Friday, August 29, 2014

Mass. Governor's Race is Gross, Man!

Coakley's goose is cooked for November:

"Charlie Baker catches Martha Coakley, new poll shows; Slim lead is first in possible matchup" by Stephanie Ebbert | Globe Staff   August 29, 2014

Republican Charlie Baker has edged ahead of Democrat Martha Coakley in the race for governor, taking the lead by the slimmest of margins for the first time in the Globe’s weekly poll.

The survey found the hypothetical general election race in a statistical dead heat, with 38 percent of respondents saying they would support Baker for governor, a slight edge over the 37 percent who said they favor Coakley. Though Baker’s lead remains well within the margin of error, it shows movement in a race between the two likeliest candidates for the November election.

Coakley still faces two Democratic rivals in the Sept. 9 party primary, but the poll found she maintains a solid lead, claiming the support of 46 percent of likely voters. Comparatively, 24 percent support Steve Grossman, the state treasurer, and 10 percent back health care expert Donald Berwick.

Related: Grossman Closing Gap Against Coakley

The race to succeed Coakley as attorney general remains the primary season’s hottest, with Warren Tolman and Maura Healey deadlocked in their fight for the Democratic nomination at 30 percent each. Meanwhile, the crowded races for lieutenant governor and treasurer are dominated by undecided voters, at 74 percent and 60 percent, respectively, the poll found.

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The latest poll data shows Baker’s favorability rising slightly among voters. Conversely, Coakley’s favorable rating dipped while her unfavorable rating climbed....

In addition, the poll shows Baker picking up general election support from an unlikely base: Grossman’s backers.

Looks like Baker will be taking the low road into office.

If Grossman loses the primary, 48 percent of his supporters say they would bolt the party and vote for the Republican, rather than Coakley, in the general election. Just 28 percent of Grossman’s supporters would vote for Coakley, said John Della Volpe, chief executive of SocialSphere Inc., which conducted the survey for the Globe.

Conversely, if Coakley loses the primary to Grossman, the majority of her supporters — 56 percent — say they would support Grossman as the Democratic nominee, while 18 percent would turn to Baker, the poll showed.

“The Grossman voters really don’t like Martha Coakley,” Della Volpe said. “As [the primary election] is getting closer, as differences are being sharpened between the [Grossman and Coakley] campaigns, the Grossman voters are liking Martha Coakley even less.”

As the frontrunner throughout the Democratic primary race, Coakley has been taking most of the heat from her rivals, facing attack ads from super PACs supporting Grossman and now Baker. On Thursday, the Commonwealth Future Independent Expenditure Political Action Committee, the same group that had been airing the positive ads for Baker, launched a new TV spot on Fox channels mocking Coakley for being unable to pinpoint the rate of the gas tax while supporting its automatic increase.

Even if Coakley emerges from the primary as the Democratic nominee, Della Volpe said, it makes sense for the opposition to try to weaken her for the general election.

“They’re trying to take her and her campaigns’s eye off the ball of what she needs to do,” he said.

Coakley continues to dominate among female voters in a matchup against Baker, with the results showing a near mirror image based on gender. Men favor Baker over Coakley 48 percent to 29 percent, while women prefer Coakley to Baker 44 percent to 29 percent, according to the latest poll, Della Volpe said.

However, the duel for attorney general revealed no real gender gap, he said.

Who is dividing us?

Healey’s slim, three-point lead, is on the border of being statistically significant, he said.

“It’s an opportunity for her,” Della Volpe said. “But I would give the Tolman campaign credit for starting so strong with that first ad based on protecting women [and rights to access abortion clinics].”

Della Volpe said analysts should keep an eye on Tolman’s support from women after this week’s controversy over a debate, in which Tolman called Healey’s aggressive line of questioning “unbecoming.” Women’s political groups and supporters launched a social media campaign criticizing the remark, which they deemed sexist, and seized upon it in a fund-raising plea....

Are you women $ick of being manipulated yet?

Related:

Unbecoming Argument For Attorney General
Unfair charges of sexism in the AG’s race

I'm so $ick of the $hallow and $uperficial nature of politics and its coverage in my Globe. Sorry.

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Also see: Things Getting UnREAL in Massachusetts

NEXT DAY UPDATES:

"Donald Berwick pushes single payer health plan" by David Scharfenberg | Globe Staff   August 30, 2014

Democratic gubernatorial candidate Donald Berwick has laid out some ambitious goals, among them ending chronic homelessness and eliminating childhood poverty. But his most sweeping proposal — arguably the most sweeping proposal of the political season — is moving Massachusetts to a single-payer or “Medicare for all” health care system. 

I used to be for it, but am not now. I spent a lot of time four years ago following the whole thing, pointed out "Sicko," pick a country, pick a plan. Now I do not want this lying, looting government on any level getting involved in anything. 

That's not to say corporate care is any better, far from it. I've just given up on the AmeriKan $y$tem for so many reasons, and am sick and tired of writing the same things, the same titles, years later. Time to do something else. Don't know what, but this isn';t working for me anymore.

Eight years after the state became the first in the country to establish near-universal coverage, Berwick is reaching for an even bigger prize sought by liberals: shifting from privately financed care to a system funded by the government.

The candidate says replacing a welter of insurance companies with a single public payer would simplify a complex system and save hundreds of millions of dollars in administrative costs that could be redirected to other needs: job creation, education, and infrastructure.

“The opportunity is vast,” said Berwick, who ran Medicare and Medicaid for the Obama Administration for 1½ years.

But observers say the hurdles to single-payer health care are many. For one thing, it would require a tax increase. For another, it can be a complex idea that is difficult to explain in campaign soundbites. That may explain, in part, the candidate’s poor standing in the polls with just over a week to go until the Sept. 9 Democratic gubernatorial primary.

It’s also unclear that state legislators or the public have the appetite for another major health care overhaul. And powerful interests, including the insurance industry, are arrayed against a single-payer system that would sharply curtail their business.

“On the face of it, it feels like the obvious solution, and yet the transformation is really difficult,” said Katharine London of the University of Massachusetts Medical School’s Center for Health Law and Economics.

The basic mechanics of single-payer are fairly straightforward. Instead of employers and employees paying an insurer such as Harvard Pilgrim Health Plan or Tufts Health Plan, they would pay the government through a new payroll tax. Then, the government would issue a health card, to be used at the existing network of health clinics and hospitals.

Single-payer advocates say there is plenty of evidence for the efficacy of this approach. Developed countries with national health care systems, they say, consistently deliver better outcomes at lower cost.

One recent study from the Commonwealth Fund, which studies health care, examined quality, access, efficiency, equity, and health outcomes in 11 developed countries and ranked the United States last.

But defenders of the American system say it fosters innovation, pointing to major advances in medical technology in recent decades. And they say the botched rollout of the federal healthcare act, in Massachusetts and across the country, shows government should not have a larger role in health care.

“Massachusetts has just gone through a pretty gruesome experience with implementing the federal Affordable Care Act,” said Republican gubernatorial frontrunner Charlie Baker, a former health insurance executive. “It should be a real cautionary tale for everybody here about putting all your eggs in one basket.”

Baker favors a targeted approach to health care, one that would zero in on specific issues, such as inadequate pay for primary-care physicians and a lack of transparency in pricing.

Attorney General Martha Coakley, the Democratic frontrunner, has laid out a similarly targeted approach. Treasurer Steve Grossman, the third Democrat in the race, has charted a middle course, saying he will host a public conversation on single-payer but not fully committing to the idea.

If Massachusetts does pursue single-payer, it would not be the first state to do so. Governor Peter Shumlin of Vermont, a Democrat, campaigned on the issue in 2010. The state Legislature voted a year later to transition to single-payer and officials expect to make the move in 2017.

Deb Richter, a family physician in Montpelier and chair of Vermont Health Care for All, says getting supportive leadership in place was vital.

“You really had to have all the stars lining up and we did,” she said. “First off, you need a governor who is fully behind it and actually pushing for it. Secondly, you need grassroots support and we have a lot of that. And you need the right legislature, we have that too.”

But she said there were other factors, too. Vermont, she noted, has a relatively small number of hospitals and just one major insurer, Blue Cross Blue Shield. That meant fewer possible opponents to single-payer and a less complicated transition to the new system. Blue Cross, in fact, is expected to administer large portions of Vermont’s publicly financed program once it launches.

London, who completed a major cost analysis of the Vermont single-payer system last year, says the Massachusetts landscape is quite different. Reform, she said “would be far more complex here, because we have a multiple of hospital systems and a multiple of insurers and a lot of vested interests in the system the way it is now.”

Gerald Friedman, an economics professor at the University of Massachusetts Amherst who favors a single-payer system, said the most realistic route to a publicly financed system in the Bay State is through a series of slow steps.

One possible step, he said: The state government could follow Italy’s lead and buy huge quantities of drugs at discounted prices, reselling them, at cost, to pharmacies.

But Eric Linzer, a spokesman for the Massachusetts Association of Health Plans, which represents most of the large insurers in the state, said a major overhaul of the system is not a reasonable way to rein in expenses. Instead, he said, the state should focus on implementing a 2012 law designed to contain health care costs.

Berwick says he would push to pass a single-payer system through the Legislature in his first term. He argues cutting costs will not be the only advantage to an overhaul.

With the government as the sole payer, he said, it will have “much more leverage . . . to push the health care system in the direction we want.” That would mean a greater focus, he says, on prevention, wellness, and managing chronic disease.

But first he has to sell the plan — to voters, who have not yet rallied around the idea in large numbers, and if he is elected, to the Legislature.

There, analysts say, he will face a number of obstacles: not least of them, convincing legislators to go along with an eye-popping tax increase.

Friedman estimates that Massachusetts employers and employees are spending about $33.6 billion on health care premiums now.

The state, he said, would have to replace that with about $30 billion in taxes — swapping the weekly payments companies and workers make to insurers for a new state levy.

Most businesses and employees would see no real hike in costs, he said. But approving what would amount to largest tax increase in state history could be a major challenge.

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"Charlie Baker for governor" |    August 30, 2014

In his long career in state government, followed by a successful stint as CEO of Harvard Pilgrim Health Care, Charlie Baker has shown himself to have the skills Massachusetts voters often look for in a Republican gubernatorial nominee: He’s a creative manager, committed to rooting out waste and finding new ways to solve problems. Unlike his mentor, Bill Weld, who didn’t sweat the details, Baker tackles them like Vince Wilfork grabbing hold of a running back. He’s not the kind of Republican who considers government the root of all problems, or an inherently flawed enterprise. What animates him is the chance to deliver the same services more efficiently.

Purely as a managerial corrective to the administrative lapses of the last two years under Governor Patrick, Baker would be a compelling choice for voters across the political spectrum. In his primary-election race against Mark Fisher, a self-made businessman running as a Tea Partier, Baker is clearly the stronger candidate. Republicans, with their long record of electoral disappointments in Massachusetts, are lucky to have him.

If Baker, now 57, secures the Republican nomination for governor for the second time in four years, he’d be a serious challenger to the usually dominant Democrats. He’s sought to draw lessons from his defeat in 2010, a race that many people considered winnable. Back then, as the financial crisis wreaked havoc on the state budget, Baker overplayed his managerial hand: He was so specific about his plans — cut 5,000 workers, slash sales and income taxes to a flat 5 percent — that he came under attack from both sides. Fiscal watchdogs found his tax cuts irresponsible, and state workers deepened their embrace of the incumbent as protection against Baker. The result was a surprisingly comfortable 6.4-point win for Patrick, after which Baker spent several years in contemplation and retrenchment.

The result is a cooler, more deliberately laid-back candidate. Always a supporter of abortion rights and gay marriage, Baker now takes pains to draw attention to his moderation on social issues. He’s not promising any big cuts, either to taxes or the budget. Times have changed, he says, and the state’s not bleeding money the way it was in 2010. Wearing jeans and an open collar, he hits the campaign trail looking more like a retired fireman than a multimillionaire health care executive.

If Baker’s sole problem in 2010 was a flawed image, he’s well on his way to turning around his fortunes. But there was another obstacle, as well: Many voters felt inspired by Patrick’s clear goals and high purpose. Beyond his personal charm, the governor was a believer in Massachusetts’ future, working to expand the state’s life-sciences cluster; touting the development of clean-energy technology as an industry of the future; promising that state government would make sure that Boston’s prosperity would spread throughout the Commonwealth. While Patrick bequeaths to the Democrats who wish to succeed him a slew of administrative challenges in the Department of Corrections, Department of Children and Families, the Health Connector, and other areas, he also gives them custody of his overarching vision. Voters may well be ready for a new hand on the tiller, but they may not be ready for a change of direction.

Baker offers nothing like a competing vision, only a nuts-and-bolts fix to the bureaucratic machine. But after all the cracks are mended, and the leaks plugged, which way does the ship sail? Mapping out a larger agenda for the state’s success will be a key challenge for Baker, if and when he secures the GOP nomination.

Mark Fisher doesn’t lack for vision, but it’s one that’s familiar to those who’ve followed the national GOP. He’s a fierce believer in unfettered enterprise and wants a much smaller government. He is personally opposed to abortion rights and gay marriage but wouldn’t seek to make them illegal. He hopes to roll back gun control, which would be a terrible mistake. He would take further steps to ensure that illegal immigrants aren’t receiving state benefits, which is OK in theory but overstates the problem: Illegal immigration isn’t a big drain on the state budget, and harping on the issue only perpetuates xenophobic anger. Fisher is on far firmer ground when he talks about removing obstacles to entrepreneurship.

An affable, sincere candidate, Fisher would be a promising new voice for the GOP if he were running for state representative. But he’s simply not qualified to be governor. Even those Republicans who yearn for a more conservative candidate would be better off supporting Baker, whose experience overseeing human services for Weld and administration and finance for Paul Cellucci gives him an insider’s knowledge of state government — and how it could function more efficiently.

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