Tom Keane

Markey’s home sweet home

YOU RUN a company. One employee shows up for work every day, arriving early, staying late, in the office on weekends, immersed in the job. A second toddles in mid-day at the beginning of the week and bolts out the door as soon as possible on Thursday, “working” from home on Fridays. Odds are you’re happier with the first hire than the second.

Unless we’re talking about the US Congress, where, apparently, such dedication is a fault, not a virtue.

Ed Markey, congressman and candidate for US Senate, is under fire. Unlike many of his colleagues, he doesn’t fly into Washington on Monday and then zoom home when the normal session ends on Thursday. No. He stays in D.C. the entire week and most weekends. My God! He even owns a house there.

Good for Markey. Some in his district may resent the time he spends at work, but his constituents are likely the better for it.

Admittedly, it makes for one of those great, embarrassing, gotcha kinds of stories. Markey’s Bay State residence is a small house in Malden, the same one in which he grew up. News stories suggest he’s rarely there. Instead, he and his wife live just outside of Washington in a million-dollar home five times the value and triple the size of his Massachusetts digs. And you know what that means . . . . He’s gone D.C. He’s become Beltway bound. He’s lost touch with his roots. There’s a touch of envy too: Markey’s out hobnobbing with the grandees and political glitterati instead of spending dull evenings hanging out at some local bar.

The criticism rests in part on a belief that politicians can only understand the concerns of those they represent by living those same lives. If Markey isn’t worrying about his bills from National Grid, goes the thinking, how can he have empathy for those of us struggling to pay for our own utilities? But our lives are far too diverse for any one politician to know them through personal experience. Politicians without children probably aren’t buying much milk. Politicians from outside of Boston probably aren’t riding the MBTA. That doesn’t prevent them from grappling with the worries of young parents or urban commuters.

Instead, good politicians keep in touch with their constituents through a wide variety of means: traditional and new media, staff outreach, listening to individuals, organizations, and interest groups. Spending more time in one’s hometown may help a little, but I’m guessing not much ­­— and it probably doesn’t tell a pol much about the lives of those several towns over.

Of course, it’s politically easier to stay in the district, spending as little time as possible in the much-reviled Capitol. Doing so protects politicians from the kind of charges now being leveled at Markey. But it comes at a great cost: effectiveness.

In some respects, the least difficult task for a politician is voting “aye” or “nay” on a particular motion or bill. If that were all members of Congress did, there would be no reason to send them to Washington. They could sit at home, pushing a button whenever a vote was required.

But politics is far more than that. Effective politicians build relationship with colleagues, both with those in one’s own party as well as from the opposition. They work collaboratively to craft legislation, creating coalitions and compromises. They get to know and understand the concerns of those from other parts of the country and from different political philosophies. Doing all of this means spending time — lots of it.

That’s what the late Senator Ted Kennedy did. Hyannis was more a vacation home for him than a real home, but the days he spent in D.C. helped make him one of the country’s most accomplished leaders. His ability to develop close connections even with those with whom he disagreed — such as Senator Orrin Hatch, a Utah Republican who ultimately became one of his best friends — paid off handsomely for Massachusetts and the nation.

By many accounts, Markey has been able to build similar relationships. That doesn’t mean that he necessarily should be Massachusetts’ next senator. But the fact that he cares about doing his job well is hardly a knock against him.

This column originally appeared in The Boston Sunday Globe on February 24, 2013.

More hats in the ring

One party rule isn’t helping Massachusetts – maybe it’s time to dump party-based primaries

THE LITANY of well-known Republicans passing on the chance to succeed John Kerry as senator underscores the extraordinary feebleness of the state GOP. It underscores as well the degree to which politics is broken in the Commonwealth. The answer, perhaps, is not some vain effort to revitalize the GOP, but rather to rethink our elections altogether.

With no effective two-party system in the state, Democrats have a kind of hegemony. Gubernatorial races excepted, general elections are often pointless affairs: The Democrat always wins. The “real” election, if you will, is the primary: a small-turnout, intramural event dominated by partisans and often won by someone securing well less than a majority of the vote. Moreover, once in office, always in office. Parties discourage internal fights, so incumbents — whether at the state level or the federal — safely stay incumbents. The politics we get is often inward turning and (judging by the parade of House speakers who have faced criminal investigation if not jail) corrupt, largely immune from the check of voter dissatisfaction.

The most-offered solution is to somehow improve the Republican Party so it can become a credible opposition. Maybe it just needs better candidates, goes the thinking. Or perhaps the cure is an improved grassroots, stronger town committees, and more committed volunteers. Alternatively, the GOP might consider recasting its politics, sloughing off its conservative social dogma and becoming something more socially liberal and economically moderate (I’ll plead guilty to having harbored that thought). These ideas have been bandied about for years, however, with little to show for them. Revitalization requires winning and — at least in Massachusetts — that not going to happen: People don’t vote for Republicans.

Perhaps we should consider something far different: getting rid of party-based primaries altogether.

The idea is that we would instead have preliminary elections, sometimes called “open primaries” or “top two” elections. The preliminary would be a free-for-all: Anyone who wants to run could run. All voters (not just party members) could vote. The top two vote-getters in the preliminary would then square off in a final. That might mean, as is traditionally the case, that a Democrat would face a Republican. But it could also mean a Republican would face a Republican or (much more likely in the Bay State) a Democrat would face a Democrat.

The widely-touted model for this is California, which adopted a “top two” system in 2010. But the system is also in use in a few other states (including Louisiana and Washington) and, notably, in some cities and towns in Massachusetts. Boston residents, for instance, choose their mayor and city councilors on a nonpartisan basis.

The reasons for abandoning party primaries are many. Open primaries encourage more candidates to run, give third-party candidates a better chance of making their case, and, since they have to appeal to all voters and ultimately secure a majority, push candidates away from the extremes. The result is a political system more responsive to voters and more focused on results.

In California, it was voters frustrated by partisan bickering who — through a referendum — forced the state to adopt the top-two system. In cities such as Boston, the preliminary system was born out of recognition that urban areas have too few Republicans to make any primary meaningful. What was true for Boston certainly now seems true for most of the state.

Not surprisingly, political parties hate the idea of top-two preliminaries: They considerably undercut party influence. On the other hand, top-two elections don’t eliminate parties. In Congress and the Legislature, elected pols would likely still caucus with a party. And candidates would be free to identify their party affiliation if they believed it might help their cause. (Interestingly, though, in Boston elections many candidates don’t — they try to appeal to voters on merits rather than labels.)

Open primaries are no panacea, but they would be an improvement. In Massachusetts, races would be more competitive, and we’d start to see real contests between candidates who — despite thinking themselves members of the same party — hold very different political views. And who knows what might happen if more states went to a top-two system? The hyper-partisanship eating away at our government could disappear, and Congress might actually get something accomplished.

This column originally appeared in The Boston Sunday Globe on February 17, 2013.

Not so fast, Democrats; Steve Lynch has appeal

Ed Markey is anointed to fill John Kerry’s Senate seat; Steve Lynch dares make a challenge. Chances are the chosen one gets the job, but don’t count out Lynch — he’s faced odds like these before, and beat them.

With Kerry’s departure, the Democratic Senate primary looms, just two-and-a-half months away. That’s a short span of time for a candidate to create an organization, raise money, make himself known, and — because this is a special election — persuade people to come out and actually vote. Markey, a US representative first elected in 1976 to represent a district encompassing much of Middlesex County and other suburbs north and west of Boston, had a solution: Do away with the primary altogether. Borrowing a page from Elizabeth Warren’s playbook, he tried to clear the field of challengers and focus instead on the June 30 final.

It almost worked. Markey announced for the seat on Dec. 27. A day later, the Democratic Senatorial Campaign Committee endorsed him, as did Victoria Kennedy, the late senator’s wife. Kerry also made clear his support (in a curious statement that sounded like an endorsement but he said was not). Others who had been sniffing around at the race took umbrage. US Representative Michael Capuano of Somerville said, “It seems that the big names of our party are trying to choose our nominee for us,” and had some defiant words about not being intimidated.

But brave language notwithstanding, Capuano decided not to make the run. And indeed Lynch entered late and only after much hemming and hawing.

Many think the nomination is Markey’s for the taking anyway. He has more money — $3.1 million to Lynch’s $740,000 — as well as a one-month lead in putting together his campaign. Combine that with his support from party leaders and his reliable “progressive” brand of politics — the kind Bay State Democrats seem to favor — and Markey’s advantages appear considerable.

The polls reflect that. A late January survey from Public Policy Polling called the match a “blowout,” showing Markey with 52 percent to Lynch’s 19 percent. Moreover, while Markey has generally high favorability ratings from Democrats, Lynch’s numbers are low, with slightly more Democrats perceiving him negatively (28 percent) than positively (27 percent).

Given this grim news, why is Lynch in the race at all? The blithe answer, I suppose, is: That’s why they hold elections. Right now, everything is prognostication. By April 30, things may look much different.

For one, both men really are unknowns. Members of Congress may be household names in their districts — each of which is roughly 11 percent of the state’s population — but they are largely unknown elsewhere. For the two candidates, much of the campaign will involve introducing themselves to that remaining 89 percent. Today’s perceptions of each candidate may change greatly, especially as the two confront each other in debates.

Further, while Markey attracts liberal Democrats, Lynch — a former ironworker and union leader — has appeal of his own, especially to blue-collar workers. He’s less wine and cheese than he is beer and brats. Lynch’s politics are more conservative than Markey’s as well. (“Conservative” in this case should be understood to mean that in other states, Lynch would still be regarded as a left-winger.) There are moderate Democrats in the state — as well as unenrolled voters, who can choose to vote in party primaries — that could well go his way. Then there is Boston Mayor Tom Menino. If Menino gets his campaign organization involved in the race, and if he favors Lynch, the Boston vote could be a game-changer.

Finally, there is Lynch himself, a man who has never fit comfortably with others’ stereotypes of what he should be and how he should behave. That was evident in his 1996 run for state Senate, when he dared challenge Billy Bulger’s handpicked successor (that is, his son). It’s evident as well in his votes in Congress. Depending on your perspective, he’s either brave and unconventional or just unreliable and erratic, but either way, he’s clearly not in anyone’s pocket.

That, I suspect, becomes the theme of Lynch’s campaign. Markey is the party’s favorite son, the pick of the Washington, D.C., establishment for the Bay State’s next senator. Massachusetts’s voters can meekly follow their lead or, Lynch will argue, show some gumption and decide for themselves.

This column originally appeared in The Boston Sunday Globe on February 10, 2013.

Navigating a do-it-yourself health system

Remarkable things are happening in health care. But if you’re a consumer — particularly if you’re ill and need something more than medicine’s standard bag of tricks — the sobering fact is that it’s up to you, the patient, to take charge.

Each year, a quarter-million people need to have one of the four valves in their hearts repaired or replaced. For most, that means open heart surgery — a grueling operation. The surgeon makes a cut straight into the breastbone, cracking the ribs, opening up the chest and exposing the heart. The surgery takes two to five hours. It takes another six weeks for the bone to heal. The risks are high: blood clots, infection, kidney failure, death. All can easily occur, especially if you’re older.

Patient X, age 86, found himself increasingly tired and two years ago his doctors delivered the grim diagnosis: His aortic valve was failing. The valve had to be replaced. He thought about it for awhile and decided no. He’d seen too many friends become victims of strokes, their last days a kind of mental purgatory. Valve and age notwithstanding, he was healthy, independent, and sharp of mind. If he was going to go, he’d rather go that way.

By chance, his wife showed him a news story. Researchers were testing a markedly different approach: a valve that could be inserted without surgery at all, snaked up to the heart via an artery. It meant no cutting, no extended healing time, and far less risk of stroke.

He tracked down physicians investigating the new device at Massachusetts General Hospital. One appointment led to more and soon he found himself under consideration as a subject. Then came bad news. The valves being tested at MGH came in only a few sizes, all too small. “My heart is just too big,” he said, making a joke to cover his disappointment.

He heard of a similar set of trials across town at Beth Israel Deaconess Medical Center, and so went through the process again. This time the valve under consideration would fit, but last spring he received a call that left him devastated: He was rejected. Human experimentation is a dicey proposition; protocol is that it should only be done when there is no realistic alternative. Even though he might not want it, Patient X’s body could tolerate open heart surgery. “I’m too healthy,” he said, another joke to cover another disappointment. He pushed back and some hope was offered. After the first round of trials, the pool of candidates could be broadened. He might qualify then.

Meanwhile, though, his aortic valve was failing. Three times over the summer he suffered cardiac events, in one case falling unconscious to the floor of his garage. He survived each incident, but it was clear that time was running short.

Just before Christmas, his doctors told him the second round had started and he was on the list. There was a long wait as an independent panel of physicians reviewed his case. Jan. 22 — his 88th birthday as it turned out — found him under general anesthesia as the procedure commenced. Four hours later he returned to consciousness. Full recovery, doctors told him, would take weeks. His heart still had to adjust to not straining as hard as it had been, but already he felt better. “Elated,” he said, although that sentiment may have been more because the long saga itself was coming to a close.

Yet while Patient X’s success should be cheered, it’s worrisome as well, for the obstacles he faced could confront any of us. As good as it is, the US health care system is vast and complicated and can too often lose sight of the individual. That means it’s patients themselves who have to seize the initiative — to ask questions, to challenge, and to be assertive — which, in turn, can seem impertinent, annoying or perhaps (as was sometimes the case with Patient X) quixotic. It means pressing forward even when seemingly defeated, never taking no for a final answer. It’s unfair, but it’s true: Oftentimes the health care we receive is up to us. Dogged persistence pays off, a lesson with particular resonance for me. Patient X is my father.

This column originally appeared in The Boston Sunday Globe on February 3, 2013.