Big Ideas Shrink When All We Talk About Is Which Candidate Has Big Bucks

Thursday, May 31, 2018

News coverage of the candidates for governor this year seems fixated on campaign cash: how much Republican incumbent Charlie Baker has and how little the candidates in the Democratic primary, Jay Gonzalez and Robert Massie, have.

Yesterday, for example, The Boston Globe reported that Baker is sitting on a campaign account of more than $8 million and that Democrats Jay Gonzalez and Robert Massie have, combined, only $132,000.
Until after the Sept. 4 primary, and until the winner of the primary raises many millions of dollars, we are not likely to hear a whole lot about what Gonzalez and Massie stand for or what they want to do as governor.

That’s too bad.  Each Democrat is peddling some audacious ideas.
To ease the struggles of persons with addictions, Gonzalez, for example, wants to require health insurers to cover the cost of medical marijuana.  And, to reduce deaths by overdose, he wants the state to allow safe injection sites.

To combat climate change, Massie wants to block all investment in new fossil fuel infrastructure of any kind, such as gas pipelines and power generating facilities that burn oil and/or gas.
I, personally, don’t support safe injection sites or a freeze on new fossil fuel infrastructure. I think medical marijuana as a reimbursable treatment for addictions may have merit but should be approached with caution because of what it could do to exacerbate the already high cost of health coverage.

Nevertheless, the media should give Gonzalez and Massie all the space and air they need to make their cases.  Too much coverage of the political horse race they don’t have the money to run makes for a less exciting, less meaningful election.
At this point in the calendar, we already know that safe injection sites are an idea whose time has not come in Massachusetts.  The legislature’s Joint Committee on Mental Health and Substance Abuse decided on May 3 to send Senate Bill 1081, An Act to Authorize Public Health Workers to Pursue New Measures to Reduce Harm and Stigma for People Affected by Substance Use Disorder, “to study,” legislature-speak for waste basket.  SB 1081 proposed to create safe spaces for drug users to take pre-obtained drugs under the supervision of health care professionals.

I’m probably missing something therapeutically valid or significant here but how does a safe injection site for morphine addicts do anything ultimately beyond ensuring the continuation of an addiction?  When SB 1081 was heard on Aug. 24, 2017, at least one witness, Ronald Hill, who described himself, according to the State House News Service, as a recovering addict, made this point better than I can. 
“If I’m high, you ain’t going to tell me about no treatment,” Hill told the members of the Committee on Mental Health and Substance Abuse.  “When I hear about treatment is when I got no money and I’m desperate.  But when I’m high, you can talk to me all day long.  I don’t hear you.”

Moving to medical marijuana as a component of addiction therapy, please consider the following from the web site of the National Institute on Drug Abuse (NIDA), whose mission is to “advance addiction science.”  NIDA reports that it funded two studies exploring the relationship between marijuana legalization and adverse outcomes associated with prescription opioids. 
“The first study,” it said, “found an association between medical marijuana legalization and a reduction in overdose deaths from opioid pain relievers; an effect strengthened in each year following the implementation of legislation.”

The second study “was a more detailed analysis by the RAND Corporation that showed legally protected access to medical marijuana dispensaries is associated with lower levels of opioid prescribing, lower self-report of nonmedical prescription opioid use, lower treatment admissions for prescription opioid use disorders, and reduction in prescription opioid overdose deaths.”
Gonzalez could be onto something.  If he has the stuff to fight the uphill battle for a new insurance mandate, let him at it.






Obsess with Me a While Please on This: Is Health Care a Right?

Friday, May 25, 2018

“Health care is a right!”

Someone is bound to say that whenever our nation's excessively costly health care system is being debated and pronounced upon. 

But, until early this week, I hadn’t heard it in a while, which meant I had been able to avoid obsessing over it, as I tend to do, for reasons I cannot explain.

Then an email from the campaign of Barbara L’Italien, the Andover Democrat state senator running for Congress in the Third Massachusetts District, arrived in my inbox on Monday, May 21, at 3:57 p.m. I’ve been obsessing ever since. 

In the voice of the candidate herself, this is what that email said:
“Health care is a right, not a privilege, which is why I’ve spent my career fighting for a single-payer system.  With endorsements from Mass-Care and the Massachusetts Nurses Association, I’m proud to be the single-payer candidate in this race.  It will be one of my biggest priorities in Washington…Every single person in this country has the right to accessible, affordable health care, and it’s time for our elected officials to make that a reality.”

All human beings have a God-given right to freedom and equality.  All have a right to think, speak, and worship freely.  We have the right to raise our children as we see fit, within the bounds of safety and reasonable care.  These are things we know naturally to be true.
How can we say the same about health care? 

How can we, with the same degree of human certainty as when we talk about the right to free expression, say that we have the right to show up in a doctor’s office or emergency room and demand our share of care?  
Good persons say exactly that all the time. 

Pope Francis, for example, said, “Health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”  And Franklin Delano Roosevelt, my all-time greatest political hero, said, “We have accepted, so to speak, a second Bill of Rights under which a new basis of security and prosperity can be established for all regardless of station, race, or creed.  Among these are…the right to adequate medical care and the opportunity to achieve and enjoy good health…”
Now, I’m a believer in universal health coverage.  I never want to see anyone denied needed care.  I think it’s simply a matter of creating a smart insurance system that will cover everyone, as many developed countries did two or three generations ago.  It all has to do with smarts and good management, both of the business and political varieties. Universal coverage is not about socialism vs. free enterprise. 

Four hundred years ago, we agreed that insurance is a good thing.  Why in the name of Grey's Anatomy (or Ellen Pompeo, for that matter) are we still arguing about whether health insurance for everyone is worth having?
I agree not with FDR but with U.S. Senator Rand Paul, R-Kentucky, a political anti-hero of mine.  A medical doctor before entering public life, Paul said, “With regard to the idea of whether you have a right to health care, you have to realize what that implies.  It’s not an abstraction.  I’m a physician.  That means you have a right to come to my house and conscript me.”

I also agree with John David Lewis, a professor of philosophy, politics and economics at Duke University, who said, “There is no ‘right’ to anything that others must produce, because no one may claim a ‘right’ to force others to provide it.  Health care is a service, and we all depend upon thinking professionals for it.”
Let’s approach this question from another angle:

When a person stands up to speak at a town meeting, he does not thank the board of selectmen for allowing him to express himself in public.  When that same person is discharged from a hospital after life-saving surgery on his brain, he would not dream of not thanking his neurosurgeon.   

I cannot imagine the philosophy and ethics of "health care is a right" having a bearing on the Third District contest.  L'Italien, however, could gain an advantage by presenting herself as "the single-payer candidate."  Single-payer almost carried Bernie Sanders to the Democratic nomination for president.  Single-payer has only more resonance now with voters -- and especially in a liberal Massachusetts district centered in Lawrence. 

With 12 Dems running in the Third District primary election, scheduled for Sept. 4,  the winner may only need a share of the total vote as low 22% or 24%, meaning a city as populous as Lawrence will have outsized importance. 

...Meantime, I'll keep wishing that L'Italien were talking about health care more in the terms of insurance than of the Bill of Rights.

Prison, Fine and a Federal Ban Behind Him, Stat Smith Wants Back in the House

Friday, May 11, 2018

What does it take to run again for the same public office you resigned from because you manipulated the balloting process and were going to prison?


A compulsion for vindication?

Whatever it takes, Everett’s Steve “Stat” Smith apparently has it in spades.
In December of 2012, Smith agreed to plead guilty to civil rights violations and resign from the Massachusetts House of Representatives (28th Middlesex District) for his role in submitting fraudulent absentee ballot applications and casting invalid ballots in multiple elections in 2009 and in 2010.

In April of 2013, Smith was sentenced to four months in federal prison for two misdemeanor counts of voter fraud, ordered to pay a $20,000 fine, and prohibited from running for public office for five years.
I remember talking to a friend in Everett at that time, someone who knew Smith well and who talked with him after his sentencing but before he reported to prison.  This is what he told me:

“Stat says he’s running again.  That he’ll be back (in office).”
“Could he get elected again?” I asked.

“Yes. He could,” said my friend.  “People have short memories.  And do they really care about this kind of cheating?  But who knows?”
We are about to find out.

The Secretary of State’s office told the Everett Independent that Smith took out papers needed to run for his old House seat on Friday, April 13.
“Smith has been seen over the past weekend,” the newspaper reported on Wednesday, April 18, “gathering signatures and talking with longtime supporters. Those close to the matter indicated he had gathered as many as 500 signatures over the weekend.”   

At the time of Smith’s guilty plea, here’s what Lanny Breuer, then an assistant attorney general of the Commonwealth said:
“Representative Smith compromised the legitimacy of his races for public office by facilitating the casting of invalid ballots for ineligible and unaware voters.  In doing so, he undermined the democractic process in Massachusetts and violated the public’s trust.”

Carmen Ortiz, then the U.S. Attorney for the District of Massachusetts, said:
“Fair and free elections are the foundation that this great nation was built upon.  Our electoral system is unrivaled, and it is egregious that an elected member of our Commonwealth would rob his constituents of a fair and honest election.”

Richard DesLauriers, then the special agent in charge of the FBI’s Boston Division, said:
“Over the last two years, the FBI methodically uncovered a voter fraud scheme designed to strip Massachusetts voters of their right to a fair election.  Representative Smith, who was a member of the legislature’s Joint Committee on Election Laws, embarked on a scheme that he knew violated the ideals of our nation and disregarded the proud history of the Commonwealth.  Whenever the pillars of government administration – equity, efficiency, and effectiveness – are undermined by corrupt public officials, the FBI will focus on those responsible.”
  • Compromised legitimacy of his races. 
  • Robbed constituents of a fair and honest election. 
  • Embarked on scheme that violated ideals of our nation.
These are the ready-made bullet points for the campaign literature of the two persons standing in the way of Stat Smith's political comeback, Rep. Joseph W. McGonagle, Jr., and Gerly Adrien.

Politically, Everett has always been a rough-and-tumble place.  Being an Eagle Scout has never been a pre-requisite for holding elective office there.  Smith's candidacy is not a joke in Everett and McGonagle will never treat it that way.  McGonagle knows he's in a fight for survival, not only because Smith knows how to handle himself in the political arena but also because there are three candidates in the race.  Gerly, who ran well in a losing race against McGonagle two years ago, could siphon enough McGonagle votes to give it to Smith.

I doubt it will go that way.

McGonagle has done a good job and is popular in his district and in the State House both.  The Speaker and other members of leadership like him and will want to help him as much as they can behind the scenes this spring and summer.  (BTW, the Speaker and his team are not crazy about the idea of having Smith back in the building.)  

McGonagle serves on five different legislative committees, including Ways & Means, which controls the state budget, and the Joint Committee on Housing, of which he is the House vice chair.  He will be able to make the case that he's in position to do more for the City of Everett and its citizens than either of his opponents could, Smith because of the baggage he's carrying, Gerly because she would be a rookie rep.

Winning Amazon's HQ2 Would Likely Complete Seattle-ization of Boston

Monday, May 7, 2018

If Amazon did in Boston what it did in Denver as part of its ongoing quest for a second headquarters city (HQ2), I hope someone has written an inside account of the proceedings and will release it soon to the public.

The New York Times reported that a 10-person Amazon team met in January with Denver officials to discuss their city’s HQ2 bid, [“One Goal of Amazon’s HQ2: Learn the Lessons of Seattle,” 4-29-18].
During that get-together, Amazon reps asked questions focusing on how local officials could help them avoid recreating in Denver problems exacerbated in Seattle by HQ1, like traffic congestion and high housing costs.

“I think they feel in Seattle they’re the scapegoat every time there’s an issue in the community and traffic,” Sam Bailey told The New York Times.  Bailey is vice president of economic development for the Metro Denver Economic Development Corporation.
Denver, like Boston, is among the 20 finalist cities in the HQ2 competition; Suffolk Downs, the old racetrack on the East Boston-Revere line, is the leading metro Boston site for HQ2.  Wherever HQ2 lands, it has been estimated that up 50,000 new Amazon jobs will follow.

In Massachusetts, officials seem unanimous in declining to discuss the state of their talks with Amazon.
Numerous New York Times readers posted comments at the end of the online version of “One Goal of Amazon’s HQ2…”  My favorite was by “Josa of New York, NY,” excerpts of which follow:

“As much as I’m a fan of Amazon, they are one of the reasons I left Seattle and have no plans to return.  Amazon has, unfortunately, been a huge part of what has made Seattle increasingly unlivable (unless you make well into the six figures, that is).  And because so many people who work in Seattle now can’t afford to live in or near Seattle, every day there are twenty-mile backups in both directions leading into and out of the city…
“With the huge influx of high-paying jobs, you have boutique markets and yoga studios and pet studios popping up all over the city.  And because landlords only want to rent to wealthy people, it’s become harder and harder for the middle-class people to keep what trembling foothold they have on a middle-class lifestyle in the Seattle area. If you’re poor, there’s no way.”

Here’s the link to the 4-29-18 article: