Senate Penitent Pro Tem John Campbell’s had a fun week, trying to walk back his unfortunate remarks about the prospects for single-payer health care. Or, should I say, trying to obfuscate his remarks with a blizzard of verbiage which appears designed to include every conceivable position while providing deniability to any position that proves untenable.
For those just joining us, Campbell stepped in it when he told VPR’s Peter “Mr. Microphone” Hirschfeld that single-payer health care “may not be… politically viable in this legislative body, due to the costs involved,” and that he believes it’s time to develop an alternative. Or, as he put it, “I want to make sure that we have a place to go if this doesn’t work out, you know, the single-payer itself.”
Ruh-roh. Governor Shumlin reacted noncommittally in public, but I’ve heard he was privately peeved. And on Friday, Campbell made an appearance on WDEV’s Mark Johnson Show, (audio podcast at link) where Mark attempted to pin him down. It was like grabbing for a greased octopus; Campbell thrashed vigorously this way and that, laying down a thick inky cloud of verbiage in response to Johnson’s every sally.
It was amazing, and not in a good way. After hearing it live, I had no earthly idea what Campbell’s position actually was. And I’m sure that’s exactly what he had in mind.
So I went back and listened again, thanks to Johnson’s podcast archive, and I transcribed a big, bleeding chunk of it. I hoped to achieve some clarity on his position, and I thought it would serve as a cautionary example for future statesmen: please don’t talk like John Campbell.
As for his actual views… when I first listened to the interview, I thought Campbell was backtracking in a purposefully clumsy way: tossing verbal smoke bombs this way and that, covering his retreat. But when I listened again, carefully, I became convinced that Campbell was actually doubling down on his doubts concerning single-payer health care.
Of course, he laid down such massive clouds of rhetoric that he could probably deny or confirm that he said or didn’t say almost anything. In effect, he said it all, and he said not a damn thing. But I think — and I emphasize here, I think — he gave an extremely conditional endorsement to single-payer: he’s in favor of it, but only if it doesn’t cost a dime more than the current system. He’s willing to shift revenues around, but not to add any new ones.
And he has a very broad definition of success on the health-care reform front. He is not — at all — committed to single-payer health care. He would be happy with any system that provides universal access to health care. Which is a creditable statement in itself; it goes substantially farther than the current round of reform.
But it isn’t necessarily single-payer. And the Governor shouldn’t count on John Campbell as an ally or a Senate vote-herder.
Okay, let’s take a look at what Campbell actually said. Johnson’s first question was, more or less, “You dropped something of a bombshell this week that you want to start pursuing an alternative to the Shumlin health care plan. Why?”
And here, word for dreadful word, is Campbell’s answer. Buckle up, kids.
First of all, I guess it’s a question of how you define what my “bombshell” is. I think some people have taken it to mean what they really, what they want to hear from what I said. And basically, my, uh, my position is this, is that we are headed right now as far as the Legislature, we are going to be focusing on making sure that we have a publicly-financed, universal access to health care in this state, and that’s known as Green Mountain Care. As far as I’m concerned, I consider it Green Mountain Care, it’s a universal access program. Um, um, I charged my, in fact we spoke about it here on this program at the beginning, I think at the beginning of the session, how I had asked all of my committees with jurisdiction to start doing their due diligence under Act 48, which was the, back in 2011, which actually started Green Mountain Care or our, ah, our, ah, move to that. And so what I did was, I asked each one of the committees that would have jurisdiction, which were five of those committees, and they were to um look and see what exactly is in Act 48 and can we actually achieve what our goal is?
And if they found things that um, through their, uh, their research and through taking testimony, that could either change this into a direction and put us in a direction that we were going to uh have this Green Mountain Care would be sustainable, then I wanted to hear about it and I thought that’s really what the Senate is doing now. So uh the fact of the matter, uh, I believe there was a statement was, um, regarding the funding, and whether or not I believed that, I think I said that, uh, the $2.2 billion dollar package that’s been put on there right now, I said I do not think that that was sustainable or viable in this, uh, current legislative — uh, Legislature. And I stand by that.
And what it, what I’m talking about in that, and people always take that $2.2 billion dollar figure, and they believe that that’s all new money. And it’s not new money. What it is is partially savings that would be found, uh, by way of not having the premiums, um, by cost savings, and so I stand by the fact is that once we find out what this financing package is, which would also first identify what the product is gonna be, um, if we do not have sufficient — if that money, um, is new money, then there’s gonna be a problem. But if we show, and we’re able to demonstrate that the money in that $2.2 billion is currently already in the system, and that Vermonters are already paying, uh, and on top of that, that we find those costs for any new money that’s — cost savings for any new money that’s coming in, then we’re, we have, I think, ahh, what we envision, all of us envision, that is to make sure that every Vermonter has full access, or access to. uh, uh, to great health care here in the state.
Feeling a little dizzy? Or completely lost?
How I interpreted that: Campbell thinks single-payer is politically feasible “if we show… that the… $2.2 billion is currently already in the system.” Or if the cost turns out to be less than $2.2 billion.
Johnson’s next question reflected the natural befuddlement of someone who just tried to fight his way through Campbell’s wordcloud: “So do you want to create a contingency plan now, or not? I’m not clear.” Campbell:
I think what we’re doing is, we’re going through and looking out, at for Green Mountain Care. And we’re going to be looking at what the plan is. I, you know, I don’t care if you want to call it the contingency plan or, um, different from what the, ah, the Governor or the Administration envisioned to begin with. Um, I think it’s clear that if you look at from when we began back in 2011 till now, you already have seen some machinations, some changes in what the scope was going to be or how we were going to deal with it.
Uh, to me it’s a constant evolution. This is not a — this is not something that’s been done before, as you know. So it is new. We are reinventing the wheel, ah if you will. So, ah, it cannot, as far as I’m concerned, it has to always be flexible, it has to be, it cannot be um so stagnant that we are, um, set on one, on one, um, course. We have to, it’s fluid. And that’s the way I want to make sure that we continue to look at it.
What I take from that: Campbell isn’t committed to any single policy or program. I think I can fairly infer that he has doubts about the political viability of single-payer. He’s certainly not personally committed to it, not if it costs any more than our current system.
Back to Johnson: “Have you concluded that the way that the Governor wants to do this can’t work, politically or economically?” Campbell:
No, because the fact is that right now, um, as you know, we have, uh, right now just a, the bottom framework, and that is what, what the goal is. Uhh, the, as you know we did not, um, have not arrived at a financing plan, and that is because I don’t believe that we actually have had, um, the entire. ahh, uhh, you know, definition of what the plan will look like. And that’s really where the key is, and that’s what we’re doing in our Act 252, our, our, the Senate bill that we passed yesterday, um, 252, and that is to set the framework as to looking how we’re going to develop the, the, what the plan is gonna look like itself.
And once you have a definition of what the plan, what we really want to be able to offer to, to Vermonters, uh, taking into consideration all of the individuals that will be in the plan and then, of course, all of them that will not be in the plan, we take a look at that, and we make a determination of what that will cost. And until then, I don’t think anyone can, can sit there and say that this is a grand slam.
Well, I don’t think anyone is claiming that it’ll be a grand slam. But Johnson tries again: “Okay. But on the other hand (sigh) I’m just not really clear here, John, where you’re coming from. Are you saying that while, before you make that determination, whether that’s going to work, that you also, on a parallel period of time here want to develop a contingency plan? Another bill, another system?” Campbell:
No, ah, Mark, I, I, you know, this is the issue, is, the fact is, the Senate, or the Legislature is the one who is going to come up with the Green Mountain plan. We’re the one that’s going to pass the law to, if we’re going to enact a universal, a publicly-financed system. Um, and right now we have, the Governor has, the Administration has put forth their idea of what they feel would be in the best interests of Vermont, and that would be a single-payer health, publicly financed system. What I’m saying is, while we’re doing our homework, ’cause we’re the ones who are going to have to put it together. We’re gonna be the, the designers, we’re gonna be the mechanics, ah, we’re gonna be, those people who make sure that every screw is tightened and every bolt is riveted down tight. And so we’re the ones who are going to have to determine what that final product is going to look like.
Which would seem to be a very processy way of saying, “The Governor might not get what he wants, and we will have the final say, not him.” But I’m sure Campbell would deny that that’s what he’s saying.
I’m going to skip the next question and answer, and move on to my final excerpt.
Johnson: “So are you looking more at how — you’re not challenging the goal, but you’re looking more at how you make the money work, how you put that together?”
Exactly. Exactly. The goal, the goal has been the same. Um, now, you know some people call it single-payer, I call it Green Mountain Care. I call it universal access. Um, I think if you look at the pure term of, of single-payer, it’s, it’s something that that’s where I might have a divergence. Maybe that’s because of the fact that in my profession as an attorney I’m, you know, words mean things, um, and I want to make sure that we are, uh, when I say something, I, I’m talking about, uh, the system, what I consider to be, you know, Green Mountain Care, publicly-financed insurance, health care coverage for all.
And there you pretty much have confirmation of Campbell’s words to Hirschfeld. He is not committed to single-payer. He is committed to universal access, which is certainly creditable; he wants universal access, which is a big step beyond Obamacare. But Campbell is holding back from any endorsement of single-payer; to him, it’s whatever keeps costs down and accomplishes the goal, even if it’s some sort of tweak of Vermont Health Connect.
Finally, I’ll point out a great moment of irony: “In my profession as an attorney… words mean things.” Bwahahahahaha. Words have rarely seemed less meaningful than in this interview.