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7 healthcare questions for Rick Lord

Rick Lord has a unique perspective on health care in Massachusetts. He serves on the state’s Health Policy Commission. He stepped down in May after more than 28 years as head of the business group Associated Industries of Massachusetts. And previously he served as the budget director of the House Ways and Means Committee on Beacon Hill.

 Lord talked health care on this week’s Health and Consequences segment of the CommonWealth Codcast with John McDonough of Harvard’s TH Chan School of Public Health and Paul Hattis of Tufts University Medical School. To give you a taste of the discussion, here are seven questions posed to Lord.

Defense attorney: Judge Sinnott ‘has no leg to stand on’

The band of right-wing provocateurs who staged a “straight pride” parade in Boston 10 days ago were hoping to stir the pot. But they likely never imagined that the tempest they’d cause would be a judicial showdown among local officials that exposes tensions set off by last year’s election of a reform-minded district attorney.

Things got unruly in the streets as the straight pride marchers were met by hundreds of counter-demonstrators, but there wasn’t exactly order in the court either when the cases of many of the three dozen counter-protesters who were arrested came before Boston Municipal Court Judge Richard Sinnott

Sinnott repeatedly, over the course of two days, rejected efforts by prosecutors to dismiss cases against those arrested for non-violent offenses of disorderly conduct or resisting arrest. (The DA’s office said it was pursuing cases against those charged with violent crimes, including assaulting police officers.) The problem: It’s not clear Sinnott is within his rights to do so, as charging decisions are generally the province of prosecutors. 

Susan Church, a well-known local defense lawyer, says Sinnott absolutely was out of bounds in refusing prosecutors’ efforts to drop charges against a young woman she was representing on charges of disorderly conduct and resisting arrest. Church was so emphatic in that belief that she got into a testy exchange with Sinnott that ended with the Cambridge lawyer hauled out of court in handcuffs for contempt when Sinnott ordered her to stop making her argument but she persisted. 

“He has no leg to stand on,” Church said about Sinnott’s ruling on this week’s Codcast. Describing her experience of being handcuffed and held for several hours in the courthouse lock-up area as “surreal,” Church offered her account of what transpired in the courtroom. 

Taking the bus to a whole new level

The service disruptions caused by the MBTA’s more aggressive maintenance schedule could provide a catalyst for better bus service, according to some of the chief proponents of bus rapid transit.

More common in other countries than the United States, bus rapid transit, or BRT, is a strategy that uses buses so they mimic the conveniences of a rail line. That should include a dedicated right-of-way in the center of roads to avoid turning traffic; bus stations with seating, shelter, platform-level boarding, a fare system that enables passengers to board at all doors; and priority given to the buses at traffic signals, according to Julia Wallerce, Boston program manager for the Institute for Transportation & Development Policy.

Wallerce found a lot of common ground with Jim Aloisi and Jarred Johnson of TransitMatters on this week’s episode of The Codcast, where the three discussed the benefits of BRT and some of the challenges of implementing it in metro Boston.

Corruption or advocacy?

When two aides to Boston Mayor Marty Walsh were convicted earlier this month on federal charges of conspiring to extort organizers of the Boston Calling music festival in 2014, US Attorney Andrew Lelling touted it as another victory for efforts to root out corruption in government.

But a lot of people don’t see it that way. The case has generated a tremendous amount of blowback from advocates, labor leaders, legal experts, and, last week, most members of the Boston City Council, who say the US attorney’s office has criminalized the usual give-and-take of political advocacy. 

“We’re in a different world where advocacy is now considered extortion,” said Boston City Councilor Lydia Edwards on this week’s Codcast. She called it a “true concern” and said the convictions have created incredible uncertainty for elected officials and advocates who are accustomed to pushing their causes vigorously, but now wonder whether that could land them in prosecutors’ crosshairs. 

Building connections one story at a time

Cara Solomon and George Powell think personal stories – gathering them and reading them – are the way to bridge differences and build a stronger sense of community in Boston.

Solomon is the founder and Powell is one of the most successful story ambassadors at Everyday Boston, a nonprofit organization that is attempting to knit together Boston one person’s story at a time.

Solomon and Powell are about as different as can be. Solomon is white and a former newspaper reporter for the Hartford Courant and Seattle Times who grew up in Wayland. Powell, who is black, grew up in Roxbury and spent eight years in prison. They would seem to have little in common, but listening to them on The Codcast they seem to have a powerful connection.

Breaking down “Operation Clean Sweep”

How do you balance public safety and neighborhood quality of life concerns with support for the most marginalized people in a community?

Those issues exploded into public view with the recent arrests of homeless people and drug users as part of “Operation Clean Sweep,” a set of Boston police actions centered on the streets near Newmarket Square where the city’s South End, Roxbury, and Dorchester neighborhoods converge. 

But the issues are nothing new to state Rep. Liz Miranda and her constituents. She grew up in the shadow of Newmarket Square in a tight-knit Cape Verdean enclave of Roxbury, and says residents have been dealing for years with problems stemming from the concentration of drug treatment facilities and homeless shelters on their doorstep. The situation has gotten dramatically worse, she said, since the 2014 closing of the city’s shelter and addiction treatment facilities on Long Island.

For the former community organizer who is serving her first term in the House, the controversy that boiled over earlier this month brought some satisfaction that attention is finally being paid to the problems, mixed with concern over the approach city officials took, and questions about why longstanding community calls to deal with the deteriorating situation had gone ignored until now.

This “is a community that’s been speaking up pretty loudly for the last couple of years saying we need help,” Miranda said on The Codcast. “There’s a clear saturation of services at this corner that I don’t see another city or town or even another neighborhood being able to withstand.”

“This is a statewide problem,” she said. “Boston cannot solve it alone.”

Miranda was joined by Yawu Miler, senior editor of the Bay State Banner, who wrote about the issue in the paper’s current issue.

Why did things go wrong at the Registry?

Most of the focus so far in the scandal at the Registry of Motor Vehicles has been on finding out what went wrong. Now attention is starting to shift to why.

On the Codcast, Sen. Eric Lesser of Longmeadow and Paul Levy, one of the state’s most  experienced managers, discussed why an agency would ignore all the warning signs and allow notices about Massachusetts driver violations in other states to pile up unattended. The situation only came to light when a Massachusetts driver who should have had his license suspended because of a drunken driving arrest in Connecticut plowed into a group of motorcyclists in New Hampshire, killing seven of them.

Lesser is vice chair of the Legislature’s Transportation Commission, which heard seven hours of testimony last week from an assortment of Registry officials who acknowledged they were aware of the backlog of out-of-state violation notices but did little or nothing to address the problem.

“What was clear from the top is that a culture had developed where this was not a priority,” he said. “There were clear warning signs along the way and there were red flags along the way and there were audits that flagged these issues. But for whatever reason, the can was kicked down the road and it wasn’t made a priority to get that backlog resolved.”

Alex Morse wants to change how Washington works

Alex Morse, the 30-year-old mayor of Holyoke, may look like he’s on a fool’s errand by challenging Rep. Richard Neal in next year’s Democratic primary. After all, just seven months ago Neal’s three decades of toil in the DC vineyards landed him in one of the most powerful positions in the House, chairman of the tax-writing Ways and Means Committee. But Morse says the veteran Springfield pol is out of step with the urgency of the times, and he questions whether Neal’s new clout will deliver tangible gains for the First Congressional District.

“I think there’s an urgency to this moment right now in our country,” Morse says in this week’s Codcast. “These aren’t normal times. It isn’t business as usual. And that urgency isn’t matched by our current representative in Congress.”

Immigrant advocates slam Trump asylum changes

It’s inhumane. It’s a violation of international law. It’s not the way things have worked since the mid-1960s. These were the arguments of immigration advocates following last week’s announcement by the Departments of Homeland Security and Justice that rules for claiming asylum in the US would be changing.

Sarah Sherman-Stokes, associate director of the Immigrants’ Rights and Human Trafficking Clinic at Boston University Law School, and Susan Church, a partner at the immigration law firm Demissie & Church in Cambridge, say the most massive asylum overhaul since the Immigration and Nationality Act of 1965 is also doing away with due process rights and the governmental rule of separation of powers.

Under the new regulations, an applicant seeking asylum in the US must be denied refuge in each country along the way to the American border.

“It’s blatantly illegal,” said Church on The Codcast. “You cannot change a law that Congress enacted with a regulation that isn’t passed by elected members of Congress.”

Rosenthal says pharma must do its part

It isn’t surprising that Amy Rosenthal, the executive director of Health Care for All, wants to rein in the cost of prescription drugs. She’s been quite clear that breakthrough drugs don’t have much of an impact if people can’t afford them.

But her talk of shared responsibility on the Health or Consequences Codcast with Paul Hattis and John McDonough took the debate in a new direction. She said she has made the rounds with all of the players in the Massachusetts health care system and discovered a shared pride in all that has been accomplished in terms of near-universal coverage and moderating prices. Each of the players has contributed.

“Individuals were required to start buying health insurance, the individual mandate,” she said. “Employers had an employer assessment. Hospitals and insurers have to go before the Health Policy Commission. All of these things were not easy. People had to put some serious skin in the game. And all we’re saying at this point is that it’s time for pharma to do their part in this.”