Can We Get our Legislative Act Together?

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I don’t know whether it’s the natural wariness of Vermont’s early immigrants who succeeded the native peoples who had foraged and hunted here for millennia but were driven north into Canada by the colonial newcomers or whether it was the Milton Friedman neoliberalism that swept American politically when Reagan came to power in 1981 and told us that government itself was the problem, not the solution, but Vermonters seem to have a natural wariness of government. Vermont’s Republican Century had just ended 16 years earlier with the surprise election of Democratic Governor Phil Hoff.

Since then, a succession of intermittent Democratic governors has brought forth new ideas and initiatives, but few, if any, led to substantive change over the succeeding years. Governor Madeleine Kunin focused on education equity and quality and, in 1989, successfully established Vermont’s Dr. Dynasaur program providing free or low cost health coverage for children and teenagers under 19. As evidence of the eroding access to affordable healthcare came into clearer view in the new century, Governor Peter Shumlin focused on it and tried to implement single-payer healthcare. But ultimately his efforts made no enduring difference. Governor Dean, now considering a second run for the Statehouse, was more successful at bringing the issue to light and finally, after several concessions, in 1995 created the Vermont Health Access Plan.

Having watched all this happen for a good thirty years and having chaired Vermont’s largest hospital, then Fletcher Allen, I feel we’ve made modest but inadequate progress towards a goal of “Population Health.”

Put simply, “Population Health” is defined by three elements: quality, access, and affordability for a specific population, e.g. in this instance Vermonters. But as I’ve often noted, Vermont healthcare infrastructure in many areas offers quality. But without access and affordability what good is quality if only accessible to a few?

There is a larger and broader view here.

The lion’s share of social and economic problems vexing our legislators  ̶  like nutrition (hunger/industrialized food supply), teenage dysphoria about their future prospects (environmental, home ownership, higher education), growth in the number of suicides, cellphone use and screen time, all the adverse childhood experiences (ACES), homelessness, lack of child care, few affordable addiction recovery programs, and conservative opposition to sex education and family planning initiative   ̶   are all elements and determinants of population health. Until we understand this we’re treating our wellbeing and the wellbeing of our young with face paint.

To make matters worse, we’ve been dragging our legislative heels. Is it the hangover of Milton Freidman’s neoliberal philosophy or is it native skepticism about regulatory authority, taxation, and expanding the code of law? We postpone, we hire costly consultants, we study, we debate, we hold hearings, but we fail to act in a timely manner. Especially when technology and scientific discovery are accelerating at breakneck speed.

At 79, I can remember a time when, as in Morrisville, the hill farms were still being wired for electricity and the scourge of “stray voltage was driving dairy herds mad.” I remember the first TV set arriving in our neighborhood in 1954. Our closest neighbor still farmed with horses. There was no credit card industry. Five-party phone lines were a source of entertainment for all.

Would we not be better reversing the legislative timeline   ̶   one that confronts problems as they occur and takes direct action to confront what’s in our face   ̶   and then monitoring a law’s human and institutional impact and then amending them as necessary?

In 1903, mankind took flight for the first time, aloft for less than a minute. Sixty-six years later we landed on the moon. But today, our failure to adequately regulate airline safety has planes and parts falling out of the sky, yet the pace of innovation continues to accelerate.

Today, our legislature is tabling a bill, S.284, desperately needed to protect our public educational system from the degradation of cellphone use in schools. My last column was about this issue. The testimony is well-documented about the damage electronic devices are doing not only in our schools and educational system but to our young learners themselves. Having taught at Mt. Abraham in Bristol in the late ‘60s, I had classes most periods and a home room. I can’t imagine my students bringing cellphones into our building as they do today. A recent missive from CVU Principal Adam Bunting to parents only further elucidated the damage to students of cellphone use at school.

It was only 20 years ago that the smartphone became ubiquitous. Almost at the same time, social media burst into the mainstream. We’ve been living with the benefits and dangers of largely unregulated use of both technologies, even as we understand the damage both are doing to our young people. And now comes artificial intelligence (AI) making it possible for young girls, boys, incels, and men who are incapable of forming human relationships to create digital partners for friendship, relationships, and even digital sex. What does this mean for the future of the human race? Do we need to replicate in our own government hierarchy a “Minister of Loneliness” as they have in England.

Given the bloom of new technologies that affect humankind in good and bad ways and the regulatory capture by business and lobbying interests consuming our regulatory and legislative systems and the narrative capture of language by marketing, public relations consultants and “influencers,” might Vermont, at least, be better off aggressively regulating new technologies that have shown a clear threat to the health and wellbeing of Vermonters, especially young Vermonters? We can and should monitor impacts and amend new regulatory legislation as we learn more, but not just in response to industry lobbying.

But instead we twiddle out thumbs, awaiting a mythical consensus which never exists in a pluralistic society divided between profit and wellbeing   ̶   freedom and unity. We want us all to agree, but that simply doesn’t happen when evidence on both sides is explicit.

As more and more technologies emerge that impact our wellbeing, we must move more quickly on evidence-based injury and benefit and make new law when it’s needed not years later when the damage is done and technology has moved on.

Our failure to regulate and support the many contributing social determinants of health in Vermont sinks us deeper. We could start with banning pesticide use in our dying industrial dairy industry and cellphones in our struggling schools,

Sadly, all of the above legislative failures inure to the decline of population health. Health and wellbeing is central to all of the legislative failures mentioned above. We need to take the bull by the horns and make laws that benefit all Vermonters. We amend as needed going forward. We can’t procrastinate in search of a perfect law. The perfect is the enemy of the good.