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Posts published in January 2020

Money and the Boise mayor

johnson

One of the great lines in American politics — “If you want a friend in Washington, get a dog” — has long been attributed, incorrectly, to Harry Truman. The soon-to-be former mayor of Idaho’s largest city, Dave Bieter, could be excused for changing one word and adopting the line as his own.

Bieter lost two elections this year, coming in second in a crowded field in November and then getting blown out in a run-off in December. He’ll soon leave office as Boise’s longest serving mayor, a victim of having overstayed his welcome, but also done in by one-time allies who turned on him with the assistance of a massive and unprecedented independent expenditure campaign.

Although municipal elections in Idaho are nominally nonpartisan affairs, everyone knew that Bieter and his victorious opponent, Lauren McLean, an appealing young activist paradoxically appointed to the city council by the man she defeated, are card-carrying Democrats and well-credentialed conservationists.

In a way, Bieter represented, as former Cecil Andrus hand Andy Brunelle astutely pointed out, a last connection to the old Idaho Democratic Party of Andrus and Sen. Frank Church.

(Full disclosure: I’ve know both the Boise candidates for a long time, long ago encouraged Bieter to seek office and supported his campaigns before moving from Boise.)

Bieter’s dad, Pat Bieter, a beloved Boise State University professor, once organized Church’s Ada County campaign and, until her death, Church’s widow, Bethine, supported Bieter. Andrus encouraged Bieter to run in 2004 when Boise’s city hall was in meltdown over a scandal that sent a former mayor to jail. Andrus continued to support Bieter, while encouraging him to think about a statewide race, which may — or may not — have been foreclosed by the December defeat.

With a thoughtful nod to his political roots, Bieter engineered fitting tributes to both the Democratic icons: a lovely trail along the Boise River named for Bethine Church and a downtown park across from the capitol named for Andrus. The park is both a reminder to Republicans who have dominated the Idaho Statehouse since Andrus left the governor’s office in 1995 that he served as governor longer than anyone else and that no one has come close to replacing him.

Bieter leaves office knowing that his was the guiding hand in turning Boise — and increasingly Ada County — into a Democratic stronghold. Every legislative seat within the city limits is held by a Democrat, as are two of the three county commission seats. But in politics no good deed goes unpunished.

Bieter has been both plodder and pusher, championing controversial projects, including an expensive new library and a sports facility for Minor League Baseball and soccer. He’s presided over a booming economy that has rippled statewide. But Boise’s too rapid growth and skyrocketing property values whipsawed the mayor between those who remember when Boise was a town rather than the sprawling city it has become and those instinctively inclined to vote “no” on everything.

After 16 years, Bieter’s style grated on many and after so many years an opponent who promised change without offering many specifics had genuine appeal.

And while it’s tempting to dismiss the defeat of the four-term mayor as just one more example of Idaho Democrats cannibalizing their own in a Democratic stronghold while largely abandoning efforts to build the party elsewhere in Idaho, there is, I think, more to the story.

I wrote last week about the origins and corrosive effect of largely unregulated, unaccountable money in American politics, the so-called independent expenditure campaign.

Ironically, Bieter’s loss in Boise in 2019 is a strange reminder of an earlier time: Church’s loss in his last Senate race in 1980. Each was victimized by shadowy, out of state money that played a decisive role in an Idaho election.

Church was pilloried by a hard right wing political action committee, the National Conservative Political Action Committee (NCPAC) that orchestrated its 1980 smear campaign from Arlington, Va.

Roger Stone, the slimy operative who will be sentenced in February for, among other things, impeding the congressional investigation of President Donald Trump, was a founder of NCPAC.

While hardly as pernicious as NCPAC, the Conservation Voters of Idaho (CVI), a local arm of the national League of Conservation Voters (LCV), went all in with Bieter’s challenger to the tune of what will likely be north of $200,000 in “independent expenditures.” This represents the largest independent expenditure in a local race in Idaho history and the money is shadowy to say the least.

CVI received a check in mid-November for $85,000 from its national benefactor LVC — headquartered on 15th Street in Washington, D.C., — and that cash fueled a last push to elect McLean. Another $25,000 was reported in early October. It’s impossible to identify who contributed that money because it is reported only as a lump sum.

We do know that LVC’s top donor last year was New York billionaire and now presidential candidate Michael Bloomberg. He gifted the group $5 million in 2018. The cochairman of Bain Capitol, the private equity firm, gave $1.5 million and another Boston investment tycoon chipped in $2.25 million.

CVI, which like most such groups sounds more local than it is — especially in terms of where its money comes from — sent mailers, made phone calls and aired television ads supporting McLean, who earned her conservation spurs spearheading efforts to protect open space in the Boise foothills.

Bieter also championed that effort, along with park improvements and trails. In fact, there isn’t a dime worth of difference between the two on issues important to CVI. Bieter even supported the group with his own contributions.

None of this is new, of course. Independent expenditure campaigns hidden behind thousands of PACs are now the norm in American politics. What is new is the astounding level of expenditures on a local election in Idaho as well as the fact that CVI would spend so much to replace one supportive mayor with another rather than expend resources to expand the electoral map in Idaho.

It’s not difficult to see where this is going. PACs raised and spent more than $4 million to influence recent Seattle City Council elections. More than $1 million was spent in Spokane’s recent mayoral election, a big chunk of it by independent groups. We’ll only see more of this in local politics.

When the U.S. Supreme Court decided the Buckley case in 1976, making possible unlimited contributions and spending by independent campaigns, it insisted that independent campaigns could truly be separate from the individual efforts of candidates. This is a myth.

McLean, who will become mayor on Monday, served as the treasurer of CVI until 2011, leaving only after being appointed to the city council. She operates her own fundraising consultancy, obviously knows the political money game and her first move was audacious enough to shame an inside trader.

On Dec. 16 — 13 days after the runoff — CVI announced that its executive director was leaving the organization. She’ll be the new mayor’s chief of staff.

If it all sounds a bit too cozy maybe it is.
 

Access

stapiluslogo1

Put this down if you will to the grump of a watcher of long-ago Idaho legislative sessions - the arrival of a new decade tends to put exclamation points on the passage of time - but in some ways the Idaho Legislature functioned better in years, in decades, past.

And some of that has to do with the environment in which the work is done.

I’m comparing the legislature of today with that of three or four decades ago, but leaving out (for purposes here) the specific people or parties involved. Consider instead how they worked, and especially the access people had to those legislators.

There have been advances. Technology has helped. It allows for better presentations and better communications, and the ability of people around the state (and beyond) to observe, in real time, what’s going on, and even allows legislators to hear from people at remote locations (an effort that has been launched relatively recently and may be expanded). The statehouse renovation of some years ago has resulted in larger and more attractive quarters, and much of the open access to the building that was a long-time hallmark of the old way happily has been preserved.

But. Any visitor to the legislature who showed up in 1980 and then in 2020 might be shocked by the diminished level of access to legislators. There was a further-back time when access (especially by lobbyists, once known to stand right behind curtains that ringed the chambers) may have been too great. In 1980, most Idaho legislators did not have offices, and many of them worked at their desks on the Senate and House floor. Legislative offices were located nearby, and lawmakers who used them often were easy to find there.

Yes, those quarters were cramped and, really, even in 1980 weren’t adequate to needs. But today, the more common reality is that legislators either appear in meetings on the floor or in committees, and then appear to vanish - often into offices located floors away, and difficult to find if you’re not familiar with the building. Obviously they can talk to whoever they want to talk to, but unless you’re staff or a friend or ally you may never bump into them. Like too many of us, more than in decades past, they often live and work in a bubble.

All this is what came to my mind in watching the latest rounds of the long-running squabble between the leaders of the Idaho House and state Treasurer Julie Ellsworth over the office space on the first floor of the Statehouse, which long has been occupied by the treasurer’s office: The legislature wants the space for additional offices, and the treasurer’s office doesn’t want to move. A court hearing on the dispute is set for January 7.

Last week a group called Priorities Over Private Offices (the origins and membership of the group have been unclear) announced itself and blasted the legislative move and the estimated millions in spending for the renovation.

Its arguments included, “Idahoans do not want to waste $10.5 million of taxpayer dollars on offices that will be used three months a year. Idahoans do not want the historic original offices within the Idaho Capitol destroyed to make room for new offices to have private meetings with lobbyists. The public’s business should be conducted in public; not in closed door meetings with lobbyists.”

Looking ahead, as the state grows so will its legislative (and other state) operations, and so will office space. That may be close to inevitable.

But legislators should be careful, maybe more careful than they have been up to now, that they do not shut themselves off from the public - from people who want to see them, as opposed to people they want to see.

Remembering back to the years around 1980, I can recall many an occasion when the course of legislation, and the views of a legislator, changed because of unexpected or even chance encounters. Those seem to be happening less. The legislature convening this week might do well to keep some of those long-time trends, and the problems as well as the solutions of better working space, in mind.
 

Board certification

schmidt

I think I just took my Family Medicine Board Certification test for the last time. They didn’t kick me out for my lousy scores, its just things are changing.

Most people (patients) aren’t aware of the hoops and hurdles of medical education. Most MD’s have a four-year undergraduate degree (Bachelors), then complete four years of medical school (where they receive their MD degree). But that’s just a piece of paper you hang on the office wall.

To legally practice medicine in any state you need a license, granted by the Board of Medicine in that state. The Board of Medicine in Idaho is given the power by the Idaho legislature (thus, the people) to grant or remove licenses by statute (Title 54, Chapter 18).

Each state sets its own requirements for Medical licensure and each state enforces this professional monopoly, through the laws enacted by the legislature.
Most states require US MD graduates have some practical training after medical school, called “residency” to get their state license. You’ve watched Greys Anatomy. I hated that show. Idaho requires US medical school graduates have 1 year of residency training, Washington 2, Nevada 3. But no state requires board certification as a standard for licensure.

So, what the heck is “Board Certification”? It’s another hoop. After you’ve done all those college hoops, National Board exam hurdles, residency requirement hours and hurdles, then, the specialty you choose to join has some more for you.

Since I decided to be a family doctor I thought I should be “Board Certified” in family medicine. I paid the fee ($1850) and took the test. It was a relief to pass, but then when I saw 95% passed I didn’t feel so special. The day long test came up every 7 years for me. I was also required to complete annual self-training requirements to maintain the certification.

Who cares about Board Certification? Not patients; most folks who walk through our office can’t tell an MD from a DO from an NP from a PA. Most pay attention to the practitioner’s demeanor. Still, when polled, 70% of the public will answer “yes” to the question “Is Board Certification an important criterion for choosing a doctor?” Seems a pretty leading question to me.

Board Certification has been used by some hospitals and health care networks to determine who can be employed or work in their facilities.

Insurance companies have used Board Certification status to adjust payment schedules.

Does it matter that 90% of practicing MDs in the US have some sort of board certification?

Since so many of my practicing colleagues have jumped through this hoop, paid the fees, submitted education credits and taken the tests, (and passed) you would think they all agree on the value of making it through the hoop. But for the last ten years there has been grumbling. Many physicians object to the silliness of the day-long multiple-choice test, where a full third of the questions have been shown to have no relevance to current practice. But most point to the lack of evidence for value. There has never been any correlation between performance on certification and clinical quality, even when studied by the national boards themselves.

Such grumbling might be a sign of change. I hope so. A profession questioning its own methods is healthy reflection. Maybe some resolve will come out of it.

From now on, the Family Medicine Boards will offer the old fashioned every 7-10-year day-long test or a quarterly open book test. In addition, I will need to show regular self-education and self-improvement activities. I’ll do my best, but honestly, hoops, at my age, with these knees?

Instead of the national certification, I would hope my patients, my colleagues would respectfully let me know when I mess up and offer me guidance when I stray. Such cultures, such comrades would do more to promote excellence than thousands of hours of tests. I’ll do my best to be part of that change.