Interview with Cassandra Gekas
The following is a faithfully transcribed conversation between me (Haik Bedrosian) and Democratic nominee for lieutenant governor Cassandra Gekas recorded at Uncommon Grounds coffee shop on Church Street in Burlington on August 12, 2012 between 9am and 10am.
HB: Thank you for joining me Cassandra Gekas, Democratic nominee for lieutenant governor.
CG: I am indeed. Thank you.
HB: Ok one question off the top.
HB: Have you ever driven a race car?
CG: I have not.
HB: ...or flown a jet airplane?
CG: I have not, but I could start doing both these things if it would convince voters that I am prepared for the office of lieutenant governor.
HB: How are you qualified to be lieutenant governor if you've never driven a race car?
CG: I know it's a very important question. Those two things are... hand-in-hand. [laughs]
CG: ...I'm thinking about sponsoring a car at Thunder Road.
HB: So you have a Facebook website... but you don't have a public website...
CG: We do have a public website.
HB: Where is it?
CG: It's www.Gekas2012.com
HB: “Geeekas?” That's how you pronounce it?
HB: ...I've been wondering. [Pause.]
CG: ...So we've had that up and running. We're optimizing the search results basically, so it should come up higher on Google at this point.
HB: So you worked on a number of different issues on the social front- heating assistance, health care, anti-hunger issues, domestic violence, gender issues...
HB: which one... is your favorite? Which one are you most passionate about?
CG: well, what I'll say is that healthcare for me is the lynchpin... So economic security, and how we do something about that in a systemic way is my absolute passion- so that allows me to move between different issues facing average working families. But to me healthcare is one of those foundational issues, and what I started to realize after all of the work that I had done on these other issues... was that I felt like I was nibbling around the edges and that everything else I was doing were these packed solutions, and what I realized was if we can really make meaningful change on the healthcare side of things that it will be a game changer- for families- for economic security- and make it easier to put food on the table- make it easier for women to get out of abusive relationships- make it easier for people to put gas in their car to get to work every day. So for me healthcare is it, because it will impact so many other areas of economic security for families.
HB: Ok so you're in favor of a single-payer...
HB: ...universal healthcare...
HB: ...publicly funded plan?
HB: And in your opinion would that take some of the burden off of business and help create private jobs?
CG: Absolutely. I mean to me, it is a drag on our state budget, on economic development and on individual family security. And when it comes to businesses- they're having a very difficult time managing the cost of healthcare, so you take that off their backs and they can do a whole lot more. The other piece is- when you have healthy workers, you get more work days, you get more productivity. And for businesses that can't afford to give their workers health insurance- if those workers aren't going to get preventative care or maintenance care treatment because their deductibles are too high, the productivity of those workers suffers. And I think about something like farmers. What happens to the family farm when a farmer doesn't have health insurance and he rolls his tractor? They are done. To me that is one of the most egregious examples of really what's going wrong in our system- that the people producing our food and doing manual labor- very dangerous manual labor- do not have health insurance. So as much as it is the right thing to do and a family economic security issue, it's an economic development issue, and really a statewide economic development issue.
HB: And what could you do as lieutenant governor to promote that issue or try to make things better?
CG: Well the lieutenant governor has basically three constitutional duties. One is to preside over the senate. Two is to break tie votes and Three is to step in if need be, if the governor is unable to perform his duties. In each on of those three roles, there's an opportunity for leadership on healthcare. So when you're presiding over the senate it's making sure that bills get their fair due on the floor. There's a lot of behind the scenes negotiations that go on in the senate. So it's something that is a little bit difficult to talk about in the public, but it's a small building and you'd better believe the lieutenant governor is talking to committee members, is talking to other legislators, and where they are on healthcare is critically important. When you look at the decisions we have to make in 2013 on healthcare, this is the point where every previous healthcare reform effort has fallen flat- when we talk about benefits and financing. So the major reason I got into this race was wanting to keep us on track with healthcare. And I can do that publicly, by campaigning on this issue, by helping explain to Vermonters what we're doing- being an ambassador of their issues into the statehouse, and I can do that behind the scenes because I have the knowledge, the expertise and the passion around this issue to help keep us moving in the right direction in the senate. That being said, you know the other critical duty is stepping in for the governor...
HB: Right. Are you ready to be governor?
HB: You're ready to be governor?
HB: Absolutely...you know, Vermonters have given a mandate to the governor. We have 67% polling on single-payer in this state. You know the governor- all indications are he's going to win this election. People are happy with the job that he's doing. The person who steps into that role should be committed to carrying that- the most critical agenda on Vermonters' list- forward. And I can make that promise. And that is just not a promise my opponent can make.
HB: Would you say you're a socialist?
CG: No. [laughs a little]
CG: No... although if you could label me something- one thing I made up is “socialist libertarian...” [laughing]
HB: Right! Me too! Right there with you!
CG: Although if you look it up, it is not what we think it means, just to warn you. [laughing]
HB: OK. No, but I hear you. I mean there's elements of, of- in terms of social policy and health care- I mean I'm right there with you and stuff- but there's also this sort of- getting back to the basics of the constitution, not violating the constitution...
HB: ...government not over-reaching and not doing unwarranted searches and seizures, and not just doing targeted killings of American citizens...and things like that, that I'm very libertarian about...
CG: Me too.
HB: So you can see the appeal of Ron Paul?
CG: Exactly. Because for me, the libertarian side of me says... government needs to stay out of people's private lives. So for me whether this is who you marry, the choices a woman makes about carrying a pregnancy, what she does with her body... and in Vermont gun rights are very important here... the private lives of Americans and Vermonters- I want to protect those, and honor the constitution. All that being said, it is the job of elected officials to use tax dollars wisely. 650,000 Vermonters are paying taxes at some point in their life and elected officials are accountable for what Vermonters get for those tax dollars. And to me that includes services like education, roads and bridges, clean water- It should also include health care. It includes safety net benefits. That's where our money needs to be going.
HB: What do you say to people who say that if Vermont's safety net is too good, or too generous, we're going to be flooded with people coming in from other states?
CG: I think it's absurd. And this is why. Vermont's benefits are already better than many other states. For instance, I was shocked to see that the State of West Virginia- and I'll have to double check the numbers, buy my recollection of this- is that their Medicaid eligibility is around 30% of the federal poverty line. So if you're making over $3,500 a year, you are not eligible for health insurance.
HB: And they don't have the number of different programs Vermont has. Vermont has more health care programs than...
CG: ...More everything programs! But people aren't flocking here. And to the extent that people do come here because they want single-payer- they're going to pay taxes. They're going to be working. We want people to come to Vermont. If we're going to create jobs here, we want young people to stay here. There's the element of people that we want to live here and prosper and they're going to pay into the system. I mean the idea that we're just gonna have people flooding in to get benefits- it's not happening now. You know single-payer's really aimed at helping people who are lower middle class, middle class- I mean if you are really living at the poverty line or or below the poverty line, Vermont has a good system for giving people health insurance. It is working people who are struggling, who don't have healthcare, who are going bankrupt, losing their homes because of this. That is really the group of people that's going to get the most benefit from reforming our healthcare system.
HB: What do you think about the death penalty?
CG: I'm against it.
CG: Because... I actually just had this discussion with my campaign manager the other day... I do not think we can have a law against murder, and then murder, number one. Number two, I'm actually against the death penalty for the same reason I'm against VY-
HB: Vermont Yankee?
CG: Yes. Because human beings are fallible. You know we set up these systems and we want to believe that we're objective, and that there are experts.
CG: We're all trying our best. And we all make mistakes.
CG: So if you look at something like the death penalty- and from your comment from earlier. You'd rather have... what was your...
HB: Oh, uh, well. The... we'd rather let ten guilty people go free than convict an innocent person...
HB: It wasn't me who said that. It was...um...somebody else.
CG: That's ok, we'll attribute it to you. It's excellent. [laughs.] But we know that people have been executed wrongly. And I read this story about the guy who just got executed in Texas and it makes me feel ill. I don't know if you saw that.
CG: He has an IQ of 60. And they compared him to the guy from Of Mice and Men. It's just unbelievable to me. So human beings are fallible. And so while I respect our legal system- I think our court system works really well... it's concerning to me to make that arbitrary judgment...
HB: Yeah but let's say theoretically though- that the system was absolutely perfect- that you could be sure that the person was guilty...
CG: But that's meaningless...
HB: ...it would still be wrong to kill the person, right? Wouldn't it?
CG: But see, that's meaningless.
HB: No... I know it's meaningless, but I'm just saying- purely philosophically- if we knew we had convicted the right person- we still wouldn't want to put them to death, right? Because that would still be wrong. Because if we've got them held in a cell or something, they're not an immediate threat...
CG: I know...
HB: And isn't it morally wrong to...
CG: What I guess I'll say is this. I have this line in my life where I think very little is black and white. Like right and wrong- somebody is still deciding what's right and wrong. So it's very hard for me to say that this is an absolute thing. What I don't like is the idea that a human being is saying 'this person is good' or ' this person is bad.' 'This person should die. And this person shouldn't.'
HB: Right. Because who are people to do that?
CG: Yeah. It's just- we're not. So- that is what I think it comes back to for me...
HB: No- I'll tell you an interesting story, actually. I applied for a job at the Temple Sinai in South Burlington as like an office manager, or whatever... and you know... I guess I'm trying to angle. I'm like “yeah my dad's a concentration camp survivor...” I'm trying to get a job. And the Rabbi there is like “the Nazis were evil people, weren't they?” And I wasn't ready to say yes to that even though they did evil things and I said... “well they didn't have the right idea.” And I did not get that job. [Laughs] But my feeling on that was- I'm not ready to say another person is evil...
CG: Yeah, it's tough.
HB: Because I think there were all kinds of circumstances where people were trying to just survive themselves. And they weren't really feeling that way, but they were scared.
CG: Also we're always a product of what's come before us. You can't stand in isolation versus the entire history of what's come before you. And so for me there's very little that's black and white. So what is important to me because of that is that human beings making decisions over whether somebody should live or die is a very uncomfortable and scary thing to me. That's the number one reason why I'm against the death penalty. It's also the number one reason why I'm against VY. Because I don't trust human beings to store anything in cold water for 2000 years to avoid nuclear fallout. It's just silly.
HB: And it's the same exact plant that was damaged at Fukushima. The same model.
CG: It's just absurd. It just doesn't make any sense. That being said though- it is the job of elected officials, of leaders- to function in reality. And we can have all the economic models that we want. We can have all the theoretical models that we want. Which are great to ponder bigger questions over coffee. But at the end of the day, the systems have to be functioning. And it's very important that we talk about as leaders, how the system is actually functioning. So the fact that people are wrongly convicted means that there should be a moratorium on the death penalty because we know we're not doing it right. I think sometimes politicians get too trapped in theory. And I think about Paul Ryan, for instance...
HB: Oh he was just nominated to be the uh.. the vice...
HB: ...the vice uh... the national you...
CG: Exactly. Which is...
HB: Which is crazy...
HB: What a crazy choice.
CG: Here is someone who's functioning, from what I read about him, on a purely ideological level. He is the the wrong kind of leader for this country, would be the wrong kind of leader for this state. Wrong kind of lieutenant governor. Here is someone who is taking the philosophy of Ayn Rand- taking our basic economic marginal utility models, which are not a function of reality at all. They're models that inform how we think about the world. And [Ryan] making policy plans that adhere to an ideology without taking reality into account- what that means for him is slashing medicare, slashing medicaid, slashing food stamps, getting rid of the health care reform.
HB: Right. And that's the kind of stance you can only take in a purely theoretical environment...
HB: ...because when you see the person before you bleeding to death on the street- do you let that person die because of your bootstrap theory?
CG: Exactly. Or because of your theory that we should have the smallest government possible and big business should pay the least amount of taxes possible, because when you do your 'curve' for economics this is what 'leads to economic growth.' It's absurdity. It's not the right thing to do. It's not the way you should be making policy. It's the same thing as these people who were signing the 'no tax pledge.' I mean give me a break. This is not how the world functions. It is your job as a leader to make difficult decisions, and wade into ambiguity, and do what is best according to metrics, and your metrics then get decided as to whether you stay in office or not. But the ideological-theoretical way of looking at the world, of operating in the world, where things are black and white, I think... results in bad public policy.
HB: So you're more of a pragmatist than an ideologue, you would say?
CG: Absolutely. I think it's important to have to have a bold vision. I think what I bring to the table, and it's unique- It's a bold progressive vision. So when I close my eyes at night I imagine a Vermont in which everybody has healthcare, in which nobody is struggling, everyone has meaningful work, they have liveable wages, they have food on the table. Ok, so that has to be the vision, but the devil's in the details. So getting from point A to point B has to be incredibly pragmatic, the numbers have to work and you have to bring Vermonters along with you. And that take compromise. That will take a lot of explaining- all those things. But you need both those things. You need the vision so that you know where you're trying to go- even if I will probably never see us realize that vision fully in a lifetime- it's what gets me out of bed every morning- but the steps have to be pragmatic.
HB: Have you thought at all about the F-35? Do you have a position on the F-35?
CG: I have been thinking about the F-35s and at first is was very confusing because...
HB: ...[Because] what was wrong with the F-16?
CG: Uh, no. What's confusing to me is that there are people on both sides of the issue that I really respect and that I care about. When I look at someone like Bernie and Leahy and Welch- I mean I'm with them on like ninety-nine percent of the things. So it gives me pause when someone like Bernie is supporting something. And then I have many friends and colleagues on the side of the people who are protesting it. And so the way my mind works I really have to delve into an issue before I can... I need to understand all parts of it. So not only what we perceive as the objective facts, but the perspectives of people on the other side to then be able to make a decision. I had a conversation with George Cross...
HB: Yeah... he's been contributing to my blog.
CG: Yes.... The plan that he put forward is incredibly common sense to me, because again- nothing is black and white, and we can sit here and protest the military industrial complex...
HB: ...except for the part where we're supposed to be held harmless for any property devaluation, which would be impossible to prove- but I like the first two parts of his plan which would be like a trial run, and making all the studies public...
CG: Yup. But I do think there should be some federal liability to that. If the feds are coming in saying there should be no property devaluation because of that, then they should have no problem saying that they're gonna pay...
HB: They can say anything they want, but let's say properties did drop, how would you prove it was because of the F-35?
CG: Well this where statistical analysis is...
CG: You can begin to prove causality with statistics... again, nothings ever black and white, right, but- for me- some of the things I read about the study they did are really concerning in that you can look at... you know, it's longitudinal- you can look at, over time- and you can draw conclusions. I mean you have to be able to draw conclusions in public policy, or in agreements, without there being 100% certainty.
CG: What I like about what he brought forward is that it's not ideological. This is practical. So we could sit here and say- and I would agree with most people that they're spending too much money on the military-industrial complex. You know you have those people on one side, and then you have the 'support our troops' 'support our military' [people] on the other side. This does not allow for common ground...
CG: … or people to move forward. So what I like about George Cross's idea is that these are some very practical metrics, we listen to people's concerns. There are practical things that can be done to alleviate them.
HB: I think the biggest one is just trying it out. Letting people hear it.
CG: But then again you run into the problem of 'Some people think it's too loud, some people think it's not.' And who's gonna make the decision at the end of the day?
HB: Well if it's really, really too loud I think most people will- you know- if it's ridiculous- that's... you know... but...
CG: It's tough because you're never going to satisfy everyone, you know?
HB: That is true. That is so true.
CG: But that's the kind of approach [Cross plan] that I like and that I can get behind.
HB: Can you speak at all to State vs. Local control over education?
CG: Education is... What I'll say in general about- and this is something I've been thinking about in terms of economic development- is that I do favor local control. I think that in general the more localized control is, the better. I think that communities know best what they need. The further away the decision making gets from the locus of its impact, the harder it is to be effective, the harder it is to have local people bought in...
CG: So, for instance- When I've been thinking about economic development in particular- When I look at, like Pine Street for instance. Incredible things have been done on Pine Street in Burlington. It used to be pretty abandoned space, and though a combination of working with local landlords and local tax incentives- not only are there good jobs there now- there's an entire culture built around it. There's a childcare center down there. There's coffee shops. There's art. There's places for people to gather. So it's become a whole community, and an identity for those young families moving in there. They're going to stay there. It's not just about what you do from nine to five. So that's Pine Street. Hardwick? Doing something completely different that's related to local foods. So what you have to do that's important is take into consideration the assets of the local community and encourage development based on the strengths of that community. So it's not that we want a Pine Street in every town in Vermont. What we want to do at the State level is put broad metrics in place- broad evaluative mechanisms in place- because you want to make sure that if you're spending State money it's being used wisely.... that we're loosening up capital, we're loosening up support so that this kind of development can take place at the local level. My initial instinct around education is that we would operate in a similar world, although... I'm a fan of administrative consolidation in general.
HB: Right. And we do have to have some kind of uniform metrics...
HB: ...statewide and nationally, so that we can know where we are...
HB: ...compared to the world, you know- which unfortunately is not quite where it should be, right?
CG: Right...But... the approach for how to make Lawrence Barnes work is going to be very different than the approach for making a school in the northeast kingdom work. I mean the dynamics of the student population are completely different, so...
CG: …there has do be a balance. I think what the State can bring is resources, expertise, broad metrics, mechanisms to evaluate how money's being spent, how things are working, where students are at. I think when it comes to pubic policy- not only do local communities know best the dynamics of their community- but for public policy to really work, people need to feel heard, and the need to feel bought in, and they feel bought in because they're part of the decision making process. And I think this is true across the board and it's another thing that's critically important to me as lieutenant governor is to make sure that people's voices are at the table- that Vermonters feel heard, that they feel like they have a part in the decision making process. We're living in a world in which people don't feel like that have control over very much.
CG: There's a lot of anxiety right now, and when we talk about changing really big things. Whether it's reforming our education system, or reforming healthcare. That can be very scary for people. If anything we need to be helping people feel like they're more in control of their lives and they're a part of the decision making process... My instinct is that's the same with education, although I will say it's one of the things I'm really trying to get up to speed on. And what I'm going to be doing over the next month is meeting with all the secretaries of the State agencies to talk to them about all the specific challenges and opportunities of their programs.
HB: When you come visit Doug Racine, say hi to me...
HB: Speaking of education- you have a bachelors in women's studies... or gender studies? ... or women's studies?
CG: Women's studies and political science.
HB: And then you came up here to get. A degree... a masters of science?
CG: I didn't come here for that.
HB: Why did you come up here?
CG: I came here because...
HB: ...And when?
CG: In 2004. So I had been working Pennsylvania and had been promoted to management in a women's health clinic in Pennsylvania and was an advocate and activist for God- as long as I can remember. So the story my mom always tells is that I was four years old, I was at the Thanksgiving dinner table and I asked her where the turkey came from and she told me, and then I ran away in my room and slammed my door crying and wouldn't come out and eat dinner. So it's like, I don't know why but it just started really young. And I had visited Vermont once before for two days and absolutely fell in love a year before I moved. For several reasons. You know it's incredibly beautiful here. Things like not having billboards. I mean there's just- it's incredible. There's places for people to gather. Having downtowns- I mean I grew up in suburbia where...
CG: ...we could drive to the mall, we could drive to Starbucks, we could drive to Borders, none of our neighbors knew each other...
HB: Right. And there's no gathering point. That's what I love about Burlington. There's this obvious core.
CG: And there is in most towns, even though, the downtowns- it's a problem what's happening in our downtowns, but there are still walkable downtown areas... people see each other at the grocery store, they see each other at the general store... The third thing I is that... I was this liberal, feminist, activist there [in Pennsylvania]. Here I'm not. Here I'm pretty pragmatic and mainstream. You know I come from Santorum country so I wanted to be in a place where we could actually move the ball forward.
HB: Pennsylvania is a purple state. You got the Quakers, and, you know, people like Harris Wofford.
CG: Basically you have Philadelphia and some parts of Pittsburgh and everything in between is Alabama...
CG: I mean that's Pennsylvania.
HB: And you went to Penn State?
CG: Yeah... which I'd be happy to talk about it if you want to go down that road. I have very strong feelings about that.
HB: Did you know about that coach?
CG: Oh my God. Penn State and I did not get along for the majority of the time I was there. But Vermont is small enough, and committed enough and people are connected enough that we can actually do things here that are impossible anywhere else in the country. And I think that we're at a point where- I mean we've know for a long time- most of us- that trickle-down does not work when it comes to State policy- or to policy- I think we're at a point where it has to be 'trickle-up' because- we can't wait around for Washington to solve these problems. They're not going to do it. That much is clear. I'm very grateful for our congressional delegation but they're mostly playing defense down there. It's very hard to move the ball forward...
HB: But what about the Affordable Care Act?
CG: The Affordable Care Act was a huge victory.
HB: Do you find hope in that?
CG: I do... but you see how much energy other states are expending just to keep from...
HB: ...complying with it?
CG: Yes. Like, they don't want to give people up to 130% of the federal poverty level health insurance. Are you kidding me? It's free. It's virtually free for them.
HB: Does that just get back to people living in their ideology as opposed to reality?
CG: Yes. Absolutely it does. So in Vermont though, the game here is if we can show that single-payer works and it saves money and it improves economic development- if we can make it work here- it will be a sea-change for the rest of the country. So we can experiment with things here and move the ball forward in ways that we can't anywhere else, and I wanted to be a part of that progress. So I packed my stuff. I moved up here with no job and no apartment.
HB: Where did you arrive? What part of the state?'
CG: In Burlington. I stayed with some acquaintances that I had gone to college with for about a week... and within a week I was temping at UVM in development, and got a sublet and I haven't looked back.
HB: And where else in Vermont? Didn't you recently live in Montpelier?
CG: I did.
HB: I thought I read that.
CG: I lived in Montpelier. That was where I was working with VPIRG because, I have two dogs and I'm working a lot at the Statehouse- it made sense- and I like central Vermont a lot actually. So the reason I went back to grad school... I had been working at Hunger Free Vermont, which I really loved that work... I was doing federal nutrition policy. I made the decision to go to grad school after knowing that Vermont was my home.
CG: The reason I went back to school is because I realize that- you know my heartstrings are pulled by a lot of things. That's not what makes the difference on policy. The numbers have to work. And so I realize that- I think when you have a combination of stories and numbers, you can make a lot of change. And I've been really successful on that at the statehouse.
HB: Tell me about some of the legislative achievements that you've been able to participate in.
CG: Absolutely... well what I still need to say is I went back to school for a masters of science in community development and applied economics because I wanted the economics and statistics background to be able to show that what I think intuitively, or what the right thing to do is, is also economically...
CG: Yes, or advantageous... is the issue. So I brought that philosophy forward with me, and that experience with me to the statehouse and been incredibly successful. So at VPIRG, on healthcare I was deeply involved in the passage of both healthcare bills- testified on them in committee- helped move them forward... And I actually spoke at the first bill signing. I was up there with...
HB: ...yeah I watched that video today before I came in... very great. Good public speaker.
CG: That's good to know [slight laugh].
HB: Uh... really good.
HB: Where do you have your background in oratory from?
CG: I've just been speaking in public for a long time. You know when I did the food stamp program, I was doing trainings all over the state on food stamps. I push myself into uncomfortable situations until I'm comfortable in them so it's not any formal training. It's just doing it enough times... But the two things that I'm most proud of that I did at the statehouse- One is I worked really hard on legislation that required insurance companies to reimburse for midwifery and home births. And that was completely original legislation. It was based on a phone call I got from a woman whose insurance company kept denying her midwifery care and I started doing research into what was going on in maternity care in this state and in this country and was horrified. We have a 30% c-section rate in this state, with the healthiest population in the country. It doesn't make any sense. I started doing research into the interventions... what's done with women's bodies when they go to give birth in hospitals. And the fact that people are paying for insurance and you should be able to decide where you want to give birth. And midwives have been licensed in this state for eleven years- I mean I could go on and on and on. I won't just because I'll bore you for another hour and a half on it...
HB: There were midwives present for both of my kids.
CG: Oh really?
HB: Oh yeah. They were at the hospital but Fletcher Allen has a good midwife program.
CG: They do, but they still have a 70% labor induction rate there. They still have a 30% c-section rate. These things are expensive and outcomes are questionable... Alright the thing with Obs... Obstetricians- It's a surgical specialty.
HB: Oh. I did not know that.
CG: When it comes to reducing our healthcare costs...
HB: They're always said in the same breath as gynecologists. You're an 'OB-GYN.' You're an 'obstetrician-gynecologist.' But they're totally different, you're saying?
CG: Herein lies the problem with it. Obstetricians are trained as surgical specialists. So basically you have surgical specialists delivering uncomplicated, straight forward, low risk pregnancies. It doesn't make sense from a safety perspective. It doesn't make sense from a cost perspective- from a care perspective- at all. These are things we have to start to change in our healthcare system if we really want to save money. Denmark has a 30% home birth rate. The United States has the same maternal mortality as Bulgaria and Croatia. It's 1 in 2100. Austria, Denmark, Switzerland, all these countries- you're looking at one in 12,000, one in 17,000. So we're putting high intervention, we're spending a lot of money- our outcomes are significantly worse than the rest of the world...
HB: A microcosm for the whole...
CG: Exactly. So I worked on that. And that was a tough bill.... So I identified the problem. I looked at models in other states, drafted language, did all the grassroots work, all the lobbying, all the testimony around it. And that bill passed and no one thought that that bill was going to pass. But again- we had a combination of stories- so we filled that statehouse up with moms and babies and dads and midwives. And we had the numbers to back it up. And it was unstoppable. Now it turns out the insurance companies have found another loophole which- herein lies the problem with private insurance being a business model- so I spent all of last year trying to fix it. But that was a big achievement for me. And then this past year- the one I'm even more excited about is- I started doing research on- which you should know- I love interacting with people, but I'm also a wonk. It's like this weird combination...
HB: That's like a perfect combination.
CG: So I spent nights reading through annual statements of insurance companies.
HB: Yeah, because who doesn't?
CG: Yeah. Exactly.
HB: Fun. Especially Friday, Saturday...[laughter]
CG: So I had heard so many horror stories from people about claim's denials so...
HB: Well I mean companies wouldn't make money if they didn't deny the claims, so what do you expect?
CG: Exactly. That's my point. It doesn't even make sense that we function this way.
HB: I don't even understand how insurance in general makes sense. It just seems like all insurance is a pyramid scheme.
CG: It is. I mean it doesn't make sense for it to be a profit making model at all, because the minute you need your insurance is exactly the point in which their incentive is to not cover you.
HB: Right. And that's the whole idea behind per-existing conditions. It's like if you actually need the insurance for something, forget it.
HB: It's only if you don't need it, that you can have it.
CG: Exactly... But I had heard so many stories... One of my co-workers needed arm surgery. And he went to Fletcher Allen. And he got a bill because the anesthesiologist at Fletcher Allen wasn't in the Blue Cross/Blue Shield network. What? It's the biggest hospital in the state. How is the anesthesiologist on duty not in your insurance company's network? And who makes their decision about when they're going to have their surgery based on which anesthesiologist is on duty.
HB: Right. 'Sorry- the regular anesthesiologist who is part of the Blue Cross network got sick today. We're bringing in the weekend guy- he's part of a different network- but do you want your surgery or not?'
CG: Yeah. It's insane. So I started doing research on this. The State was not collecting any data on the number of claims that insurance companies denied. Only data from paid claims. Not only that, but virtually no state in the country is collecting this information. The information we do track about when somebody makes an official appeal at Department of Financial Regulation for instance...
HB: Which was formally BISHCA?
CG: Yes... Or insurance companies will release some data- the little data we do have shows that only 2% of people appeal a denied claim from their insurance company. When they do, the rate of it [the denial] being overturned is astronomical. So what I started thinking about is- This is like the Best Buy scheme or something... where like, you know how you used to go into- and I'm not picking on Best Buy in particular- but you used to go into Best Buy or Costco or whatever and a TV would be on sale. OK then you would just buy the TV because it would be on sale. Now- you go in and there's a $150 mail in rebate. Right? So they get you to pay the money up front, knowing that a certain percentage of people are going to lose their receipt. They're going to forget to send it in. And they even send you a gift card in the mail, and of course people lose their gift card, they're not going to use it for a year. All this stuff. So they made a calculation that by putting five hurdles between you and getting your rebate, that most people are going to fall off which increased their profits. To me this seems to be a very similar thing to what's going on with insurance companies. So then I started cataloging all the lawsuits that have been taking place across the country- I'm talking billions of dollars in penalties against insurance companies for systematically denying claims. So coding their systems...
HB: Well there's got to be a formula. I mean if those penalties are less than the cost of paying the claims then it's worth it.
CG: Exactly. And you'd better believe- you know the insurance companies are making the claim that it's too hard for them to release that data- I know that you're [insurance companies] are analyzing that data on a daily basis and making calculations. And that's- again- the problem with insurance companies because they're making calculations based on wide economic data and profit instead of the individual impact on people. So I said we have to collect this data. So I looked at some models. There are three other states that collect some version of this data- and found sponsors for the bill. And actually I'm proud of it because it was two Republicans and a Progressive. Senator Bill Doyle, senator Vince Illuzzi and senator Anthony Pollina co-sponsored the legislation to, not only require the State to collect data on the claims that insurance companies deny, but to do it by category so we understand why they're denying them, whether they've been overturned, and that all of that be publicly accessible. So now they have to fill out a lay-language memo that goes on top of their annual report, and it's signed off by the CEO of the insurance company and that is uploaded online so every Vermonter can see exactly what their insurance company is and isn't paying for.
CG: I also started reading about the amount that it costs- physicians spend 78 Billion dollars a year arguing over claims. How many people- how much care could that pay for? It's absurd. Not to mention a full day a week physicians spend dealing with paperwork. So we brought this legislation forward, pushed it thought the senate and then made it even stronger in the house. This is the fun part...
HB: And this is something you did while working for VPIRG?
CG: Yes... We made it stronger in the house, which I'm really grateful to the house healthcare committee for. So in addition to reporting on denied claims insurance companies have to report in this lay-language memo how much they're paying their CEOs, how much they're paying their board members, financial contributions, legal expenses related to fighting claims payment for patients, charitable contributions, marketing expenses... there's a list of like 12 different things, all of which have to be reported publicly, because to me this is about showing- not only what they are and aren't paying for- but how they're spending out dollars. And people are angry when their claims are getting denied. And they have the 7 million dollar golden parachute. And I am a firm believer that sunlight is the greatest disinfectant. For instance when I started working on this in particular I saw that in Massachusetts, the Blue Cross/Blue Shield there was paying its board members a whole lot of money and a reporter made that information public, and once the story got wheels, not only did Blue Cross/Blue Shield, but the other two non-profit insurers voluntarily stopped compensating their board members. They were compensating like $70,000 for like four meetings a year.
CG: How can you do that if you're non-profit?
HB: That's a good job if you can get it.
CG: So it's the most aggressive insurance disclosure law in the country... We're checking on the implementation of that now because the data should be coming out soon here. But it passed, I think it was 145 to 1 or 144 to 1 in the house. There was only one Republican who voted against it. So this all brings be back in a circle to the lieutenant governor's role...
HB: Which is good... to bring it back...
CG: People want to ask me, you know- 'Are you ready to be this? Are you qualified?' and I say look at my track record. Because in the past decade- for my twenties, I have accomplished a lot, and shown myself to be a leader in a lot of ways. When I look at what I've been able to accomplish in the statehouse- it's identifying a problem. It's looking at the best models for fixing that problem. It's figuring out how we apply that in Vermont, and bringing people along with me on that solution across the aisle, and then seeing it through to implementation. I would love to have those questions asked of my opponent so see how many things he's been able to do that on, or what he's lead on in the past decade.
HB: Your opponent drives a race car. So how do you top that?
CG: This is about public policy. This is about leadership. This is about an actual track record. It needs to be... I want to talk about my track record, not a race track. That's what my opponent should be talking about. To me it is there. It is all there. And I will gladly go toe to toe with him on policy and on accomplishments.
HB: Do you have some debates scheduled?
CG: ... I want six debates with him and it's something I keep mentioning every time I'm in the media, is that we need to have five debates on specific policy issues...
HB: Are there any scheduled right now?
CG: ...we just got word in St Albans- I don't know if he's agreed to it yet- but public access in St Albans and they want to push it out across the state... wants to do a healthcare specific debate. What I want to do is five topic specific debates. Policy specific debates. I want one on taxes. I want one on clean energy. I want one on healthcare. Because this is the only way that Vermonters are going to really see the nitty-gritty differences between us.
HB: But right now there are none that both parties have agreed to?
CG: No. Not yet.
HB: That's too bad.
CG: But that is something I am really committed to making happen. I think in this case... I'm hoping that organizations or entities that care about each of these issues will step up to the plate and ask for these policy debates because it is really important for us to wade into the depth of these issues. And with my opponent there's two dynamics going on. One is there's an actual track record of votes which does not match the values or the perspective on the issues that most Vermonters have. And people don't know about that track record. So this includes voting to keep open VY. It includes helping to kill the collective bargaining bill for childcare workers. It includes one of the worst environmental records in the senate. I don't know where he was, but he was not present for the veto-override vote on gay marriage. And what I heard this week is that he's being endorsed by the Right To Life committee in Vermont. These are very, very concerning things and I don't think enough Vermonters know about them. The other part is that we don't know where he stands on a lot of issues. So if you ask me where I'm at on healthcare and what I think we need to do, it is very clear, my vision for healthcare. What I have heard from my opponent is that he is 'concerned.' It's very...
CG: Vague. And that's a problem because he could be the next governor. And we need to know exactly where he stands on the issues if he could be the person stepping in and leading Vermont. So that is the most critical thing and what I think distinguishes me. Not only do I have a clear vision- it's clear where I stand on the issues and when I think something, I will tell you what I think. And I will listen. You know it's not that my mind isn't open to changing, but I will tell you what I think... I also have a track record of moving that from vision to reality. And I would love for people to ask those same questions of my opponent, regardless of whether or not he drives a race car.
HB: Awesome. Thanks so much for this.
CG: It was fun.
Left to right: Cassandra Gekas and Haik Bedrosian