Editorials from around New England
Editorials from around New England:
Helping schools is good, but not at the cost of transparency
The Hartford Courant, June 5
A $100 million donation to Connecticut’s struggling schools from billionaire Ray Dalio’s foundation seems like too good a deal to pass up.
But it requires a $100 million contribution from state taxpayers, and that means the public should have a transparent view into how its money is being spent.
The legislation that creates the panel that oversees the project, though, explicitly states that it will not be a public agency, potentially exempting it from the Freedom of Information Act and ethics rules. That raises serious concerns.
The legislation is baked into the massive budget bill that could soon be on Gov. Ned Lamont’s desk. It establishes a nonprofit corporation called the “Partnership for Connecticut, Inc.” The bill “specifies that the corporation must not be construed (1) as a department, institution, public agency, public instrumentality, or political subdivision or (2) to perform any governmental function.”
And while the panel initially overseeing the fund includes top state officials, members appointed by the governor and by Mr. Dalio’s foundation, they are required only to issue semiannual reports on its workings, “in form and substance agreed to by the corporation and governor but (the bill) does not otherwise specify any required contents or deadlines.”
That means the people with control over $100 million in state funds would have no accountability to the public. Disclosure of the panel’s operations will be at the discretion of those who hold the purse strings. Clearly, there is a public interest in transparency. If the Dalios wanted to create a fund with only their own money, then of course they could handle it however they wished. But if they are bringing state money into the process, the public gets to see how that money is spent. A gift to the public good shouldn’t come with conditions that exclude the public from the conversation.
The plan itself — to help struggling districts and connect young adults with jobs — looks good on its face. The Dalio’s foundation is already active in a number of Connecticut school districts. Meriden’s superintendent Mark Begnini recently said that “Barbara (Dalio) has visited our districts, held round tables with students, heard from our staff . She doesn’t just invest in public education. Her heart is in this work. She cares about what’s happening in this district. She wants success as much as we do.”
But in other places, the value of philanthropic contributions to schools has been questioned. Some have wondered whether investments in schools from Facebook’s Mark Zuckerberg and Microsoft’s Bill Gates have been effective.
The issue of transparency, though, is critical. How are taxpayers to be assured, for example, that their money isn’t being funneled to politically connected groups, or to businesses that have other oars in state waters, or in exchange for other favors down the road?
Deputy House Minority Leader Vincent J. Candelora, R-North Branford, put a fine point on the problem during a break in the debate on the bill. “Since when are tax dollars not subject to complete transparency?” he asked. “The governor has created a diversion of taxpayer revenues into a corporation that can spend money in the shadows. . I would be shocked if any legislative leader would honor this cloak of secrecy.”
He’s right. In principle, partnering with a philanthropic interest to help solve the state’s workforce and education problems is a great idea. But the devil is in the details, and those details must be open to the public.
Transport chief Chao’s links to shipping business raise real red flags
Republican of Springfield, June 4
The members of a president’s Cabinet are supposed to serve the citizenry. As such, they take an oath to defend our nation’s Constitution.
While this used to be a given, what had been normal has been largely stood on its head in our era, with members of President Donald Trump’s Cabinet often acting as though they’d pledged to honor and defend the businessman-chief executive, no matter what.
One Cabinet secretary, though, appears to have a different view, one that could politely be termed a bit more old-school: using the office to the benefit of her own interests and those of the family business.
A lengthy report published in The New York Times on Monday detailed myriad ways that Transportation Secretary Elaine Chao has appeared to work to aid her family’s international shipping business, Foremost Group, a company with deep ties to the Chinese government.
Though the secretary herself has no official role in the company, her actions, taken together, show her working to see that the family business had a seat at the table -- sometimes literally.
The report in Monday’s Times begins with the tale of a canceled trip. Back in October 2017, nine months after Trump had been inaugurated as president, Chao had been scheduled to visit China, in her official capacity. But her plans to bring along at least one family member, and to have others sit in on meetings, raised a red flag with an official at the American embassy in Beijing.
After a series of questions, from government officials and journalists alike, the trip was scuttled -- because of a scheduling conflict, don’t you know.
Chao, it must be noted, is married to Senate Majority Leader Mitch McConnell, a Kentucky Republican who, thanks largely to gifts from his wife’s family, is now one of the Senate’s richest members.
Before she was tapped to head the Department of Transportation under Trump, Chao had served as labor secretary in the administration of President George W. Bush. And during the eight years between those government appointments she made at least four trips to China with Foremost.
The report in The Times paints a portrait of a tangled web of money and influence and family connections. Oh, and government posts.
One wonders how Trump, who was on his way to London when the Times published its report on Chao, would feel about a member of his Cabinet working for the betterment of someone other than him. One can imagine that Trump would look approvingly at a department head trying to grease the skids for one of his real-estate projects. But someone trying to assist another? Maybe not so much. Or perhaps he won’t care a whit, just dismissing the report as “fake news,” Trumpspeak for any news account he dislikes, no matter its veracity.
China’s shipping and shipbuilding interests are not ours. If our nation’s transportation secretary has her eye on the family business, even in part, can she at the same time be trusted to be putting America’s vital interests on the high seas at the top of her agenda?
In our nation, we, the people, are supposed to have the ultimate power. We need to be able to believe that those in Washington who have been elected or appointed to positions of importance have the needs of the country foremost in their minds. Taking even a cursory look at the Chao family business and the doings of the transportation secretary can give one serious pause, and then some.
Transparency a good place to start to reduce prescription drug costs
The Bangor Daily News, June 4
Prescription drug costs, which have risen substantially in recent years, now account for a fifth of all health care spending. As a result, a quarter of Americans say they have a difficult time paying for their prescription medications and nearly one in 10 say they do not take their medication as prescribed to save money.
This is not sustainable. There are efforts in Congress and the Maine Legislature to slow the cost increases to ensure that people don’t go without needed medication.
Although rising drug costs have been a problem for years, action is slow at the federal level. That leaves it to states to find ways to lower drug prices for their residents. This is not as effective as a comprehensive national approach, but state action could propel movement on federal fixes.
Maine lawmakers are considered a package of bills aimed at lowering prescription drug prices. The Legislature’s Committee on Health Coverage, Insurance and Financial Services has given bipartisan support to four of the bills.
“When it comes to health care, Maine needs to be fighting for patients over profits. This is especially true when it comes to prescription drugs. Nobody should have to choose between putting food on the table, heating their home or taking their medicine,” Senate President Troy Jackson, a Democrat from Allagash, said in a statement. He sponsored two of the bills.
“It’s high time we took action to lower the cost of prescription drugs in this country,” he added. And I don’t mean making minor progress around the margins. We need to tackle the prescription drug crisis head-on.”
The most comprehensive, LD 1499, would establish a prescription drug affordability board. The board would, for the first time, review how drugs are priced. Manufacturers would be asked to provide information to justify their prices and any price increases.
Such transparency will begin to answer questions about why some common medications have recently risen in price, why different groups are charged different amounts for the same medications and why some specialty drugs are so expensive.
Based on this review, the board would set prescription medication spending targets for public entities based on a 10-year-rolling average.
LD 1162, a bill from Democratic Senator Eloise Vitelli of Arrowsic, is also about transparency. It would broaden the information about drug pricing that is collected by the Maine Health Data Organization in an effort to zero in on the reasons that overall costs are increasing, such as rising ingredient costs, marketing and price negotiations with insurance companies and pharmacy benefit managers.
Pharmacy benefits managers negotiate drug prices with public and private insurance providers, with little transparency of how prices are set. They are often incentive for the manger to keep drug prices high so they are paid more. In addition to providing more information to insurers, an amended version of LD 1504, sponsored by Sen. Heather Sanborn, D-Portland, would require PBMs to pass manufacturer rebates along to consumers or to the insurance carrier to lower insurance premiums. It would also require that consumers be offered the cash price for a drug if it is lower than their co-pay.
Another bill from Jackson, LD 1272, Jackson would allow Maine to create a wholesale prescription importation program to acquire lower priced medications from Canada. While this could help some Maine residents, the state would need a waiver from the federal government to import medications from Canada and not all medications would be available.
Sen. Susan Collins is currently working in Congress on a comprehensive bill to lower drug costs that includes many of the same fixes, including more disclosure of how drug prices are set and pharmacy benefit manager reforms. In a recent meeting with the BDN, she predicted that a comprehensive bill would soon come of the Senate Committee on Health, Education, Labor and Pension.
Late last month, Collins and two other Republican senators introduced the Prescription Drug Price Reporting Act. It would create a web-based federal database that would include pricing and rebate information and require drug companies to explain any price increases.
Lowering prescription drug prices is also a priority for Sen. Angus King, who recently introduced legislation to require more pricing transparency in drug advertising. He has cosponsored other bills to allow importation from Canada and to allow Medicare to negotiate prescription drug prices.
With three-quarters of Mainers saying they are concerned about prescription drug costs, this work is vital. The same polling found strong support in Maine for many of the fixes currently before the Legislature.
Seeking to address the problem from many angles — transparency, importation and price negotiations — and at both the state and federal level makes sense. It will take a comprehensive, sustained approach to reverse the pricing trend that puts the health of too many Americans at risk.
PFAS lawsuits will protect public health
Foster’s Daily Democrat, June 2
New Hampshire citizens have a right to expect the water they drink will not make them sick.
This week, three lawsuits were filed to hold responsible the manufacturers of PFAS chemicals that have polluted drinking water across the state and pose a health risk to every man, woman and child.
These suits, if successful, will provide communities the financial resources needed to detect, monitor and remove PFAS chemicals from the water we drink.
The federal Agency For Toxic Substances and Disease Registry has found exposure to PFAS can increase cancer risk, lower a woman’s chance of getting pregnant, interfere with the body’s hormones and affect the growth, learning and behavior of infants and children. The Environmental Protection Agency lists PFAS as a possible carcinogen.
On Wednesday, Gov. Chris Sununu, Attorney General Gordon MacDonald and Department of Environmental Services Commissioner Bob Scott announced two lawsuits against companies that manufactured and distributed PFAS in New Hampshire.
“We are confident that this lawsuit will be a success, and that it will provide proper assistance to the state and or communities,” Sununu said.
MacDonald explained the basis of the lawsuit at a press conference. ”... The defendants possessed unique knowledge of the dangers of PFAS chemicals but continued to make and sell them without warning the public of their health risks,” he said.
Mindi Messmer, a former state representative from Rye, applauded the state’s action. Messmer first sounded the alarm about PFAS on the Seacoast and worked in the Legislature to improve water quality standards.
“The state of New Hampshire was successful in a similar lawsuit relating to a gasoline additive (MtBE), which resulted in payouts of up to approximately $388 million and is being used to fund drinking water projects across the state,” Messmer said. “Polluters must be held accountable for the damages associated with public health impacts from exposures to these chemicals in our drinking water.”
Dr. Tom Sherman, a state senator from Rye who chairs the Senate’s Health and Human Services Committee, also spoke strongly in support of the lawsuits.
?... New Hampshire taxpayers should not bear the burden of cleanup of chemicals marked and sold by companies that have been aware of their toxicity since the early 1960s,” Sherman said. “Further PFAS detections in Stratham, Kingston, East Kingston and Brentwood underscore my concern that New Hampshire does not have the resources to address this remediation on our own.”
State Sen. Martha Fuller Clark of Portsmouth, who has tried to balance protecting Portsmouth taxpayers while supporting remediation of PFAS pollution from the Coakley landfill, said, ”...the lawsuit is the right thing today because it will help ensure New Hampshire communities aren’t obligated to absorb the costs of environmental cleanup efforts, which is clearly a responsibility of the PFAS manufacturers.”
Fuller Clark points out that one PFAS manufacturer, 3M, was already successfully sued in Minnesota. The state of Minnesota in February 2018 reported an $850 million settlement of its suit against 3M.
A third lawsuit was filed in federal district court on behalf of military servicemembers and workers at the former Pease Air Force Base (now Pease International Tradeport), who allege exposure to PFAS chemicals in Pease drinking water has already damaged their health and presents additional future health risks.
The city shut down its Haven well at the tradeport in 2014 after tests by the Air Force detected PFAS levels significantly higher than those deemed safe by the EPA. Since that time, the Air Force has spent $14 million to install a carbon filtration system with tests showing removal of PFAS to non-detect levels.
These lawsuits are the first significant steps toward ensuring communities impacted by these dangerous chemicals will have the funds to apply the needed technologies to remove these dangerous chemicals from our drinking water.
Pushing forward with merger talks
The Providence Journal, June 4
Showing bold leadership, Gov. Gina Raimondo has joined battle in one of the most consequential issues facing Rhode Island. She is pushing for the unified health-care system that would help keep medical jobs here, and prevent the hollowing-out of the local system.
Ms. Raimondo announced Tuesday that she has asked Lifespan, Care New England and Brown University to resume negotiations that could lead to a locally-run academic medical center in Rhode Island. Legislative leaders as well as The Providence Journal have also advocated for a unified system.
This is risky business, because the state’s renewed interest in a unified system prompted Boston-based Partners HealthCare, one of the top hospital systems in the world, to back out of its proposal to buy the financially troubled Care New England system, which operates Women & Infants Hospital, Butler Hospital, Kent Hospital and other facilities.
“In order to give this effort the best possible chance for success and to provide maximum flexibility to the governor and the leadership of these three institutions, we will be withdrawing our application to acquire CNE,” Anne Klibanski, M.D., the interim president and CEO of Partners, said in a statement.
People have known for years that the small state of Rhode Island would benefit from having a unified health-care system that would provide comprehensive services and employ economies of scale to cut costs. Egos and competing financial interests have blocked that in the past.
It now seems clear that there is no more time for petty differences. With Partners pulling back, a deal seems the best hope for all concerned.
Lifespan, the largest private employer in Rhode Island, has been warning for some time of the “dire consequences” of the Partners deal to local health care. It feared that procedures now done in Rhode Island would be siphoned off to Boston, making it much harder to maintain the concentration of surgeons and staff needed to provide first-class local care.
That might also do serious damage to Brown University, which maintains a vibrant school of medicine.
Lifespan CEO Timothy Babineau praised the governor for taking an “important first step to achieve a vision that has eluded the state for more than two decades.”
“A thriving hospital system is critical to the health care of all Rhode Islanders. Over the past several months I have increasingly heard from a number of stakeholders and understand the appeal of a locally-run, academic medical center based in Rhode Island,” Governor Raimondo said.
While she does not control private local hospitals, she has significant influence through the bully pulpit, which she has decided to wield in behalf of the state. She called on the parties to work quickly through the summer to see if they can move toward a unified system. The Rhode Island Foundation and the Partnership for Rhode Island will provide financial support for consultant work.
Legislative leaders showed their support. “A unified hospital and health care delivery system appears to be in the best interests of the needs of Rhode Islanders,” House Speaker Nicholas Mattiello said, adding that he is pleased that discussions have resumed.
We are encouraged too, and hope that egos and lesser considerations can be set aside in the interests of protecting Rhode Island jobs and promoting high-quality local health care.
A different pace
The Times Argus, June 6
An article in the New York Times this week raises an interesting conundrum about people — across all ages — using devices for information and entertainment.
In fact, it may be true that the argument we are getting dumber as a result of too much screen time is a fallacy. Data suggests the opposite might be true.
For certain, younger Americans are quick to point out to adults that they can find information faster; they can multitask better; and when standing in line or at other idle times, they are actually being productive. (The definition of “productivity” could be more aptly debated.)
According to the article: “Consider what a person can do in just the time it takes to wait for a bus: text, watch a comedy skit, play a video game, buy concert tickets, take five selfies, each with a different set of cartoon ears.”
Social scientists say learning how that behavior shapes an individual’s life experience requires an entirely new approach, one that recognizes that screen time is no mere habit but now a way of life.
That seismic shift in perception was recently argued in the journal Human-Computer Interaction. The phrase “screen time,” authors noted, is too broad to be scientifically helpful; it cannot remotely capture the fragmented, ever-shifting torrent of images that constitutes digital experience.
According to the article, researchers have linked daily time spent on specific platforms, like Facebook, to measures of well-being and mental health. But to build a more compelling understanding of the effects of digital experience, they’ll need far more, the new paper argues. Scientists need to look over people’s shoulders, digitally speaking, and record everything, on every device, that an individual sees, does and types. The researchers call this ultra-fine-grained record a “screenome,” adapting the concept from “genome,” the full blueprint of one’s genetic inheritance. Each person’s daily screenome is similarly unique, a sequential, disjointed series of screens.
What might seem like a frenetic pace to many is the new normal for most young people — and even many adults. The argument becomes, the experts maintain, we actually may be evolving into higher-functioning beings.
A paper written by researchers from Penn State University, Boston University, Apple Inc. and Toyota Research Institute is based on exactly what those “threads” look like, and how individuals respond to them.
In arguing to develop such an approach, the researchers presented the digital threads of several dozen people, recorded with consent: screenshots taken every few minutes for periods ranging from a day to several days. Those records showed that people switched from one screen activity to another continually, every 20 seconds on average, and rarely spent more than 20 minutes uninterrupted on any one activity, even a full-length movie.
Perhaps most intriguing, the paper presented color-coded graphs of the digital threads of 30 college students, monitored over four days. The graphs revealed wide differences in what people used their screens for, as well as in their patterns of switching from one kind of activity, like email, to another, such as entertainment or news. Some people sprinkle brief periods of work between huge chunks of streaming movies and YouTube, for instance; others appear to be bouncing between email, work and news sites compulsively.
Researchers also could examine screen time to predict other factors.
The most commonly cited downside of excessive screen time is low mood, or depression. In a recent study, researchers examined (with permission) the Facebook activity of 114 people diagnosed with depression. Using machine-learning algorithms, the team analyzed the content of the users’ posts from the months and years before receiving the diagnosis, and compared these to the posts of similar people who did not go on to develop depression.
The analysis found differences in how frequently certain kinds of words appeared. For instance, people who later received a depression diagnosis talked about themselves on Facebook measurably more often than people who did not develop the mood problem. The analysis, while small by big-data standards, was the first to link to diagnoses in medical records, and it solidified previous correlations between online language content and low moods.
It is a fascinating sign of our times.
“How much screen time is too much” is a puzzle for a past era, the article concludes.
What we are looking at, and how we are using that information, are different issues altogether.