(Nicely expressed. – promoted by JulieWaters)

Peter Shumlin heads to the Vermont Governor’s office with some striking parallels to President Obama and his election two years ago. Both are riding a wave of partisan relief to be regaining their respective executive offices. Both candidates had health care reform as central planks in their platforms, and take office with high expectations of delivering on that promise despite severe economic challenges. The Vermont Legislature, like Congress just two years ago, has a decisive Democratic majority to support Shumlin’s efforts. Questions abound about a more sustainable energy policy, potential economic impacts of change, and the alarming environmental fallout of the status quo, just as they did nationally in 2008. Overshadowing and integral to all these issues is concern about the fundamental economic strength of our financial and jobs markets.

Vermont managed to avoid most of the conservative/Tea Party tidal wave that swept large swaths of the country this election, but if Governor Shumlin follows the same path as President Obama, that storm surge will come pounding on our ballot boxes in 2012 just as it did in the Lower 49 last week.

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But enough about the similarities, how can Shumlin learn from Obama’s difficulties and find a better way?

There is already one glaring and encouraging sign of difference between the two men; Shumlin hired Howard Dean.

Howard Dean, along with the rest of the impressively experienced transition team, signals above all to Vermont that Shumlin is serious about good government.

This group will be nothing if not competent. Throw in Shumlin’s references to the tax study commission looking for ways for Vermont’s tax code to provide “sustainability, appropriateness, and equity” and there is hope that we will see effective governance emerge from this administration. It’s my strong belief that competence is the best political strategy in these uncertain times.

Competence, or the perception of competence, will also make or break any health care reform efforts undertaken by the Governor-Elect. More than any other issue, health care reform will only be accepted if it makes good sense to the average voter. The good news is that there is a huge tract of space available within which to make significant, progressive and sensible improvements in the system. The flip side is that there are many ways of bungling this issue. Over-reaching, over-complicating, or the kind of politicized special interest accommodations that Obama made would each have likely-fatal impacts on the 2012 Shumlin re-election campaign in this environment.

I’m hoping to see a strong progressive agenda put forth from our new governor, it will be just as important for the long-term health of Shumlin, Democrats and our state that this administration really have its act together in a way that restores some faith in government in these reactionary times, and shows that people are being put first.

We’ve just seen what can happen otherwise.

I’ve found it difficult to chose between the great candidates running for governor, especially three that I think are excellent choices. I started out in Racine’s camp, even attended a supporters gathering. But as this campaign went on, I heard Dunne and Racine talking in terms of how they would navigate the waters, Shumlin sounds more like he will carve his own canal. Not the best analogy but that’s the sense I got.

With the political environment today being what it is, promoting things like internet for all, transparency, efficient government, etc is not going to cut it. We need someone to run on firm positions and win, then it will be possible to bring about the level of change we need.

In the VPR debate, I heard the other candidates take prudent, reasonable positions on what they would do as governor. Then Shumlin came in a laid out a vision:

Reduce the number of non-violent offenders in jail, redirect the money to early education, pass single payer health care, and relieve business of the burden of that cost and make VT a business mecca.

Boom.

Education, not incarceration. Shift money from the corporate interests of corrections and insurance companies, and reinvest it in getting our kids a solid educational foundation, universal health coverage, and a better job market. These have the possibility of making a real difference.

Using the rainy day fund, broadband for all, jump starts, etc… they are not enough at this point. Whatever is being proposed now, in the heady days of the democratic primary, this is the high water mark. Candidates who are running an essentially defensive position or a effective government approach have no vision to stand on going forward. Whatever hints we hear now will get’s diluted in the general election, unless there is a clear vision thrown down.

When you listen to the candidates, ask your self what exactly they are committing to, not what you are reading into the rhetoric.

As always in this primary, I have probably exaggerated the differences and some points to draw some distinctions. I think all 3 of these democrats would be great nominees.

I’ve appreciated the constructive exchanges in recent weeks. How refreshing to be choosing between a number of quality candidates, and doing so civilly? (Could we just get rid of the Republican party?)

That said, I’m really looking forward to Wednesday when we all get back on the same team.  

Deb Markowitz recently unveiled a plan for health care reform that leads with a proposal that raised serious concerns to me.

I will launch a pilot program statewide with the largest hospitals and doctors groups to implement standardized billing procedures that will reduce overhead in health care, cost consumers less and eliminate headaches for  medical professionals.

I’d like to make clear that I would support Deb if she wins the primary and think she would be huge improvement over the Douglas/Dubie approach. However, as an expert on this issue in my non-blogging life (I’ve been asked to testify to state legislators on this subject), I feel compelled to raise the issue while we are trying to chose the best democratic candidate in our primary election. The proposal brings into question the depth of knowledge of this critically important state issue.

The problem with this proposal is that there is already a national billing standard, and creating another “standard” would either be unenforceable, or worse, would actually add to the administrative burden if enforced.

I’ll try to outline the details of this issue below the fold without getting too wonky on technical billing issues…

On the campaign webpage, and just now as I am typing this in the VPR debate, Deb Markowitz is touting her plan to reform health care with a central goal of creating standardized billing procedures.

This proposal seems to be ignorant of the fact that there are already “standardized billing procedures” outlined in the Administrative Simplification sections of the 1996 HIPAA legislation. In fact, the current environment is much better than it was in 1996 when insurance companies could each dictate their own standards. Now we have a significant level of standardization across all payers, although ironically state medicaid systems like Vermont’s tend to be the least compliant among payers.

As I said, there are two damaging outcomes that could result from the Markowitz proposal.

First, if VT enacted its own “standards”, they would be in conflict with the national standards, and most insurers who do business in Vermont would simply not accept them and point to the national requirements as a defense. I don’t understand how anyone would make this proposal seriously and expect it to be carried out, if they understood the health care environment.

Without question, even if this was enforced on some payers, Medicare would continue to follow the existing federal standards that they are so integrally involved with. So the other possibility is that somehow VT obtains a waiver in our lifetime to create another “standard” and there is effective enforcement to force all participants other than Medicare to comply. All Vermont providers (and others doing some business in VT) would have to then create and support a parallel programming track to meet these specs when claims go to payers that follow the VT “standard”.

So rather than save money, the best this proposal could hope for would be to be ignored, otherwise it would actually ADD to the already mind-numbingly wasteful health care bureaucracy overhead.

This may seem a bit too technical to get all lathered up about, but it comes down to this – a candidate running for governor (and certainly a governor) needs to know the technical details of a vital issue like health care before they propose something that could be ineffective or counter-productive. I’ve shared this concern with the candidate and the concerns were not recognized, indeed this plan was mentioned again tonight. I hope that Deb will consider these concerns anew and engage in a discussion or explain her rationale further here on GMD.

We need a nominee who has the depth of understanding of vital issues to stand up to Brian Dubie and present a vision of competence and leadership for the general election, and to governing effectively after victory. I’m hoping that raising these concerns here will help us towards an end result of a nominee that possesses those qualities.

Ezra Klein is banging out a great series of article about the new health care bill and how it works. One of them, about insurance exchanges, talks about a piece that will be available to be crafted by states as they see fit. He sees it as the most important feature of the bill.

http://voices.washingtonpost.c…

The bill gives states the option of setting up an exchange for individuals or small business, and allows partnering with other states. In 2017, states can decide to open the exchanges to larger employers.

The exchanges provide a market for competition to take place, and where regulation can be applied. Quality ratings and enrollee satisfaction will be available on each plan for comparison. Klein says, “A state with an ambitious exchange administrator could really do a lot with this provision.”

There are also concerns outlined about the successful implementation of the exchanges. In fact, Klein feels this is a crucial point in this process, going as far as saying that, “success of the exchanges is the difference between health-care expansion and health-care reform”

So now that this is on its way to an Obama signing ceremony, I wonder how our candidates for governor plan to move forward with this component of health care reform?

On the Windsor County Listserve, we were recently discussing whether any candidates were talking openly about single payer.

It was noted that Peter Shumlin was on a panel June 9 in Middlebury and spoke eloquently about single payer. He is a sponsor of S.88:

This bill proposes to establish the goal of universal access to essential health care services in Vermont through a publicly financed, integrated, regional health care delivery system; provide mechanisms for cost containment in the system; and provide a framework, schedule, and process to achieve that goal.

This morning, Amy Shollenberger from the Racine campaign posted this update about Doug’s commitment yesterday to take up S.88 in the committee he chairs:

Doug Racine, along with several others, spoke at the Vermont Labor Council Convention yesterday. Here is an excerpt from his speech:

“I’ve been working on healthcare. I’ve been working to reduce the cost of healthcare and find ways to extend healthcare to all Vermonters. I think it’s time we recognize, as many of you do – I was talking to Ben and others the other day – in a country as wealthy as we are, I think we should be recognizing healthcare as a basic human right. We can afford to do this. It’s really a question of priorities, and it’s not happening in Washington right now for a lot of reasons, but it can happen here in Vermont. I heard you talking a few minutes ago – Marvin and others – about S.88.

I made a commitment the other day with Ben and the folks I was talking with. I chair the Health and Welfare Committee. We’re going to take that up. It’s going to be our starting point, to say how can we do this? How can we work with the federal government to make universal access, single-payer, a reality in the state of Vermont?

I’m going to tell you, it’s not going to be easy. There are a lot of tough questions to be answered. There are a lot of tough issues to work out, but we aren’t going to work it out if we don’t start, and we’re going to be starting on this in January.”

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On the national front, reports from Congressman Peter Welch’s recent Health Care Forum were also positive. According to single payer advocates in attendance, Peter “came out for Single Payer”, “made it quite clear… that the Health Insurance Companies ARE the problem” and constantly defended having a Public Option in the federal bill.

Those Single Payer advocates have been busy building support, and have a public forum coming up soon:

Single Payer Health Care 4 Vermont: How do we get there from here?

 Tuesday Nov. 10, 7 pm Hotel Coolidge – Downtown White River Jct.

    State Senator Dick McCormack

    Phil Fiermonte, Sen. Sanders staff

    Dr. Deb. Richter, VT4 Single Payer

    Attorney Marjorie Power

    Dr. Paul Manganiello, Good Neigh.Health Ctr.                  

 Sponsored by Windsor./Orange Single Payer Health Care 4 VT

On the other end of the “progress” spectrum, the current legislative proceedings on reform do not seem to be very significant. At a recent forum I attended in my professional role, a speaker involved in the legislative work on “health care reform” talked about some administrative tweaks that are under discussion in various panels and committees. Frankly they seemed from my vantage point to not recognize the scope of the mess that our system really is, and basically admitted as such. I did hear that it was expected that the statewide budget was expected to start playing a stronger role in the state government’s efforts to control costs.

S.88 would definately shake things up if passed. That process starts here with how the primary positions of the various candidates get established and set in stone for the campaign.

Do you like Bill Moyers? He is not happy with the Democratic Party. He lays out the problem very, very clearly in this video:

In it he says that the problem is the Democratic Party, that we have two corporate parties, the Republicans and the Democrats. If we don’t pass meaningful health care reform, don’t put Ted Kennedy’s name on it. If what we get because of the influence of heavy money in our party a very watered down bill, that is not health care reform. Money, money, money.

Watch it, especially if you’re not outraged yet. Then decide what you’re going to do about it.

Bill Maher Interviews Bill Moyers  

Yesterday I drove my oldest child to college, and this morning I helped her move into her dorm. A momentous and poignant moment in her life, and in mine. At our hotel last night, we happened to watch a documentary on Ted Kennedy.  Amidst the emotions of the moment, the references to lessons the Kennedy’s had learned from their parents, Joe and Rose, struck me with particular impact. Ted Kennedy grew up being taught that his life would be measured by the contributions he made to society. He was taught that public service is an honorable and patriotic pursuit, to be held in esteem and respected. He was taught that it mattered, and that it was worth the effort. In an interview with Barbara Walters soon after his second brother had been assassinated, she reflected on the Kennedy commitment to life public service, then turned and asked him if it was worth it given the high price it had exacted? Ted was almost visibly taken aback, and you could see a rare glimpse of the pain still fresh in him. He paused, and then softly but decidedly responded, “Yes, yes I believe it is.”

The passing of Ted Kennedy is a bigger national event than I had thought. It’s bigger and has more of an impact on me than I expected or realized. In the solitude of my drive back from my daughter’s new college home, I listened and was moved by the eulogies given by his two sons. The funeral rites are being shown live as I write this on cable stations across the dial. The reexamination of Kennedy’s life upon his death has brought to light for me not just the depth of importance this man had to our nation, but the significance of his passing. A radio commentator compared it to the end of the Fellowship of the Ring, as the last of the ringbearers passed into the west. A little corny it seemed, but like the mythic images of Camelot, based on some sense of inspiration lost.

There have been all too few moments of national inspiration, or even of partisan inspiration if you must qualify it, in my lifetime. Kennedys eulogizing their fallen brothers and speaking of their dreams. Martin Luther King. Obama’s nomination speech.

But even Barack Obama seemed small on this day.

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Ted Kennedy was a politician, but he was driven to do good by guiding principles that were fundamental to his philosophy, his politics, and his faith. At his graveside, a letter was read from Kennedy to the Pope; a last petition on his own behalf, admitting his shortcomings and requesting blessing from the leader of Kennedy’s church. In this letter he includes his life’s work to achieve universal health care for all Americans as part of his petition, evidence of his devotion to the catholic principles of helping those less fortunate. A young Kennedy maybe 12 years old led the intercessions in the mass, including praying that what his grandpa called “the  cause of his life” on healthcare reform be granted, lord hear his prayer. Can you imagine any other politician today including such a petition or appeal for an issue? A posthumous appeal for the employee free choice act? For privatizing social security? A cap on carbon emissions? It’s not only the issues that fall short, it’s the lack of passion and commitment to issues so fundamental and unalienable that it transcends poll-driven position statements.

Kennedy had that inherent passion and commitment, to work to help those less fortunate in a variety of ways that presented themselves. From civil rights to minimum wages, to education to health care, Ted never needed to run a poll to guide his positions, nor did he need a wordsmith to dull the edges of rhetoric to avoid offending segments of the voting public. He simply steered by his principles, and followed his heart.

These qualities are missing in our public sector today. While Ted was eulogized as a person in a deeply emotional and moving way by his sons today, there was no younger brother, or any other standard-bearer to give a eulogy that “kept the dream alive”.

I was born at a hospital in Hyannis within walking distance of the Kennedy compound, just days after JFK’s election as president. For my entire life, I have always carried a deep respect for public service that was grounded in the principles inspired by the Kennedys and the vision that they so eloquently communicated in word, and in more importantly, portrayed in action.

He once famously said, “For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.”

For all those whose cares have been Sen. Kennedy’s concern, the work does indeed remain. Let us hope it goes on. In a cruel irony, these are critical days for health care, and seem to be pivotal times for our nation as our party and President Obama’s principles and commitments come into question.

He rephrased his earlier words when endorsing Obama at the convention last summer, saying, “The work begins anew. The hope rises again. And the dream lives on.”

Who will inspire us to that calling now that the lion rests?

The Markowitz campaign sent out a fundraising email this week that focused on her announcement of support for the “public option” under consideration in the national health care reform debate, and contrasting that with Jim Douglas’s opposition.

I agree with Governor Dean when he said the only way we can really reform the health system, increase access and bring down costs is to give Americans a choice between a public and private system.  

But Jim Douglas disagrees – he’s putting politics ahead of our priorities.

Politically, this may be a good fundraising technique, if many VT voters share her favorable view of the public option then highlighting the difference between her position and the Governor’s makes sense, and mentioning Dean will probably help too. It’s also sticking with the high road in terms of campaigning against Douglas rather than against other Dems. Might help to activate the base and bring in some cash, so I’ll give it a passing grade for short-term political effectiveness.

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But for the long-term, I’m not crazy about this move. Coming out strongly in favor of an issue that has only national application and has no real relevance to the governor’s office does nothing to build a mandate. If we have learned anything in the past few months, it is that any meaningful progressive legislation is only possible by stating clear, basic principles, not by wishy-washy, please-everybody rhetoric.

Markowitz has still not made enough clear statements of principle in my opinion, to make up for her lack of voting record on issues of substance. I hope she will still take the opportunity to do that in the campaign, but this was not an example of visionary leadership.

My hope is that a healthy Democratic primary will produce a general election candidate who has made a strong case for progressive positions, and can carry that message and momentum to victory and can legislate from that platform.

A candidate who runs a safe campaign designed mainly to appeal to moderates may possibly get elected, but he or she cannot turn around after the election and legislate progressively, despite their true intentions, real or imagined, without having created that mandate in the election. Taking a moderate approach to win the election means that we get a moderate mandate.

This primary is a rare chance to do better than that in Vermont, and I hope we will take advantage of the moment.

It may be early in the race, but there is some important action taking place in the 2010 Democratic Gubernatorial campaign. Senator Doug Racine has announced a follow up to the Phil Hoff endorsement with this announcement:

Please join us at a reception for State Senator and Gubernatorial candidate Doug Racine. Featuring special Guest Kathleen Kennedy Townsend former Lt. Governor of Maryland, Author and eldest child of Robert Kennedy.  The reception will be held Saturday June 20th, 2009 at the home of Rep. Joan Lenes. Please see the attached invitation for more information.  

Joining Former Governor Hoff and his wife Joan in sponsoring the event were Rep. Joan Lenes, Rep. Kate & Marshall Webb, John Hasen, Jerry O’Neil, George Burrill, John & Jane Ewing, Lola Van Wagenen

Townsend is the former Lt. Gov of Maryland and previously worked in the Clinton Justice Department.

Townsend and her siblings Robert and Kerry were in the less publicized Kennedy camp who endorsed Hillary Clinton in the presidential primary. In an editorial, they wrote:

By now you may have read or heard that our cousin, Caroline Kennedy, and our uncle, Sen. Edward M. Kennedy, have come out in favor of Sen. Barack Obama. We, however, are supporting Sen. Hillary Rodham Clinton because we believe that she is the strongest candidate for our party and our country.

The wording suggest that the Racine campaign is touting its experience and electability. It will be interesting to see if this endorsement defines the Racine/Markowitz dynamic in any way relative to the Obama/Clinton pattern, as Markowitz seems to be building a strong contribution base according to early rumors, against the “established” candidate in Doug Racine. Event sponsors appear to have been strong Obama contributors according to campaign finance records though. Yet to be established is which candidate will take the more progressive tack in the race, with Racine seen as leaning towards that more than Markowitz, but without much of a track record to judge the Secretary of State on yet.

Another interesting twist in how the endorsement family tree is evolving is Hoff’s endorsement of Progressive Anthony Pollina in the last race.

Rep’s Lenes and Webb are second and first term legislators from Shelburne, respectively. Other sponsors range from strong party contributors to solid Dem “good guys” if you want to play the judge-the-candidate-by-the-supporters game. A solid team to build the foundations of a campaign on in the early going, but only Hoff so far appears to be the kind of endorsement that would sway public opinion.

I just received an email from Deb Markowitz announcing her support for marriage equity. I’m not decided as a primary supporter yet, but want to share this because I think it’s commendable for two reasons; for making a clear statement of her position as part of the primary process, and of course, for the position she took!

The other oft-mentioned prospective candidates, Bartlett, Racine and Shumlin, have all also indicated their support by voting in favor of this issue.

From her email:

I’m reaching out to you now to share a recent opinion piece I wrote on marriage equality. Given today’s vote, I thought it was important to share my position – please feel free to forward it to anyone else who might be interested.

I was surprised and disappointed to see that Governor Jim Douglas has stated that he will veto the marriage equality bill that is now moving through the legislature. Vermont was a national leader when we adopted the civil union law in 2000. Since that time we learned that civil unions are not good enough.  

(full text below)

Thank you for joining the hundreds of Vermonters who have signed up to stay in touch with my campaign efforts. As we move forward, I hope you and I can continue a meaningful exchange of ideas through my website and through email.

I’m reaching out to you now to share a recent opinion piece I wrote on marriage equality. Given today’s vote, I thought it was important to share my position – please feel free to forward it to anyone else who might be interested.

OPINION EDITORIAL

March 27, 2009

The Time for Marriage Equality is Now

By Deb Markowitz

I was surprised and disappointed to see that Governor Jim Douglas has stated that he will veto the marriage equality bill that is now moving through the legislature. Vermont was a national leader when we adopted the civil union law in 2000. Since that time we learned that civil unions are not good enough.  

My office was charged with assisting in the implementation of the civil union law.  It was our job to train the clerks and justices of the peace and explain the law to the public.  I was also asked to report back to the legislature on the success of its implementation.  As I reported to the commission appointed to study marriage equality, unlike a person who has been married in Vermont, a person who has obtained a civil union here leaves the state, and enters into a legal limbo that has meaningful consequences for the individuals and their families.

For many families this is a very personal issue. In my family both my sister and my stepsister are in long term lesbian relationships. My sister and her partner have been together for 21 years. My stepsister and her partner have a beautiful daughter together. It is hard to explain to my children why Laura and Rachele do not have the same right to marry that Paul and I have. I love my sisters and want them to have every possible benefit in life including the right to marry the people they love.  

There is no question that these are difficult times for many Vermonters and that the legislature must, and will focus on getting Vermonters back to work and helping our struggling businesses. There is no question that the legislature must and will pass a tough and balanced budget and they will decide how best to use the federal stimulus money to create new jobs, to make our roads and bridges safer, to bring fast internet connections to our rural communities, and to help more Vermonters tighten up their home to save on energy costs.  

By threatening to veto the pending legislation the governor has taken a step to further divide the state rather than using his unique position as governor to bring us together in recognition of our common interest to have stable loving families. It is divisive and will create a greater distraction.

I know firsthand that separate is not equal when it comes to this important civil right.  The legislature is capable of addressing multiple issues, so the argument that there are more compelling problems facing the state is no excuse.   Standing up for the rights of all Vermonters to join in marriage is the right thing to do.  

Best,

Deb

www.debforvermont.com