This week, CSA Online First features two viewpoints on the Democratic Governors Association convention, the first written by Paul Yost, M.D., Chair of LPAD, and the second written by Kenneth Pauker, M.D., CSA President. Each author shares his own, complementary perspective on the day.
LPAD Chair, Dr. Paul Yost and I made the pilgrimage from Orange County to Beverly Hills to attend the Democratic Governors Association (DGA) Annual Meeting at the Beverly Wilshire on the first Tuesday in December. I was offered a ticket to attend and represent the ASA, and I had heard about Past CSA President Dr. Trivedi’s positive experience at the Republican Governors Association last year. I wondered who I might meet, perhaps Governor Jerry Brown, for example. As Dr. Yost described in his perspective on Blue Tuesday, we had breakfast before the event at the hotel (not qualifying for the VIP breakfast). It was one fancy venue! I guess nobody ever said that you had to be poor or middle class to be a Democrat…
There were three panels, all moderated by Bill Press. The dinosaurs and NPR listeners may recall that he was chief policy advisor for Governor Brown, 1975-1979. He has also served as Chair of the California Democratic Party. There were a few Democratic governors and a few business people on the panels, and an audience which seemed fairly sparse to me, perhaps 75-100 people, many of them sponsors ($50,000 per ticket) or panel participants.
The topics were: “Energy in the 21st Century: Making the US More Energy Independent; Government Efficiency: How to Tackle the Debt Crisis within States; and Technology: Its Role in Government.” As Dr. Yost also noted, there was no opportunity for questions or any audience participation in the panels, which started an hour late and lasted a total of about two and a half hours. Most interesting to me were comments from Gov. Neil Abercrombie of Hawaii who described Hawaii’s zero waste program; Gov. Martin O’Malley of Maryland (DGA Chair) who explained Maryland’s performance measurement in government, in terms stunningly similar to how P4P in medicine has been described; Gov. Peter Shumlin of Vermont where they apparently have a single payer system and are instituting data cards with a patient’s medical data and co-pay right at the point of care; and Gov. Brian Schweitzer of Montana (brother of Dr. Mike Schweitzer of Texas, a vocal ASA Western Caucus member), reportedly the only state which is not now in dire economic straits, who described how to listen and empower state employees rather than fire them.
Health care costs were described as being a major issue for each of the states, but a discussion about what to do to address costs was not on the agenda. There was mention of a single payer system, enhanced scope of practice for APNs, and other Vermont innovations, and all appeared to have drunk the water from the P4P well in medicine. I wished that I had an opportunity to challenge them to consider the ideas of those who work in the trenches. Based upon what we experienced, neither of us felt inclined to attend the Holiday Party at Paramount Studios, scheduled for that evening.
I did introduce myself to Governors Brown, Schweitzer and Abercrombie. I complimented Governor Brown on his rational approach to budget issues and gave him my business card: He did not seem to know who anesthesiologists or the CSA are, but he said he would keep the card. My immediate impression is that we think about him much more than he does about us and our opt-out lawsuit.
I left feeling disappointed, somehow cheated about the “one way street-edness” of it all, having learned little about national politics except for some mildly interesting stories in a few states, and the motto of the DGA: “Jobs. Opportunity. Now.” which is what each discussant on the luncheon panel stated was the “take away message” for the fall 2012 elections. This was a bit too scripted for my taste. I came with an open mind, but the panels and lunch seemed like nothing more than a “dog and pony show” to me. I sincerely echo Dr. Yost’s sense of feeling “blue” after our day at the DGA.