(GMD has a policy of front paging all diaries from people currently running for statewide office in Vermont. – promoted by JulieWaters)

“Challenges for Change” is a good idea gone bad. The bait and switch is now evident.  It was advertised as a way for state government to achieve better outcomes with less money, but the reality is proving much different from the spin. The result of many of the proposed changes will be cost-shifting to local communities, less enforcement of laws that protect our quality of life, and less access to services our families need. In other words, worse, rather than better, outcomes.

Releasing non-violent offenders is a good goal that will save state money, but we must think through the consequences and understand that our local communities will face higher costs to support these folks as they come back into the community. We cannot just release them and count that as a savings.

It’s possible that we could be more efficient in our economic development strategies, but simply eliminating regional development corporations and regional planning commissions to consolidate them into state-sponsored agencies takes focus away from our local communities, where economic development needs to happen. It also takes away local control.

Certainly, the permit process could be more streamlined; however, shifting the responsibility for permit review to private business and reducing enforcement efforts is not the answer. The proposals in “Challenges” may actually result in a slower permit process and more pollution, just as the water quality of Lake Champlain is getting worse.

In addition, “Challenges” does not even achieve the targeted savings. Even if all of the proposed changes were acceptable, we would not achieve the $38 million in savings that we need.  

Despite this shortfall and despite the consequences of the changes, “Challenges” is being pushed through the legislative process at breakneck speed. I reject this crisis mentality. We have other options. We should use those options and make a thorough examination of the proposals before us in “Challenges.”

The architects of “Challenges for Change” have created an apparent emergency to rush the proposals through, claiming that the only other choice is severe cuts to essential services. We have money paid by taxpayers sitting in the state’s piggy bank – the rainy day fund – that could be used for some of the budget gap that is to be filled with “Challenges” changes. We are also expecting to receive more federal Medicaid money that can be used to fill other holes in the budget.

As a committee chair, my responsibility is to thoroughly consider any proposals put before me through the committee process. Many of my colleagues in both the House and Senate share my concerns and are beginning to ask serious questions about the reasons for and the consequences of these proposals. Any wholesale changes to our service delivery system must be examined carefully – both to determine whether savings will actually be achieved and also to ensure that Vermonters retain access to services they need.

I will not allow these changes to be made unless the process is thorough, transparent, and truthful. Some of the ideas in “Challenges for Change” are good ones, and they must be examined, considered thoughtfully, and implemented. However, we must not make these changes in haste and without deliberation, despite the challenge. Vermonters deserve better from us.

-Doug Racine

http://dougracine.com/

(Continuing site policy of promoting diaries from officeholders and candidates – promoted by GMD)

On Thursday the House and Senate health care committees heard from Dr. William Hsiao, an international expert on health care system design. I found Dr. Hsiao’s testimony both interesting and encouraging, and he made it clear that we need to take the essential next step of designing a health care system. Dr. Hsiao praised Vermont’s efforts to date (Catamount, Health Information Technology, the Blueprint for Health), saying that we are the vanguard of health care reform here in Vermont.

At the same time, he pointed out that all of our efforts have been piecemeal, and what we need is a health care system to tie all the pieces together. He listed several problems Vermont is facing, including:

+despite valiant efforts, 7 1/2% remain uninsured, and 15% of insured are under-insured.

+costs are escalating and creating fiscal pressure for the programs we have

+we have a fragmented health care delivery system

Dr. Hsiao talked about how our efforts to date haven’t gotten us to the fundamental issues because we have not taken the essential step of designing the whole system.  

He talked about what a single payer system is, and how Taiwan has used this model. He described four major features of Single Payer:

1) a single insurance fund – I was interested to learn that there might be multiple ways of collecting the financing for this fund (for example, Taiwan uses employee and employer payroll taxes, as well as insurance premiums), but there is only one payer to pay the providers.

2) a centralized information system – because you have a single payer, all records (provider and patient) are available through that one payer’s database

3) a prospective global budget for the upcoming year – Dr. Hsiao explained that this forces discipline in the allocation of funds and forces providers to live within the budget. In Taiwan, the providers are still paid through a fee-for-service system, but if they go over budget in one quarter of the year, in the next quarter, the fees they are paid are reduced accordingly.

4) a standard payment rate for providers – this eliminates competition on price, and encourages competition for quality because there can be incentives or bonuses for good health outcomes

Dr. Hsiao noted that when Taiwan was designing their system, they looked at several options and then chose the one that worked best for their situation and goals. He said it is important to look at options so that you can see the costs and benefits of the choices that you are making.

For instance, he noted that Taiwan chose to have a co-payment for office visits and hospitalization because the Taiwanese tend to go the doctor for minor issues, and they wanted to discourage abuse of the system. They do cap the amount that anyone has to pay for copayments at 10% of the average income in the region – he said Vermont’s cap under this system would be about $5000. Low income people and children are exempt from co-pays in Taiwan. He also noted that many studies show that if people don’t have to pay for medicine, they don’t take it, so Taiwan chose to make people pay in part for their drugs.

When I asked Dr. Hsiao if designing a few different systems is a good idea for Vermont so we can look at our choices, he replied that any good technical consultant would give us even more than three options, so that we can see all of the ways we can choose to achieve our goals and what each choice would cost. He said that we can all usually agree on the vision, but compromises often happen when the costs are known. He said the Senate Health and Welfare committee members are realists because we need to see which options are more feasible before we can begin implementing a new system.

Overall, I was encouraged that we are on the right track in Vermont with S.88 – the Healthy Vermont bill. This bill passed out of my committee last week with a unanimous, non-partisan vote. My committee members worked hard on this bill, both in and out of committee, to reach consensus. We all listened to many advocates, citizens, and groups, and tried to incorporate the feedback and address the concerns that were raised. Senators Flanagan (Chittenden), Kittell (Franklin), Lyons (Chittenden), Mullin (Rutland) and Choate (Caledonia) all worked together with me to find a meaningful way to move forward, and I appreciate their work and dedication.

The bill creates a board to oversee one or more experts like Dr. Hsiao to design three options for the legislature (and governor) to look at in January. One of these options must be a “single payer” system. All three of the options must meet criteria outlined in the bill. I believe this is the essential next step in health care reform in Vermont – system design for fundamental change. If you agree, please sign on to the bill as a “Citizen Cosponsor” to help keep the bill moving forward.

http://dougracine.com/about/po…

I think we should invest in our future and commit the needed funds to achieve fundamental reform. Please sign on as a Citizen Cosponsor today, and if you already have, please ask your friends to sign on.

Thanks for your activism – without you, we would not have come this far.

Sincerely,

Doug Racine

(Doug Racine posted this and, as part of GMD’s policy of placing candidate posts on the front page, here is the latest from Doug Racine.   – promoted by Caoimhin Laochdha)

Just sent out this press release – Doug Racine

MONTPELIER, VT — The Senate Health and Welfare Committee today unanimously passed S.88, which calls for a complete overhaul of Vermont’s health care system. The bill creates an oversight panel to hire expert advisors who will design an implementation plan for health care reform. The stated purpose of the redesign is “to ensure that individual programs and initiatives can be placed into a larger, more rational design for access to, the delivery of, and the financing of health care in Vermont.”  

“This bill lays out principles and goals which will ensure that our new health care system will guarantee all Vermonters quality, affordable health care every day of their lives,” committee chairman Doug Racine noted. “We’ve made a lot of progress by tweaking our current system and picking the low hanging fruit, but now we need systemic changes to make real progress.”

Under the proposal, the new health care system will be in place by July 1, 2012. The bill calls for three complete system designs – one of which must be a government-financed, single payer system – to come back to the governor and the legislature by January 1, 2011. The legislature will then choose one of the designs and begin the implementation phase. The designs called for in the bill must be complete packages, ready for execution as soon as the preferred option is chosen.

“This is the essential next step in health care reform that will lead to universal access to affordable health care for all Vermonters,” Racine explained. “What is needed is true systemic reform, and we cannot have real reform without a real plan to create a whole new system-and this bill creates that new system.”

The bill will now move to the Appropriations committee and then to the full senate. “I am optimistic that we can get this bill through the senate quickly,” Racine commented. “By listening to the various stakeholders and including many different interests in the discussion, we have crafted a bill that achieves systemic reform and addresses the concerns that have been raised.”

Racine, a candidate for governor, has made health care reform one of the priorities of his campaign. More information can be found at his website: www.dougracine.com.  

(Continuing the policy of promoting diaries from officeholders and officeseekers – promoted by odum)

I am excited to tell you about something I’ve been working on for several weeks. All of us candidates have been saying how essential it is to achieve universal access to affordable health care — and I’ve been figuring out how to actually make that happen.

The escalating cost of our current system is crippling our state, our families and our businesses. Health care in Vermont will cost $1 billion more in 2012 than it does today if current trends continue — this is a crisis, and we cannot let it continue.

That is why today, I introduced a revised version of S.88 — so that we can design the system that will deliver health care to Vermonters, and answer all of the questions that need to be answered to implement this new system. My bill calls for the state to hire independent advisors, who will be overseen by a panel of Vermonters, to provide the state with a “menu of options.” These advisors will design three different health care systems — fully design them, not just study them — and deliver back to the legislature a full implementation plan for each of the three possible systems.

This will not be easy. Change comes with uncertainty and risks. But the option of doing nothing is simply not acceptable. We are now paying the price of a broken system, and that price will only go up. The time to move forward is now. Please join me and help me to build the system we need.

There is more information on my website, and when you visit you can sign on as a “citizen co-sponsor” of the bill. I’ll also be posting a copy of the bill as introduced on the site very soon. It will change as it moves through the process – probably several times – but I am committed to the goal of access to affordable, quality health care for every Vermonter.

I hope you will read the bill, sign on, and work with me to create the new system that will lead the way to true reform.

http://dougracine.com/about/po…

Doug Racine

Just a quick update to let you know that Tom Kavet will be talking with the Senate Health and Welfare Committee this afternoon at 1:30 pm about the economic impact of the proposed Agency of Human Services budget cuts.

-Doug Racine

(Continuing the policy of promoting diaries from officeholders and officeseekers – promoted by odum)

On Friday, the Senate Finance Committee will be voting out a bill about Vermont Yankee’s future. This bill will come to the Senate Floor on Wednesday. The bill asks whether the Public Service Board can grant a Certificate of Public Good to Entergy to continue the operation of Vermont Yankee past its original license, which ends in March 2012.

I will be voting “No” when this bill comes to the floor. I am opposed to the continued operation of Vermont Yankee after the license expires.

Many have tried to reduce this question to a political argument. They say we need cheap power and Vermont Yankee provides jobs that we can’t afford to lose.

The “cheap power” has not been cheap, though — it has come at a great cost, in the form of tons of high-level radioactive nuclear waste stored on the banks of the Connecticut River. This waste will likely be Vermonters’ responsibility for decades to come. The recent tritium leaks have shown us that problems can occur — and tritium is a relatively minor problem compared with the issues that would be associated with spent fuel. Entergy has proven again and again that its profits come first and Vermonters come last.

In terms of the jobs, we must work to ensure a just transition for the workers at the plant. We should include the workers at Vermont Yankee in the discussions about how we transition to a clean energy future, and we should ensure that Vermont is working together with labor to provide retraining and new job opportunities for these workers. They are the front line at the plant with regard to our safety, and they deserve our best efforts to make sure they are not left behind when the plant shuts down.

That’s why my economic development platform includes focusing on Vermont’s strengths, including clean energy jobs, high-tech, and value-added agriculture processing.

Vermont needs a governor who will stand up for Vermonters and not for out-of-state corporate profits. I will be that governor. Vermont must have a clean energy future, and we must have good jobs for our people. This is not an either-or issue. We can have both.

I hope you will join me to move Vermont forward toward a brighter future for all of us.

We’ll need to work together to build a brighter future.

http://dougracine.com/

(Continuing the policy of promoting diaries from officeholders and officeseekers – promoted by odum)

Thanks to those of you who attended my Campaign Kickoff Party. Over 250 people at 10 different locations across the state joined me as I shared my vision to restore hope and opportunity to all Vermonters. I was in Winooski, and we were able to live-stream my kickoff speech to the other nine locations, so that everyone around the state had a chance to listen. I am committed to a real Vermont grassroots campaign, and this party was just the first step in what will be an effective field operation.

It’s really exciting for me to see this kind of interest and enthusiasm this early in the campaign. You can watch the video of my speech and see some photos from the various parties at my website: http://dougracine.com/

I’m in this race for you – for all of you – because I believe we have to stand together and make sure that each of us has health care, and each of us has a chance to get a good education, and all of our children have a chance to do better than we did. I am convinced that we can work across party lines with Progressives, Independents – and even Republicans – to find common ground and move Vermont forward.

I hope you’ll check out my website – I’ve been adding to it, including a position piece on ATVs (per your request) here: http://dougracine.com/news/dou…

You might also want to check out the “On the Road” section in the “Newsroom.” This section allows you to see what I’m up to on the campaign trail. You can also get involved in the campaign through the website – by signing up for email alerts or to volunteer. The Newsroom also has links to recent articles and some videos of recent events.

(Continuing the policy of promoting diaries from officeholders and officeseekers. Some text moved subfolda to conserve real estate on the FP. – promoted by GMD)

Thanks for the comments on my last post. I hope you will all join me at my Campaign Kickoff Party on Saturday, January 23rd from 3 to 5 pm.

We have added a few new locations since last week, so please check out the website and find a party close to you! Remember that if you RSVP through my website, you will be able to submit a question for me to answer at the party. All the details are at: http://dougracine.com/.

We’ve also added some video clips to the site – they are in the issues sections. Check them out and let me know what you think.

We spent the last week focused on the health care bills, and we are really starting to dig down deep into the questions that we must answer to apply for the waivers we will need to guarantee universal, affordable access to quality health care in Vermont.  

This week, Dr. Deb Richter and Con Hogan will present on the global budget issues. I truly believe we can make significant progress on this issue this year. Health care for all will be a priority when I am the governor, but I do not want to wait another year to begin the process of making it happen.

I also wanted to respond to the question about touch screen voting machines. Touch screen machines make me very nervous. I do not see a need or a reason to have these machines in Vermont. I believe that we should vote with paper ballots – we should make our mark on paper and that paper ballot should be the paper trail. I believe that touch screens leave too much opportunity for meddling with our votes and also that they may actually dissuade some voters who are not comfortable with computers from voting.

Of course, I need to mention Vermont Yankee as well. I have been firm in my commitment to shut down Vermont Yankee when its license expires in 2012, and the past week’s news has only confirmed what I already believed – we cannot keep this plant open past 2012. We cannot make this situation any worse than it already is. If we can’t even trust the company to tell the truth on the record, then we certainly can’t put our trust in an LLC that is a spinoff – we must ensure that we will be able to decommission the plant without pushing those costs onto future generations, and we must stop producing high level nuclear waste as soon as possible.

Thanks again for your comments and questions. Please keep in touch with me and get involved with my campaign if you can. I am committed to a grassroots campaign, and there are plenty of opportunities to get involved, offer me feedback, and help get the word out that we must do better for all Vermonters.  

(Continuing the policy of promoting diaries from officeholders and officeseekers. – promoted by odum)

First, I’d like to thank everyone who came to the public hearing on health care last night. The House Chamber was packed full, and the testimony was compelling. Now, we must do the work of figuring out how to get universal, affordable, quality health care in Vermont.

But the real reason I’m writing today is to invite all of you to my Campaign Kickoff Party. Although I announced that I am running for governor a year ago, I haven’t yet had an official kickoff for my campaign, and I think it’s time to do that.

The party is on Saturday, January 23rd, from 3 to 5 pm, and there are locations all across the state. You can find all the details on my website: http://dougracine.com/kickoff

When you RSVP for the party, you can send me a question, and I will answer a question from each location during the party – there will be a live video stream at each party location. I hope you will join me on the 23rd, and I look forward to working with you to build a brighter future for all Vermonters.

(Promoting, with a reminder to candidates that GMD will front page messages such as this to the community. – promoted by odum)

Thank you to those who responded to my post about health care. Your comments are consistent with what I’m hearing around the state. I think we all share the same goal of health care for all.

I would like to have as many people as possible participate in the process moving forward. It is a great suggestion to take the hearings on the road, and I might try to do that, but there is strong pressure to limit the legislative session length because of budget issues. I will find ways to offer people opportunities to give their input as we move forward.

With regard to the question about how I will respond to a challenge that I am using my position for electioneering, I will say that I have a position of leadership in the legislature, and I want to show Vermonters that from my position of leadership I can get things accomplished. As governor, I will do the same.

Please keep in touch with me. You can visit my website at www.dougracine.com to get the latest information about my campaign.

-Doug Racine