Category Archives: Health Care

In 8-3 vote, House Judiciary Committee approves end-of-life bill

An end-of-life bill that had been dismantled on the Senate floor earlier this year has been pieced back together in the House, where the judiciary committee this afternoon approved legislation that would allow doctors to prescribe lethal doses of medication to terminally ill patients.

The Oregon-style “death with dignity” bill heads to the House floor next Tuesday, where it to have the votes needed to pass the full body. The legislation will then head back over to the Senate floor.

Supporters are hoping for better luck there this time around than they had in February, when a 21-page bill was scrapped on the Senate floor in favor of a three-paragraph provision that essentially indemnifies doctors for knowingly supplying suffering patients with doses of pharmaceuticals sufficient to end their lives.

Sen. Peter Galbraith, the Windham County Democrat who authored the amendment, said the language satisfied the desires of people seeking control over end-of-life decisions without creating a state-sanctioned process by which physicians can abet the hastening of death.

Galbraith’s amendment passed, thanks in part to votes from senators opposed to any kind of end-of-life bill passing this year. But the original bill has been restored in the House, where lawmakers said the Galbraith amendment opened the door to abuse by eliminating the safeguards in the original bill.

Those safeguards, according to Rep. Ann Pugh, chairwoman of the House Committee on Human Services, “ensure people are competent and capable and at the end of their lives, and that they’re not under duress.”

“And it brings a practice that many say is happening already into an open and transparent process,” Pugh said.

While the bill will almost certainly win approval on the House floor next week, its path through the Senate isn’t so clear. For a more in-depth look at the political and procedural hurdles awaiting the legislation, check out Sunday’s editions of The Times Argus and Rutland Herald.

Soda tax could get revote as early as Wednesday

The House Committee on Health Care looks poised to settle some unfinished business tomorrow morning, when members might reconsider their tie vote last Friday on the soda tax.

The committee by all accounts had the votes to pass the penny-per-ounce surcharge on “sugar sweetened beverages.” But when Rep. George Till departed suddenly to tend to a medical emergency (he’s a doctor), he took with him one of the ‘yes’ votes needed to pass the bill.

Committee chairman Mike Fisher proceeded with the vote anyway, which resulted in a 5-5 tie. Following the vote, Fisher declared the bill dead. But it looks like the committee is eager to resurrect the measure, and that someone will make a motion to reconsider, possibly as early as tomorrow.

The likeliest outcome, according to people closest to the issue, is a 6-5 vote in favor of the soda tax, which would raise about $24 million annually. But the provision might not have much of a shelf life.

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Nine-person committee to recommend tax for single-payer – in 2015

The Shumlin administration and top legislative leaders will delegate to a nine-person panel the task of coming up with a way to finance single-payer health care.

The issue of financing has followed the Democratic governor since he made single-payer the cornerstone of his gubernatorial agenda in 2010. The single-payer law enacted five months after his election directed his administration to deliver a financing plan by last month. Shumlin, however, said it was still premature to tell Vermonters what tax he’d use to pay for the universal system.

The decision to form the new panel defers until 2015 the unveiling of an official financing recommendation.

The panel will includes two appointees each from Shumlin, House Speaker Shap Smith and Senate President John Campbell. The three men will then decide together who should fill the three remaining seats.

“They will really dig into the issue of what the cost of the system will be and how the system is currently financed, and what a system going forward would like if you financed it a different way,” Smith said today. “I would see them putting forward a financing plan that supported a single-payer plan, or as close to single-payer as we could get under law.”

For more on this story, check out tomorrow’s editions of The Times Argus and Rutland Herald.

Dramatic vote in Senate proves game-changer for “death with dignity”

Stefan Hard / Staff Photo Stefan Hard / Staff Photo Sen. Claire Ayer, D-Addison, introduces end-of-life bill S. 77 Tuesday in the Senate Chamber of the Statehouse in Montpelier. Ayer is flanked  on her right by Sen. Christopher Bray, D-Addison, and Sen. Peter Galbraith, D-Windham. Sen. Robert Hartwell, D-Bennington, is in the foreground right.

Stefan Hard / Staff Photo
Sen. Claire Ayer, D-Addison, introduces end-of-life bill S. 77 Tuesday in the Senate Chamber of the Statehouse in Montpelier. Ayer is flanked on her right by Sen. Christopher Bray, D-Addison, and Sen. Peter Galbraith, D-Windham. Sen. Robert Hartwell, D-Bennington, is in the foreground right.

The Legislature may have 180 members, but the biggest votes in Vermont’s history often come down to a single individual. And in the Senate Wednesday evening, Sen. Peter Galbraith used his turn at the wheel to derail a decade-old push for a state-sanctioned process by which doctors could hasten the death of their terminally ill patients.

As one of four senators refusing to say publicly whether he supported “death with dignity,” the Windham County Democrat has been at the center of the intrigue since last month. On Tuesday, he broke his silence by voting in favor the bill. His support would prove fleeting.

The controversial legislation outlined a process by which physicians could prescribe lethal doses of medication to mentally competent, terminally ill patients with less than six months to live. Galbraith said he supports the intent of the bill – to allow suffering individuals to bow out on their own terms, surrounded by friends and family. But he said the “state-sponsored process” constituted undue government intervention in what should be a sacred exchange between doctor and patient.

Peter Galbraith

Peter Galbraith

Instead of a defining a lengthy and highly regulated procedure by which patients of sound mind can seek a fatal dose of barbituates from their consenting doctors, Galbraith said, the state ought to simply indemnify any physician who agrees to prescribe the medication.

Under normal circumstances, Galbraith’s proposal wouldn’t have stood a chance. But Wednesday wasn’t a normal day.

The vote on the bill Tuesday passed by a 17-13 margin, and Galbraith wasn’t the only ‘aye’ to register  concerns with the bill. Sen. Bob Hartwell, a Bennington County Democrat, also dislikes the legislation, and said his ‘yes’ vote Tuesday was only to give its supporters a chance to make it more palatable before a final vote Thursday.

Galbraith’s amendment sought to strike entirely the underlying bill, which was modeled after a 15-year-old statute in Oregon and has been years in the making here. He then replaced the 22-page bill with a five-paragraph amendment that insulates from civil and criminal liability a doctor who prescribes a “lethal dosage” to a terminally ill person. The amendment also protects from liability any friend or family member who is in the presence of the person when they ingest the medication.

The amendment gave opponents of the original bill the opening they’d been looking for. By voting in favor of Galbraith’s bill – a measure most wouldn’t support generally – they could effectively kill off the legislation it sought to replace. Sure enough, all 13 people who voted against the bill Tuesday voted in favor of Galbraith’s amendment today. They were joined by Galbraith and Hartwell, which led to a 15-15 tie on the floor of the Senate. That left the tie-breaking vote to Lt. Gov. Phil Scott, an avowed opponent of “physician assisted suicide.” He voted ‘yes’ for Galbraith’s amendment.

It was a dramatic moment that took even jaded Statehouse veterans by surprise.

It isn’t the end of the road for the original bill. Sen. Claire Ayer, an Addison County Democrat, chairwoman of the Senate Committee on Health and Welfare, has spent the last six weeks shepherding the Oregon-style bill through the Senate. “As much as I detest” the Galbraith amendment, Ayer said, she encouraged her colleagues to vote in favor of it.

By getting it through the Senate and over to the House, she said, lawmakers can bring the bill back to its original form and get a second chance to pass it as-is. Sen. Dick McCormack agreed, saying there are procedural reasons to pass the bill, “even in its presently grotesque form.”

Galbraith said his amendment differs philosophically from the bill it replaces in only one area.

“And that is as to what safeguards are built in,” Galbraith said. “The other bill leaves it to the state to decide who can do what under what circumstances. I believe the best safeguard is the close relationship between a doctor and their patient.”

He seemed taken aback by the intensity of the hostility to his amendment.

“It’s not grotesque. It’s not a travesty,” he said. “It isn’t exactly what they wanted, but it delivers the result they were looking for.”

Ayer said the underlying legislation sought to end precisely the kind of ill-defined, poorly overseen, under-the-table process that Galbraith’s bill would legalize. She said the legislation sought to engender deeper conversations between doctors and patients about the dying process, and make sure terminally ill people understand the range of palliative care options available. Ayer said she worries the Galbraith amendment may also create some new legal loopholes ripe for exploitation by unscrupulous doctors or caregivers.

Dick Walters, head of Patient Choices Vermont, an advocacy group pushing the bill, said Galbraith’s amendment “strips all of the carefully crafted and well-tested safeguards from the bill and instead gives physicians full immunity when prescribing lethal doses of medication.”

The bill comes up for final reading Thursday, creating another potentially interesting vote. A number of senators who supported the underlying bill voted against Galbraith’s amendment today. The amendment carried only because of unanimous support from opponents of the underlying bill. But the original bill is dead now, in the Senate at least, and can’t be resuscitated regardless of the fate of the Galbraith amendment. That means the same people who wanted to see the bill killed off entirely can now vote against the Galbraith amendment without consequence. And if senators who supported the original version don’t come around to Galbraith’s language, the legislation, in all its forms, could die for good.

Walters said he hopes senators who support the underlying bill will hold their noses and vote ‘yes’ for the amendment.

News out of D.C. today opens up $4 million hole in health care budget

The feds have dealt a financial setback to the Shumlin administration’s efforts to assist low- and middle-income residents heading into the exchange next year. But Shumlin’s health care chief, Robin Lunge, says the administration is already putting together a “plan b” to deal with the news.

Word came over the phone from Washington, D.C., today that the “cost-sharing assistance” in Shumlin’s fiscal year 2014 budget won’t be eligible for a federal match. That opens up a $4 million hole – a solution to which Commissioner of Vermont Health Access Mark Larson could present to lawmakers as early as tomorrow.

The cost-sharing assistance is essentially an updated version of Catamount Health, tailored to complement the framework of the federally mandated “health benefits exchange.” It would subsidize insurance costs for people making as much as 400 percent of the federal poverty level.

Critics have said the administration’s plan doesn’t go far enough to alleviate the financial burden on the estimated 45,000 poor and working class Vermonters who will be eligible for the aid. But Shumlin’s $22 million proposal considerably reduces the out-of-pocket exposure facing that population.

The $22 million plan, however, will now cost taxpayers $26 million, since the Centers for Medicare and Medicaid Services says it’s not on the hook for the matching funds on which state officials had been counting. Larson is tentatively scheduled to meet with the House Committee on Health Care tomorrow to present a plan to deal with the setback.

Peter Sterling, director of the Vermont Campaign for Health Care Security, said the news could have been far worse. Sterling says the feds have agreed to a federal match for premium assistance in the exchange, something they also could have denied.

 

Hoffer announces five auditing projects

Recently elected State Auditor Doug Hoffer announced this morning his office has begun five performance audits of state government functions.

The Auditor’s office will review

  1. The Department of Corrections’ “Correct Care Solutions” contract (a three-year contract worth $53 million);
  2. Two Agency of Transportation contracts that have yet to be determined but will be identified in the planning phase;
  3. The Agency of Administration’s Workers’ Compensation and Injury Prevention Program (which paid $7.3 million in claims in fiscal year 2012, according to the Auditor), to see whether the program has focused on prevention of causes of claims and identify trends in claims;
  4. State-issued cell phones to see whether the phones are under-used and / or costs can be reduced;
  5. Finally, the office will take a look at the state’s “last mile” telecom project, which is intended to bring high-speed internet to every home and business in Vermont through subsidies for the low-yield ‘last mile’ areas, and the state’s investment in health information technology.

 

Vaccine issue resurfaces in Montpelier, but leadership not keen on reliving old battle

One of the surprise controversies of 2012 arrived at the Legislature in the form of a bill that sought to rescind the “philosophical exemption” invoked by hundreds of parents across Vermont to sidestep school vaccination requirements.

A grassroots coalition of well-organized citizens managed to quash the legislation, convincing lawmakers to adopt a watered-down version that made it only slightly more difficult to invoke the exemption.

One the top supporters of the 2012 bill, however, is renewing the push this year to address what he says are alarmingly low vaccination rates in pockets of the state.

Rep. George Till, a Jericho Democrat and the lone medical doctor in the Legislature, wants to remove both the philosophical and religious exemptions for the vaccination that prevents pertussis – a.k.a. whooping cough. And at public schools where the vaccination rate drops below 90 percent, Till has a separate bill that would revoke the religious and philosophical exemptions for any vaccination.

Till says the pertussis problem is particularly acute, growing from 18 confirmed cases in 2010 to 645 in 2012.

“And in 2012 that included four cases in infants,” Till says. “And while we got lucky and none of them died, the quote mortality rates for infants is 50 percent, so we really could have had a tragedy.”

The second bill would take a school-by-school approach to the vaccination issue, eliminating the religious and philosophical exemptions only at public schools that fall below the 90 percent threshold. When rates for any single vaccination fell below that mark, Till says, his bill would require all current and prospective students to have the vaccine administered. Parents that didn’t comply wouldn’t be allowed to send their children to the school. Till says the bill preserves the medical exemption.

Rep. Mike Fisher, chairman of the House Committee on Health Care (on which Till also sits) doesn’t sound keen on revisiting the vaccine issue.

He says the House dedicated a lot of time to the issue last year.

“We addressed vaccinations last year, and I think we should give that law time to play out before coming back to it,” Fisher says. “I don’t think we’re interested in taking it up at this time.” In a report submitted last week to the Legislature, Commissioner of Health Harry Chen said the most effective way to protect “immunocompromised” students is to require universal immunization.

Republicans break out badges in move to become health care police

House and Senate Republicans have accused Gov. Peter Shumlin of violating state law by failing to tell Vermonters how he plans to pay for single-payer health care.

Legislation signed into law by the Democratic governor in 2009 included a provision calling for the recommendation of a single-payer financing mechanism by Jan. 15 of this year. Administration officials say the mandate was rendered unnecessary by a shifting federal landscape that postponed for at least three years any hope of implementing the publicly financed system.

Senate Minority Leader Joe Benning, however, said Vermonters are looking answers, not excuses.

“Businesses need to have the information necessary to make important decisions for themselves and their employees,” Benning, a Caledonia County Republican, said during a Statehouse press conference Thursday morning. “We need to have a clear understanding of what the game plan is, and at present we don’t have that game plan.”

Jeb SpauldingAdministration Secretary Jeb Spaulding dismissed the GOP attack as a “stunt.” The administration last week unveiled a highly anticipated report on single-payer; Spaulding said the administration had explained to lawmakers in advance that it would not include any specific recommendations for financing. He said reasonable people agree that it makes no sense to design a financing system for a program that won’t begin until 2017.

“These are people who want to undermine the effort to move to a single-payer system and are looking for any opportunity they can get to confuse people and erode support,” Spaulding said. “Issuing a specific plan at this stage of the game would not in any way help Vermonters understand what a new system would look like or what the options are to pay for it.”

For a deeper look at Republicans’ grievances, and whether they have any merit, check out the full story in today’s edition of The Times Argus and Rutland Herald.

 

Anti-single-payer group steals page from Michael Moore

You might remember ‘Sicko,’ the 2007 documentary from Michael Moore that made the case for single-payer by contrasting the for-profit health care industry in the U.S. with government-run systems in places like Canada, Cuba and the UK.

Now, this state’s leading anti-single-payer group is stealing a page from the liberal provocateur as it tries to send precisely the opposite message. 

Vermonters for Health Care Freedom wants to raise $18,250 to fund production of “Lessons from Canada,” a documentary it says will show what a train wreck single-payer is north of the border.

In an email to would-be benefactors, Jeff Wennberg, executive director of VHCF, says the documentary “will help us activate an already existing coalition of conservatives, independents, and moderate Democrats who think Vermont’s single payer plan is reckless.”

 

Wennberg already has a trailer up  – you can check it out at https://transaxt.com/Donate/4EP84S/VHCFSSinglePayerDocumentary/

 

The teaser gives a little taste of what the full documentary would have in store.

 

This whole idea that it’s free, well it’s  like if you have a free bar at a wedding, some people won’t be as careful as they should, and as a result the liquor may run out,” says one guy in a suit.

 

Look for the health care debate to ramp up next Thursday, when the Shumlin administration unveils it’s long-awaited single-payer financing plan. They’d been scheduled to present the plan today – statute actually required them to – but are holding off until the governor drops his fiscal year 2014 budget.

 

 

Vermont wins federal approval for health care exchange

The federal government has given a preliminary thumbs-up to an online health insurance marketplace set to go into effect in 2014.

In a press release fired off this afternoon, the Shumlin administration said the U.S. Department of Health and Human Services gave conditional approval to the ”Health Benefit Exchange” now under construction at the Department of Vermont Health Access.

The federal Affordable Care Act mandates that every state have a health benefit exchange in place by January of next year, but Vermont has pursued the program more vigorously than most.

The state has drawn down well more than $100 million in federal grants to create the exchange, and legislation passed last year will require companies with 50 or fewer employees to purchase their insurance plans through it.

“Vermont continues to be a leader in health care reform, and this is another illustration of our progress toward meeting our reform goals,” Gov. Peter Shumlin said in a written statement. “We are building an Exchange that works for Vermonters now and in the future.”

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Single-payer group offers ideas on how to pay for it

From the Times Argus and Rutland Herald today, a story from Pete Hirschfeld:

MONTPELIER — A group that helped build the political will for single-payer health care in Vermont has issued a report telling elected officials how to pay for it.

The Health Care is a Human Right Campaign unveiled a 17-page proposal Monday in which it identifies a combination of income and payroll taxes as the most “equitable” means of financing the new system. More a conceptual framework than a solid proposal — the report doesn’t estimate overall system costs or calculate the dollar value of the new revenue streams — the report says its blend of financing options would place the lion’s share of the financial burden on those best able to afford it.

“And that’s been one of the key principles from the beginning,” said James Haslam, director of the Vermont Workers’ Center, which oversees the campaign. “The Shumlin administration is doing all the work to figure out how much it’s going to cost, and we’re essentially saying this is the most equitable way to come up with the money.”

Administration Secretary Jeb Spaulding said he was impressed with what he called a very well-written report. “It will be a helpful document as the dialogue on how to pay for single-payer takes place in the coming months and years,” Spaulding said.

As to the specific proposal, which would use a mix of corporate and personal income taxes, combined with a “progressive” payroll tax, Spaulding said, “In general they make a strong case.”

For the rest of the story, click here.

Does more competition in health insurance actually bring down costs?

David Sanger

David Sanger speaks at the Paramount Theatre in Rutland Tuesday.

While speaking at Rutland’s Paramount Theatre last night, the New York Times’ Washington bureau chief David Sanger raised an interesting question about our assumptions on health insurance and competition.

He referred to a study that was written up in the Times’ Economix blog, which compared the concentration of competition, measured by how much of a state’s insurance market is concentrated in the largest two insurers, to the rise in the cost of health insurance premiums in the same state over the ten years between 2000 and 2010.

The study finds that there is not a meaningful correlation between more competition and lower costs. In fact, Sanger pointed out, the reverse actually seems to be true – and this raises concerns about the direction we’re taking with Obamacare.

The concern comes from the increased competition required from health insurance exchanges – which states are required to have set up by 2014, or the federal government will set up for them.

Apparently, the more concentrated the insurance market, the more leverage the biggest insurers have to bring down costs. The more fragmented the market, the less leverage each individual insurer has. As Economix puts it:

In imperfect health care markets, competition can be counterproductive. The larger an insurer’s share of the market, the more aggressively it can negotiate prices with providers, hospitals and drug manufacturers. Smaller hospitals and provider groups, known as “price takers” by economists, either accept the big insurer’s reimbursement rates or forgo the opportunity to offer competing services. The monopsony power of a single or a few large insurers can thus lead to lower prices. For example, Glenn Melnick and Vivian Wu have shown that hospital prices in markets with the most powerful insurers are 12 percent lower than in more competitive insurance markets.

Food for thought as we steadily advance on the way to a single-payer system. For the full Economix blog post on this, please click here.

 

Anti-single-payer group to take to Vermont airwaves

Four weeks after cutting its first television ad, the state’s leading anti-single-payer group has finally raised enough money to put it on the air.

Vermonters for Health Care Freedom will spend about $12,000 to run the 30-second spot on WCAX and WPTZ between now and the end of the October.

Jeff Wennberg, executive director of the organization, says that with Election Day on the horizon, it made sense for the group to bring the message to a statewide audience. The ad will run during “news and information” shows, he said.

“The good thing is that prior to an election, people are thinking about policy matters and thinking about the direction state and our nation are headed,” Wennberg said this afternoon.

Production was a low-budget affair. The spot, titled “Bureaucrats,” was made using donated space and unpaid volunteer “actors,” according to Wennberg.

“Even so we believe it effectively communicates the message that once the government has full control of our health care system, our access to needed services will be limited, not by medical professionals but by unaccountable bureaucrats in the name of cost containment,” Wennberg said when the ad was released on the internet last month.

The spot features a woman, facing a potentially dire prognosis, and a doctor saying, “I think we need to run a test, if that’s okay.”

“That’s okay with me,” the female patient says.

“Sorry – I wasn’t talking to you,” the doctor says. “Is that okay with you?”

The conceit here is that the doctor is in fact talking to the “bureaucrats” that Wennberg says would, under a single-payer system, be empowered to make health care decisions on behalf of Vermonters.

“Gov. Shumlin’s single-payer health care plan gives unaccountable bureaucrats the power to limit the care Vermonters receive,” the ad says.

As a nonprofit 501(c)4 organization, Vermonters for Health Care Freedom is permitted to engage only in “issue advocacy,” and cannot advocate for the election or defeat of a specific candidate.

Despite the use of Shumlin’s name in the ad, and the fact that it’ll be running on the eve of an election, Wennberg says the group is on sound legal footing.

“We are certainly not advocating that anyone vote for or against any candidate,” Wennberg said. “I believe we mention that the single-payer program is Gov. Shumlin’s single-payer program, and the ad speaks directly to concerns for what that program will do to the doctor-patient relationship if it’s implemented. I think that’s fair game and I don’t think we have any (legal) issues there.”

Republican challenger Randy Brock, who yesterday outlined in greater detail his free-market alternative to single-payer, has made opposition to Shumlin’s health care plan one of the touchstones of his fall campaign.

Wennberg said the ad campaign is also intended to provide a countervailing view to the pro-single-payer ads run by the organization “Vermont Leads” earlier this summer. That group, funded entirely by a chapter of the Service Employees International Union, spent about $100,000 on the ad campaign.

Wennberg has not disclosed the sources of funding for Vermonters for Health Care Freedom.

Randy Brock unveils his long-awaited health plan. In an email.

In an oddly timed press release almost certain to assure underplay in Vermont media outlets, Randy Brock a few minutes ago unveiled the health care proposal he’s been promising since early June.

We anticipated a glitzy, glamorous rollout for the plan, which is, very broadly speaking, a free-market alternative to the single-payer system favored by Gov. Peter Shumlin. Or at least a press conference, to draw TV cameras and front-page headlines, which he easily could have gotten.

Instead, “The Brock Health Care Vision: A 100% Solution,” rolled in unannounced to reporters’ inboxes at a time when many might have already called it a day.

Hard to make heads or tails of the strategy yet, but Brock obviously isn’t looknig to make this plan the cornerstone of his campaign. 

A quick scan of the six-page proposal shows about what Brock had telegraphed: drive down costs by luring more private insurance companies intoVermont. Making them compete for residents’ business, the theory goes, will force them drop their costs.

Critics, of course, say this approach will only erode the quality of the product, and exacerbate the “underinsurance” problem already plaguing the health care system.

Brock says Shumlin’s plan will “lead to rationing through global budgets” and “discourage physicians and dentists from moving toVermont,” among other bad things.

Brock’s plan, fashioned with help from a team of advisors, would allow Vermonters to purchase plans from any state in New England. He also wants to lure more insurance companies into the state by undoing what he says are “unreasonable legal and regulatory restraints.”

Brock also wants to change the rules governing what is known as “community rating,” a mandate that forces insurance companies to fold very low-risk and very high-risk policyholders into the same risk pool. Community rating aims to level out price points, meaning young, healthy people pay more in order to make things affordable for older, sicker patients.

Under the federal Affordable Care Act, private insurers can charge high-risk customers triple what a low-risk consumer would pay for the same policy. Vermont law, however, requires far greater pricing equity.  Dropping Vermont’s standards in favor of the more lenient allowances under federal law, Brock said, would bring premiums to within financial reach of a wider swath of the middle class. 

He said he would institute a variety of mechanisms to help older, higher-risk  people absorb the resulting spike in their premiums.

You can check out the full plan by visiting http://randybrock.com/health-care.

Check out Sunday’s editions of The Times Argus and Rutland Herald for an analysis.

Republicans struggle for passing grades in VPIRG test

The Vermont Public Interest Research Group has unveiled its legislator report card for the 2011/2012 legislative biennium and, as per usual, most of the A’s are going to D’s.

With a few exceptions, House and Senate Democrats outperformed their Republican counterparts in a test based on 10 floor votes chosen by the nonprofit advocacy group. VPIRG leaders also says it’s a nonpartisan organization, though more than a few Republicans that would argue the point.

The issues range from single-payer health care and a moratorium on fracking to the national popular vote and an expansion of the bottle-bill.

VPIRG counts more than 20,000 “members and supporters” across the state, according to executive director Paul Burns.

“We believe the scorecard can be a useful tool for our members and others to see how their legislators voted on a number of critical state issues,” Burns said in a written statement.

It’s probably worth noting that Republican candidate for governor Randy Brock scored worse in VPRIG’s test than all but one person in the 180-member Legislature. Brock’s score of 20 percent – he got points for supporting the use of green cleaning products in schools and a moratorium on fracking – was second only to the 13-percent grade given to Rep. Tom Burditt, a West Rutland Republican.

Check out the scorecard here: http://www.vpirg.org/wp-content/uploads/2012/09/2012-Scorecard-Final.pdf