Senate candidate makes a campaign swing to the Vineyard

Elizabeth Warren discussed her candidacy and the issues on a visit to The Times Sunday. — Photo by Ralph Stewart

In November, Democratic candidate and Harvard professor Elizabeth Warren will attempt to unseat Republican Scott Brown and return the Senate seat Ted Kennedy held for more than 46 years. Senator Brown staged a dramatic upset in January 2010.

Ms. Warren visited Martha’s Vineyard over the weekend. Her itinerary included small meetings with supporters, a major fundraiser at the Whaling Church in Edgartown and a visit to The Times, where she sat down for a brief question and answer session with Times managing editor Nelson Sigelman.

Ms. Warren: It’s not a lifestyle move. I feel the urgency of the moment. America’s working families are getting hammered. Washington is not working for them. Let me just say this in another way, I’ve been out there working on issues about the economic survival America’s middle class for 20 years, and every year I’ve watched things get worse and I’ve tried to find ways to push back. First, it was writing. I wrote about it, then it became more public speaking, and then it was coming up with an idea for a legislative change, the consumer agency, so families wouldn’t get cheated on mortgages, and tricked on cards, and fooled on bank fees. And then it was going to Washington to fight for that. Then, it was spending a year in Washington to set that agency up. So, in one sense, it is the next logical, no, not logical, that’s not the right way to say it, it is the next step in trying to fix a system that’s rigged against families. In another sense, in a personal sense, it’s about turning my life upside down, but you’re right to ask the question. It’s not because I ever possessed any desire to run for political office. I was never interested. In fact, for a long, long time I never wanted to have anything to do with politics.

MV Times: Let’s talk about jobs. That is the big issue. Without going into all its complexity, can you name one or two specific actions you would take in the short-term and the long-term, if elected?

Ms. Warren: You’re the first person who has asked me a question that has identified that there is a short-term problem and a long-term one and solving them is not the same thing. There are different things we need to do. So, short-term, put people to work through the jobs bill. This part is not rocket science. There were three jobs bills this fall that came up. The first jobs bill would have supported about 22,000 jobs.

MV Times: What kind of jobs?

Ms. Warren: Well, they were all over. They were in transportation, construction, infrastructure, they were in public service, teaching, they were everywhere. But it was the omnibus jobs bill. Then there was a second focused on teachers, firefighters, police officers, first responders, to prevent any layoffs. The third was a jobs bill solely on transportation. The Republicans blocked all three jobs bills. They all voted against it, Scott Brown voted against it, there’s a real distinction. They also voted against extensions of unemployment insurance, voted against summer jobs last summer

MV Times: So, in the short-term you would support legislation that would immediately funnel tax dollars into subsidizing work. What about the long-term?

Ms. Warren: Let me just say one more thing. These jobs would not only help families, the paychecks would be spent at local businesses. The idea is that long-term the government is the best way of getting people back to work, the idea is that, in the short-term, getting people back to work so that they have paychecks to spend in local businesses jump starts the economy. I think of it as like pulling the rope on the lawnmower to get it started, then the government backs out. Long-term, we need to make the investments that build a future. It’s the investments in education, so we have an educated workforce; it’s particularly important in science, technology, engineering, and mathematics, it’s making the investments in infrastructure, roads, bridges, power, internet, the things it takes so that a business can flourish. We all make the investments in the infrastructure so that a good business idea can grow. It’s an investment we make together.

MV Times: These long-term jobs, are they coming from the private sector or the government?

Ms. Warren: The private sector. But the way we get those long-term jobs is we all invest in creating conditions for them. So, here’s my example, from the great depression to about 1980, as a country we made the investments in education and infrastructure and research. Those were the three types of investments we made as a country. And we made them from the federal level. And those investments created opportunities for all of us. I’m the product of that, other people in this room may be the product of that. But it gave us unparalleled growth.

MV Times: But give me one specific action, you’re talking in broad terms, give me one action that would affect long-term prospects?

Ms. Warren: Transportation. Making the investment in roads and bridges. Without roads and bridges, businesses can’t flourish. They can’t get their goods to market.

MV Times: Would this be a government program to rebuild bridges?

Ms. Warren: It could be. If that’s what we need, in some cases it’s to build new bridges where we need so that we could have more access. The key, this is the part to distinguish for me, what the government does, the part that’s the government, that’s when we make the investments none of us can afford to make. You can’t build a school by yourself, you can’t build a road by yourself. You can’t build a road in front of your house and count on your neighbor to build up the road in front of his. The only way the road is of any use is if it goes everywhere. The only way the school is of any use is if it’s big enough to give us an educated workforce, not just one educated person, an educated workforce.

MV Times: So both in the short and long-term, I think I’m hearing you say, we need to make more investments in the country’s infrastructure.

Ms. Warren: China’s investing 9 percent of GDP in infrastructure. They’ve been doing that for years now. Here in the United States, we’re investing 2.4 percent. Under the Ryan budget, we’d cut that even more dramatically, and we’ve been at 2.4 since before the crisis.

MV Times: Martha’s Vineyard Hospital this week reported almost a $600,000 deficit (June 26, “Health care winds buffet Martha’s Vineyard Hospital”).

Ms. Warren: Yep, I read about this.

MV Times: After nine years of being in the black the CEO, Tim Walsh, told me that one of the problems is that the state programs and federal programs, regulators will say, oh, we’re saving money, but in reality, they’re saying, oh, we’re only going to pay you 40 cents on the dollar for that procedure. He said then he needs to shift that cost to private payers. How’s that going to change, going forward, with the health care law?

Ms. Warren: So, I think that the health care law, the Affordable Care Act, does a couple of things that make a lot of sense. There is a question for all of us of how are we going to break the cost curve. Right? It’s a bigger question than just hospitals. We cannot continue to spend an ever-growing proportion of our GDP on health care, we cannot be a country that just treats each other for medical conditions, that’s just not going to work. It’s not sustainable. So, the question is how do you break the cost curve? I think a principal part of that is going to be changing, let me put it this way, is the investment in the research to find the practices that give better outcomes at lower costs? And, let me give you an example of that. Children’s Hospital recently came out with a study in the spring. The children in the study we’re all children who had been hospitalized for asthma sometime in the last year, and had multiple trips to the emergency room. In other words, kind of the most serious cases. And so what they did was they tried a whole new set of treatment protocols. They were much more intensive at the beginning, they involved a visit by a home health care nurse, they bought Hepa vacuum cleaners for the families. They came in and said you got to get rid of the rugs, here are the things to do, and what they discovered is that they could accomplish over the space of working with these families for over a year, they got these children down to many fewer hospital admissions, many fewer trips to the emergency room, and for every dollar spent on treatment, they saved a $1.46 in terms of what the old treatment protocols cost.

MV Times: Again, to bring us to the hospital, Tim Walsh would tell you: look, whether you have 20 kids come in with asthma or one kid come in with asthma because all the families now have Hepa filters, I’m still paying a doctor full-time, 24/7 to staff an ER and now I’m running at a big deficit. So, small hospitals are struggling with this reimbursement structure.

Ms. Warren: I understand they have a reimbursement structure but surely you’re not making the argument that we’d be better off to have all these children in the emergency room because it would help pay hospital costs? You don’t want all those children turning blue?

MV Times: I am commenting on the structure right now, on the payments, in small communities like Martha’s Vineyard, where you might have one hospital that provides care for everyone. The current system of reimbursements doesn’t allow them to be financially viable.

Ms. Warren: If everyone on Martha’s Vineyard were twice as sick they’d be making lots of money. That can’t be the right answer. You asked what’s the affordable care act going to do? The affordable care act is working on breaking the cost curve, it’s really working on developing the best practices which will give us better outcomes at lower costs. In Massachusetts, this is the place where much of the research will be done. The top five hospitals which receive reimbursements are in Massachusetts. The question you’re asking is whether or not small communities, particularly those that are isolated, whether or not they may need special forms of reimbursement in order to remain economically viable. Ultimately the idea is to provide the best health care services for all our citizens and not to isolate those in smaller communities. So, yes, there needs to be flexibility in payment schedules to make sure there is adequate medical care on Martha’s Vineyard including a financially viable hospital. But you’re asking what ACA is going to do. What ACA is going to do is, and what it should be doing, is trying to figure out how it is that we deliver better health care at a lower cost.

MV Times: Looking at your website, you’re committed to clean energy, energy efficiency in the long run, but you also reference the natural resources of Massachusetts, from the Cape to the Berkshires and the thousands of jobs that those create. What’s your position on Cape Wind, which is going to be placed right out there on Nantucket Sound?

Ms. Warren: I support Cape Wind. It will also be the front end of technological development here in Massachusetts that may lead the entire country. We have an opportunity to be on the front end of clean energy, not the trailing end and that’s important not only for the environment, it’s important for the economy.

MV Times: Let’s go to foreign affairs. I read this morning in a Pakistani newspaper, The Nation, that a U.S. drone killed eight suspected militants in Northwest Pakistan. The London based Bureau of Investigative Journalism said that under President Barack Obama, one drone strike has hit Pakistan an average of every four days. It said that most of the 2,200 to 2,800 killed were low-ranking militants. It also has reports of 700 civilians being killed. You have a legal background — where do you stand on this idea of drone strikes?

Ms. Warren: Well, I think you have to start with Pakistan. The right way to understand this is the threat posed by Pakistan. Here’s a country with nuclear weapons and a not stable, I guess an unstable government, that is widely reported to deal with terrorists and our position, the United States position has been that we try to work with the Pakistanis to try to deal with terrorists who have taken refuge in Pakistan. But when the Pakistanis will not do that, that our national security interests require that we pursue those terrorists and that’s what we’re doing. Osama bin Laden is probably the best example of that.

MV Times: That was very personal, we had men on the ground, we’re talking about unmanned drones, basically government-sponsored assassination, I don’t know how else to characterize it. The only due process occurs within a small group of people. So, are you saying you support the continued use of drone strikes in various countries around the world?

Ms. Warren: Well, I’m saying that right now in Pakistan, which is where we’re using them

MV Times: and Yemen

Ms. Warren: Well… that the legal use of drones, that is we have put in place our own review of that process in order to protect ourselves from terrorism, or from terrorists, is right now our best way to fight terrorists. I think what the President has done is right.

MV Times: Irrespective of this investigative group…

Ms. Warren: Look, if they want to bring more evidence forward then they should, and we should look at what the evidence is. Based on what we know right now I think that the president has used, has said to the Pakistanis we want to work with you if you’ll work to deal with the terrorists but we can’t just let the terrorists run across the border from Pakistan to Afghanistan and then build up so that they can launch terrorists attacks around the world. We can’t do that. And I think the president’s right on that.

MV Times: On a similar subject, our country continues to hold 169 people in Guantanamo Bay prison. Aside from the cost, which is about $180,000 per detainee, I listened to a report on NPR the other day, in which a lawyer said her client, a young guy, had been there over 10 years. Where do you stand on the issue? President Obama came into office and said he was going to close Guantanamo Bay. Where do you stand on the continued detention of these people?

Ms. Warren: Well, anyone who thought ten years ago when Bush first started to bring people to Guantanamo, none of us, well, I shouldn’t say none, many didn’t expect this to be an ongoing way to deal with terrorists worldwide. I’m glad to see the military tribunal started, and it’s my understanding that those who represent the people in Guantanamo are satisfied. That we are exercising due process. We’re also starting to move some of the people of Guantanamo out to other countries, which is appropriate, there are other places they should be in the care of other countries.

MV Times: So you’re comfortable with the current situation?

Ms. Warren: Of course I’m not comfortable. Who would be? No, I’m not comfortable. It’s, right now it’s a bad situation, the problem is it’s not obvious that there is a better situation. Some pieces of it are moving in a better direction than they were ten years ago. It’s at least no longer the case that the number of people in Guantanamo are growing and that there is now a system for giving them trials. That at least has changed.