By, Jonathan L Weker, Montpelier
James Leddy’s nomination to the new Health Care Reform Commission raises ethical concerns of such magnitude as to make his appointment objectionable, if not illegal. Mr. Leddy, the Commission, and the people of Vermont should not permit it to proceed in its present form.
James Leddy has performed valuable public service for the people of Vermont, first as director of the Howard Center for Human Services and then as a senator from Chittenden County. I have heard him speak on the topic of health care on several occasions; he has been thoughtful, eloquent and passionate.
Mr. Leddy would make an excellent member of the Committee, but for one thing: he brings to the position a very significant and unavoidable conflict of interest.
Mr. Leddy is currently the president of the Vermont chapter of AARP. That organization serves as a health insurance broker, marketing insurance products for United Healthcare under the AARP name and bringing in considerable revenue by doing so. Thus AARP is not a disinterested party when it comes to creating health care policy; and when it does become involved, it puts its own interests ahead of those of the people at large.
AARP actively worked in support of the very flawed 2003 legislation that established pharmaceutical benefits for Medicare recipients (Medicare Part D), which spawned such monstrosities as the doughnut hole and forbade cost reduction negotiations with pharmaceutical companies. That legislation also mandated an unnecessary and costly middleman role for health insurance companies–including United Healthcare and its partner, AARP.
My father always told me, “Never ask an umbrella salesman what the weather is going to be.” When it comes to forecasting a health care delivery model for Vermont, Mr. Leddy is an umbrella salesman. Given his present job, he would face an unavoidable conflict of interest were he to assume a seat on the Health Care Reform Commission: it is not difficult to imagine that what is best for AARP is not always what is best for the people of Vermont, and Mr. Leddy would have obligations to both. By definition, he cannot be a disinterested party; even if he says he can set aside his conflict of interest, he would bring his conflicted loyalty with him. Taking a seat on the Commission would be the wrong thing to do, and it may well violate the law that established the Commission.
This situation can be satisfactorily resolved in one of several ways. First, Mr. Leddy could resign from his job at AARP and then take a seat on the Commission. Second, he could appreciate the inherent and irrefutable conflict and decline the appointment to the Commission. Third, Shap Smith could recognize his error in appointing Mr. Leddy and rescind the nomination. Fourth, the Commission could refuse to seat Mr. Leddy. And fifth, if no other remedy is brought to bear, Mr. Leddy’s appointment could be fought in court.
We need to hope that Mr. Leddy and the Health Care Reform Committee will do the right thing for the people of Vermont.