Till on Healthcare Forum Panel

Dr. George Till (D-Jericho, Underhill) will be one of six panelists at a public forum in Burlington, according to an announcement from Jake Perkinson, chair of the Chittenden County Democratic Committee.

The forum is at Burlington’s City Hall (Contois Auditorium) April 27, 6:30-8:30 p.m., and is being cosponsored by the Franklin County Democratic Committee.

The panelists include:

Anya Rader Wallack, PhD., Health Care Advisor to Governor Shumlin; Policy Director and Deputy Chief of Staff for Governor Howard Dean; ran the Vermont Program for Quality in Health Care 1995-1998. Dr. Wallack earned her PhD in social policy from Brandeis University.

Deborah Richter, MD, Co-Chair of Vermont Health Care for All, a doctor with Family Practice Associates in Montpelier, former president of Physicians for a National Health Program, years of experience caring for the uninsured, and extensive knowledge of the Canadian health care system. Dr. Richter attended SUNY at Buffalo School of Medicine & Biomedical Sciences and trained at Highland Hospital.

Representative Mark Larson, (D-Chittenden 3-2) Chair, House Committee on Health Care, has served in the Vermont House since 2000 and on the Vermont Health Care Reform and Vermont Health Care Access Commissions.  He was instrumental in achieving passage of H.202 in the House.

Representative George Till, (D-Chittenden-8), Member, House Committee on Health Care,  Assoc. Prof. of Ob/Gyn at UVM and a hospitalist at FAHC; received his MD from the University of Pennsylvania in 1981. He is serving his second term in the Vermont House.

Senator Sally Fox, (D-Chittenden), Member, Senate Committees on Health and Welfare and Finance, has been Director of Family Court Operations, Policy Director for VBSR, and involved in the Burlington Community Justice Center, VT State Colleges, and a member of the Vermont Children’s Hospital advisory board. She also served 7 terms in the Vermont House.

Senator Hinda Miller (D-Chittenden), Member, Senate Committees on Health and Welfare and Appropriations. Sen. Miller is serving her 5th term in office. She was recognized as Legislator of the Year (2010) by Vermont Businesses for Social Responsibility. Prior to politics, she was a successful entrepreneur. She received a BFA from Parson’s School of Design & MFA from New York University.

I’m not at all sure that 2 hours will be enough. I am sure that it’s going to take a stern moderator’s hand to cut off self-serving, political blather and allow questions from actual healthcare consumers.

Margolis

I enjoy Jon Margolis’s work a lot, but he does suffer chronically from that journalistic beyond-left-and-right-itis. What I mean is, he rarely misses an opportunity to assert that “the left is saying ‘x'” while “the right is saying ‘y’,” and that he – as an objective journalist – can see that neither are correct, and reality is in the middle. On some particularly egregious cases where a Republican has done something untoward, his obligatory Dems-do-it-too counterpoints have at times been rather strained.

In the case of his commentary on the Till survey, where we at GMD are once again IDed as the fringe lefties, he doesn’t offer a strained counterpoint per se, but to strike his middleman ground, he is forced to ignore a key documented fact.

Here’s Margolis from vtdigger:

On the other side of the political spectrum, the liberal Democratic web site Green Mountain Daily accused Till of “trying to derail” the bill.

This seems unlikely. Dr. Till voted for the bill, though he has been critical of some aspects of it.

It seems unlikely only if you choose to ignore the email from Till that was forwarded to GMD. Again, that was an email clearly sent by Till to his fellow ideological opponents of the heart of the proposal: the modified Hsiao single-payer model. A reminder; in it, Till said:

Thanks to all who have answered my survey.  Anyone who has not yet completed it please do so.  If you need the link please email me directly.

[…] I want to make it clear that the single payer religion is very strong in Montpelier as is the magical thinking that it will cure all problems with our health care system.

I want to make you all aware that next Thursday, April 7 at the State House there will be a public hearing for providers.  I’m pretty sure the single payer crowd plans to pack the room and witness list.  The more of you that can come to Montpelier and testify the better.

Best wishes,

george till

So Till set up an open-ended, unscientific, unverifiable “poll.” Then he sent a rallying email to those of a certain ideological bent to be sure and take advantage of that “poll” in order to muster a rhetorical defeat of those he identified as the opposition. Frankly, it is unreasonable not to assume that the poll’s very intent was to scuttle the fundamental mechanisms of the bill. Certainly that’s what supporters of the legislation – both inside and outside the legislature – concluded. 1+1=2. No “liberal” math needed, just math.

I suppose the argument could be made that “fundamentally changing its very essence” is not the same as “derailing,” but it would be a naive argument, or at the least a real reach. Bills of this magnitude and complexity are houses of cards. They don’t get fundamentally reworked without virtually collapsing. Catamount Health passed over the complete collapse of the House bill in the Senate. That both the original House bill and the Senate’s ultimately triumphant Catamount alternative were about “health care” doesn’t alter that fact.

Till did vote for the bill, as we noted. And in the context of his full engagement with the bill – before, during and after its passage in the House – its hard to see that vote as anything other than cynical, even craven.

The Way Congress Works Now

Another brief video diary. This is how Congress works now.

Notice how the Speaker pro-tem denies the points of order and inquiry by redefining the terms? Notice the uproar when he does so. Notice that  the “nays” are clearly louder than the “ayes,” but the Speaker pro tem declares the “ayes” have it. The vote here is the defunding of National Public Radio.

This is the atmosphere Peter Welch is working in. Thugs are running the place. We need to help other states elect Democrats. This is why it matters.

Verconsin and Wismont

 Wisconsin and Vermont seem to be tangled in an odd embrace of political opposites and similarities. Wednesday night RNC chairman and former head of the Wisconsin Republican Party Reince Preibus addressed 200 members of the Vermont Republican Party in Burlington. Between one hundred and one hundred twenty five union members, Democrats and others demonstrated against his perceived anti-union stance nearby while he spoke.    

Today Governor Shumlin testified and took questions before a congressional committee along with Wisconsin Governor Scott Walker (protégé of RNC head Preibus). Rep.Elijah Cummings (D-Md.) the committee’s ranking member said Shumlin would

“… bring a perspective that is markedly different than that of the majority’s witness, Wisconsin Gov. Scott Walker…”

Both governors addressed their work reducing state budget deficits. Shumlin providing a distinct counter point to Walker/Preibus’ scorched earth budget slashing tactics.  

Shumlin opened his testimony saying in part “Governor Walker, it’s good to see you again”  noting they each had just finished their first 100 days in office he added  “I wish you the best as you continue your term” How far from Walker’s mind could a possible recall vote be as he listened to Shumlin’s greeting?  

Gov. Shumlin continued bluntly:

What is puzzling to me about the current debate about state budgets is that the focus has been not on bringing people together to solve common problems, like we have done in Vermont, but on division and blame.  

Whatever legitimate gripes we may have with Shumlin here in Vermont it’s easy to be thankful he’s no Scott Walker. Vermont is closer to the right track than it has been in eight years. But Wisconsin was once a Blue state and the Preibus told the Vermont Republican party his vision last night in Burlington.  

Vermont could replicate the recent political history of Wisconsin. The state was perceived as a Democratic stronghold, but in large part through the efforts of the Wisconsin GOP, Republican Ron Johnson defeated Democratic U.S. Sen. Russ Feingold, and Republican Scott Walker became governor in the 2010 campaign.

Pretty fair warning, however if  that’s the goal got to wonder if  someone with a little more campaign finesse than Tom Salmon might wind up running against Senator Sanders.  

Birther Pome

you don’t get a birth certificate

for being hatched

nor for crawling out

from under a rock

you don’t get one for being a hand job

or an abortion (all the fuss is about?)

or for being a shit (literally)

and you corporate persons?

show me your birth certificates please

I’d like to see how you got

all these rights us born folks

don’t got

does Donald Trump have a birth certificate?

nah  he was the baby in It’s Alive

the doctors tried to kill

but he got away

does Glenn Beck have a birth certificate?

I just don’t think an ooze out of slime

can legitimately be called birth

so come on, you scumbags

show us your birth certificates

cause it’s getting harder and harder

for us to believe you were really born

I mean, if you were, it must have been

through a very unnatural act

so stay away from the schoolyards please

Peter Buknatski

Montpelier, Vt.

Embattled Burlington CAO Jonathan Leopold resigns, speaks of BT “hindsight”

This from the office of Burlington Mayor Kiss:

“I have accepted Jonathan’s decision with regret,” said Burlington Mayor Bob Kiss.  “I want to thank him for his hard work and personal commitment to the City throughout his career.  Among many other accomplishments, Jonathan’s management of the budget has resulted in 5 straight fiscal years of a level general services tax rate and an increase in the City’s undesignated reserve fund from $75,000 to over $5 million.  Jonathan has also built a strong management team in the Clerk-Treasurer’s Office which will ensure a successful transition.”

Leopold’s resignation letter can be seen here. Here’s the quote that most will notice:

I regret the difficulties the City has faced as a result of the BT controversy and I hope the

City is able to resolve these issues. In hindsight, I believe that we could have made a more complete disclosure of the violation of Condition 60 when we first learned of it in November 2008.  This has resulted in an unfortunate division within the city.

I believe it is time for Burlington to come together and move forward.  I do not want my continued role as Chief Administrative Officer to polarize the City further or hinder progress in addressing the challenges of the future.  I will work with you to develop a sound budget for FY 2012 and to provide a smooth transition

The GMD (not very) exclusive: “Access Codes” for the CIA… the Federal Reserve… the iPhone 5…

Here’s a fun sidenote on the George Till Survey Monkey monkey survey that’s too fun to pass up. We’ve heard Republicans defend the unscientific online poll which was built by Democrat Till out of his desire to derail the “single payer religion.” They haven’t learned that the first lesson of what to do when you’ve trapped yourself in a hole is to stop digging, though.

I found this in the comments at vtbuzz from a few days back. It’s Rep. Anne Donahue (R-Northfield) trying to claim the high ground by asserting that it was a breach of trust for pro-reform legislators to take the poll themselves as a demonstration of just how bogus it is, and how (un)seriously it should be taken:

The only persons other than MDs who were aware of the access code to respond, however, were members of the House Health Care Committee.

I believe Dr. Till felt he could trust the ethics of his peer physicians and his legislative colleagues to maintain legitimacy of responses. Sadly, that proved to be a misplaced trust

Actually, Representative, what you refer to as an “access code” is generally called a URL, or more colloquially, a web page address. You know, those things that are wide open and identified by search engines. Of course, the simple charge that legislators passed on a web address already in statewide distribution doesn’t have quite the punch that suggesting they dishonestly passed out a secret code does. Also, acknowledging that the “access code” was nothing more than a URL in a browser would kind of reinforce your opponents’ point about the absurdity of the whole exercise, no?

Look, I’ll be the first to grant that there are a lot of things to like about Rep. Donahue, but this is silly.

So here, then, are some more Rep. Donahue-style access codes. Oh lord, think of the havoc which will be wrought now that GMD is daring to make them public:

Can you handle the awesome access power?

Taxes Are The Price We Pay For Civilization

Say you're a human being, in a society of human beings.  You folks get together during the day to find food, and at night gather around the fire because there's lots of things that'll eat you.  Then you invent agriculture, settle down, get better at the whole thing, start producing surplus which you have to store and keep track of, and ultimately you invent civilization.

The civilization gig is pretty handy, providing some order and predictability you might not have had wandering around looking for nuts and berries, and even allowing for some division of labor.  As your civilization grows, you enjoy some economies of scale and can start tackling some big, complex projects through coordination and management, but that takes some people away from directly producing food.

That's cool because some of the public works projects, like irrigation canals and whatnot, can help produce more food or contribute to safety.  Sure there are boondoggles like pyramids, but people also dig looking at cool things and they're certainly an expression of human nature.  Anyway, you gotta feed the workers, so the managers look for contributions from society at large.

Thus the Taxman is invented.

Okay, I'm being a bit glib, but I think Oliver Wendell Holmes, Jr, was right about taxes and civilization.  We have it pretty good being a part of society, and everybody's got to ante up and kick in to make it work.  Nice to see that President Obama generally thinks so, too:

We recognize that no matter how responsibly we live our lives, hard times or bad luck, a crippling illness or a layoff, may strike any one of us. “There but for the grace of God go I,” we say to ourselves, and so we contribute to programs like Medicare and Social Security, which guarantee us health care and a measure of basic income after a lifetime of hard work; unemployment insurance, which protects us against unexpected job loss; and Medicaid, which provides care for millions of seniors in nursing homes, poor children, and those with disabilities. We are a better country because of these commitments. I’ll go further – we would not be a great country without those commitments. 

For much of the last century, our nation found a way to afford these investments and priorities with the taxes paid by its citizens. As a country that values fairness, wealthier individuals have traditionally born a greater share of this burden than the middle class or those less fortunate. This is not because we begrudge those who’ve done well – we rightly celebrate their success. Rather, it is a basic reflection of our belief that those who have benefitted most from our way of life can afford to give a bit more back.

Also channeling a bit of Teddy Roosevelt today:

The man of great wealth owes a peculiar obligation to the State, because he derives special advantages from the mere existence of government. Not only should he recognize this obligation in the way he leads his daily life and in the way he earns and spends his money, but it should also be recognized by the way in which he pays for the protection the State gives him.

Now that wild-eyed communist, Adam Smith, observed (slightly bloggified for easier reading):

According to the system of natural liberty, the sovereign has only three duties to attend to; three duties of great importance, indeed, but plain and intelligible to common understandings:

  • first, the duty of protecting the society from the violence and invasion of other independent societies; 
  • secondly, the duty of protecting, as far as possible, every member of the society from the injustice or oppression of every other member of it, or the duty of establishing an exact administration of justice; 
  • and, thirdly, the duty of erecting and maintaining certain public works, and certain public institutions, which it can never be for the interest of any individual, or small number of individuals to erect and maintain; because the profit could never repay the expense to any individual, or small number of individuals, though it may frequently do much more than repay it to a great society.

Most anti-government, pro-free market fairy types have boiled Smith's masterwork of five tomes down to the Invisible Handjob and like to pretend he was completely laissez faire and all about unfettered individual liberty being the best for society.  Of course that's not entirely true, and those folks tend to ignore vast swaths of text that are a bit more sophisticated and subtle than a blanket love for the marketplace.

One can certainly squint at The Wealth of Nations, cherry picking and interpreting however one wishes to prove a point just as one can the Bible or the Constitution.  If we were left with the three duties of government enumerated above, one might argue that everything Obama mentioned today goes well beyond Smith's vision.  However, he further expanded on these basic objects with specific examples:

  • Sterling marks on plate and stamps on linen and woollen cloth (WN138–9); – consumer protection!
  • obligations to build party walls to prevent the spread of fire (WN324); – building codes!
  • ‘Premiums and other encouragements to advance the linen and woollen industries’ (TMS185); – government subsidies!
  • ensuring the ‘cheapness or plenty [of provisions]’ (LJ6; 331); – price controls and busting monopolies (“as goods are a conveniency to the society, the society lives less happy when only the few can possess them”).
  • erecting and maintaining certain public works and public institutions intended to facilitate commerce (roads, bridges, canals and harbours) (WN723); – but certainly not electricity, telephones and broadband Internet, right?
  • regulation of institutions, such as company structures (joint- stock companies, co-partneries, regulated companies and so on) (WN731–58); – how dare the government interfere!
  • education of youth (‘village schools’, curriculum design and so on) (WN758–89); – did that inspireVermont's framers?
  • education of people of all ages (tythes or land tax) (WN788); – wait, higher education, too?
  • encouragement of ‘the frequency and gaiety of publick diversions’(WN796); – just noMapplethorpe. for Christ's sake.
  • the prevention of ‘leprosy or any other loathsome and offensive disease’ from spreading among the population (WN787–88); – yeah, like healthcare is a public good or something.
  • government restrictions on interest for borrowing (usury laws) to overcome investor ‘stupidity’ (WN356–7); – weird the banksters never mention this.

That's just a subset of Smith's list which I've stolen from Canadian economist, Jacob Viner, with the help of this site (or vice versa), and briefly annotated.  The point is that many things conservatives decry as being government intrusions on the genius of the market are actually part and parcel of government duty.

In fact, Smith also noted in his Lectures:

[T]he government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that the one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich. There are many expenses necessary in a civilized country for which there is no occasion in one that is barbarous. 

That jibes with what Adolf Wagner postulated the following century: The advent of modern industrial society will result in increasing political pressure for social progress and increased allowance for social consideration by industry.

A brief background of Wagner's Law:

Wagner offered three reasons in support of his hypothesis.  Firstly, as nations develop they experience increased complexity of legal relationships and communications, as a result of the immense division of labour that accrues with industrialization.  Because of this, Wagner envisaged an enlarged role for the state in  the form of public, regulatory and protective activity.  Further, increased urbanization and population density would lead to greater public expenditure on law and order, and economic regulation due to the associated risk of more conflict in densely populated urban communities.  

Because of the substitution of private for public activity, the administrative and protective functions of the state would expand.  Thus, as nations become more advanced the number and/or magnitude of  market failures would force the state to become more regulatory in nature, thereby expanding its role and this would inevitably involve higher public expenditures. 

Wagner predicted the expansion of ‘cultural and welfare’ expenditures based on the presumption that as income rises, society would demand more education, entertainment, a more equitable distribution of wealth and income, and generally more public services.  Public Services were seen as normal goods,  that is, their income elasticities of demand exceeded unity.  Wagner cited education and culture as areas in which collective producers were more efficient than private producers.

I think we've reached a critical point, though, where we've collectively come to rely on the services of civilization without expecting to pay full price.  The orgy of tax cuts since Reagan slashed the top marginal rates (though he did raise taxes 7 times in 6 years to mitigate the tumbling economy and deficit, people only remember the reductions) has created an imbalance in our accounts, briefly corrected during the Clinton Era and pushed out of control by Bush.

Eexacerbating this is the incredible economic inequality that's developed in the United States over the last few decades.  When the richest of the rich dominate our policy decisions and electoral processes, we end up with the discordant sounds we hear in Wisconsin and Ohio, and in Washington, DC: cries of “we're broke” as all the progressive gains we made since before the Depression are wantonly destroyed to pad the wallets of uberwealthy corporatists.

Sadly, we hear similar refrains in enlightened Vermont from our Democratic governor, who won't brook raising taxes on the top earners but brags about making deep cuts in spending.  We've even got folks who view taxation to support vital services and human rights as slavery.  Which is weird because that Smith guy (again!) observedEvery tax, however, is, to the person who pays it, a badge, not of slavery, but of liberty.

Indeed, as Alexander Hamilton said just before the American Revolution: Civil liberty is only natural liberty, modified and secured by the sanctions of civil society.

And civil society requires a little investment:

The subjects of every state ought to contribute towards the support of the government, as nearly as possible, in proportion to their respective abilities; that is, in proportion to the revenue which they respectively enjoy under the protection of the state.

What's more, to help protect all the services that an advanced nation requires:

It is not very unreasonable that the rich should contribute to the public expense, not only in proportion to their revenue, but something more than in that proportion.

So raise taxes on the rich at the Federal level.  Patriotic rich folks won't mind!  And raise taxes on the rich at the state level.  Again, patriotic rich folks won't mind!  Our civilization demands it.

ntodd