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Douglas in middle on health care

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MONTPELIER — Gov. James Douglas walks a fine line on health care reform, one that puts him at odds with fellow Republicans across the country and Democrats here in Vermont.

That divide is no clearer than in the announcement this week that President Obama — who is facing tough Republican opposition to his proposals in Washington — selected Douglas to headline a health care forum in Burlington later this month.

"I'm afraid I just don't understand it," said Richard Davis, the executive director of the Vermont Citizens Campaign for Health, which supports a single-payer health care system. "The substance of the governor's health care reform measures just doesn't match up with Obama's plans."

Douglas' special relationship with Obama has developed very quickly — it was just months ago that he openly supported the president's Republican opponent, Arizona Sen. John McCain, in the general election.

But Obama saw in Douglas a Republican partner to help pitch his economic stimulus package. Days after an Oval Office meeting between the two men, Douglas was invited back for Obama's signing of a bill expanding the children's health insurance program — a priority for both the Republican governor and Vermont Democrats that was dashed under President Bush.

The March 17 forum at the Davis Center on the University of Vermont campus in Burlington will also feature Obama administration officials and Massachusetts Gov. Deval Patrick, a Democrat.

"Lowering the cost of health care for all Vermonters, indeed all Americans, is a goal I share with our partners in Washington and my fellow governors throughout the country," Douglas said in a statement.

Susan Besio, the director of the Office of Vermont Health Access, overseas much of the health care reform efforts for the Douglas administration. She said there are a number of similarities between the president's plans and the governor's approach, starting with that both see a role for insurance companies in the health care industry.

Both men also support increasing employer-sponsored health care, subsidizing insurance for low-income residents, focusing on wellness and prevention and using health information technology to reduce the overall costs of the health care, she explained.

"There are a lot of similarities between Gov. Douglas' record in Vermont and President Obama's plans for health care," Besio said.

Obama's offer to Douglas came as a surprise to administration officials this week. Besio said the Burlington health care forum will likely gather input from Vermonters and showcase reforms made here in the state.

A full agenda and start time for the session are still being worked out. Besio said this will be the second of five health care forums the Obama administration will host — the first being in Michigan on March 12.

"We're working out the details right now," she said, adding that the session may have a limited guest list because of high interest and tight meeting space.

But there are some clear places where Douglas and Obama disagree, according to Deb Richter, a Montpelier doctor who has pushed for a single-payer system.

She said Obama has talked extensively about cutting down the administrative costs of health care — typically the cost of filing paperwork and bills back and forth — and that is an issue she doesn't recall Douglas narrowing in on in his reforms. Obama also wants a top-down review of health care costs, Richter added, which goes further than reforms supported by Douglas.

But Richter said it makes sense for Douglas to take Obama up on his offer.

"Why wouldn't he do this?" she said. "It seems like a natural fit in some ways. And if this means Douglas will be bringing back more federal money to the state, than that's even better."

But Douglas is also out of synch with many national Republican officials as he embraces Obama's health care reform agenda. The party platform for the Republican National Committee notes that, "Radical restructuring of health care would be unwise."

During an MSNBC interview this week, U.S. Rep. Zach Wamp, R-Tenn., a member of the House Appropriations Committee, summed up the national Republican Party opposition to Obama's health care plans.

"It's the next major step toward socialism," he said during the interview, adding that the government should be using tax cuts to make health insurance more attractive to the 45 million Americans who don't have coverage.

Sen. Doug Racine, D-Chittenden, the chair of the Senate Health and Welfare Committee and a probable Democratic candidate for governor next year, said he has clashed several times with Douglas over health care issues.

Racine noted that Douglas vetoed the Vermont Legislature's health care reform bill in 2006, which later led to a political compromise and the birth of the Catamount Health program.

"Over the last six years we haven't seen Jim Douglas be a leader on health care reform issues," Racine said, adding that he hopes Obama's push for bipartisanship will rub off on the governor. "All the major reform efforts have come from the Legislature."

Anthony Pollina, an independent candidate for governor last year who supports a single-payer system, called the upcoming meeting a "farce," in a statement released Friday. He said Douglas just wants to align himself with a popular Democratic president.

"But, when it comes to health care the charade just goes too far," Pollina said. "While we all appreciate Obama's efforts to tackle this issue and appreciate efforts to be nonpartisan, this summit can only be a farce if Jim Douglas is running the show."

Some see a political angle to the unique relationship between Douglas and Obama. The Democratic president needs Douglas as an example of a Republican he can work with on key reforms and the Republican governor needs Obama on his side to continue attracting independent Vermont voters.

Eric Davis, a retired Middlebury College political professor, said Douglas' strategy here is similar to the one used by Bill Clinton when he was first elected president in the early 1990s.

"What Douglas is doing is casting himself as the moderate, pragmatic centrist," Davis explained. "He opposes the hardcore Democrats who want to see a substantial expansion of the role of government in health care and he opposes the hardcore Republicans who want to rely solely on the insurance companies."

Daniel.Barlow@rutlandherald.com.