Editor’s note: This oped is by Morgan W. Brown who lives in Montpelier and runs the blog Vermont Watch.
Members of Vermont for Single Payer have taken issue with the appointment by House Speaker Shap Smith of Jim Leddy as a non-voting member of the Health Care Reform Committee and have declared his appointment to be both unethical as well as quite possibly illegal, violating S.88 (Act 128; PDF version) passed by the Vermont Legislature during this year’s session.
Read recent news reports about it, here (via Burlington Free Press), here as well as here (via Times Argus) and here (via Vermont Public Radio).
A Matter of Opinion:
As I understand it, Jim Leddy is not employed by the Vermont chapter of AARP (AARP VT) and he serves in a volunteer capacity as its president, with only his traveling expenses reimbursed or covered by the Vermont AARP chapter.
If Vermont Single Payer and those associated with it were to get their facts correct, there would be little issue with this nomination.
It would have served Vermont Single Payer and those associated with it to have first directly contacted both Jim Leddy and Speaker Shap Smith as well as others to talk about their concerns rather than to go into attack mode doing this by press release, etc. This could have been handled very differently and did not rise to the level where the tactics used by members representing the organization needed to be employed as there were other means available to address these concerns before hand.
Even if it was not intended to do so, those representing Vermont Single Payer in these matters have wrongly impugned the reputation and integrity as well as the motives of a fine upstanding retired public servant.
It might not have been meant as an attack on Jim Leddy, however it still is one and not at all justified either.
Jim Leddy has done nothing to deserve these attacks and he should not be forced to resign from his volunteer position as president of AARP and neither should he withdraw or be withdrawn from serving as a non-voting member of the Health Care Reform Committee as appointed by House Speaker Shap Smith.
In my opinion, the way those representing Vermont for Single Payer has chosen to approach this matter could hurt efforts of those who share the same passion for their cause, since they are inadvertently asking people to make a choice between the cause and someone they should not have to be making a choice about.
To the those representing Vermont for Single Payer concerning such, the matter seems to be clear cut, but it appears they are being unreasonably rigid.
It seems that they are so focused on the cause that they might be forgetting the most important things their cause is all about: i.e., people and doing our best by them. This is very saddening and too bad as well.
It is my hope that somehow that everyone involved can find a way to talk this through and work it out.
What I would hope is, if were possible to do so and everyone was so inclined — as well as if everyone could stop fighting over the higher moral ground no matter how right they think they are — that all of the persons involved could sit down in person and calmly talk these matters over in a civil fashion.
I would hate to see this thing continue to blow up and hurt the efforts of so many throughout the state who have been working toward bringing about health care to everyone in one manner or another.
In the end, maybe everyone can learn something from all this without it getting much worse in order to do so.
If, however, this is how those representing Vermont for Single Payer go about their business as a matter of course, then I want nothing to do with them or their organization whether directly or indirectly.
As a supporter of the single payer concept, I agree that the most important thing is that we are all working toward a common goal, and I certainly hope to see the day when all Vermonters have universal access to health care in a system that can also contain costs and therefore be sustainable.
However, I assume that the Health Care Reform Commission will play an important role in getting us to this goal, and thus its’ composition and the rules laid out regarding its membership are also important.
Therefore, I think it was not wrong for Vermont for Single Payer to raise this issue because the law very clearly states that no one who has an official relation to insurers can be appointed to the non-voting position of the Health Care Reform Commission. The issue was never about Jim Leddy, because all the objections I heard or read clearly reiterated that Jim Leddy was and is an outstanding public servant.
Also, the law does not say that official relation means a paid position.
And finally, it is clear that AARP does earn substantial royalties from the processing of premium payments for insurance companies (a fact duly noted by the assistant attorney general, even though he thought the appointment was okay).
I assume that this part of the law was there for a reason, which was supposed to prevent conflict of interest. So, my thought is that if Jim Leddy is President of Vermont AARP, and also on the national policy council of AARP, and if the AARP clearly has an official relationship with insurance companies through sale of their policies, then he would not qualify for this position, even though he is a very dedicated public servant.
I think there are many other wonderful people who would also be disqualified because of the wording of the law, and the fact that they cannot serve on the Commission certainly does not impugn their excellent qualities.
I know the attorney general did not agree with Vermont for Single Payer, and he thought the appointment of Jim Leddy was okay, because AARP sells insurance, but is not an insurance company. But, most people looking at this certainly connect AARP to the sale of insurance policies because they have received these requests themselves in the mail.
It is not a personal attack, and I think it is totally legitimate for an organization to raise questions if they think that the law is not being complied with. Even though the assistant attorney general thinks this is legal, we don’t know what would happen if this were legally contested. I doubt it will be challenged in the courts given that the timeline is so short here, but I don’t think it was wrong for Vermont for Single Payer to raise the issue.
Jim Leddy has a lot of explaining to do about his relationship with an organization that co-operated with the Republicans to screw AARP members as well as every less-than-wealthy elderly person in America with the Medicare “reform” of 2006. First of all, the bill was crafter to bankrupt Medicare. This meant that AARP would in the future make even more money shilling for the insurance companies as desperate seniors bled themselves to death. Second, the “doughnut hole” was crafted to expedite the shift to private insurance as people like my parents could either spend themselves into a life on the streets in order to purchase “bridge” insurance, or they could do without the needed meds and die the Republican way– fast and paiinfully.
The fact that Leddy serves as the state rep for AARP indicates either his ignorance of the true nature of the organization or his willingness to ensure that they keep shilliing. I will start cutting him some slack when he details how much AARP has profited annually in Vermont insurance “royalties,” starting in 2002 (so we can see just how much they gained from being pals with the DeLay Thuglicans), and how he’s going to feel about cutting off this source of revenue without losing his job. He can also let us know how AARP feels about him knifiing them in the back.
Meanwhile, I will do my best to see that Shap Smith fades from legislative history. I thought he was a Democrat. Obviously, I was mistaken.
As I understand it, Vermont for Single Payer is being criticized for issuing a press release rather than calling Speaker Smith about the Leddy appointment. While I agree that calling Mr. Smith would have been courteous, I do not think it would have altered what appears to be a fundamental disagreement over what the legislature intended as the eligibility requirements for the two new positions on the Health Care Reform Commission.
The fact is that Jim Leddy has an official relationship with AARP, an entity that is in the business of marketing health insurance–billions of dollars worth of health insurance–and collecting millions of dollars worth of royalties from those marketing efforts. I will agree that Jim Leddy may be the nicest guy in the world. He is certainly someone who is deeply interested in health care issues. But I feel that Vermont for Single Payer was entirely justified in challenging his appointment, because the law clearly was written to try to avoid just the kind of conflict of interest (or appearance thereof) that Mr. Leddy’s appointment represents. Maybe Speaker Smith should have called some of the people outside the Statehouse who worked so hard just to get S.88 drafted and taken up by the legislature. That would have been courteous too!
I do think the significance of this one appointment was blown out of proportion. But I feel that single payer supporters have been marginalized for so long. Maybe some of their paranoia is justified. There have been so may health care reform measures (Catamount for one) that have amounted to little or nothing. The cost of health care keeps going up. The profits keep pouring in to health insurers and drug companies. The uninsured keep going bankrupt, and yes, dying. So single payer people are naturally skeptical, even of well-intentioned efforts, because the public has been hoodwinked so many times in the past by false promises of reform. And usually the stealthy hand of the insurance industry is behind those false promises.
S.88 was, and still is, a ray of hope. However, because the hiring of a competent consultant is of paramount importance, many people were disappointed to learn that Speaker Smith’s appointment to the commission seemed so blatantly contrary to the spirit of S.88, to the spirit of really taking a fresh look at how to design a universal health care system–outside of the private insurance model.
Vermont for Single Payer lost the challenge over the appointment on a technicality–the ruling that AARP is not an insurer because it only markets insurance and receives royalties, and is not therefore an insurance company under the regulatory statutes. But that ruling has not diminished
the intensity of hope that surrounds this process of designing a health care system. A lot is at stake, and there will surely be new disagreements in the days ahead. That’s OK. Democracy was never meant to be easy.
Dear Mr. Brown,
The whole issue about Speaker Shap Smith’s appointment to the Health Commission had nothing whatever to do with Jim Leddy, whom we all respect (I knew his Father and Bill Sorrell’s Mother, Esther, for heavens sakes!). It is about the S.88 law. The S.88 law clearly states that “the two non-voting members with experience in health care shall not be in the employ of or holding any official relation to any health care provider or insurer or be engaged in the management of a health care provider or insurer, etc.”
The Vt. for Single Payer Network raised the issue, thinking as many of us have long thought, that the AARP which Jim Leddy serves as volunteer president in VT, is a Health Insurance organization in addition to other activities. Speaker Smith responded in the press, defending his appointment, and so, very appropriately the Vt. for Single Payer folks requested a ruling by the Attorney General’s office. That ruling makes a distinction that AARP is not a seller of insurance, but a broker of health insurance, and therefore ruled there to be no conflict of interest and no abrogation of the S.88 law in Speaker Smith’s appointment.
While many may still be amazed at the hair-splitting decision that the AARP is not a purveyor of health insurance, while making their major income from the sale of such policies as brokers, the ruling stands and Shap Smith’s appointment stands. He is following the letter of the law if not the spirit of the law. We will remain vigilant in following the Health Commission’s process while they carry out the procedures of the S.88 law. I, for one, am certain that Shap Smith will be vigilant as well. The matter of the AARP’s volunteer president’s appointment to the Health Commission has been resolved by the Attorney General’s office. We have no choice but to accept it and we wish Jim Leddy, a former (perhaps even current) single payer advocate well.
I am a health care provider, as are many of the single payer advocates in this State who work long and hard providing health services and paying administrative costs to jump through hoops of the for-profit Health Insurance Companies. These companies are in business to make money for their stockholders and for their lead executives (who are paid several millions of dollars in yearly salaries ); they are NOT in the business of providing health care services. Whether an organization brokers these policies or sells them outright, their fiduciary interests lie in maintaining the existence and control of these for-profit Health Insurance Companies. We look forward to the day when folks recognize that there is a simpler, more cost effective (hopefully this will be proved in the S.88 designs) system for delivering health services to all.
Ann Raynolds
Pomfret, VT
From the quote from Dr. Richter in the other related article on this website, it is clear that this is not a personal attack on Mr. Leddy, but merely following the language of S.88 bill (see farther below for quote and link).
If you think about the “revolving door” in Washington of Congress members, Pentagon officials, Federal agency managers, and Federal regulators, that later become lobbyists and/or corporate managers, I think Dr. Richter is right to bring up this issue.
While Mr. Leddy is surely qualified for this position in terms of knowledge and experience, and very likely well intentioned, that is not the point. He is connected to AARP which is connected with health insurance companies. Just connect the dots and follow the money trail.
This is the very beginning of the S.88 process, so Dr. Richter is correct in not wanting to have this process either become like Washington-business-as-usual, or at least give any perception of such “revolving doors”.
The energy industry and the Federal Minerals Management Agency was a little to cozy. That is an extreme case, which in this Vermont healthcare case is not. But we just have to be careful. Yes, maybe this snafu could appear to be overblown, but we must be careful and not be a repeat of Washington DC.
———————————————————–
http://vtdigger.org/2010/06/17/vermont-attorney-general-rejects-health-care-groups-conflict-of-interest-complaint/
“I want to make very clear, I have respect for Jim Leddy and his service to Vermont,” Richter said. “He has worked tirelessly on health care reform – that is not the issue. … Unfortunately, he is president of an organization that lobbies against publicly financed health care. … AARP worked against single payer at the national level, and it’s understandable why. If we eliminate the private insurance industry from health care, they would lose a good deal of money.”
“Meanwhile, I will do my best to see that Shap Smith fades from legislative history.”
Chuck: First of all, Shap played a decisive role in bringing S.88 over the end zone. I was there at the statehouse through the process of the bill and the going was not easy, especially at the end. Without Shap’s quarterbacking skill this bill probably would have been punted at the twenty or the forty yard line. I hope that Shap is speaker next session and for many more sessions. Shap will be the one up there on the speaker’s podium to work on the design options when the consultant (with luck, Dr. Hsiao) present them to the legislature. He knows the bill. We should not forget that Shap, together with Shumlin, engineered two veto overrides last year. I would posit that these overrides were instrumental in Douglas’s letting S.88 go into law without his signature. There were other reasons to be sure, but I would guess that this fact was a big one in why Douglas let it go through.
While I think that I can understand the spirit that led Shap to chose Jim Leddy (I do not know him) for the commission, the potential conflict of interest here is disconcerting. Whether or not this conflict will actually happen is, of course, an open question, but there is potential. We will have to watch the process closely.
I also agree with you about the role that the national AARP played in crafting of the medicare plan D. Republicans have all along wanted to destroy medicare, to prove that any government-run system does not work (which would be easy to prove since they were deliberately trying to wreck it) and to force people onto highly expensive private insurance plans to enrich their donors and themselves.
I think now that the issue has been raised and put out there by both the Worker’s Center and VT. for single payer will help the process as it goes along to win what we have long been fighting for.