Jim Douglas: More Than a Moderate Success

"If we have the same objective, we can find the common ground necessary to get there."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Jim Douglas' story.

Anyone who watched the deeply partisan, mean-spirited wrangling in Washington, DC, this past year during the healthcare reform debate would not be faulted for believing that the American political system is dysfunctional.

To find a working, bipartisan, political system that focuses on practical results within budgetary constraints, leave the Beltway and look to the states. In striking contrast to Congress, Vermont provides a great example of what Republicans and Democrats can achieve in healthcare when they agree upon a common goal. And perhaps no one better embodies that bipartisan spirit in the Green Mountain State than long-serving Republican Gov. Jim Douglas.

A career politician who has held various roles in state politics for three decades, Douglas is serving the last of his eight years in office, having been elected and reelected four times as a fiscal conservative and social moderate Republican in a state with a national reputation as a quirky hotbed for progressive politics.

In 2003, shortly after taking office, Douglas launched the Blueprint for Health in Vermont, with an emphasis on preventing illness and complications, rather than responding to health emergencies. Working with Democratic majorities in both chambers, he signed a package of healthcare reforms in 2006 to expand access to coverage, improve quality, and contain costs.

"If we have the same objective, we can find the common ground necessary to get there," Douglas says of his work with Democrats. "We found ways to make the progress here in a bipartisan basis that we can all be proud of. There are always advocates who will want to do more or something different, and that is a dynamic of our system. But the commonality of the interests in serving the people of Vermont and working toward a healthier population has allowed us to find that common ground."

Vermont's healthcare successes have not gone unnoticed. For the past three years, Vermont has been ranked the nation's No. 1 healthiest state by the United Health Foundation, the American Public Health Association, and Partnership for Prevention. The state ranked among the Top 10 states in 11 of 22 measures, including second-highest level of funding for public health, and ninth-lowest percentage of people without health insurance.

In March, Douglas was awarded the 2010 Health Quality Award from the National Committee for Quality Assurance for his work to improve Vermont's healthcare system through a focus on chronic disease prevention and management resources. Douglas, who was chairman of the National Governors Association during the healthcare reform debates this year, says the nation's governors share similar experiences, regardless of party affiliation.

"We have to deliver. We don't have the luxury of talking about things and letting deadlines pass. We have to balance budgets. Governors have to live within their limited resources, make tough decisions on a daily basis," Douglas says. "I spoke with a colleague—who I won't identify—who served in both the U.S. Senate and as a governor and he said the difference was striking. He said the Senate was a debating society where you talk about things and don't have to make a practical decision, whereas an executive has to make things happen and happen on time."

In this most recent election season that ended last month, the partisan gridlock and charred-earth tactics that has crippled Washington for years crept into a number of hotly contested state campaigns. Douglas, who will retire from state government at the end of his term, says he hopes the days of the moderate, consensus-building politician are not numbered.

"The American people like moderation. I don't think Americans are extremists at one end of the spectrum or the other. They want someone who is practical, gets the job done, who makes the trains run on time. On balance, it is going to be people who are more centrist who ultimately accomplish that," he says. "I hope I am not a breed that is dying. I think that is where most Americans are. Ultimately, it's not ideology. It's putting food on the family table that guides decisions and priorities of the people in our country."