focused on GMO labeling, an issue he didn’t support until the last minute. And why a recurring theme in other ads was Irene recovery, something that happened in his first term.

Now we can now look forward to more incremental gains and belt-tightening. His downsized proposals for the 2015 legislature on health care were purely incremental in nature. None will generate headlines or fuel a grassroots movement.

The governor’s gonna have to pull a rabbit out of a hat somewhere to restart his political career. And his biggest hat is now empty.