Watch Out for the Buzz Words in Green Mountain Care

            The Vermont legislature has laced the new single payer health care bill with a lot of Orwellian words and phrases that upon close inspection have  negative implications for the future of health care for us Vermonters.

Accountable Care Organization (ACO).  This is the government’s version of the Health Maintenance Organization.  The ACO is supported by the same people who opposed  HMOs in the 1990s.  All Vermonters will be assigned to an ACO most likely based upon geographic considerations, proximity of hospitals, clinics and other health care providers.  Providers will be employed by the ACOs.  The ACO will put everyone in a government prescribed health care organization whether they like it or not, and force a move away from individual to group health care.

Pay for Performance (P4P).  Under Green Mountain Care health care providers are to be paid based upon a number of criteria applied to accountable care organizations.  For instance, an ACO will be considered to be doing well if it controls costs by operating within its assigned budget, if hospital readmissions are kept to a minimum, and if overall outcomes meet  standards determined by the government.  In the event the State bureaucracy determines that an ACO is doing well, it will allow for bonus payments to physicians and other providers.  “Doing well” means staying within budget. It does not mean providing appropriate health care for individual Vermonters.         

Out of Network/Cross Border Care.  The new health care bill mentions these issues in passing, noting only that they will be dealt with at a later date.  Dr. Hsiao said in his report that there will need to be disincentives for people who wish to obtain care outside of their Accountable Care Organizations.  If disincentives to receive treatment out of state, as Dr. Hsiao recommends, are placed into Green Mountain Care,  then those of us  who live on the eastern side of our State will be discouraged from going to  Dartmouth Hitchcock in Hanover, NH or to a specialist in Boston.   We do not yet know what those disincentives will be, but they would range from requiring Vermonters to pay more for out of state services to refusal to reimburse Vermonters for out of state treatment.

Global Budgeting.  Global budgeting amounts to the imposition of an overall health care budget by the State of Vermont.  It is meant to control costs.  Its effect will be to limit the availability of individual health care options.  For example, , high cost diagnostic options involving new and effective imaging technologies will be curtailed.  As applied to Accountable Care Organizations the incentive will be to spend less on health care for its member population in order to meet budget targets.  

Evidence Based Medicine.  Government run health care will seek to control costs by establishing treatment protocols for various health care issues.  Approved protocols will be based upon health outcomes for large populations with the same basic diagnosis.  This will interfere with patient/provider relationships to the extent that it limits treatment options and fails to recognize that every individual is different.  When most of us go to doctors we expect them to exercise their professional judgment on our behalf without being constrained by limited treatment options.

Basic Benefit Package. Under Green Mountain Care, the basic benefit package is to be determined by the five person Health Care Reform Board.  No one knows at this point what will be included, but it will be subject to change every year.  The concern is that in years of tight budgeting, the basic benefits available will be cut back.

Wrap Around Insurance.  Dr. Hsiao, in his report to the legislature acknowledged that the basic benefit package to be offered in the State’s single payer system will likely not meet the needs of many Vermonters.  Therefore it will be necessary to purchase additional insurance from private insurance carriers to cover needs not met by the State.  We should be concerned that no one has identified the cost of these policies, and no one has determined whether insurance companies will even be interested in offering them to fill the unique needs of the tiny population of Vermont.     

Provider Tax.  This is a tax levied upon providers including hospitals. It was raised in the current legislative session from 5.5% to 6.0% of revenues.  The rationale for increasing this tax was to leverage higher reimbursement rates from the Federal government for Medicaid.  The effect is to increase the cost shift to private payers which will increase the cost of insurance to all of us who pay premiums.  The logic of this tax is questionable because it actually increases the cost of health care to Vermonters. 

Cost Shift.  Medicaid and Medicare consistently underpay for health care services provided by hospitals and other providers at rates that typically run at 50% to 60% of cost.  The difference is largely made up by private health insurance companies and by private payers.  This is the cost shift. When we complain about the dramatic increases in health insurance premiums, we need to keep in mind that the root of the problem is underfunding by the State and Federal governments.   

Bucket List--Part II

Author's Note:  I wrote this a year ago after a winter trip to Yellowstone.  It was a fabulous adventure, and I highly recommend you put it on your bucket list.

A Winter Adventure in Yellowstone Park

By Deborah T. Bucknam

                In 1962, my parents decided to take the family on a camping trip to the west.  Four teenagers, one eight year old, and two adults piled into a 1958 Chevy station wagon with our camping gear on top in a wooden car carrier made by my father. We camped in a ten-man circus-like tent, and saw, among other things, the memorable sights of Yellowstone Park.   I always wanted to go back.

In January 2010, I went back to Yellowstone with my husband, Charlie, to cross country ski in the Yellowstone backcountry.   We were not at one of Yellowstone’s famous old hotels or lodges, but in a yurt camp located near the winter-abandoned Canyon Village, about 45 miles northeast of Old Faithful.  The camp is run by Yellowstone Expeditions, which enjoys the only yurt concession  (and has for 37 years) in Yellowstone.  Because of our remote location and strict limitations on motorized vehicles, we were virtually alone in the Yellowstone wilderness.

The yurts are a bit more modern than the ones located on the Central Asian steppes.  They are individual structures with wooden sides, a canvass top, a propane space heater, one light bulb, and a bed on a wooden platform.  That did not keep out the cold entirely, so the bed sheets were flannel inside sleeping bags.  It was quite cozy.  The camp also boasted a large, more traditional yurt that housed the kitchen and dining room, heated by a rather decrepit wood stove and softwood, as there are virtually no hardwood trees in Yellowstone.   The toilet facilities consisted of an outhouse heated by a space heater, its blue flame a welcome sight in the middle of the night after a cold walk from the yurt.    Another outdoor shed housed a shower, which was considerably more pleasant than the outhouse.  The shower shed contained a floor to ceiling space heater, which made the small shower area satisfyingly warm, and almost made me forget that I was going to have to step out to the cold dressing room after the shower.  The shower consisted of a large bucket of very hot water hauled from the yurt kitchen, with a hose at the bottom and a clamp for turning the water on and off.  The bucket was large enough for a satisfactorily long shower.  Another luxury item at the camp was a real sauna ferociously heated by a propane space heater.  It was wonderful.   The finest luxury: there was no satellite, phone or wireless service so we had no communication with the outside world.

We had two guides who cooked our meals, cleaned up afterwards, and took us on ski tours. During the week we were at the yurt camp, there was only one other “camper”.  Oregonian Peter Reader was 71 years old and a veteran of 32 marathons, so his overused knees would not allow him to ski.   Consequently, we had a ski guide all to ourselves while Peter took to the snowshoe trails with the other guide.   In Yellowstone in the winter, the roads are groomed, not plowed, so that only snowmobiles and motorized snow-coaches can travel the roads.  Snowmobiles are limited to no more than ten in a group, with a licensed Yellowstone guide in the lead.  They are not allowed to travel anywhere except on the roads.  Snow coaches are regular vans fitted with skis and tracks similar to snowmobiles, and as a result, they can only go about 35 m.p.h.   

The first day, we took a daylong tour on the snow coach to Old Faithful and other thermal areas on the way to the yurt camp.  Old Faithful lived up to its promise, and the other thermal features were impressive in the winter landscape.  There were about 40 people viewing Old Faithful—far less than the hundreds of sightseers present for the event on a summer’s day. 

The second day, we skied from camp along the north rim of the Yellowstone canyon.  It was a beautiful clear day, and we viewed the icy lower and upper falls from our perches on the rim.  While there was plenty of snow, the canyon was still colorful as it has several thermal features where there was no snow, and the steep sides did not allow much snow to stick.  Our guide, Sarah McCormack, is a biologist and knowledgeable not only about Yellowstone wildlife, but also about the geology of the area.  So we were treated to information about the geological features as well as information about the Yellowstone animal and plant life.  Sarah pointed out tiny mistletoe growing on the pines, which caused cancer like thickening in the affected area, and eventually death to the tree.  The 1988 Yellowstone fire—the devastation still evident in the hundreds of thousands of dead trees still standing—killed not only the lodge pole pines, but also the native mistletoe, allowing for young healthy trees to rejuvenate the forest.  In the evening, we were treated to Sarah’s baked salmon and good political talk.  Peter is an avowed socialist, and we had fun sparring cordially about politics.

The next day, we trekked across alpine meadows south of the Yellowstone canyon region to a thermal area hidden in a valley of lodge pole pines. We ate lunch on top of a meadow in a grove of pines, then skied down to the thermal area.  We saw bubbling mudpots, steaming geysers and emerald green hot springs. 

On the morning of the third day, we skied to the top of Dunraven pass, not going further because of avalanche risk, and enjoyed a magnificent view of the Washburn Range.  In the afternoon, we skied to another thermal area, crossing sage covered hills and valleys.  This area boasted the blue geyser, which spouts sapphire blue water.  We saw much evidence of bison that had relaxed on the warm thermal ground, as well as wolf and coyote tracks crossing through the area. 

The last day of skiing featured a fun downhill ski along a snow-covered road beside a stream that turned into a large waterfall, and around one corner, a view of the western mountains.  Sarah dropped us off and picked us up at the bottom of the road, a nice relaxing ski trip after some fairly strenuous (for me) ski treks on the previous days.

Each day we saw wildlife up close and personal.   The bison herds were large, and the bison often trudged along the roads, causing our snow coach to stop for long periods waiting for them to get out of the way.  They used their large heads to scoop out the snow to reach the frozen grass below and their heads were often snow covered.  Coyotes periodically trotted along the road or through the meadows comfortable in the cold snowy landscape.  Trumpeter swans,  Golden Eye and Bufflehead ducks swam in the thermal heated waters of the Yellowstone River, and otters slid and played along the colder upper reaches of the Yellowstone.  One morning we were treated to the sight of a small wolf pack—one male and two females—loping along the road out of Canyon village.  We were in the snow coach, alerted to the wolves by one of the guides who had been out early that morning looking for wolves after hearing their early morning howls.   We kept a respectful distance until a ranger and a wildlife photographer on snowmobiles came the other way.  We all stopped, but the wolves felt trapped.  The two females were brave enough to finally trot by the snowmobiles, but the Alpha male would have none of it.  After hesitation, he jumped into the woods.  We traveled on slowly, and our guide said that she thought the Alpha male would come out of the woods eventually to find his female companions.  Sure enough, the male came out of the woods behind us, and screwed up his courage to trot by the snow coach to find the rest of the pack.  So we had a splendid view of the black male wolf right next to our vehicle.   

Because of our remote location and the strict rules for snowmobiles, when we went off the road to ski, we were absolutely alone.   I could imagine this dazzling place as John Colter first saw it in the winter of 1807-1808 when he left the Lewis and Clark expedition to explore the western mountains by himself.   Colter reported his findings of bubbling mud pots, geysers, and hot springs when he returned to civilization. He was derided by Easterners, who called his descriptions of Yellowstone  “Colter’s Hell”.   Exploring Yellowstone as Colter did made me appreciate the wonder he must have felt as well as the Easterners’ skepticism.

January is an ideal time to visit Yellowstone.  The geologic and thermal features are more distinct in the winter and the wildlife is abundant.  And exploring Yellowstone alone in the wild is an unforgettable experience.

True North Radio warns that Health care "reform" is a job killer

True North Radio has shone a light on the Vermont General Assembly's disregard for Vermont's biggest job creators.   In this article, True North reports that Republicans introduced an  amendment to H-202 to ensure that the biggest employers in the State like IBM and General Electric, who self insure their employees under ERISA,would not be double taxed under Health Care "reform" .  The amendment failed in the General Assembly.  

How Not to Lower Health Care Costs

In an fascinating sleight of hand, Governor Shumlin and the Vermont Democrats have now changed their emphasis from promoting health care “reform” as universal access to health care (we already have it) or universal health insurance coverage (93% of Vermonters are already covered) to claiming health care “reform” is a way to contain health care costs. Gov. Shumlin’s recent reaction to the House passed Health Care “Reform” (H-202) reveals this change in emphasis. Governor Shumlin bragged H-202 was the “…beginning of a plan …that spends less money, makes Vermonters healthier, gets rid of the waste and bureaucracy in the system, and allows us to deliver quality health care to all Vermonters at an affordable price."

This is pure nonsense. The empirical evidence is incontrovertible. In every single economic sector where government has tried to regulate costs, costs have skyrocketed. And in every sector where government has abandoned its regulatory effort to control costs, costs have declined, often dramatically.

Remember the Interstate Commerce Commission? Established in the 1880’s, its purpose was to control costs in the trucking and rail industries. When the commission was scrapped by the Motor Carrier Act of 1980, trucking and rail costs plummeted, resulting in lower costs in every other economic sector that was dependent on rail and truck deliveries.

Similarly, the Civil Aeronautics Board regulated the cost of airline tickets. When the Airline Deregulation Act was passed under President Carter in 1978, plane fares were cut dramatically, and the American public took to the air in unprecedented numbers.

The Federal Communications Commission regulated the telephone monopoly, AT & T (“Ma Bell”). The Commission, far from representing consumers, protected Ma from anyone who tried to improve telecommunications service. For example, in 1957, a young entrepreneur tried to obtain permission from the FCC to market a product called a “Hush –A-Phone” a plastic device that made phone calls more private. With AT & T opposing the device, the FCC would not allow it to be marketed. It wasn’t until Ma Bell was broken up and the telephone industry de-regulated that rates went down dramatically, and as a result of competition, telecommunications technology took off. Today the quality and variety of telecommunications bears no resemblance to Ma Bell and her black rotary phones.

In each industry, labor and management opposed deregulation. Why? Because they both had a cozy relationship with regulators, and they preferred to retain that relationship rather than risk competition with customers they could not control. It is much easier to hire lobbyists and lawyers whose job it is to get to know the regulators and their staff and to persuade those regulators that proposed price hikes and stifling any competition both benefit the public.

Health care “reform” panels will not contain costs. The health care panel will end up operating like any government commission formed to control costs, no matter what their good intentions. The “experts” with whom the panel will deal will be from those sectors which are regulated. The public will not have an adequate voice in the process. The result will be higher costs, lack of innovation and lower quality health care.

What has been proven to lower costs and increase quality? The deregulation of airlines, trucking, rail and telecommunications provides the answer. Competition will lower the cost of health care and enhance the quality of health care. The Vermont legislature should be providing incentives for competition, like my earlier proposal, rather than trying to regulate costs with a system which has repeatedly been proven a failure.

The Real Estate Market: The Government Gets It Wrong

The housing market is still in a slump slowing the recovery of our economy.  What is the solution to revitalizing the housing market?

First, we need to analyze why we are in this situation.  In the 1970’s, the Community Reinvestment Act went into effect, largely because many banks were avoiding lending in poor neighborhoods in big cities.  Rather than considering individual credit, they were “redlining” entire areas in large cities as off limits to lending.  It was a simple way to avoid risk, but a shortsighted policy.  Lazy lenders were not bothering to determine individual risk but were disqualifying entire communities.

The government’s solution was to require banks to invest in low income communities.  The government enforced that requirement by mandating a certain level of lending in the affected areas. However, the government set unrealistic requirements. There were certainly credit worthy customers that banks had ignored in the affected areas, but the level of lending the government sought would have resulted in banks lowering credit standards. Because banks were regulated by the government which required certain credit standards, banks were put in an untenable position—they could not lower their credit standards, or they would run into trouble with regulators; but those same regulators required investment in the affected communities at an unrealistic level.

Government attempted to fix the problem it created by allowed Fannie Mae and Freddie Mac to lower their credit standards while providing mortgage guarantees for most mortgages issued by banks.  Banks, seeing a way to meet their CRA goals, lent money to low income households in the affected CRA areas, knowing the loans would be guaranteed.

 

The government’s good intentions had major unintended consequences. Not only did lower income households qualify for loans that under past higher credit standards would not qualify, but higher income families began to purchase homes beyond their means.  Because of the increase in demand for homes, home prices shot up creating a classic bubble which finally burst in the summer of 2007.

The government is now trying to solve the housing problem by forcing tax payers to subsidize home mortgages that are under water.  This policy is contributing to our stalled economic recovery:  Government is interfering with the normal market cycle in real estate; and, the increased tax burden hinders economic growth.     

The housing crisis can be solved by reducing government involvement in the market.  Here’s how: 

• Stop the mortgage buyout program.  Let the market do its job.
• Maintain mortgage guarantee programs that help low income households through Fannie Mae and Freddie Mac but reduce the percentage of the mortgage guaranteed from the present 95% to a more realistic 85%, so that buyers have to put a realistic down payment on a home, and reduce the maximum guarantee amount from $750,000 mortgage to $300,000. There is no need to continue subsidizing people purchasing high priced homes.
• Continue low income housing tax credits.

As we reduce the government involvement in the housing market, the free market will adjust and reinvigorate the housing market.  As long as government continues to artificially try to prop up markets, the uncertainty created and costs to taxpayers will be a drag on our economy.      

Missing Grandpa

We would arrive at my grandparents' house late on a Friday night -- usually 10:00 -- when I was a kid, overtired from the long drive south. My parents were not the coddling types. Rather than carry me into the house and place me gently in bed, they would wake me up, make me walk inside to greet my grandparents properly. Then, rather than let me go to bed, they would plunk me down at the table with the adults, where I would wait for the signal that I could finally go to bed. Forgotten -- seen and not heard -- I would wake up enough (having given up on ever going to bed), to hear my mom and her dad, my grandpa, already deep in a political discussion. There'd be "hollerin'", as Grandpa put it, and pounding on the table. "Now, Dad", Mom would say, "it isn't quite like that", and she'd launch into her counter-argument. And the two would argue back and forth. Grandma would shake her head, and when voices got raised too high, she'd leave the room or change the subject -- and it would finally be time to go to bed.

By today's standards I should have felt traumatized by these conversations. But I relished these arguments. They weren't yelling, in my view; they were discussing political topics. There was no name-calling; there were no hurt feelings. It was a full-on discussion, and I loved it. I still do.

As I grew up, I learned that politics was off-limits; that it was considered impolite to discuss politics with anybody any time, anywhere. Getting animated and excited about your view was low-brow, unacceptable. We were allowed to discuss anything -- gossip, the weather, anything at all -- other than anything that really matters -- like religion and politics. I have had friends come right out and tell me they don't want to talk to me about anything substantial -- but otherwise we can be friends. What? What kind of a friendship can we have if we can't discuss or argue over anything meaningful? If only your choice of lunch or the weather next week are possible topics?

The idea that Americans should discuss nothing of importance is one hundred percent wrong and has led us all to today -- where overheard discussions center on the latest android, the weather, celebrity's mishaps, Justin Bieber's haircut. What is the point of free speech in the United States of America if we are not allowed to discuss sensitive topics, according to our peers? The United States was founded on the idea that we should and must discuss ideas freely, openly, and loudly. We are not supposed to be subdued, polite company, but inquisitive, challenging, loud and boisterous company. We Americans need to cut out labeling each other "mean" for disagreeing and we need to get back to hollerin'.

Bill Me Now, Please!

Recently I was at the doctor's examination room with a child, where the person from the billing department had followed me and was discussing copayments. (The new law has completely perplexed our doctors' billing department's in the area of copayments). The doctor arrived to treat my child, and he made some comment about having no idea about billing -- he just treats the patients and leaves all the payment issues to the billing department. I thought this was odd -- not that he should be handling the bills, but that he had no idea of the costs associated with his job and does not wish to know. He considers billing beneath him. That's fine (I have no interest in billing either and would hate to run a billing department). But still, we should all know what our medical care is costing us -- the doctors who provide the care, the patients who receive it, as well as the insurance companies who "cover" it.

Speaking of insurance, with insurance policies today, doctors generally order a myriad of tests for a vague ailment, and I as the consumer have no idea of the cost. There's never a mention of cost, except as to a concern whether insurance will "cover" it. We just hope that we have "good insurance".

After undergoing a series of tests, most of the time I hear only that the test was "normal" or whatever, but this is only after a phone call. I never receive paperwork (except the stray postcard with a "check" for "normal"), an email, and I have never received the results of an actual test. Although, admittedly, after receiving an MRI, I did skulk over there once to request a copy for myself. (There's nothing like having a creepy picture of one's skull stashed in the closet). Then insurance mysteriously "covers" the test, except that we'll occasionally receive a stray bill from the doctor or test facility, which we then spend a few weeks or months trying to "deal with" -- which means trying to get the insurance company to "accept the right code" from the doctor's office. It's a strange system. We'd at least be better consumers if we actually received a statement of the costs -- perhaps even before undergoing a fancy test.

Speaking of billing and doctors, it would also be nice to be able to actually choose a doctor whom we like. Recently I was speaking to my mom about building up her practice and I suggested that she put her legal track record on her website. She could mention cases won, describe issues she tackled, Vermont Supreme Court experiences -- that sort of thing. "Oh no!" she said. "I couldn't do that. That violates the ethics rules. You should know that!" I guess I should, being a lawyer and all (no, I'm not practicing -- it's been a few years). So in the legal field, people apparently choose their lawyers based on hot tips, and I guess if they want to comb the court records, they could piece together a case for who's "good".

With eight people in my family, choosing a doctor is similar, but it's also nearly impossible. We are supposed to have "choice", but woe to the person who actually has a specific doctor in mind!

I am always looking out for a great doctor. When I get a tip from someone, I call the office in question to see if we can start seeing that doctor. Rather than hearing a gasp of delight at the prospect of a new patient, every time I hear "She's not taking any new patients". And yes, it's usually without the "sorry" part. Then there's an uncomfortable pause and then... the question whether I would like another doctor. And then I'd like to say, "Yes, who's good?" But of course, that would be inappropriate and I wouldn't get a good answer anyway. I'd get something like: "All our doctors are good. They went to medical school, after all." Or something like that.

Here's the secret: not all doctors are good. Not all lawyers are good. Not all plumbers are good. Not all teachers are good. Not all librarians are good. Not all pastors are good. There is a difference in skill level and interest among people in all fields. Some people are devoted and enthusiastic in their work; some look at their jobs as something to get through -- and that applies to professionals as well as to everyone else. I want to be able to pick the doctor who's good -- and not have to base it only on a tip from a friend, the age of the doctor, or the doctor's medical school (this is the extent of information I seem to have available), or on whether the doctor is "accepting new patients." I think opening up our healthcare system so we all know costs and actual prices charged and allowing us to share information openly about quality so we can figure out who's good is a terrific idea. I am opposed to regulation, but I support access to information. As consumers of medical care, we should know who our doctors are and what our medical services, from doctors' visits to medical tests, actually cost.

Single Payer Health Care: Promise and Reality John McClaughry

Ed. Note:  Here is an article by Ethan Allen Institute's John McClaughry.  The General Assembly is speeding towards government control over 1/6 of our economy, and John's article rightly points out the huge problems that will ensue as a result.

            The Vermont legislature is about to take its first decisive step toward imposing a grand single payer health care mega-system on most of the people of the state. The House will vote this week to advance H.202, the “road map” bill to launch “Green Mountain Care”.

            The single payer idea springs from at least three arguments. One is ideological – the belief that health care is a “human right”.  As such, the advocates believe, government must use its power to force other people to pay for what the government believes to be “appropriate health care at the appropriate time in the appropriate setting.”

Our state and national constitutions affirm that every person has individual rights that governments may not prohibit or infringe. But nowhere can be found a right to enjoy government-mandated health care.

            The second argument for single payer flows from dissatisfaction with the operation and financing of what the advocates would call the present chaotic health care “non-system”: a collection of patients, providers, insurers, employers, programs and regulators that, because of continually competing interests and inefficiencies, produces inadequate care and unnecessary costs.  To the advocates, one grand government-run, centrally coordinated single payer system will assure superior care, maximize efficiency, and save hundreds of millions of dollars.

When skeptics point to the very apparent failure of the single payer systems of Canada to achieve those standards, the Vermont advocates reply “But we are Vermonters – we can make it work” (an actual quote). Given the malign contributions to the present health care “non-system” inflicted by unwise government policies over the past 50 years, this assertion does not satisfy many of the skeptics.

The third argument for single payer is political and rarely stated. Even if the single payer System fails to fulfill its lofty promises, it will put the government in control of all employers, medical providers, insurers (if any), and patients. The government’s power and reach will expand dramatically.

That will mean many more jobs for (unionized) government bureaucrats. It will require unionization of doctors and other professionals who will have to bargain with the public body over their compensation and working conditions. It will mean more campaign contributions and votes for politicians who will work to rig the system in favor of their particular group of “stakeholders”. 

If the State becomes the final authority over $6 billion worth of health care spending, it will matter a lot who controls the State.

The House bill gives page after page of instructions, and $1.1 million, to administration officials and the Green Mountain Care Board -  referred to under the Dome as the “Jedi Council”.  According to Dr. William Hsaio, the consultant hired by the legislature, this supposedly “independent” five- person body, appointed by the Governor, is designed to “remove the budgeting decisions from the political process.”

The Board will determine what “high quality, medically necessary” benefits the taxpayers will pay for, and for which patients; how much hospitals can expend; how much the doctors, dentists, hospitals and nurses will be paid for performing which Board-authorized services; how much of the System’s costs will be shifted onto the providers by underpaying them; and what payroll and other tax rates the state will need to levy to raise enough revenues to keep the whole System afloat.

Can such a single payer System be fiscally sustained? In a word, no. Joint Fiscal Office director  Steve Klein has already informed the solons that the their  single payer plan would produce cost savings for the first two years, but over the longer term “health care costs would rise faster than revenues”. “It’s not going to be a pretty picture”, Klein concluded.

What happens when infinite demands run up against finite taxpayer resources? The government must ration the resources. A common technique in Canada is to limit the number of providers.  Fewer providers equal fewer billings for fewer services. Costs contained!

That may solve the System’s annual budget problem, but from the patient’s point of view it’s called denial of care.

Is this government monopoly System likely to achieve its ambitious principles?  Or will it, as critics have claimed, quickly degenerate into rationing, waiting lines, maddening bureaucracies, demoralized doctors and nurses, shabby facilities, obsolete technology, declining quality of care, and much  higher taxation?

The single payer advocates have scoffed at this characterization.  If they would look honestly at the unacceptable (to Americans) outcomes produced by the single payer System just north of the border, they might revise their opinions. Of course, they won’t. They’d rather push the bill through to Gov. Shumlin’s desk and let Vermonters find out the hard way.

A modest (radical) proposal to lower health care costs

It is fun to criticize political opponents’ policies, and we have done our fair share since the Bayley Hazen blog started.  We are going to attempt to balance criticism of policy with proposals for solutions.   So, here goes: 

The Vermont General Assembly has recently required chain restaurants to post the number of calories for each of their products.  The idea is to give consumers more information with which to make more informed and healthy choices.

The General Assembly is also trying to lower the cost of health care.  Indeed, that appears to be the main goal of the health care reform proposal before the General Assembly.

Lowering costs only comes through competition, not mandated price controls.  And an integral part of competition is informing consumers of the cost of products or services.  

At the health care freedom rally last week at the State House, an anesthesiologist said that he did not know what prices his competitors were charging.  He even said he did not know what prices he charged.  He went on to say it  would be illegal for him to find out about his competitors’ prices. That is not true.  It is not illegal to find out about other professionals’ fees.  It would is only illegal to collude with competitors to fix prices.  Indeed, in every other retail sector, retailers often check their competitors’ prices, and some even brag about undercutting their competitors’ rates.

Providers of professional services have traditionally not publicized their prices.   There are a variety reasons.  The most prominent reason is the snob factor: it has traditionally been considered beneath professionals to discuss the cost of services with their clients or patients.  Other factors include the complexity of the services, and the unpredictability of outcomes which make predicting the price difficult.  Pricing for medical services is made more complicated by the fact that reimbursement for Medicare and Medicaid services is below the cost of the services, which means private consumers pay higher prices to make up for the losses health care providers incur serving their Medicare and Medicaid patients.

So here is a proposal for the General Assembly:  require all health care providers, including physicians, hospitals, chiropractors, physical therapists, to publicize their prices for services, including the prices they charge Medicare and Medicaid. 

The requirement would be a first step in bringing competition to medical services.  It would also require health care providers to simplify and rationalize their prices. Moreover, it would also tell consumers how much they are being charged to subsidize other people’s care.  To be sure, pricing will not be easy, but it is done in other sectors of the economy where pricing for services can also be complicated.

I generally do not favor such government requirements.  A far better solution would be for professionals to inform consumers of the cost of their services.  However,  the chances of that happening are low.  And we need to change the conversation from government control of health care costs to consumer control of those costs. A requirement to post prices would begin to change the culture of health care services to begin put the consumer in charge of his or her own health care.  I hope this proposal starts that conversation.

Bucket List

Charlie and I travelled to Scottsdale Arizona to visit with my Aunt and cousin and their family.  We took an overnight trip to the Grand Canyon.  The day was gray and cloudy; the weather was coolish and windy.  Never mind. My first look at the Grand did not take my breath away--it involuntarily brought tears to my eyes.  There are no words to describe the magnificence of the Grand Canyon, even on a dullish gray day.  Put it on your bucket list, if you haven't seen it.

We visited my 96 year old Aunt, and she is an inspiration to women everywhere.  She still has blonde bouffant hair, and is impeccably made up.  Until a few weeks ago, she was driving her 1973 Mustang...and she is now reluctantly selling it to an enthusiastic 14 year old from California.  She has a crystal clear memory, and a mischievous sense of humor.  Fun to visit her and her family!

Congratulations to Lisa and Catlow Shipek on their excellent video!

My niece Lisa Shipek and her husband Catlow run Watershed Management Group an organization that educates people on sustainable community based solutions for such issues as water conservation.  The Shipeks just won a youtube contest with this video  about a simple way to prevent childhood death from diarrhea.  It is a story made compelling by this excellent production.  Congratulations to Lisa and Catlow!

A little perspective

The reaction to the Fukishima nuclear disaster demonstrates a fear of radiation that does not comport with the facts.  Newscasters and commentators have said that there should be no risk of injury or death from nuclear power plants.  That standard has been achieved in the United States in the last 40 years since nuclear power plants came on line.  Other aspects of our modern life do not have such a record.  In the 40 years that Fukishima has been operating,  approximately 2 million Americans  have died in auto accidents, and nearly 80 million have been injured.  Other sources of power have resulted in death and destruction.  Oil, gas, even wood heat have cost thousands of lives over that same period.  Even wind power, a miniscule source of power in this country, has killed 35 people in the last 40 years.  If we use the standard of zero tolerance of risk for other sources of power, or for other modern aspects of our lives, we would close down our roads, ban woodstoves, oil burners, even wind power.  And more people would suffer and die without reliable sources of electricity and heat and reliable sources of transportation.  We need to assess the risk of nuclear power the same way we assess risk elsewhere:  how much is the risk compared to the reward?  Even with the disaster at Fukishim, nuclear power will pass with flying colors.    

It's not their ice cream

Author's note:  I wrote this article last fall during the 2010 election season.  The message is still important today.  Yesterday I heard an ABC news anchor ask the question whether Gov. Walker was "mean".  Elected politicians who make difficult decisions to cut spending are not mean; they are courageous.  It would be far easier to continue spending taxpayers' money and look like a hero to various recipients of government largesse. 

When I was in high school, I worked at an ice cream shop, scooping ice cream, making frappes, ice cream soda, and sundaes.  We were taught how much ice cream to put on the 15-cent and 25-cent cones.  Some kids would come in and want me to put more ice cream on the cone than I was supposed to.  I wouldn’t do it.  Sometimes my friends and classmates called me “mean” for not being generous with the ice cream.  I vividly remember thinking “It’s not my ice cream.”

The same principle applies to government spending. Several years ago when I was volunteering at the Republican booth at the Caledonia County fair, a young woman came by and said,  “I am going to vote for Bernie.  He helped me pay for college.”  When I told her taxpayers paid for her college tuition, she gave me a quizzical look. 

 Representative Welch, Sen. Sanders and Sen. Leahy swoop into Vermont towns and cities with checks from the federal government.  They get their pictures taken with happy constituents and garner free publicity for their campaigns.  They brag on their web sites and in interviews about massive government programs  they say will help ordinary Vermonters.  They are applauded for their generosity.

But it’s not their ice cream.  It is ours—the taxpayers—and increasingly our children’s and grandchildren’s ice cream.  Our congressional delegation is spending our money to aggrandize themselves and help their re-election efforts.  It is no coincidence that Sen. Leahy has been re-elected in Vermont for the last 35 years.  He is a senator with a trifling legislative record and a dangerous propensity to gossip.  He has been in two Batman movies and is on GQ’s best-dressed list.  His political philosophy is to follow the national Democratic Party and Moveon.org agendas without deviating.  But he brings in taxpayer’s ice cream to Vermont, so he wins elections. 

This system has resulted in a  government debt of  more than 12 trillion dollars.  But the news is far worse.  Before this year, government debt was partially funded by social security tax income because social security income was higher than the benefits paid out.  So the social security surplus was “lent” to the government to pay for other government programs.  In February 2010 the Social Security Administration started paying out more in benefits than it collected in taxes.  The Social Security administration is now calling in its IOU’s from a federal government that is already awash in debt.   Because the federal government has no money, it will be forced to take on even more debt to pay its IOU’s to the Social Security Administration.  Moody’s Investor Services has recently warned that the traditionally gold plated U.S. credit rating could be downgraded in the future because of its enormous debt.  That means even more bad news:  a lower credit rating results in  higher interest rates on the debt, which will burden taxpayers even more.   And if the government prints more money to pay the debt, that will mean higher inflation. 

Congress’ “generosity”  with taxpayer’s money will lead to impoverishment of our children and grandchildren who must shoulder this massive debt and suffer from higher inflation. 

To be sure, those who advocate spending restraint will be called “mean” by some.   What is truly cruel is to spend other people’s money to garner more power and acclaim while presenting the bill to future generations.

Health Care "Reform" Board...Cutting Costs?

The health care bill (H202) currently before the legislature, calls for the formation of a 5 member part time board with broad powers for determining the kind of health care benefits to be provided under Green Mountain Care and for imposing budget limits for hospitals and compensation levels for physicians.  This new board represents the beginning of an enormous and costly bureaucracy which will be put in place to control our health care.  Governor Shumlin recently announced that the 5- member board will cost $700,000 annually in salaries plus benefits even though only the chairman will be a full time employee.  This figure does not include the cost of the board's administrative staff which will initially include an additional 12 people.  Our State is already dealing with a substantial deficit.  We cannot afford this additional cost. 

Basketball brackets

Japan is imploding. Libyan rebels are being slaughtered. Stock markets around the world are tanking. Gas prices are well on their way to $4.00 a gallon. Unemployment is persistently high. Housing starts are at their lowest level since 1984. Food prices are skyrocketing and the U.S debt is unsustainable. What is the leader of the free world doing during these pressing times? He is picking basketball brackets on ESPN and planning a trip to Rio. The President seems strangely detached from the crises plaguing the United States and the world. The following are examples:

Japan: Our ally is in a deep crisis. There is not enough, food, shelter or water. It would not be uncalled for, for the President to direct U.S. resources to organize a small-scale Marshall Plan and get food and water in there and direct our nuclear technicians to come up with a plan to help with the nuclear crisis. The President, instead made an offhand comment while making basketball picks, that while the rest of us were picking basketball brackets and were on the internet anyway, maybe we could go over to USAID and figure out how to help. I'm sorry, President Obama, I am too busy to worry about basketball - and you should be, too. It seems President Obama has moved on.

Libya: After several days of rebellion, the President announced that Quadafi should step down and he pledged support to the rebels. There was even talk of a no-fly zone. Now Quadafi has gained the upper-hand and is slaughtering the rebels and the U.S. and its leadership are no where in sight. President Obama has moved on.

Haiti: The media heralded Haiti as an opportunity for the President to show everyone that he was engaged and was going to handle the situation better than Bush handled Katrina. He made a statement about how the United States stood ready to help. Yet what have we done in Haiti? It is a year later and rubble still lines the streets, a million are homeless and they are still pulling bodies out of the rubble. President Obama has moved on.

Unemployment: President Obama on numerous occasions has said that unemployment was his number one focus. He said that the stimulus package would ensure that unemployment would not go over 8%. Yet here we are, over two years after that announcement with unemployment persistently above 9%. President Obama has moved on.

BP Oil Spill: The President pledged to do everything he could to prevent the devastation and damage, but when the governor called for permission to install booms, the President failed to respond and moved on.

Deficit reduction: President Obama pledged to work with Republicans and Democrats to focus on the fiscal crisis. However, he has yet to meet with Republicans and Democrats and even members of his own party are begging him to lead.

$4.00 Gallon Gas: The President has lamented the gas prices, but continues to fail to act on drilling permits in the gulf as directed by a federal court. Shell Oil has given up on drilling in Alaska due to regulatory delays. Another opportunity to lead, lost.

Healthcare overhaul: Even with his signature plan to overhaul the nation's healthcare system, the President was detached. He directed Congress to come up with a plan instead of proposing his own plan. As a result Obamacare is an incoherent mess.

What is the reason for the President's detachment on critical issues? Perhaps he enjoys the trappings of being President but not the work involved. Perhaps he is frustrated by the fact that he has to make decisions? Perhaps he doesn't like the fact that he has opposition in Congress. Perhaps he would rather be President of China. Whatever the reason, these critical times call for leadership and he is in a position to lead. The country needs him to lead and the world needs him to lead.

1960's Freedom and 2010's prisons

OK, my mind wanders, but there were two separate incidents tonight that caused me to mull over my generation's descent from their devotion to freedom down to their clinging to the prison of security.  I went to a "public comment" meeting on a 23.8% rate hike that has already been imposed by Washington Electric Coop.  The procedure is that the Coop raises its rates, then the public service board holds hearings and takes comments;  then ten months later decides whether the rate hike that went into effect ten months earlier is justified.  Several people commented that the Coop is a "geographic monopoly"; therefore its customers have no choice on the rate hike except to beg the public service board not to allow it.  The public comment session was merely a charade:  people complained about the effect of the hike on their household budgets, which of course makes not one whit of difference to the public service board.  A taxpayer funded stenographer was there to dutifully take down the public's comments, as if it mattered.  Yet this is exactly what the General Assembly is attempting to accomplish for 1/6 of our economy, namely our health care sector, and in the process take away choice for the most private and important decisions we make--decisions about our own health.  I can picture it now:  the "Health Care Reform Board" holding public hearings on what procedures are most cost effective treatments for the public.  It will be a similar charade with the public begging the Board to allow funding of certain procedures, and the Board politely listening, with a stenographer duly recording. 
Then I came home and found a public television station broadcasting old footage of the folk singers of my youth singing freedom songs.  I looked at those young people on the TV, now old and wrinkly like me, and wondered what they would think of their older selves supporting such constraints.   To be sure, the members of the public service board and the soon to be created health care reform board are mostly well meaning and honorable.  But it is government restraint on our freedom nonetheless.

Silly Senator Sanders

I have written here and here about Bernie Sander's rigid unblinking ideology which has not changed one iota in over a half century.    Sander's ideology is a product of a lazy mind which doesn't bother to investigate or question his own views and assumptions that were spawned during childhood and college  Now Sanders' stunning laziness has been demonstrated by his "outrage"   over the Smithsonian selling trinkets made in China. Why? Because according to Sanders, American manufacturing has shrunk over the last several decades because Americans buy trinkets from China.  Really.  Sanders is bullying the Smithsonian into purchasing trinkets manufactured in America to sell at the Smithsonian gift shops.  If Americans manufactured such trinkets at American wages, American consumers would not be able to afford the trinkets at the Smithsonian.  Even the ABC story  Bernie cites on his website states that the two American made souvenirs found at the D.C. gift shops were twice the price of similar products sold at the stores that were made in China.  Bernie supposedly cares about the working and middle class, but he wants to price goods out of American consumers' price range.  Americans manufacture  high end products more efficiently; that is why the percentage of Americans in manufacturing jobs has declined over the last 60 years while the American standard of living has increased dramatically.   But Bernie doesn't want to bother to learn about rudimentary economics.  After a lifetime in politics, one would think that Bernie would have learned something about economics in order to better represent his constituents.   That is too much to ask our  clueless and magnificently uninformed Senator.

What effect will Sanders' campaign against the Smithsonian have on his Vermont constitutents?  None.  But that is not Bernie's goal.  He wants his name in the media because he has already started his 2012 campaign, even if his name is attached to a silly subject.    Vermonters deserve better than Silly Senator Sanders. 

Dramatic demonstration of the law of supply and demand

     Oil, like any other commodity, is subject to the laws of supply and demand.  While those opposed to domestic oil drilling claim it won't make much of a difference if we open up more areas for domestic drilling, the facts belie that assertion.  President Bush in July 2008 by executive order lifted the ban on offshore drilling.   The results on the price of a barrel of oil were astounding.  Here is the chart:

To be sure, there were other factors, including the recession, which suppressed demand, but the price of a barrel of oil, as demonstrated by the last month's spike, is based in part on psychology, and traders who realized the US would be drilling more oil domestically helped to drive down the price of oil so that it was only $35.00 a barrel when Pres. Obama was inaugurated.   Pres. Bush's change in policy on oil drilling helped consumers at the gas pump.  Pres. Obama should follow Pres. Bush's example, and open up more areas for oil exploration and drilling.

Washington Electric: Renewable Energy at Any Cost

Washington Electric Coop recently announced a 23.8% rate increase.  The reason for the increase stated in WEC's annual report was that the renewable energy certificates (REC's) it was selling in conjunction with electricity generated at WEC's Coventry landfill generating facility were not yielding the price projected when the plant was conceived.  Renewable energy certificates were designed to be purchased by individuals and companies as credit toward their renewable energy requirement.  Washington Electric gambled that REC's would continue to be marketable at prices that would be equal to or greater than original projections.  The market for REC's has fallen significantly and now WEC must find the means to replace that lost revenue.  The result is its pending application for a huge rate increase.  WEC's board of trustees is now looking to households and businesses to pay dramatically higher rates to make up for its bad investment decision.

WEC has for years eschewed the use of inexpensive, reliable, and clean power from Vermont Yankee and instead has opted for more costly sources keeping rates high for its customers.  The Coventry REC debacle is an example.  The Public Service Board is conducting an investigation into this rate increase and will hold a public hearing on March 15 at 7:00 at the Old Brick Church in E. Montpelier.  I hope the public will be there in force to demand that the rate increase be reversed.  WEC should seek lowest cost sources of power for its customers.   

Same Old Sanders

 

Author's Note:  I wrote this last November for the Caledonian Record in response to Sander's kick-off  commentary to his 2012 Senate campaign.  Since Sanders' positions have remained rigid for nearly 50 years, this article is still timely.

Sen. Bernie Sanders’ opinion piece in the Caledonian Record on November 8, 2010 (“Where do we go from here?”) was so wrong on so many counts it is hard to know where to begin. Sanders’ theses in his November 8 commentary are identical to his positions nearly  forty years ago when he first ran for office on the Liberty Union ticket.  His rigid fixed  beliefs have not changed despite the overwhelming evidence over the last four decades that his policies would lead to economic stagnation and authoritarianism.   Reality has never intruded into Sanders’ belief system.

How does Sanders continue to cling to his socialist faith?  By self righteously attacking his opponents as morally bankrupt and their followers as dolts.   The November 8, 2010 piece is an example of Sanders’ approach.   He starts by calling Republican candidates,  who gained over 66 seats in the United States Congress and 680 seats in state legislatures as  “extreme right wing”.  Republican candidates in 2010 ran on fiscal responsibility,  more transparent, efficient government; less regulation and lower taxes.  Those positions are not only mainstream, but many were embraced by candidate  Barack Obama in 2008.

Bernie then smears Republicans by claiming they are only interested in the “wealthiest” Americans, want to allow the “crooks” on Wall Street to continue their alleged criminal conduct, and  “huge banks” to “do anything they want.”  There is no room in Bernie’s world for honest disagreement.   Of course, the unspoken but necessary inference of Bernie’s conclusion that Republicans are extreme, greedy, and evil is that the millions who voted for Republicans in 2010 are dunces.  His disdain for the people whom he claims to fight for is obvious.

After abusing his political opponents,  Sanders’ solutions are the same tired old proposals that have proven to be unworkable, and as a result  rejected, by the public in this year’s elections.  The proposals are based on his socialist ideology, not on real world economics. 

First, Sanders wants to raise taxes. He wants to raise taxes on small business owners and raise corporate taxes—already the highest in the industrialized world.  In typical Sanders fashion, he is not honest enough to tell us directly what he is proposing.  We can only surmise by his claims that large corporations are not paying enough in taxes, and that we must raise taxes on the “wealthiest Americans”—many of whom are small business owners.   Sanders claims that corporations which are headquartered outside the United States need to pay more U.S. taxes.  Either there will have to be a world government that prohibits corporations from moving freely to other countries, or Washington will tax foreign corporations in such a way that they will not want to do business in this country. 

Second, Sanders  does not want to change a jot or tittle of Social Security, except to raise Social Security taxes on --guess who—the “wealthiest” Americans.   He claims that the Social Security system has a 2.6 trillion dollar surplus, declaring it is in fine shape and nothing needs to be done to protect the Social Security retirement system.  He fails to note that the so-called Social Security surplus is in the form of IOU’s from the debt ridden U.S. Government, or that as of this year, Social Security is paying out more to recipients than it is taking in from today’s workers.  Sanders’ opposition to allowing today’s younger workers to put some of their earnings into their own retirement trust fund rather than paying it into the government black hole reveals his disdain for ordinary citizens.  He believes that Washington D.C. can take better care of us than we can take care of ourselves.  And, as usual, Sanders demagogues the issue, railing against “privatizing” Social Security, ignoring the fact that all proposals for allowing individuals to control their own retirement provides that older Americans—over age 50—would retain their benefits under the present system. 

Sanders asks in his opinion piece, “How do we create jobs we need to rebuild the middle class?”  Instead of answering the question, Sanders spends two long paragraphs condemning President Bush and his economic policies.  He hand picks statistics to create a false picture.  Americans know the statistics that count are the unemployment rate and the gross domestic product growth.  When President Bush left office, unemployment was 6.5%, and three months after Obama was inaugurated, the recession officially ended.  Yet nearly two years later, unemployment is close to 10% and underemployment close to 20%, with no relief in sight. 

Then Sanders outlines his solutions to rebuilding the middle class.  Bernie’s solutions have never changed:  He proposes spending even more taxpayer’s money.   Sanders  proposes spending more on “crumbling infrastructure”.  He ignores the fact that 18 months ago Congress passed a nearly 1 trillion dollar stimulus plan that was supposed to be used in large part on “crumbling infrastructure”.   It didn’t work.  So now he wants to double down on a spectacularly failed policy. 

He also claims he wants “stronger regulation of Wall Street”.  The new Dodd-Frank bill just passed by Congress is not strong enough for Sanders.  The Dodd-Frank bill will result in consolidation of banks because small banks will not be able to afford  its onerous regulations, and the regulations regarding consumer credit will hurt those most in need of credit—those whom Sanders calls “the struggling middle class”.   Yet Sanders wants even more regulations that will slow down any recovery and ultimately hurt Vermonters.

Restricting free trade is another tenet Sanders has clung to for four decades.  Free trade has resulted in spectacular economic growth not only for the United States, but for the developing world.   Sanders advocates trade protectionism to protect the rich and powerful unions that support him.   

Sanders’ proposals for higher taxes, increased government spending and increased regulation are all job killers.  Instead of clinging to his fixed ideas and condemning opponents as greedy evildoers, Sanders would do well to analyze what works for the people he claims to represent.    I won’t hold my breath.

More Potty Talk

Serena Varley is not the only one complaining about government interference with consumer choice.  So is Sen. Rand Paul from Kentucky.  He wants consumer choice in light bulbs, toilets and other consumer items which the government has over-regulated.  Mothers of America, Unite!

A Statement the President should make, but won't...

The democratic process in Wisconsin is threatened and under attack. President Obama, in the spirit of the new civility he called for in January, needs to step up and lead. To be helpful, I have written a sample statement, taking into account his disagreement with the action taken by the legislature.

"Let me be clear. Although I heartily disagree with the action taken by the Wisconsin legislature, they were duly elected in the November election and are thus called to make difficult decisions. The way we make policy changes in America is through the democratic process of voting - not by violence or threats of violence. If the people of Wisconsin disagree with the actions of this legislature they may exercise their civic responsibility by voting in the next election."

This is an opportunity for the President to rise above partisanship and become the leader he was elected to be. Standing up for civility and democracy should not be a difficult decision.

Potty Talk

Oh, for the days of the real flush. Who would have guessed thirty years ago that I'd be pining for the old days of the toilet? Fast forward to today. I have twins (aka the "twinkies") -- who are two and potty-trained -- and the two of them jockey over who gets "the Flush". Well, one day we were visiting a ski shop, which was really someone's office with a counter and stuff piled everywhere in apparent disarray. Of course the twinkies needed to use the potty and the man at the ski shop offered his bathroom. He warned, however, that the toilet was "cleaner than it looks". With that warning, I braced myself for the latest potty visit. Well, the toilet was indeed frightening looking, coated with black something -- not sure what it was. But little did I know the joy that was to come. When it came time for "the Flush", we were rewarded with a really satisfying forceful swish, swirl and resounding "glug", like the end of a sentence, and everything was gone -- just, plain gone. Oh, yes, now I remembered the toilet of yore. Those were the good old days -- back before the environmentalists' cry for less water, for the "efficient" toilet -- back when the toilet flushed and we didn't give it a second thought -- when we didn't even keep a plunger in the bathroom. When toilet troubles were rare, if unheard of. I would have happily taken that toilet home, black coating and all. Because today, in our modern house, I battle daily with our toilets. Gross, gross, gross, but a reality of my life. I have taught the children "one square is all you need, dearies". Oh yes, we are very conservative with those toilet paper squares. But it's all for naught with today's toilets. Every day I find myself with the plunger, plunging away (a fascination for the twinkies -- who knows what their memories will be when they grow old...) -- and incidentally -- old-fashioned plungers are completely ineffective with the modern environmentalist's toilet. Sadly, the toilets, and multiple flushes -- I am sure we use at least as much water on these flushes in the end -- occupy too much of my thoughts every single day. My husband Paul has had to purchase various advanced plumbing tools, which he often has to use on his arrival home from a long day at work. ("Welcome home, dear!"). So, I will gladly surrender my modern role of toilet-babysitter. For Mother's Day, we can skip all the niceties of flowers and chocolates. Just give me three old-fashioned toilets. Then I can get out of the plumbing business and get back to the job of mothering.

VPR's biases are showing again

This morning, VPR broadcast yet another story about Vermont Yankee.  In the story they interview someone from  Vermont Public Interest Research Group, (VPIRG) a far left organization who has been on a (pardon the politically incorrect word)  crusade against Vermont Yankee for decades.  Of course, VPR does not identify the group's leftist tilt or its bias against Vermont Yankee.  VPIRG's parent organization was founded by Ralph Nader, who, when he ran for President, was too far left for most Democrats.  And of course, VPR did not interview anyone from Vermont for Vermont Yankee  or I am Vermont Yankee ; or Ethan Allen Institute , a think tank which has written cogent and insightful articles over the years about Vermont Yankee.  To be sure those organizations have a point of view.  But so does VPIRG.  And VPR routinely quotes VPIRG, on Vermont Yankee, never quotes other organizations who have a different point of view, and never identifies VPIRG's  hard left tilt.   It is the kind everyday bias that infects VPR, made more troubling because VPR pretends to be unbiased.  Taxpayers should not have to pay to support such an organization.  

March weather in Walden Vermont