Conventional Wisdom Wrong Again: Mayor Menino Is a Master of Verbal Jujitsu

Friday, September 27, 2013

When you think of how cunningly Boston Mayor Tom Menino can send a message, you have to wonder why any supposedly intelligent person would think of him as verbally challenged.

Consider his oft-quoted comment to the effect that he would remain neutral in the race to choose his successor -- as long as none of the candidates “attack” the City of Boston.

Menino knew when he said it that no serious candidate thought he could win votes by attacking the city.

The candidate who said something like “anyone who says Boston is in good shape now ought to have his head examined” was the candidate headed to oblivion.

This wasn’t about attacking the city, and it wasn’t about attacking Menino. 

Because of the special status Menino enjoys after 20 very successful years in office, no candidate would dare risk a frontal assault on him.

Rather, it was a case of the mayor reminding his would-be replacements that he’s sensitive to criticism and slights of any kind.  Even implied criticism will get you on my bad side, the mayor was hinting. 

Hell, faint praise will get you in trouble with this guy.

The state of the mayor’s feelings is particularly relevant now that we’ve moved from the preliminary election to the final. The last thing either finalist, John Connolly or Martin Walsh, needs is to have a miffed mayor putting the word out to his superb campaign organization that he’s against him.

This could be a close election; every little thing matters.  

With that brief “attack” comment, Menino guaranteed there will be nothing even remotely critical of his tenure coming from the Connolly and Walsh camps.  He thus made progress toward the only major goal left in his public life: protecting and enhancing his legacy.

Menino’s ability to get inside other people’s heads has always been a key to his effectiveness. 

Everyone knows there’s a penalty for letting the man down, never mind crossing him.  This has worked to Menino’s advantage, as it does to every boss’s.   Last year we saw the proof of that again when the mayor was unable to come to work for many weeks due to illness and the city operated just fine in his absence.

An effective leader doesn’t have to be physically at his post when he resides permanently in the mind of every underling and inferior. 

Make no mistake.  No matter who is elected mayor of Boston on November 5, that person will remain Menino’s inferior in the political pecking order for a long time to come, maybe even forever, depending on what he’s able to get done in office.

That’s why you’ll see the new mayor being very solicitous of the former mayor.  The new mayor will desperately need the former mayor for expanding and securing his base.  The former mayor will deign to accept the blandishments of the new mayor. 

That is how icons keep their glow.

Of Casinos, Senate Leaders, Mayoral Legacies, etc. Some Wayward Friday Thoughts

Friday, September 20, 2013

Dan Conley, the Suffolk County District Attorney who’s running for Mayor of Boston, stuck his neck out early in the race by saying the entire city should vote on accepting a casino at Suffolk Downs, and not just East Boston, as the casino enabling legislation allows, as the owners of Suffolk Downs want, and as outgoing Mayor Tom Menino prefers it to go.  Polls now show a majority of Boston voters agree with Dan Conley.  Questions: Will Conley emphasize that position in the closing days of the preliminary election campaign? Will voters reward Conley by making him one of the two finalists in the November election?...Stan Rosenberg of Amherst, the Majority Leader of the Massachusetts Senate, has the votes sewed up to become the Senate President in late-February, 2015, when Therese Murray’s allotted four terms are up.  He will be following in the footsteps of another illustrious politician from the Pioneer Valley, Calvin Coolidge, the Northampton lawyer who went from Senate President to Governor to Vice President to President of the U.S.  Lest you think there are no parallels, other than the geographic, between Rosenberg, a liberal, pro-activist-government Democrat, and Coolidge, a small-government Yankee Republican of the old school, consider that both Rosenberg and Coolidge were carpetbaggers who captured the hearts of their adopted communities in Western Mass.  Both moved to the Pioneer Valley as young men from places far different from Amherst and Northampton.  Rosenberg was born and raised in Revere, a densely settled haven for immigrants on the Atlantic coast, while Coolidge was a product of the small, insular, mountain village of Plymouth Notch, Vermont…To paraphrase Robert Frost, who advised John Kennedy at the start of his presidency to "be more Irish than Harvard," I hope Stan Rosenberg is more Revere than Amherst when he's leading the Senate…They’re going to tear down and relocate Malden City Hall, which is not even 40 years old.  Will Boston City Hall be the next to go?  The problem with Malden City Hall, originally known as the Malden Government Center, is that it sits in the middle of what was once the community’s main east-west thoroughfare, Pleasant Street/Route 60.  When it was built in the mid-Seventies, pedestrian malls were the rage. The new Government Center was designed as the western anchor of a mall extending east three blocks to the intersection of Pleasant and Main Streets, where a now-long-gone Jordan Marsh department store stood at the time.  The mall was supposed to revive the fortunes of downtown Malden, once a diverse retail center that drew shoppers from many neighboring communities and then a shadow of its former self, having been eviscerated by the new shopping malls in roomier suburbs.  It just never worked out.  The blocking of Pleasant Street to vehicular through-traffic slowed commerce, rather than intensifying it…From the outside, the city halls in Malden and Boston could not be more different.  The one in Malden is a square, brick-covered box with identical rows of square windows on all of its six floors.  The one in Boston is constructed mainly of concrete, and tapers outward, like a wedge, as it rises.  Malden City Hall is a predictable cube; Boston City Hall puzzles the eye with different levels, planes and angles.  But they share a common architectural vice in that both make a visitor feel small and isolated.  Malden and Boston City Halls are almost totally lacking in humanity and warmth…It’s hard to see many people shedding a tear when they implode that monster that’s squatted in Pleasant Street, Malden, all these years.  Yet I will wince to see a part of the Walter Kelliher legacy blown to bits.   He was the longtime mayor of Malden who championed the plan for that mall and pushed it through the City Council.  And that’s not all he did in 16 years as mayor.  Kelliher was an absolute master at winning state and federal grants for redevelopment projects: new and rebuilt roads, schools, parks, playgrounds, apartment buildings for the elderly, parking garages, etc.  He traveled regularly to the State House in Boston and the Capitol in Washington to shake the government money trees.  He was big stuff.  There was no mayor anywhere in Massachusetts, and maybe all of New England, who was better at obtaining state and federal grants in the Sixties and Seventies than Walter Kelliher.  But if you walked down any street in Malden today and asked people at random, “Who was Walter Kelliher,” most would probably say, “Who?”  It’s not Kelliher’s fault, that’s just the way things are.  Legacies are fragile, short-lived things.  Anyone knocking himself out in a publicly elected position, and making headlines as easily as falling out of bed, should keep that in mind…About ten years ago, I had a meeting at Malden City Hall with an at-large member of the City Council.  I went out to Malden early on a summer afternoon just to walk around and see how all those changes made downtown twenty years before had stood the test of time.  When I entered the meeting, I mentioned that I had enjoyed my visit to his city because it gave me the opportunity to walk the lanes I’d walked as a young reporter at the Malden Evening News (1974-84).  “It’s amazing to think,” I said, apropos of nothing, “that there were years when Walter Kelliher won all of the discretionary Chapter 90 (road-building) funds in the state.  He could put together an application faster than anyone.”  I expected the councilor, who was anything but dull-witted, to nod and say something like, “Oh, yeah, Walter was incredible.”  Instead, he looked at me blankly and said, “He did?”  Kelliher hadn’t been dead ten years at that point…Speaking of Malden, former U.S. House member and newly minted U.S. Senator Edward J. Markey, who grew up in the Edgeworth section of the city and still has a home there, issued a press release yesterday on the passage in the Senate of a bill to keep the federal helium reserve open.  This was important, Markey noted, because helium is used in MRI machines, the manufacture of computer chips, and NASA rockets, not to mention those nifty balloons that float to the heavens when you let go of the string.  “This legislation is proof that we can work together to keep important government services up and running,” Markey said, “not shut them down over ideological battles.  As co-author of this bill in the House, I know this bill can pass and get signed into law, which is more than we can say for most bills these days.”  I love Markey for his optimism.  But anyone who thinks Congress can avert a government shutdown over the budget as easily as it will keep the helium flowing has been taking too many whiffs of another kind of gas, nitrous oxide, a.k.a. laughing gas.  Come to think of it, I'd like to administer a powerful dose of that to every Tea Party Republican every day Congress convenes…We’ve seen this kind of story too often. “Rides to Nowhere, for No One: Owner of Medical Transportation Company Allegedly Billed Taxpayers for Rides Under Dead People’s Names.”  That was the headline on a press release today from the office of Attorney General Martha Coakley.  The case concerns the owner of a medical transportation company in Webster, MA, who stands accused of defrauding the state’s Medicaid program of more than $470,000 by billing for services under the names of deceased individuals, and for other medical trips that were never provided.  As we used to say in Revere, crime does pay.  Well.  For a time.  And often much longer.

Legislation Poses the Question: Are Surgical Robots Automatically Good?

Friday, September 13, 2013

Senator Dick Moore is one of those legislators who know how to “move an issue,” as they say at the State House.  That’s a good thing for anyone who may ever become a patient at a Massachusetts hospital or surgical center.

Moore sits today in the second-highest place in the upper branch of the Massachusetts legislature: Senate President Pro Tempore.  But for years he was the Senate’s point person on health care as the co-chair of the Joint Committee on Health Care Financing.

There are few state legislators across the nation, and certainly in Massachusetts, who know as much about health care practices, policies and costs as Moore.  Senator Minority Leader Bruce Tarr likes to tease Moore during Senate budget debates by referring to him as “the high commander of health care.”

Moore’s knowledge and leadership proved crucial in 2006 to the enactment of the state’s universal health care legislation, which in turn became the template for federal health care reform in 2009, the Patient Protection and Affordable Care Act, also known as Obamacare.

So if Dick Moore thinks we need a new law governing the use of robotic surgical devices, you can bet that surgeons and hospital administrators everywhere in Massachusetts are taking notice.   

And you can reasonably expect that the doctors and hospitals who have lately made big investments in robotic surgical training and equipment will be represented in some effective way at the State House on Tuesday morning, September 24, when the Joint Committee on Public Health holds a hearing on Moore’s “Act Relative to Robotic Surgery in the Commonwealth,” Senate Bill 1069.

SB 1069 would create a special commission to investigate and review the use of robotic surgery throughout the state.  This commission would develop a process for certifying applications by hospitals for any new robotic surgery programs, and establish guidelines for the training and experience of all surgeons who wish to perform robotic surgery.

I’m probably like most folks in that I have been vaguely aware of the existence of robotic surgical devices.  I’ve heard they’re supposed to be good for removing prostate glands, for example. I never want to find out how good.   

I’m like most folks, too, I assume, in not wanting to dwell on the mental image of a computer-driven robot slicing me open on an operating table someday. I was born too long ago to have an ingĂ©nue-like trust in anything that runs on microchips.

There seems to be no stopping the rise of the robots in the surgical suites of America.

“…robotic surgery has grown dramatically,” the New York Times reported on September 9, 2013, “increasing more than 400 percent in the United States between 2007 and 2011.”

According to that article, headlined “New Concerns on Robotic Surgeries,” U.S. hospitals have acquired approximately 1,400 surgical robots known as the da Vinci system from a California company called Intuitive Surgical, Inc.  The da Vinci systems cost between $1.5 and $2.5 million apiece.

If they buy it, you can be sure they’ll use it as much as possible.

There’s conflicting evidence on whether there are more or less surgical errors associated with robotic equipment, and the federal government is looking into the question.  But there can be no doubt that innovations like surgical robots are adding to the nation’s already staggering health care bill.

Dr. Martin A. Makary, an associate professor of surgery at Johns Hopkins University, asserted in that September 9th New York Times piece that the expansion of robotic surgery has occurred without proper evaluation and monitoring of the benefits.

“This whole issue is symbolic of a larger problem in American health care, which is the lack of proper evaluation of what we do,” Dr. Makary was quoted as saying.  “We adopt expensive new technologies, but we don’t even know what we’re getting for our money – if it’s of good value or harmful.”

That article may be found at:

I’ve never spoken with Senator Moore about his robotic surgery bill, but I am certain he considers it one means to the end of getting good value for all the money we spend on health care in Massachusetts.  I’m basing that on the senator’s many persuasive public comments on the importance of controlling health care costs so that we can maintain our state’s popular system of universal health coverage over the long haul.

It will take many measures like SB 1069 to get us where we need to be.  The sooner it’s passed the better.

ADDENDUM:  There are at least two other New York Times articles I'd recommend to anyone interested in robotic surgery and its implications for the health care system.  One was written by Roni Caryn Rabin: "Salesmen in the Surgical Suite," 3-25-13, the other by Ezekiel J. Emanuel: "In Medicine, Falling for Fake Innovation," 5-27-12.  They may be found, respectively, at the following:

Attention Massachusetts Gaming Commission, Get Ready to Split the Baby in Everett

Friday, September 6, 2013

Two parties have been locked for months in a ferocious contest of wills over whether the City of Boston can lay claim to “host city” status for a proposed casino on some land at the Everett-Boston line once occupied by a Monsanto chemical factory.

This past Wednesday, the Massachusetts Gaming Commission told the contestants: Settle it among yourselves by the end of this week, or we’ll settle it for you.

An amicable resolution of this matter by 12 midnight on Saturday, September 7, is about as likely as my winning the Lottery.  (PS, I never buy tickets.)  Commissioners, I hope you’ll be good in the role of Solomon.

It’s easy to net this out:

Mayor Tom Menino cannot consent to “surrounding,” or “neighboring,” city status for Boston because that would put him in a subservient position to Wynn Resorts.  And Steve Wynn cannot recognize Boston as a host city for his Everett-based casino because that would  give Menino veto power over the project.

Under Massachusetts law, a casino operator first needs to negotiate a host city agreement with a mayor. Then a majority of voters in the community have to approve the agreement.  Once the voters say yes, the operator must go to the surrounding communities and negotiate agreements to mitigate impacts of the casino there. 

The law says neighboring communities cannot refuse to negotiate with a casino operator at that point. And if an operator and a neighboring community cannot reach a mitigation agreement, both parties must submit to binding arbitration.  That means each puts forth a “final and best offer” to a state-appointed arbitrator, who considers both offers, chooses one in its entirety over the other, and declares the chosen one a binding agreement upon both parties forevermore.

So, a host city cannot be forced to make an agreement with anyone who shows up and wants to build a casino there, but a neighboring city can be forced to an agreement with an operator who has a voter-approved casino proposal in hand.

Menino has already signed a host city agreement for a casino at Suffolk Downs that will deliver an annual payment of $32 million to Boston if that casino gets built, and Everett Mayor Carlo DeMaria has already signed with Wynn for a deal that will pay his city $25 million a year, a deal overwhelmingly approved by Everett voters in June.

Menino cannot reasonably hope to get more out of Wynn as a surrounding city than he will get out of Suffolk Downs as a host city, so naturally he’s hoping the Gaming Commission awards the one available eastern Massachusetts casino license to the racetrack. 

Wynn knows that, on top of what he is committed to paying Everett, he probably can’t afford to pay Menino what he’d demand of him if Menino obtains host city status for his casino project.

Rather than settle voluntarily by the end of this week, both sides will almost certainly roll the dice with the Gaming Commission.

Wynn has a strong case that not one inch of his Everett casino will be built on the sliver of Boston land that abuts the old Monsanto site, just across the Mystic River from the Charlestown section of Boston. But Menino has at least a chance that the commission will grant him host city status because of that sliver.   
Stranger things have happened in Massachusetts politics.

Menino is too protective of Boston and too good a politician not to go for a checkmate move via the commission.  Winn is too good a businessman to willingly give Menino anything that resembles checkmate on a billion-dollar project.

EPILOGUE: Within hours of my posting this item, the Boston Globe published an article proving my thesis was way off base: "Boston gives up claim on Wynn casino," Saturday, Sept. 7, 2013.  It hurts to be wrong, but for me it is a familiar pain.

"Mayor Thomas M. Menino's administration has agreed to begin talks with Wynn as a 'surrounding community' under the state's casino law, according to a joint statement Friday from the city and Wynn," the Globe reported.  

The article did not state why Menino had dropped his bid to secure host city status, although it noted that: "The two sides say their appearance Wednesday before the gambling commission helped break the stalemate."

From that, it's fair to infer that Menino realized after the Wednesday hearing that he did not have the votes on the commission to win, and probably would not be able to change the minds of enough commissioners in the limited time available to him.  He thus decided to exploit the inevitable by embracing the surrounding community negotiations, not only because this will make it easier for both parties to negotiate in a professionally friendly manner, but also because he's likely to get a (slightly) better deal by playing nice with Wynn. (Politics is like football in that it's a game of inches.)

Bottom line: this was a big win for the man from LasVegas.