What happened to the 14th Amendment?

If things go as planned, a quite long-standing effort of a private-sector provider to sell a serviceat-home nursing servicesprimarily into the health-care industry will soon be ended, and the non-profits can go back comfortably to their nobody-competes-with-us monopoly status. The presumptuous invader of exclusive quasi-governmental turf for these last 28 years has been Professional Nurses Service, and it has been cutting into the market share no, make that official monopoly of VAHHA, the Vermont Association of Home Health Agencies. In sharp contrast to governments hostile treatment of PNS stands the Montpelier program called Project Big Dog, whereby favored industries are showered with grants and loans, zoning changes and bridge promises to do just what PNS was prevented from doing: business in Vermont. The label Project Big Dog is Montpeliers idea of a fun-loving play on words when referring to Husky Industries, which set up shop in Milton almost a decade ago. How these two entities have fared raises questions, if youre Constitutionally-minded, about the equal-treatment-under-law provision of the Fourteenth Amendment. Now, the Rutland Herald reports, Nursing Service Likely to Close and, of course, what you see in the impending closure depends on where you stand. The government viewpoint was dismissively articulated by Joan Senecal, of the Vermont Department of Disabilities, Aging, and Independent Living, who opined of PNS that this is still a small organization and it really stretched them to provide State-wide service. A quite different point of view comes from Megan Price, Communications Director for PNS, who had commented to me on several occasions on PNS struggle to survive against entrenched VAHHA opposition, and observes in the Herald article that around the State, very quietly, we affect thousands of lives. A more cutting analysis comes from the Ethan Allen Institutes John McClaughry: PNS spent 20 years trying to break into the VAHHA monopoly, against fanatic legal resistance (six-figure legal fees) which demanded that PNS be excluded from the MediCare-funded majority of the market for home health services. They finally won, and started accepting MediCare patients, but were unfamiliar with MediCare regs and didnt hire an expert firm to advise them. If they had back all they money they had to spend fighting the State, they could have hired the best. Now, PNS needs some $650,000 to stay in business and cant find it. Using a little medical terminology, the prognosis is not good. Both sides agree that the demand for home health services is growing, and VAHHA even offers to employ all of PNS nursing staff, but the competition in terms of service quality that might have happened, now wont. Which, of course, was the government intent in the first place. Compare PNS travails to the list of incentives and path-smoothings offered to Husky (like PNS, just another private-sector, and, ugh, for-profit company and you get quite a contrast. John McClaughry has written on this subject, too: Husky owner Robert Schad, a Canadian, came down and went skiing with [Gov.] Dean. Husky wanted a U.S. plant and Dean promised him the moonnotably VEPC credits, which the Legislature hadnt even approved at that time. When Husky finally applied, VEPC approved in 10 days flat its first award. Schad also got Dean to agree to pay for a $6 million bridge, but Jeffords and Leahy couldnt get the earmark approved for it so, to compensate, Dean got Husky $9 million in VEPC credits. In his 1998 commentary, A Sweet Deal for the Big Dog, McClaughry also delineates all the zoning and planning changes which had to be, and were, put through, regarding regional and town planning, Act 250, and so on, which were needed to make Huskys entr_to Vermont pain-free. Those of you who have tried even to get a permit for commercial construction, let alone a zoning change from residential, will appreciate the Fourteenth Amendment, equal-protection-under-law, implications of a Husky/PNS comparison. It may have been quite intentional that Big Dog was the label used for a government-based and -funded program to bring politically-well-connected industries into the State, the unstated corollary, aimed at such as PNS, being the old country adage If you cant play with the Big Dogs, youd better stay on the porch.

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