Editorials from around New England

Excerpts of recent editorials of statewide and national interest from New England newspapers.

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MASSACHUSETTS

(Worcester) Telegram and Gazette, June 23

While the latest disruption capturing public attention may be Amazon’s entree into the grocery business, a major transformation is being debated within the Massachusetts Legislature over eye care - who can treat glaucoma as well as minor eye infections.

The political maneuvering is pitting optometrists, doctors carrying an O.D. degree obtained after a four-year, post-college study at an institutions like MCPHS University, which has a campus in downtown Worcester; and ophthalmologists, physicians carrying an M.D. obtained after four years of post-college study in medical schools, such as UMass Medical School in Worcester, and who undergo a one-year internship, and then three-to-five years of residency/fellowship in their specialty.

The existing symbiosis in which optometrists refer patients to ophthalmologists could be altered for some patients with glaucoma, as well as those with routine eye infections. Optometrists want the ability to provide immediate, first-line treatment of glaucoma with eye drops that reduce the condition’s elevated eye pressure and to treat minor eye infections such as styes and dry eye with oral antibiotics.

The Massachusetts Senate has approved this expansion in some form at least six times, only to see it die in the House. The Senate’s latest version has been incorporated into the July 1 budget proposal by the Baker Administration under the assumption it will save the state’s MassHealth (Medicaid) system $20 million a year. But what gets to the governor’s desk also depends on what the House does.

Making this all the more remarkable in its political maneuvering is that 49 states have all allowed optometrists to treat glaucoma in this fashion. The U.S. Veterans Administration medical system allows optometrists to provide this first-line treatment. (Three states even allow optometrists to perform laser surgery - although the other side says they’re rural states where medical access can be an issue.) Last year, the Obama Administration Justice Department’s Antitrust Division and the Federal Trade Commission bureaus of Competition and of Economics weighed in supporting a Massachusetts change.

Deanna Ricker, M.D., president of the Massachusetts Society of Eye Physicians and Surgeons, says the measure’s wording is too vague. A specified prohibition against “invasive surgical procedures,” for instance, leaves open a possibility that optometrists might be allowed to perform laser surgery, as “non-invasive,” just for one. She has said the $20-million MassHealth savings, from a study done for optometrists by a former MassHealth director, “falsely inflates” savings in assumptions of how people would access care.

Matthew Forgues, O.D., who is president of the Massachusetts Society of Optometrists and who practices in Worcester and Shrewsbury, points to the experience of all the other states, going back as far as 40 years, without issue. He says the fact that optometrist malpractice insurance rates in Massachusetts are no different from elsewhere shows that the expanded treatments aren’t causing problems.

Charles F. Monahan Jr., president of MCPHS University, where about 280 students studying optometry out of 2,000 in the city, lives this 49-to-1 split. Students come from all over the U.S., Canada and overseas. Their accredited training includes treatment for glaucoma and eye infection. They graduate, go home and put that education into practice, except for those graduates remaining in Massachusetts.

Shlomit Schaal, M.D., chair of the Department of Ophthalmology at UMass Memorial Medical Center and UMass Med, cited the disruptive nature of these moves across the country - not surprising given that politically there are significantly more optometrists than ophthalmologists. But because glaucoma is a progressive disease, she points out that even questions of when to stop a treatment and make a referral for surgery by a glaucoma specialist can be very challenging. Dr. Schaal is pioneering efforts to bring ophthalmologists and optometrists together in a UMass/MCPHS “eye to eye” symposium twice a year on patient care, as well as in monthly seminars. She finds that each group brings perspectives that benefit the other.

It’s time Massachusetts joins the rest of the country. It will improve access to care and lower costs. We’d like to see a thorough reading of practices allowed in each state, and adjustments to the legislation’s wording to avoid any unintended fallout.

Online: https://bit.ly/2tXBt1Y

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CONNECTICUT

The (New London) Day, June 22

The recently submitted petitions challenging the education and municipal budgets approved by the New London City Council provide one last opportunity for the council and Mayor Michael Passero to reconsider and reduce the steep tax increase they are about to impose on property owners.

The $90 million budget for the fiscal year that begins July 1 - $48.3 million for city government, $41.7 million for education - boosts the tax rate from 40.46 mills to 44.26 mills. That’s a 9.4 percent increase. It would mean taxes have increased 30 percent in the last four years. It’s too much.

When asked about such a sharp increase in taxes, Mayor Passero makes the case that his hands are tied. He notes that overall spending under the budget only increases a modest 1.9 percent. The cause of the big tax increase is predominantly an anticipated reduction in state aid for the city as the legislature struggles to fix its own budgetary crisis, Passero said.

Trying to force the tax increase below the 9.4 percent planned would require an unacceptable reduction in city services and/or reneging on his commitment to support the effort to improve city schools, he said.

The mayor’s position misses the point that whether the cause is spending or cuts in state aid, the burden for struggling working-class families in trying to come up with more money to pay taxes is the same. The deleterious effect on home prices due to the higher taxes is the same. And the potential to discourage investment in the city is the same.

Signatures on the petitions challenging the education and city government budgets far exceeded the necessary number of about 340. Taxpayers are not happy and with good reason.

Under the City Charter, the council has the option of amending the budget and tax increase in response to the petition. Or, with five votes, the seven-member council could send the budgets to referendum in a month’s time, requiring the council to make changes only if one or both are rejected.

Finally, the council could delay the referendum until the next regular election, Nov. 7, more than four months into the fiscal year.

Despite the mayor’s misgivings, reducing the budget and trimming the tax increase is the most appropriate response to the petitions.

Yes, trimming the tax increase roughly in half would have an impact on city services. It would require the Board of Education to find additional savings. But failing to make these tough choices places all the burden from lower state aid on city taxpayers.

Passero is urging the council to stand pat. He points to the uncertainty in Hartford, where the legislature has yet to submit a budget to Gov. Dannel P. Malloy. Cuts in state aid could go even deeper. If the council were to lower the tax increase, then see the legislature further cut state aid, it would devastate city finances, Passero told us.

Better to delay a budget referendum until November, he said.

Yet other municipalities in the region have managed to approve budgets despite that uncertainty, none with a tax increase approaching the one planned in New London.

The mayor and council are in a tough situation, no doubt. New London’s limited tax base, its high percentage of untaxable nonprofit and government properties, and the role it plays providing many of the region’s social services leave it without the fiscal flexibility enjoyed by its wealthier neighbors.

But New London’s property owners are being squeezed. Through their petition drive they are crying out for some relief. As difficult as it may be, the council should find a way to provide it.

Online: https://bit.ly/2tD0no6

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Rhode Island

The Providence Journal, June 22

Those who want to see a vibrant economy return to Rhode Island have been troubled by a new threat, in the form of a costly proposed mandate for paid sick leave. Advocates pushing harsh measures at the General Assembly have little understanding of what it takes to turn a profit in a state where red tape already chokes off jobs and opportunity.

In the waning days of the legislative session, the Senate Labor Committee suddenly scheduled a vote Wednesday on a bill that would have imposed heavy costs on job creators and make Rhode Island even less competitive. As John Simmons, chairman of the Rhode Island Business Coalition, warned on these pages, the measure would have saddled businesses of all sizes in the state with “the most onerous mandated paid sick leave policy for employers in the country.”

Under pressure, the Senate committee backed off that very extreme measure, and approved something of a compromise. But the revised legislation also fails to address many concerns of the business community. Its definitions are hazy. It would not exempt companies that already offer paid leave. It would impose costly and complex new reporting requirements.

Adding onerous new regulations on businesses is not something that Rhode Island needs now, as it struggles to get back on its feet after more than a decade of economic malaise. If such mandates force more small businesses to close their doors, they could end up hurting the very people the bill was purportedly supposed to help - by putting them out of a job.

Clearly, the grown-ups in state government, possibly in the House, should study this matter more carefully and talk to people who actually run businesses. Jobs are crucial to the state.

There may be a case to be made for imposing mandates on larger businesses that fail to provide the benefit of any paid sick leave for employees. But they constitute only a small percentage of the state’s larger businesses. Inflicting a costly new regulatory burden on every business - including ones that already generously offer a variety of benefits that employees prefer - makes no sense. Businesses might have to respond by taking away other benefits.

In short, this is not something that should be mindlessly rammed through in the waning days of the session.

A grasp of economics has not traditionally been the strong suit of Rhode Island legislators. That is why the state consistently turns up in surveys as having one of the worst business climates in the country. Despite Rhode Island’s many fine qualities, its high taxes, burdensome regulations, crumbling infrastructure, poor public schools, and corrosive special interests make for a business climate so arduous that many entrepreneurs steer clear. That makes it harder for citizens to get jobs, which produce the tax revenues needed to provide public services.

This is not the time to foist a Draconian sick leave mandate on Rhode Island businesses. Leaders should talk to the people who actually must meet payroll and turn a profit. Any compromise should focus on encouraging paid sick leave without damaging all businesses, large and small.

Online: https://bit.ly/2rLj0VL

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MAINE

The Kennebec Journal, June 22

There’s an energy boom underway in this country, and it’s not in the oilfields.

Advances in solar power technology have brought down prices, putting photovoltaic panels in financial reach of millions of homeowners as well as small and medium-size businesses. There are opportunities for utility-scale solar projects - the most cost-efficient application of the technology - and for community solar farms, where people can pool resources and invest in a solar project that puts energy on the grid, earning its owners credit for the power produced that’s applied to their home electric bills.

Two percent of all new jobs in the nation - one in 50 - are in solar energy-related fields.

It’s not happening in the oilfields. And it’s not really happening in Maine, either, because political division has kept the state from modernizing its regulations.

A bill that just passed preliminary votes in the House and Senate, L.D. 1504, would move Maine in the right direction. Sponsored by Sen. Tom Saviello, R-Wilton, the bill would make three major improvements:

It would stabilize the market by keeping net energy billing, also known as net metering, in place through 2021, both for existing and new solar customers.

It would require the Maine Public Utilities Commission to study other compensation schemes that better reflect the real value of the power produced by rooftop solar installations and report back to the Legislature by the end of 2021.

It would lift the cap on the number of people involved in community solar farms from 10 to 200, creating opportunities for people to benefit from solar power even if they can’t afford a system or live in a place where it can’t be installed.

It’s important to make these changes. Maine ranks last in the region for solar jobs on a per capita basis, and it’s not because the sun doesn’t shine here. Maine is on a much lower latitude than Germany, a country that is able to generate nearly 7 percent of its power from solar (Maine currently gets less than 1 percent of its power from the sun).

Maine can’t keep up because its regulatory scheme hasn’t kept up.

The Legislature has attempted to tackle the issue in each of the last two years, coming up with a compromise plan last year that had the support of solar installers, environmental groups and the transmission utilities, but not Gov. Paul LePage, who vetoed it.

This year the PUC came up with its own version of reform, grandfathering net energy billing for current solar customers, but phasing it out for those who sign on later. The commission also required a complicated arrangement where solar users would have to install additional meters and pay transmission fees for electricity that they produced and used on site without it ever going on the grid.

If the Legislature does not act, the PUC rules will stay in place, creating uncertainty in the marketplace and stifling development in a promising sector of the economy.

As was the case last year, the really important vote will not be on the bill itself, but on whether to override the expected veto from Gov. LePage.

Lawmakers on the fence will have to decide: Is Maine going to be able to take part in the new energy boom, or will our politics force us to keep sitting on the sidelines, where all we can do is watch?

Online: https://bit.ly/2rKZVTH

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NEW HAMPSHIRE

The Portsmouth Herald, June 20

We don’t doubt the science that cures major illnesses and has greatly extended the length and quality of human life. We applaud the brilliant minds whose scientific endeavors took us to the moon and beyond. When we flip on the light switch we don’t deny the science behind the generation of the electricity that runs our homes.

But even though 97 percent of the world’s climate scientists have concluded that climate warming trends are caused, at least in part, by human activity, and that this warming poses an existential threat to life on earth as we know it, Republican leaders in Congress and the White House say there is too much doubt around the science to take action and that agreeing to reduce our carbon emissions will damage the nation’s economy.

Climate science has been politicized because, in the short term, it threatens the powerful and well-funded fossil fuel industry, which has done its best to sow doubt and confusion. We have no doubt that in the years to come these same forces of opposition will look upon their actions with chagrin similar to those who once argued that smoking is not bad for your health.

Sea levels and global temperatures are rising, oceans are warming, ice sheets are shrinking, sea ice is declining, glaciers are retreating, storms are growing in intensity, the list of destructive changes goes on and on. In response, in October 2016, the United States, China, and India joined 191 other nations and the European Union and signed the Paris Agreement aimed at slowing the carbon emissions that are contributing to global warming.

Elections, however, have consequences.

Donald Trump was very clear that if elected president he would pull the United States from the Paris Agreement and that’s exactly what he did on June 1.

But a strange thing happened following Trump’s announcement. Led by California, New York and Michigan, a dozen states, including Massachusetts and Vermont, which are led by Republican governors, (but sadly not New Hampshire and Maine) vowed to honor the Paris Agreement and work aggressively toward meeting carbon emission reduction goals.

When Donald Trump said: “I was elected to represent the citizens of Pittsburgh, not Paris,” the mayor pushed back.

“As the Mayor of Pittsburgh, I can assure you that we will follow the guidelines of the Paris Agreement for our people, our economy & future,” Mayor Bill Peduto tweeted.

Closer to home, Portsmouth Mayor Jack Blalock reaffirmed the city’s commitment to clean, renewable energy and joined 274 mayors nationwide in signing a letter to honor the Paris Agreement goals.

“Despite recent actions by the president, I want the community to know that environmental initiatives will remain a key priority for our city for many years to come,” Blalock said.

“In response to the president’s planned withdrawal from the Paris Climate Accord, I felt it was important to reiterate our city’s commitment to sustainable practices and continuing its role as an eco-municipality,” the mayor said.

The town of Durham also affirmed its support.

“While the president of the United States has the authority to withdraw the country from the Paris Accord, the town of Durham has the ability locally to pursue initiatives that address the reality of climate change for our state and our nation,” said Town Manager Todd Selig. “Sometimes we just need to set the direction from the bottom up.”

While we wait for our nation’s top leaders to begin to think globally, it is good to see so many who respect the science and are willing to act locally before it’s too late.

Online: https://bit.ly/2rKXgJL

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VERMONT

Times Argus, June 23

The dimensions of the opioid epidemic have become well known. In Vermont 106 people died from opioid overdoses in 2016, a huge leap - 41 percent - from the year before.

Nationally, the total was about 59,000 deaths. That’s more than died in the entire Vietnam War.

The hardest hit states, according to the Centers for Disease Control and Prevention, were in the South and Northeast, including West Virginia, New Hampshire, Kentucky, Ohio and Rhode Island. States experiencing significant increases in 2015 included Florida, Connecticut, Louisiana and Maine. Vermont’s 41 percent increase qualifies as significant.

It should not escape notice that many of the states suffering the worst are Trump country. Appalachia has seen a scourge of addiction, and mortality rates among white males have begun to rise rather than decline. Nationally, drugs are the largest cause of death for people under 50.

In Vermont the problem has had a significant budgetary impact. In 2016, the state spent $63.7 on medical treatment related to opioid addiction. That is mostly Medicaid money, which is a combination of state and federal dollars, but even with the federal contribution, it represents a significant cost to the state.

The state has been making progress in expanding treatment for addiction, but the frequency of overdoses is continuing evidence of the scope of the problem, which points to the need for the continued expansion of services. That means more money will be needed to address a problem that is one of the most pressing in the nation.

In the midst of this unprecedented crisis, Republicans in the Senate have unveiled a health-care-reform plan that would slash federal spending on Medicaid, starving states of money that is essential in battling this growing problem. The cuts in funding for health care are accompanied by cuts in taxes for wealthy taxpayers, and it is worth asking Republican senators what their plan says about the priority of America’s problems.

On the one hand, there is an epidemic of addiction and death that is claiming the lives of tens of thousands of Americans every years, ravaging communities, ruining families, depressing economies, overburdening state budgets. On the other hand, Republicans appear to believe that a more pressing problem is that the wealthiest Americans - the billionaires of Fifth Avenue, Palm Beach, Dallas and Hollywood - don’t have enough money. Giving them more money by cutting their taxes would address this problem, and that is what the Republicans’ repeal of Obamacare would do.

Waiting lists for treatment for opioid addiction have been reduced in Vermont in the past few years, but those waiting lists persist. Meanwhile, other states continue to look for ways to handle the problem. A news story recently described how drug treatment has been integrated with incarceration in Kentucky. Cutting federal money available to Vermont, Kentucky and other states grappling with the problem seems like an assault on America.

Underlying the Republican attack on the nation’s health care system is a fundamental difference of philosophy on the government’s responsibility for the welfare of Americans. Democrats generally believe that helping to maintain a certain level of economic security is the proper role of government. Social Security, Medicare, Medicaid, food stamps, welfare, aid for child care, housing and education - these are essential for smoothing the rough edges of a free economic system. The poor may always be with us, but we don’t need to consign them to a persistent level of degradation and hopelessness. Better to extend a helping hand so they can rise, as they yearn to do and as generations of struggling Americans have always done.

Faced with President Barack Obama’s embrace of this progressive role in relation to health care, Republicans vowed to repeal the Affordable Care Act, fostering belief in a contrary view: that government aid amounts to a handout for the lazy, undeserving poor.

Except now, people of all income levels and social groups have been afflicted with an addiction that is eating away at our communities. Turning our backs on those who suffer the illness of addiction is turning our backs on our friends and family members, on our communities, on the American people. Three Republicans in the Senate can keep it from happening. Let’s hope they do.

Online: https://bit.ly/2szslm9