It Hurts to Lose a Seat in Congress. But after the Hurt Comes the Relief Package

Thursday, September 18, 2014

I have never met John Tierney.  I have never had a reason to ask for a meeting with him or a member of his staff for one of our clients. Tierney holds a federal office, United States Representative, and we do most of our work at the state and municipal levels of government.

However, I happen to know a lot of persons who know Tierney or have dealt with him on various matters through the years.  He’s been in the Congress since 1998. They all say Tierney’s a good, down-to-earth person, a man you can trust, a guy who delivers on what he tells you.  They also say he’s easy to take, no fathead.

I take as Exhibit A of Tierney’s “good guy-ness” that young, fresh-faced, sincere, teetotaling Joe Kennedy the Third was out campaigning for him just a little while ago.  Kennedy didn’t owe Tierney anything.  Nor did he need him to keep moving up the ladder.

As everyone who follows politics knows, the voters of the Sixth Massachusetts District gave Tierney the boot nine days ago.  He lost the Democratic nomination for re-election to his House seat to Seth Moulton.  The margin of defeat was decisive.
Today, September 18, as Tierney celebrates his sixty-third birthday, he is likely reflecting upon both his past and his future.  Unlike a lot of persons his age who’ve been forced from a job, he has some good options for future employment.  He’s a member of the bar and could restart his private law practice in Salem, his hometown, without much difficulty.  He could also do what a lot of former lawmakers do these days: become a lobbyist.  Or he could simply decide to retire when his term’s up.  He could do what Al Pacino, age 73, said in a recent article in the New Yorker he has no interest in doing: “Smell the golf balls.”

Tierney qualifies for the kind of pension and other retirement benefits that the vast majority of Americans will never attain.*  By my rough, non-expert calculation, which is based on the average annual salary for a U.S. representative, $172,443, and on Tierney’s 16 years in the Congress, he could collect a federal pension amounting to $49,663 every year for the rest his life.
The average 63-year-old man in the U.S. today can expect to live to age 84, according to the Social Security Administration.  If Tierney starts collecting his federal pension upon leaving office in January and if he lives for 84 years, his total pension income would come to $1,042,923, (21 times $49,663).

It’s also possible that Tierney qualifies for monthly payments from Social Security and from a federal Thrift Savings Plan (TSP). 

If, upon taking office in January, 1998, Tierney had joined the TSP, the federal government would have contributed the equivalent of 1 percent of his salary to his account every year whether or not Tierney himself made contributions to it.  If Tierney has contributed, the government would have equally matched those contributions, up to 5 percent, every year.
So, for example, if Tierney contributed 5 percent of his annual gross salary to a TSP in 2013, his personal contribution would have amounted to $8,622, (based on the average annual salary of U.S. reps), and Uncle Sam would have matched that contribution and added another 1 percent -- the “give-away” portion built into the system.  His accumulated retirement savings for just last year would have, in that scenario, totaled $18,968.73.

Don’t forget health coverage. 
As a retired Congressman, Tierney may obtain insurance for him and his wife for the rest of their lives through the Federal Employees Health Benefits Program.

The U.S. Bureau of Labor Statistics reports that fewer than one in five persons working in the private sector today qualify for a pension; thirty years ago, that situation was reversed: more than four in five qualified.
It’s tough to lose an election.  Given the way so many voters said afterward that Tierney had been around long enough and that it was time for a new face, his defeat on September 9 was no doubt particularly painful. 

I’ve heard former elected officials describe their losses as a kind of “public death.”  Think about it.  The average person who gets downsized doesn’t have to get up the next morning to find his picture on the front page of the Boston Globe.
I wish John Tierney the best.  I won't hold it against him if he takes all the pension money, retirement account payouts, Social Security checks, and health coverage he’s entitled to by law.  I would not have the necessary wealth, nor would I be so self-less or patriotic, as to refuse those things if I was in his place.

On balance, we have to say that the electorate is a kindly and generous beast.  Else why would it countenance so much relief to those who must endure the demise of their public lives?
*Members of Congress, representatives and senators alike, need to serve only five years in order to qualify for a pension.






Suddenly, It Seems, an Ex-Selectman Is on Verge of Becoming State Treasurer

Friday, September 12, 2014

Politics is a strange and wonderful thing.  Consider that the last and only time Deb Goldberg held elective office was from 1998 to 2004 when she served on the Brookline board of selectmen, and that she’s now about eight weeks away from being elected State Treasurer, a constitutional office -- annual salary: $125,000 -- that will put her in charge of about $46 billion in public assets.  It’s a situation that evokes John F. Kennedy’s observation to the effect that “Anyone who would discount the importance of politics ought to consider that it was politics that took a lieutenant junior grade in the Navy and in fourteen years made him commander-in-chief.”

No doubt there were folks besides Goldberg and her family and friends who saw her victory coming this past Tuesday in the race for the Democratic nomination for treasurer, but I was not among them.  Even after she received the most votes for the nomination at the party’s June 14 convention, Godlberg’s candidacy never much figured in my thoughts -- yet another illustration of my nearly fatal lack of perspicacity. Oh, well.
At 7:00 p.m. on June 14, as the Democrat convention limped to a close, the party decided not to bestow its endorsement for Treasurer on Goldberg because she was one of three candidates who had received at least 15% of the convention votes, the threshold for getting on the primary election ballot.  Goldberg won 38.9% of the delegates' votes that day, while Wayland State Representative Tom Conroy and Andover State Senator Barry Fine gold took 33.9% and 27.1%, respectively.

The last poll I saw, on Friday, September 5, in the Boston Globe’s nifty, new “Capital” section, had Finegold leading, with the support of 21% of survey respondents, followed by Goldberg at 15% and Conroy at 14%.  Four days before the election, in other words, the region’s premier news organ put Goldberg one percentage point ahead of the person who ended up last in that particular race. 
Here are the primary vote totals: Goldberg, 202,077 (42.7%); Finegold, 149,188 (31.5%); Conroy, 121,802 (25.7%).

Goldberg, who is 60 years old, is nothing if not a portrait of the power of persistence.  After leaving the select board in 2004, she ran in 2006 for the Democratic nomination for lieutenant governor and finished second in a three-way contest behind then-Worcester Mayor Tim Murray.  She waited almost eight years to emerge from political hibernation on February 27 of this year and announce for treasurer.  It’s fair  to say that, at that point, her profile was noticeably lower than that of Senator Finegold, who’d been kind of a big deal in the Merrimack Valley for at least a decade, and of Representative Conroy, who’d attracted statewide attention in 2012 during an unsuccessful-and-ultimately-aborted campaign for the Democrat nomination for U.S. Senate, a prize ultimately taken by Elizabeth Warren, the bane of Scott Brown’s existence.
Goldberg’s treasureship is an almost-but-not-quite-accomplished fact.  She faces a Republican opponent in November: Michael Heffernan, a financial services professional from Wellesley, one of the few places in the world with real estate prices in the Brookline range.  But just by being a Democrat on the ballot in Massachusetts, Goldberg has to be rated a prohibitive favorite.

Goldberg’s background suggests she won't have much trouble with the duties of chief state financial officer: she has a bachelor’s from Boston University, a law degree from Boston College, and a master’s in business from Harvard.  More tellingly, she’s from the immigrant family that launched Stop and Shop, the largest chain of grocery stores in New England; the Goldbergs are an accomplished lot.  
One day, we should expect to see Treasurer Goldberg running for governor.  That is what treasurers in Massachusetts do.  (Apparently, there’s plenty of time on that job for dreaming and scheming.)

Goldberg will be bucking the odds if/when she goes for governor.  The last four treasurers -- Steve Grossman, Tim Cahill, Shannon O’Brien and Joe Malone – have all run for governor, and each, in his or her turn, has suffered defeat.
Yet Goldberg now has a credible chance of becoming governor.  If that happens in 2018, she will have made the jump from selectman to governor in less than 15 years. 

She deserves more than one ovation for putting herself in such a neat position.

On Fifth Anniversary of Kennedy's Death, I Found Myself Reflecting on a Particular Fact

Friday, August 29, 2014

This past Monday, August 25, on the fifth anniversary of the death of Senator Edward M. Kennedy, I eagerly read Marty Nolan’s column in the Globe: “Obama’s Kennedy.  Five years ago, the president lost his only real friend in Congress.”  I thought how good it was to be reading something by Nolan again; he’s been retired a while and no one has replaced him, if you know what I mean.   I also found myself thinking of the times I’d met Senator Kennedy and of how good he was, as so many public persons are, at shielding his actual self from the persons who came at him without end…

On a weekday morning, late in November of 1997, there was a large group of mourners gathered at a funeral home on Broadway, Everett, waiting on Ted Kennedy. 
This was the day of the requiem Mass for Joseph A. Curnane, Sr., a friend of Kennedy’s for nearly 40 years.  The senator had called the deceased’s son and namesake, young Joe Curnane, to say he was stuck in traffic.

 “Could you hold things up a bit?” the senator asked.
He wanted to see his friend one last time, to pay his respects properly. 

The time to form the cortege to the Immaculate Conception Church was drawing near. 
A few minutes later, the senator walked in, alone, to the funeral home.  He offered his condolences to the widow, the former Rosemary Murdock, once the most beautiful girl in Everett.  He had a gentle word, too, for each of Mr. Curnane’s four children.

Then the senator made his way purposefully through the room to the casket.  He knelt in prayer for half a minute, stood, and moved back two or three steps.  He did not take his eyes from the figure of his friend, a campaign warhorse he’d inherited from his brother the President.
No one spoke above a murmur.  No one approached their senator.  It was right, everyone knew, to let him have at least a moment on his own to reflect and to grieve.

The senator turned to his left, where I happened to be standing.  I introduced myself and shook his hand.
“Joe was my father-in-law,” I said.

“An amazing man,” the senator said. “Incredible.”
“Oh, yes.  He was…He was,” I said.

Neither of us seemed to know what to say next.  We stared at the exquisitely crafted wooden casket, nestled in a wall of flowers.
Fidgety, I blurted out: “He hated lies.”

The senator turned abruptly to me.  His eyes had a look of alertness, as if he had been stung.  It was an unguarded look from a naturally guarded man, something I’d never observed in previous encounters with him.
“That was like my father,” Ted said. “He hated lies more than anything.  You did not want to lie to him.”

I searched my mind for something that would keep the conversation spinning that fiber of the personal.  I hoped that I might have an honest-to-goodness conversation with a living legend of American politics.  Maybe I should say something to him about my father, I wondered. 
Before I was able to speak, the senator turned and shuffled off through the crowd.

Was he more mindful of the clock than I? 
His car was waiting.  Perhaps he wanted another look at the eulogy he was about to give at the church.

Or did he want to head off a too-personal conversation, however brief, with yet another stranger, an in-law no less?


Now Comes the 'Moore Commission' to Corral Growing Herd of Surgical Robots

Friday, August 22, 2014

Senator Dick Moore, Democrat of Uxbridge, has his robotic surgery bill on the verge of enactment, and that’s a good thing.

The Massachusetts Senate, where Moore serves as President Pro Tem, second only to the President herself, passed An Act Relative to Robotic Surgery on July 11. 
The legislature’s Joint Committee on Rules gave the bill, now designated Senate Bill 2261, an “ought to pass” recommendation on August 14 and sent it to the House Committee on Steering, Policy and Scheduling.

Steering Policy and Scheduling placed SB2261 in the Orders of the Day for the session of the House held on Monday of this week, August 18, and the bill went through a quick, ritualistic third reading on that day.
“Third reading” does not mean it was actually read aloud three times on the floor.  Rather, it refers to the step where a legislative body formally considers a measure for a third and final time in public session.  It is a step equivalent to passage: a bill’s third reading and its passage are accomplished in the same motion. 

To become law now, An Act Relative to Robotic Surgery needs only to be engrossed by the House -- a perfunctory step -- and signed by the governor.
SB2261 would set up a 17-member special commission to “investigate and review the use of robotic surgery,” develop a training protocol for each application of robotic surgery, devise an application and certification process for hospitals seeking to perform robotic surgery, and establish guidelines for the training and experience of surgeons who use robots.

Representatives of the Massachusetts Medical Society, the American Urological Society, the Society of Gynecological Surgeons, the Society of Thoracic Surgeons, and the Massachusetts Hospital Association will be among those appointed to the commission.  Three state representatives and three state senators, including, presumably, Dick Moore, will also be put on it.
The robots now widely deployed in U.S. hospitals are operated by surgeons working at consoles.  The surgeon does the directing; the robot does the cutting.  In certain procedures, there are definite upsides to having a robot wield the scalpels and other surgical tools.  For example, they can use tinier instruments and work in tighter spaces than a surgeon’s hands can.  They also often accomplish the desired results with less extensive cutting.  Studies have indicated that many patients recover quicker from robotic surgery because of smaller incisions and fewer disturbances of internal organs and tissues.

Surgical robots, however, are expensive little devils. The initial outlay for what may be considered the top-of-line surgical robot can exceed $2.5 million; the per-procedure instrument costs often approach $2,000; and the annual service contracts run into the tens of thousands of dollars. 
Robotic surgery is also more costly than conventional surgery. As an example, prostate removal by robot will run about $4,500 higher than standard prostatectomy. 

That money is well spent, robotophiles say, because patients who have undergone a robotic procedure experience less post-surgical pain and discomfort, and are able to return to their normal routines sooner.
Perhaps the hardest knock on robotic surgery is that studies to date have not found it to be more effective than standard surgery.  If future studies corroborate that finding, it will mean we’re paying more for robotic surgery to get the same results as from standard surgery. 

Robots in the surgical suite have also been criticized for setting off a new kind of “medical arms race,” with hospitals having no choice but to acquire robots once their competitors have them.
Dr. Marty Makary, director of surgical quality at Johns Hopkins Medical Center in Baltimore, has decried the surgical robot as “a symbol of what’s wrong with American health care: the widespread adoption of expensive new technology with little evidence to support its use – all within the context of a poorly informed, even misinformed, public.”

On my clearest days, I’m barely one notch about “poorly informed, even misinformed” on this topic.
That’s why I’m glad Dick Moore, Beacon Hill’s most knowledgeable person on health care costs, has come up with this special commission idea.  If they get the right persons on it and if they do their jobs energetically, we’ll all become better informed.  And our health care system will end up spending our limited dollars more wisely.

THAT LAID-BACK TIME IN THE LEGISLATURE, POST-JULY 31:  We’re at a point in the 2013-14 legislative session when you might say that only “feel good” measures are on the agenda.  Back in 1995, the legislature adopted Rule 12A obligating itself to conclude “all formal business” no later than the last day of July in the second year of a session; after that, the House and Senate may meet informally.  Only a few legislators from each party show up for these meetings, and no debates are held.  The rules governing “informals” make it impossible to go beyond routine business or to vote on controversial matters.  If even one member present objects to taking a vote on something, that item must be tabled for that entire session.  As the minority party in the legislature, Republicans send at least one member to all informals to prevent Democrats from passing anything momentous or contentious.





Gas Pipeline Proposal Fuels a Hot Debate Across Northern Massachusetts

Friday, August 15, 2014

We the people of New England, ever more dependent for sustenance and gratification upon the electric-powered devices of the modern age, need more natural gas to generate the power we’re hooked on.  The utilities are eager to meet that need.

New England consumers could use an additional two billion -- 2,000,000,000! -- cubic feet of natural gas every day, according to reliable estimates.  But we can’t get that fuel because the aged pipelines supplying the region are operating at their limits.
Two companies, Kinder Morgan and Algonquin, propose to rectify that problem by building new pipelines.  Kinder Morgan’s would go from New York State to Dracut, Massachusetts, on a path roughly paralleling Route 2.  Algonquin’s would come into southeastern Massachusetts from Connecticut.

Thanks to the fracking of the Marcellus Shale, a gas-saturated rock formation beneath four eastern states, there’s more than enough gas, nearby, to fill those pipelines.  The prices charged for it are surprisingly cheap.
[DISCLOSURE: Preti Minahan Strategies is affiliated with the law firm of Preti Flaherty Beliveau & Pachios, which represents the Industrial Energy Consumers Group (IECG) in Maine.  The IECG  favors increasing deliveries of natural gas to New England.]

Today, we pay a huge premium for gas because pipeline constraints make it very difficult to get the fuel we need when we need it.  Industry folks call that premium the basis differential.  Last year, New Englanders paid basis differential costs totaling $3.6 billion.  As the largest sub-group, Massachusetts residents paid the highest basis differential: $1.6 billion.
If the existing pipeline limits were eliminated via the construction of the Kinder Morgan and Algonquin pipelines, Marcellus Shale gas would flow freely into New England and we’d no longer be paying the basis differential.

The people of Massachusetts would have more than a billion and a half dollars to spend on other things.  Such spending would jolt the economy forward.  Young people would find it easier to find a job; older persons would have less trouble holding onto a job and getting a raise.

Sounds simple, no? But simple it is not. 

The people who would have to live with the Kinder Morgan pipeline don’t want it.  And they’re mobilizing.  Big time.  In virtually every city and town it would cross, the pipeline faces a buzz saw of opposition.
One gentleman who attended an anti-pipeline rally on Boston Common in July complained that it would cut a terrible swath through his property in Ashfield.  Many trees would be cut down, he lamented, including one under which he scattered his mother’s ashes.

Another man, who operates a family farm in Deerfield, estimated he’d lose at least 600 fruit trees to the pipeline.  “Our very way of life is being trampled,” he said.  “Our orchards will be ripped apart and our iconic hillside will be destroyed.”
Elected officials have naturally sided with their constituents who would, under federal law, have to yield parts of their land to the pipeline right of way.

In an open letter, Congressman Jim McGovern wrote, “Let me be clear: I believe that this pipeline is irresponsible.” 
Five state legislators from Western Massachusetts, led by Pittsfield senator Ben Downing, issued a joint statement, declaring, “We oppose the (pipeline) project for environmental, economic, public safety and public health reasons.”

U.S. Senators Edward Markey and Elizabeth Warren both oppose the Kinder Morgan proposal. In a recent guest column in the Berkshire Eagle, Warren wrote, “I have heard from many Massachusetts homeowners and businesses that are deeply concerned about the impact of this proposal on their farms and properties.”
Instead of allowing the pipeline to be built, Warren later suggested to the Boston Herald, we should repair and upgrade the state’s existing pipelines and gas service pipes – “the old methane-leaking pipes,” as she described them.

Warren dared not say those repairs and upgrades could prevent two billion cubic feet of gas per day from leaking into the atmosphere, an utter implausibility.
If my property was in the path of the pipeline, I have to admit I’d react to this project as most folks in its direct path are.  It’s asking too much of someone who believes his orchard is threatened to stand back from the situation, to consider please the overall benefits of a pipeline, or to sacrifice his interests for the greater good.

A part of me would regret I was taking an approach, which, if successful, would shut the door of opportunity in somebody’s face. I’d keep that regret to myself. 
Part of me would know that someone like me, who’s experienced the American dream as a reality, has more say than someone still dreaming.  Still, I’d have my say. 

Fear is a most powerful emotion. 

STATEWIDE, MORE PEOPLE LIKE PIPELINE THAN DO NOT. According to the results of a statewide poll published today in the Boston Globe, 52% of respondents support the construction of the new pipeline to Dracut; 28% oppose it; and 20% don’t have a position on it.





Lawsuit vs. State Auditor Maybe Shortens Election Odds for Patricia Saint Who?

Friday, August 8, 2014

What a mess.  State Auditor Suzanne Bump got sued this week by her former chief assistant, Laura Marlin, someone who knows everything about Bump.

The first question that came to mind was: Does Patricia Saint Aubin have the stuff to exploit the messiness?
Patricia Saint Who?

Patricia Saint Aubin, the Republican candidate for State Auditor, that’s who.  Check her out at

I suspect there’s been more traffic at that site since Marlin filed her suit on Wednesday in the U.S. District Court of Massachusetts.

Before Wednesday, I would not have given Saint Aubin one chance in a hundred of bumping off Bump in November.  Now, I might give her one in ten.  And if more shoes drop in the Marlin vs. Bump affair, Marlin’s odds could improve to one in four, or even one in three.  You never know.
Marlin’s lawsuit against Bump states, “Her (Marlin’s) forced resignation resulted from her repeated objections to the fact that Ms. Bump was improperly conducting re-election campaign activities during her working hours and out of her office at the State House, using state employees to assist her in those activities, and attempting to curry favor with a possible political ally as part of an independent audit.”

Marlin is asking for a jury trial on all her claims.  If she wins, Marlin’s hoping to receive money for her lost wages and benefits “and other remuneration.”  She also wants punitive damages, damages for emotional distress, pre- and post-judgment interest, attorneys’ fees and costs, and “such other relief as this Court deems equitable.”

Bump wasted no time putting out a statement denying Marlin’s claims.  “I am proud of the ethical standards that I have established and continue to uphold for my office,” Bump said.  “They have contributed to our receipt this spring of the highest possible rating from our peers in government auditing.  As her former employer, I must respect Ms. Marlin’s privacy rights, so I will not elaborate on the reasons for asking for her resignation other than to say that it was for cause.”

Saint Aubin, too, was quick with a statement.  “These unconscionable allegations of illegal campaign activities and a rigged audit of the Department of Children and Families (DCF), to protect supporters, are more disturbing evidence of the corruption created by one-party rule on Beacon Hill.”
“Evidence” is clearly too strong a word for what gets trotted out in a lawsuit such as Marlin’s.  People can and do say just about anything when suing someone’s pants off. 

Nothing prevents anyone from suing anybody or from saying anything nasty about anybody in that suit, especially at the outset. 
The lawyer who puts the suit together for a plaintiff only has to believe that what the plaintiff alleges is true and to have no facts in her possession that would indicate it is untrue.   

Civil lawsuits, in other words, are a time to swing for the fences.
That doesn’t mean it will be easy for Bump to brush the suit off or to move away from it as if nothing has happened.  The Power of the Word is at work.   We tend to remember bad things said about someone much more than the good.  The more colorful the accusation, the harder it is to purge from our memory banks.

And Marlin, through her lawsuit, has already accomplished what Lyndon Johnson strove for in many a political fray.  Johnson famously said, “I can at least make the (blankety blank) deny it.”  Marlin forced a denial out of Bump.  (Bump would have been crazy not to deny it.)

Marlin wants us to believe that her former boss went a little soft on an audit of the Department of Children and Families because many of the department’s employees are members of the Service Employees International Union and Bump wanted the union to endorse her for re-election this year.
“On May 14, 2014, Ms. Marlin met with Ms. Bump regarding the list of audits she had prepared,” the lawsuit says.  “During that meeting, Ms. Bump stated that Ms. Marlin should have, during the course of a recent audit, contacted the political director for the labor organization with which she had met the previous day because the organization had members who worked at the audited agency.”

The lawsuit continues:
“Ms. Marlin responded by stating that engaging in such contact would have amounted to political contact during the course of an audit, which would compromise the independence of the audit in violation of the Comptroller General’s auditing standards.  At that time, she presented Ms. Bump with the memorandum she had prepared regarding compliance with the Comptroller General’s auditing standards.

“Ms. Bump became extremely angry and combative in response to Ms. Marlin’s statements and memorandum.  She hurled invectives at Ms. Marlin, at times raising her voice and using foul language.
“The following Monday, May 19, 2014, Ms. Marlin arrived at work and received an email from Ms. Bump instructing her to cancel her morning meetings and appear at her office at 9:30 a.m.

“When Ms. Marlin arrived at Ms. Bump’s office, Ms. Bump stated that she was terminating Ms. Marlin because, ‘based on [their] interactions the previous week,’ she felt she ‘could no longer trust [Ms. Marlin] to act in the best interest of the organization.’ ”
In her prepared statement Wednesday, Bump averred, “…I have never allowed any organization or individual to influence the conduct or independence of an audit.  All of these allegations against me and my office are without merit.  I will be conducting a vigorous defense of my reputation and my office’s ethical standards.”

Marlin was given the choice of resigning as First Deputy Auditor and Deputy Auditor for Audit Operations, or being fired.  She chose to resign, submitting her resignation letter to Bump on May 23. 
This is one of those cases, inevitably bitter, where affection and admiration have turned into their opposites.

Marlin, 44, began working for Bump, 58, in May, 2007, when Bump was appointed Secretary of Labor and Workforce Development by Governor Deval Patrick.  Three years later, Marlin left her state job to serve as Bump’s campaign manager as Bump began her run for Auditor.  When Bump won, in November, 2010, Marlin served as her transition manager.  In one of her first moves as Auditor, Bump made Marlin her top deputy.
Marlin holds two degrees from Northeastern University and is a member of the Massachusetts bar.  Her curriculum vitae includes a stint as an Assistant Attorney General.

And what of the woman who would replace Bump, Patricia Saint Aubin?
I know only what I’ve read and seen on her campaign web site.  She looks like a normal, pleasant person.  She does not seem to be a lightweight or a nut. 

Saint Aubin graduated from Providence College with a bachelor’s degree in accounting in 1980, which would make her about 55 years old.   Some years ago, she worked as “an auditor with the Asset-Based Lending group of the Shawmut Bank in Boston.”
Bump will be able to hit Saint Aubin hard for having no recent, substantial experience as an auditor.  Saint Aubin will be able to point out that Bump, an attorney, had no experience as an auditor before she was elected.

In a state where only 11% of the registered voters are Republicans, Saint Aubin was on a kamikaze mission against Bump prior to the filing of Marlin’s lawsuit.  Now, you’d have to say she at least has a chance of surviving the battle with Bump.  It will be interesting to see what she makes of that.


With Survey Results on Patient Deaths, Nurses Hatched a Non-Cause Celebre

Friday, July 18, 2014

I’m still wondering why the nurses’ union didn’t get traction with its survey alleging thousands of patient deaths caused by inadequate nurse staffing.

I thought something would happen after the Massachusetts Nurses Association (MNA) announced on June 4 that one in four nurses were personally aware of patients having died in hospitals because there weren’t enough nurses around.
But nothing really happened that I could see.  The survey was a one-day blip on the news radar.   It didn’t make the front page of the Globe or Herald.  It didn’t dent the evening news broadcasts.  The Massachusetts Hospital Association barely lifted a finger to refute it.  And no government bigwig, caught in anguished surprise, declared her intention to launch an investigation.

The headline on the MNA news release touting the survey said: “Nearly One in Four MA Registered Nurses Report Patient Deaths That Are Attributable to Unsafe Patient Assignments.”
Under that was a long, explanatory paragraph in bold face, italic type:

78% of RNs agree that the quality of patient care in Massachusetts hospitals is suffering due to unsafe patient assignments including 59% of RNS who are aware of patient complications and 46% who are aware of patients who have been injured or harmed because hospitals are forcing nurses to care for too many patients at one time.

Here’s the scary list of particulars from the body of the news release:

·         …nearly one in four nurses (23%) report patient deaths directly attributable to having too many patients to care for at one time.

·         46% report injury and harm to patients due to understaffing;

·         51% report longer hospital stays for patients;

·         56% report readmission of patients due to unsafe patient assignments;

·         57% report medication errors due to unsafe patient assignments;

·         59% report complications for patients due to unsafe patient assignments;

·         68% report RNs don’t have the time to educate patients and provide adequate discharge planning;

·         82% report RNs don’t have the time to properly comfort and care for patients and families due to unsafe patient assignments.
The release ended with: “The 2014 survey respondents were all nurses currently working in Massachusetts hospitals randomly selected from a complete file of the 92,000 nurses registered with the Massachusetts Board of Registration in Nursing.  According to the researchers, the survey results can be assumed to be representative of the 92,000 nurses to within plus or minus 7% at a 95% confidence interval.”

In a June 6 blog post, I took a stab at translating that last sentence.  I said that, if you could somehow ask each of the 92,000 nurses if they were personally aware of a patient having died because there weren’t enough nurses to care for all of the patients needing care, you could be confident that between 16% and 30% of them would answer in the affirmative.  (Sixteen percent of 92,000 is 14,720; 30% is 27,600.)
I also said that, assuming just one witnessed patient death per surveyed nurse, the MNA is suggesting that at least 14,720 and as many as 27,600 hospital patients died because of inadequate staffing during the working lives of those 92,000 nurses.

Maybe the survey fell flat because the nurses’ union bought and paid for it.  That gave everyone a ready-made excuse to dismiss it.  We could say, “The nurses got the numbers they paid for; that’s what you do these days,” and move on to other news.
Maybe the survey got swamped by all of the other things happening in our world that day.  The torrent of news, or what passes for news, never lets up in the Internet age, even for a second.    Too much stuff competes for our attention.  How much of what comes before our eyes on a typical day can be remembered, never mind acted upon?

Or maybe it failed to achieve loft because the nurses’ union tried to accomplish too much with too little.  The news release said the results “can be assumed to be representative” of the experiences of 92,000 nurses.  It did not say how many nurses were actually surveyed by the union’s research firm, nor how much the union spent on the survey.  Skeptical minds could infer that: (a) the total number of respondents was not impressive, and (b) the project was done on a slender budget.
I’m being a little unfair when I say nothing happened as a result of the survey.  Later in June, after all, the legislature passed, and the governor signed, a bill mandating nurse staffing ratios in hospitals for the first time ever, House Bill 4228, An Act Relative to Patient Limits in All Hospital Intensive Care Units.  The survey might have nudged HB 4228 an inch closer to the goal line, but I think the legislature was ready to do something on this issue in any event. 

The new mandate is limited to hospital intensive care units.  It stipulates:  “…in all intensive care units the patient assignment for the registered nurse shall be 1:1 or 1:2 depending on the stability of the patient as assessed by the acuity tool and by the staff nurses in the unit, including the nurse manager or the nurse manager’s designee when needed to resolve a disagreement.” 
Literally for years, the MNA has been working on Beacon Hill to get a comprehensive nursing staff ratio bill passed.  While HB 4228 is truly a significant piece of legislation, it falls miles short of what the union was aiming for when it began its latest round of lobbying on this issue, way back in January, 2013, at the start of the current legislative session.

The hospitals seemed glad, having ceded only their ICUs, to leave the battlefield.  Said Lynn Nicholas, president of the hospital association, “The legislation focuses on the intensive care unit where there is a collaborative role for staff nurses, for nurses who manage care for all patients in an ICU, and for an acuity system to help determine the severity of an ICU patient’s illness.  Importantly, the legislation leaves flexibility throughout the rest of the hospital to properly address every patient’s needs.”
The nurses’ union vowed it would be back next session, trying to get a bill through to set mandatory nurse-to-patient ratios in all hospital units.   Many legislators no doubt have severe nursing-staff-ratio fatigue.  But every rep and senator who’s there for the 2015-16 session will hear the union out.  Nurses are respected, rightly so.  There’s a lot of them. They vote.