Whitcomb: Candidate Epidemic; Lucrative Nonprofit Work; Minute Clinics vs. Physician Groups

Robert Whitcomb, Columnist

Whitcomb: Candidate Epidemic; Lucrative Nonprofit Work; Minute Clinics vs. Physician Groups

Robert Whitcomb, columnist
“Every year, back comes Spring, with nasty little birds yapping their fool heads off and the ground all mucked up with plants.’’

--Dorothy Parker

 

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 “We had a hierarchy in my office in Congress. If you’re a lobbyist who never gave us money, I didn’t talk to you. If you’re a lobbyist who gave us money, I might talk to you.”

 

--- Mike Mulvaney, head of the  Consumer Financial Protection Bureau and a former congressman from South Carolina.


A  Libertarian might say in response to this that the only way to reduce this sort of legal corruption is to shrink the size of the federal government, which would reduce the importance of lobbyists.

 

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Scott Avedisian
News, first reported by GoLocalProv,  that Warwick Mayor Scott Avedisian will become the CEO of the Rhode Island Public Transit Authority is good news for public transit in the state. Avedisian has in the past served as board chairman of the agency and has considerable expertise in public-transit matters.

 

I hope that naming someone of his stature and political ability will help RIPTA get the resources it needs to meet the growing demand for good mass transit, as the population ages and in order to address the environmental problems caused by our car-dependent culture. Among other things, he would go down as a hero if he led a movement to get light rail in Rhode Island to take the pressure off the roads.

 

Mr. Avedisian is the longest-serving mayor in Warwick’s history, having been in office since 2000. He has run an honest, efficient and careful administration, with a minimum of partisanship. Warwick has generally done well during his tenure. His only major mistake, in my view, was joining with some neighbors of T.F. Green Airport in delaying and delaying construction of a longer runway, which was urgently needed if Green is to be economically viable over the long term. This delay did a lot of economic damage to the state. In any event, the runway has finally been extended and so the airport has been on a roll lately with new flights, including international ones. It’s on its way to becoming a truly major airport, which is what the Federal Aviation Administration and others have long sought,  to take the pressure off overcrowded Logan International Airport, in Boston.

 

Scott Avedisian is one of those remaining dinosaurs called  “liberal Republicans,’’ along the lines of  the late Sen. John Chafee, Lincoln Chafee, before he switched to the Democrats, and, most famously,  the late New York Gov.  and Vice President Nelson Rockefeller (whence came the  old expression “Rockefeller Republicans’’) They tended to be socially liberal but fiscally more careful than Democrats. But Rockefeller helped invent the horror of the “moral-obligation bond.’’

 

 

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Lincoln Chafee, looking to challenge Sheldon Whitehouse
Does Lincoln Chafee’s announcement that he’ll probably run against U.S. Sen. Sheldon Whitehouse in September’s Democratic primary represents a grudge match informed by Mr. Whitehouse’s defeat of then-Republican incumbent Chafee in 2006 or substantive disagreements with his fellow liberal Democrat, especially about American foreign policy, most notably last week regarding Russia? So far as I can see, their positions on domestic matters are similar. Mr. Chafee’s admiration for the murderous Russian dictator Vladimir Putin is intriguing.

 

Last week’s stirring political news: The probable Chafee-Whitehouse primary battle; former Rhode Island Secretary of State Matthew Brown taking on Gov. Gina Raimondo in the Democratic primary and, again, Avedisian leaving the leadership of the Ocean State’s second-biggest city, in which post he was a key ally of Cranston’s GOP Mayor and gubernatorial hopeful Allan Fung; that Providence Mayor Jorge Elorza may face a serious primary challenge, and House Speaker Nicholas Mattiello’s  continuing re-election problems. All this make it seem that we’re facing vast political personnel changes.

 

Well, as the late British Prime Minister Harold Wilson observed: “A week is an eternity in politics,’’ but I’d guess that Governor Raimondo, Mayor Elorza, and Senator Whitehouse will still be in office next year. No really serious scandals have befallen them, although of course with something as complicated as government, politicians always have baggage. In the case of the Raimondo administration, the biggest are the benefits-payments snafu (not unique to Rhode Island) and sometimes inadequate transparency (as in many states) about incentives to lure companies to the state. For Elorza, it’s the city’s continuing failure to get a grip on its pension costs. If the economy dives in the next few months, they’ll be (unfairly – recessions are national and international) blamed for some of the effects, but a recession is far more likely to start next year than this.

 

And the governor’s and mayor’s re-election campaigns are very well funded.

 

The articulate and well-funded Sheldon Whitehouse, for his part, is shielded as a legislator of the congressional minority party from being blamed for the sort of administrative mistakes that bedevil those working in an executive branch. It’s a lot easier to make speeches and propose legislation than to run something as complicated and unpredictable as a government, where you’re always at the utter mercy of events.

 

Meanwhile, note that two progressives focused on the environment have been running for months for the Democratic gubernatorial nomination – Paul Roselli,  best known as a leading foe of the proposed natural-gas plant in Burrillville, and former state Rep. Spencer Dickinson, who considers addressing climate change his priority. And House Minority Leader Patricia Morgan and avid Trump fan/former state Rep. Joe Trillo are running hard for the GOP nomination against Mr. Fung. These non-celebrities deserve more attention than they have gotten so far.

 

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Matt Brown, Co-founder of Ground Zero
The nearly $300,000 in compensation that Rhode Island gubernatorial candidate Matt Brown drew as head of a small anti-nuclear-proliferation nonprofit called Global Zero ($2 million-a-year budget) reminds me of how much many execs of many small nonprofits expect to earn these days. It used to be that most people running nonprofits expected to be paid modestly, with as much money as possible going into an organization’s direct programs. Nonprofit executives took lower pay than they could get in private business in return for the satisfactions of public service.  Indeed, we used to have “dollar-a-year men’’ – people with personal wealth who were willing to run nonprofits or some government operations basically for free.

 

But now many nonprofit boards – including those of schools  -- feel that they must pay their executives compensation similar to that of profitable businesses. And their executives aren’t embarrassed to take it. For example, consider that many small private schools pay their heads hundreds of thousands of dollars a year, along with free housing and other perks.

 

GoLocalProv reports that in 2016, Mr. Brown was paid $271,700 in salary and an additional $27,438 in non-taxable income for a total of $299,138. The non-profit trade publication, The Non-Profit Times, writes that for organizations with operating budgets between $1 million and $2.5 million, the average CEO salary is $103,704. Perhaps the need for a lot of tiring international travel and/or other onerous duties explain Mr. Brown’s high pay.

 

The charming and brainy Matt Brown would be taking a big pay cut as governor, for whom the salary is a ridiculously low $129,210.

 

As for Global Zero, Wikipedia describes it thus: “Global Zero is an international non-partisan group of 300 world leaders dedicated to achieving the elimination of nuclear weapons. The initiative, launched in December 2008, promotes a phased withdrawal and verification for the destruction of all devices held by official and unofficial members of the nuclear club. The Global Zero campaign works toward building an international consensus and a sustained global movement of leaders and citizens for the elimination of nuclear weapons.’’

 

Global Zero’s mission is admirable but so far its success seems to have been, well, camouflaged, given what we’ve seen in the past decade around the world.

 

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Lots of communities, especially on the East and Gulf coasts, have been working to mitigate the effects of sea level rise. Planned projects include raising the first floors of flood-vulnerable buildings,  elevating roads and railbeds, building storm barriers in some places,  creating park-like green spaces and expanding marshy areas to minimize wave action and soak up flood waters.
 

But what do you do in a thickly settled historic urban neighborhood, such as Newport’s glorious Point neighborhood, which has one of the nation’s highest concentrations of colonial era houses? Residents of the neighborhood have been dealing with ominously high tides in the past few years.  Newport and the state need to consider new measures to protect such neighborhoods, which might have to include special local taxes for local mitigation.

 

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CVS
As insurers, drugstore chains, such as Rhode Island-based CVS, with its Minute Clinics, and the likes of Walmart team up to provide direct health care, independent physician groups face growing pressure. Many doctors have decided to throw in the towel and become hospital employees. Meanwhile, many physician groups (including the one I use) are extending their hours and making other changes to be more convenient for harried patients in order to better compete with the retail clinics.

 

The clinics are a response to America’s astronomically expensive, fragmented and inefficient health-care system. They offer a range of services for injuries and illnesses that can often be treated by a nurse, nurse practitioner or physician’s assistant at a cost considerably less than a physician would charge and much, much less than a hospital emergency room.

 

But will your local Minute Clinic get to know you, especially if you have a chronic illness, as well as  your primary-care doctor, so as to be in a position to adjust your care over time? And what sort of relationships will develop between local physicians and retail clinics, considering that they’ll often be competitors? The retail health-care revolution is just getting going. The old model of American health care is falling apart; it’s economically unsustainable.

 

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If Rear Admiral Ronny Jackson, M.D., who last week withdrew as a nominee for U.S. secretary of veterans affairs, is such a nasty piece of work, how come he managed to serve as the White House physician for 12 years, under George W. Bush, Barack Obama and Donald Trump? Perhaps it was because he was such a superb suck-up to presidents and their senior staffs, telling them what they wanted to hear, such as Dr. Jackson saying that the semi-obese Trump is in fine health.  What happened to oversight? Of course, if Dr. Jackson’s behavior can be proven to have been as bad as reported, he should be immediately fired as White House physician.

 

Among the accusations:  That Dr. Jackson created a hostile work environment (treating his underlings badly), improperly dispensed prescription drugs and was sometimes drunk.

 

 

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Barbara Bush
I think that a major reason for the surprisingly intense public interest in the Barbara Bush funeral was a craving for the dignity and restraint that the Bushes have represented in this tawdry time in our public life.

 

 

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One of the successful frauds of the past few years has been very rich right-wingers such as the billionaire Koch Brothers wrapping their anti-tax, anti-regulation efforts in the word “freedom’’. The Kochs and others of their ilk have been creating various “freedom’’ centers at colleges and universities, such as the Center for the Philosophy of Freedom at the University of Arizona, while of course raising large sums to help elect right-wing Republicans who will help the Kochs by cutting their taxes and eliminating such pesky things as some environmental protections.

 

(By the way, contrary to Environmental Protection Agency Administrator  (and fossil-fuel industry pal) Scott Pruitt’s stance, one of his jobs is not to help “create jobs,’’ in his beloved fossil-fuel industry or anywhere else. It is to, of all things, protect the environment.)

 

What the Kochs mean by “freedom’’ really translates into serfdom for the nonrich under politically powerful plutocrats such as the Kochs, who, by the way, inherited their business empire.

 

All this reminds me of A.J. Liebling’s line: “Freedom of the press is for those who own one.’’

 

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Speaking of news media, the Department of Homeland Security seeks a contractor to build a “media-monitoring’’ system with, it says, “24/7 access to a password-protected, media influencer database, including journalists, editors, correspondents, social media influencers, bloggers, etc.’’ so that DHS can “identify any and all media coverage related to the Department of Homeland Security or a particular event.’’

 

This sounds creepy, especially given President Trump’s antipathy to much of the news media.

 

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I wish that news people would stop calling those who favor virtually unlimited gun rights “Second Amendment supporters.’’ It’s far more accurate to call them “supporters of a libertarian interpretation of the Second Amendment’’ Reminder yet again, this is the wording of the Second Amendment:

 

“A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.’’ (Italics mine.)

 

Before the 2008 Supreme Court case District of Columbia v. Heller, courts had generally ruled that the right of individual citizens to bear arms existed within the context of participating in the militia. In Heller, the Supreme Court overturned that precedent.

 

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When people complain about “The Deep State’’ they’re in effect complaining about the highly trained and patriotic Americans who work in very difficult government jobs, especially the FBI and CIA, that require great expertise and prudence and sometimes bravery. I’m glad such “elites’’ serve us. Yes, there are always bad apples, but they are few in these agencies compared to people in other sectors.

 

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Amazon warehouse
As states and localities continue to offer huge tax incentives and other goodies to big rich companies (e.g., Amazon) they seek to lure to their jurisdictions, citizens would do well to read Nathan Jensen’s recent piece in The New York Times, “Do Taxpayers Know They Are Handing Out Billions to Corporations?’’ He writes:

 

“Every year, states and local governments give economic-development incentives to companies to the tune of between $45 billion and $80 billion. Why such a wide range? It’s not sloppy research; it’s because many of these subsidies are not public.’’ That sounds like a secrecy about public funds that some would construe as illegal.

 

His central theme is that many of the deals crafted by political leaders and companies are purposely kept opaque to the point of invisibility. The aim is to hide from the public just how much tax revenue is being given away to please powerful companies. “The idea is to make economic development so twisted that it’s nearly impossible to figure out who is responsible for it,’’ Mr. Jensen writes.

 

To read his essay, please hit this link:

 

 

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As the gap between business/first class and everyone else on airlines continues to widen, we have Aviointeriors Group’s design for tiny cheap seats (the design is called the Skyrider 2.0) that look like they’d force passengers in coach to virtually stand during the flight. The idea is to enable airlines to squeeze in even more budget-class passengers. The seats look as if they’d certainly be good for the business of physicians treating pulmonary embolisms and extreme anxiety.

 

Too bad we can’t take a fast train to Europe.

 

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Serenbe, an “intentional community’’ outside Atlanta, which is infamous for sprawl development, speaks to the desire of many Americans for a return to the idea of close-knit towns in some partly mythical past and/or to go to a utopian future where people can live close to nature without giving up such urban pleasures as high-class entertainment, nice restaurants and shops.  Serenbe is a mix of single-family houses (in different styles), townhouses and apartments and incorporates many energy-saving “green”” ideas. It’s not cookie-cutter. It also looks a bit small-town New Englandish.

 

It is, however, a bit precious. As Mimi Kirk wrote in an article about Serenbe, “In some ways, Serenbe is like a less-gritty version of a gentrified urban enclave, one that’s surrounded by woods instead of less-affluent neighborhoods.’’ In any case, sociologically and environmentally, it’s a major improvement over the usual suburban sprawl of ranch houses and McMansions.

 

To read Ms. Kirk’s article, please hit this link:

 

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“Conservatives are coming to see that Big Business can also threaten our liberties and the flourishing of civil society.’’

“What I am saying is we should not underestimate the importance of our immediate commercial environment to the forging of a sense of community, and that the shift from locally owned businesses to multinational corporations comes at a cost.’’

“As our attachments, and consequently obligations, to families, neighborhoods, small businesses and charities diminish, I fear that people cease to exercise civic responsibility and fill the empty societal space with whatever appears on their easily accessed screens: reality TV, strident talking heads on cable news, gossip on social media.’’

-- John A. Burtka IV, executive director of the American Conservative magazine, in “Conservatives Should Be Wary of Big Business,’’ in The Washington Post. To read his essay, please hit:


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