The public face of the existentially challenged Vermont Health CO-OP is CEO Christine Oliver, a former top official in the Shumlin and Douglas Administrations. But the motive force behind the company is Board Chair Mitch Fleischer. It was he, Oliver says, who had the idea to form a CO-OP under the terms of the Affordable Care Act. She outlined his crucial role at a recent media briefing:

The CO-OP is not even an potion for Vermonters without Mitch Fleischer. When the application was before the [federal government], he was the linchpin; he could bring a lot of things the CO-OP would need to be successful.

She portrayed her business partner as sort of a cross between Martin Luther King and Thomas Edison: a public-spirited entrepreneur bringing his talents to bear for the betterment of the community.

But that’s not the only way to describe Fleischer’s motivations. There’s this, from Anne Galloway of VTDigger:

In the spring of 2011, Fleischer, who has worked as an insurance broker for 30 years, was critical of the Shumlin administration’s plans to limit all insurance products for small businesses to insurers on the state exchange. The federal law also cut brokers, who made about $17 million a year on commissions, out of the system.

That fall, Fleischer made plans to create the CO-OP as a way to salvage business for his company.

And that, boys and girls, is a whole nother hovercraft full of eels. It’s a picture — not of an entrepreneur doing public service in the private sector — but of a desperate businessman latching onto a new opportunity in the ACA’s generous startup funding for state health CO-OPs.

Next step: the nascent VHC, with Fleischer as board chair, signs a no-bid contract with Fleischer’s brokerage firm to provide education, outreach, and large group sales. A contract that could net as much as a million bucks a year.

Nice work if you can get it.  

Fleischer’s potential conflict of interest was noted by Susan Donegan, Commissioner of Financial Regulation, in her rejection of VHC’s bid for a certificate of public good. Fleischer and Oliver insist that there is no conflict, because VHC has high ethical standards and the contract was thoroughly vetted by the feds.

I don’t know if there was an actual conflict of interest or not, but it damn sure smells funny. Especially when you read this comment by Fleischer at that media briefing:

[State regulators] never asked me about the Fleischer-Jacobs contract, they never asked me about my board pay, they never asked me about conflict of interest. …I would have walked away from the board. If that was an impediment to our getting the license, I would have walked away.

Fleischer would have walked away — from the board. Not from the lucrative contract.

I think that reveals Mitch Fleischer’s true priorities. If push came to shove, he’d be more concerned with the Fleischer-Jacobs contract than with continuing to serve as “the linchpin” of the Vermont Health CO-OP.

That makes me question his motivations in starting the CO-OP and tapping into $33 million in federal loans. And I’m not the only one. Falko Schilling of VPIRG, in this week’s Seven Days:

“When we plan to transition to single-payer health care in 2017, it almost feels like the introduction of this new cooperative is betting against that,” he says. “While it has promise, I don’t think they are really on board with the larger goal that a lot of people in the state are trying to move forward.”

Which makes a lot of sense, in view of Fleischer’s professional interests. The CO-OP would, at the very least, give his brokerage a big infusion of business. At most, it might make the health care exchange more palatable to Vermonters and slow the momentum toward implementation of single-payer.

In the same article, single-payer advocate Dr. Deb Richter questioned “whether [the CO-OP] was really needed, or is it just sort of going after a pot of money the feds were throwing our way?”

There’s no way to know for sure. And there are a lot of good people working at the Vermont Health CO-OP. But the whiff of mixed motives, the hint of conflict of interest, that hovers around its “linchpin,” is one reason why I’m ambivalent about the CO-OP’s future. And why, if push comes to shove, I give somewhat more credence to Donegan’s view of the company than to Fleischer’s.