Health Care Reform 101

OK, now that just about every breathing soul in the nation seems to have had their say about the current hot political crisis topic du jour…yes, health care…here goes my take on the raging debate. First, health care costs (including insurance premiums for most people) are exploding at a rate unsustainable in the eyes of every credible expert.  In other words, “yes Martha, we gotta see somethin’ done about it.” If not, local, state and federal government budgets…not to mention those of average households…will be increasingly impacted in ways that could eventually prove crushing.  So…Job #1.  Do something, and do it before Washington drops into the Delaware and California into the Pacific.  Second, the “reform” plan has to be simple to be sold politically.  Four, maybe five major reform items at most…ones that the average person genuinely cares about…this is salable to the American public.  Most notable — portability (ability to take your coverage wherever work and life take you), eligibility (ability to get decent insurance at a reasonable cost regardless of current physical condition), permanence (can retain your coverage and not be “cancelled” due to use of the insurance/care), affordability (something the average working family and individual can pay for), and choice (a range of plans to meet various tastes and desire for differing levels of deductibles, etc.)  Most of the rest of any reform package?  Not important to the average person and potentially politically poisonous.  Third, the missing item from the above list that federal and state policymakers are obligated to care about?  How we are going to pay for it.  In many ways, this is the toughest nut for reformers to crack.  Cut costs and/or get some new revenue.  That’s it.  Sounds simple but can be very tough to pull off and pass unless this is figured out in a palatable way.

So that’s it, friends.  Health Care Reform 101.  “Not rocket science but dang near as hard” as some old mule trader was undoubtedly heard to say while trying to shoe a scruffy long ear.

And one more thing…and it isn’t minor. What we’re seeing in the current health care policy debate is a nearly unprecedented (in recent times at least) interest and involvement by average Americans in a fairly complex policy debate.  You hear it everywhere…people are talking about this issue.  (And I’m getting asked about it on the street and at events constantly.)  Someone described it as another awakening of “The Sleeping Giant.”  Actually, I don’t believe the American public “giant” was ever asleep on this one.  He’s had one eye open the entire time…knowing the day would come when something just about everyone cares an awful lot about – how they and their kids, and folks, and friends would be cared for when sick or hurt – would finally be debated fully in the public arena.  And that Giant darn sure wanted to make certain He had a say in what went on when the dust settled.  Well there can be no doubt now that the Giant is fully awake…and kinda grumpy too.

A Strange Summer—State Budget, State Parks, State of Frustration

You’d like, as a native Californian, to simply be able to take the summer off.  After all, ’09 hasn’t been the easiest of years…for anybody…not only in the Golden State but globally.  Yet in California, the angst so many have felt around the world seems to have taken on an added urgency, sense of frustration and even anger in this place of eternal Gold Rush optimism.  Can’t a guy or gal just enjoy the sunshine and forget about it all…just for those few blissful weeks when most school kids are absent their books and the dogs make a special point of just lying around in the sun a few extra minutes each summer’s day? For some, yes…for many, not so easily.

We vacationed at Yosemite early in the summer, then at Lake Tahoe recently, two favorite camping spots. The Eagle Scout in me simply won’t rest easily in any year unless the return to and connection with the creation has been established.  Being in the unspoiled outdoors is about as close to heaven as I’ve gotten here on terra firma.  And despite the fact that, yes, I still did several media interviews from the campgrounds, I still was able to let down, let it all go, let myself feel the permanence and transcendent hope that comes with time in settings we didn’t create but have the privilege of being replenished in.

Yet it was here that I came to fully understand the depth of this summer’s cultural anxiety, and in particular, California’s deep chasm of public disenchantment with the political arena.  There, tacked on a post at a family’s campsite, was a paper plate with the words “SAVE CA STATE PARKS” scrawled on a surface in normal years reserved for hot dogs and watermelon.  In decades of camping, a first for me…politics invading the sacred family time of “getting away from it all.” Not enough time here to get into the policy wonk details of the budget issues related to state parks currently, but suffice it to say, Californians, and Americans in general, are feeling the effects of budgetary politics at the most personal of levels, in ways most have never experienced.

My inside contacts under the Capitol dome in Sacramento let me know over the weekend that a state budget deal, attempting to close what is at least a $26B deficit, may have finally been cut.  The Gov and the Legislature may finally get the thing done this week.  But the real impacts, and political residue, are just beginning to be felt.  If this summer is any indication of the feelings of the average citizen, 2010 may be a year of political upheaval rarely seen, as voters unleash their angst at the ballot box and elsewhere with ferocious frustration.   It is a summer, sadly, of significant discontent.

Judgement Day Approaches for CA State Budget

OK guys…this week is when the stuff really hits the fan at the state Capitol. Wednesday is Judgment Day, as with no budget July 1, Controller says IOUs are coming starting Thursday. So if the state owes friends or loved ones any cash…and you’re expecting some of it…you better get it quick. At this point…I see almost no chance of a balanced budget in place by then. What’s next? Almost certainly the state will hit the cash flow wall soon as well. Simply no way to pay bills unless they can borrow money… which ‘aint gonna be easy with no spending/revenue plan in place that lenders can believe in. Lots of bean counting tricks being floated under The Dome, but none solve the problem…and most now believe next fiscal year will be even worse.

LA Mayor Drops a Major Political Bomb by Dropping Race for Gov

And then there were two… That’s where CA Dems find themselves now in the race to succeed Arnold next year. What started as a political free-for-all amongst 5 or 6 Dems in a bid to take back the governorship of the largest state in the U.S. has turned currently into a two man slugfest…Atty General (and former Gov) Jerry Brown vs. SF mayor Gavin Newsom. LA mayor Antonio Villaragosa dropped the bomb yesterday on national TV…and said in so many words…”I’m out.” Polls, even in LA, didn’t show him in strong position versus Brown (he had, however, beaten Newsom in those polls) and LA’s fiscal troubles rival the state’s own mess in terms of difficulty. So he’s staying put…for now. A run for U.S. Senator Diane Feinstein’s seat in 2012? Maybe. But that’s a loooooooong way off in political light years. We’ll see… So what does his exit do to the race? It likely strengthens Brown’s hand, as a bigger field would make Newsom’s job easier in peeling off enough votes to squeak through a Dem primary. He’s got a base…but right now it’s much smaller than Jerry’s. So Gavin may actually welcome those who may take a second look at the contest…if…and that is a gargantuan IF…they think Brown can be made vulnerable. Right now Jerry is sitting tight and sitting pretty…officially undeclared (but sending plenty of signs that he’s in) and leading by a long rock throw in every poll so far. So does some potential candidate with lots of cash and/or name ID jump in? Plenty of time…but they’ve gotta get moving. As soon as the current state budget is done (and that could take who knows how long…) the race for the post-Arnold gov kicks into high gear. Stay tuned.

The mother of all CA fiscal showdowns has finally arrived!

The true mother of all CA fiscal showdowns has now fully arrived, to wit:

·        The Guv dropped a huge bomb late last week when he rescinded the state’s ability to borrow short-term for cash flow with so-called RAWs (Revenue Anticipation Warrants) – effectively forcing the Legislature’s hand to come up with a budget in the next few weeks, or literally cause the state to run out of money.
·        The Guv’s RAW move signals he is fully cranked up for a battle royal with the Leg.  He shows far less willingness to cave in this time around to whatever deal the Dems and Reps can come up with. Maybe the moment has truly arrived…when not only will he start “blowing up the boxes” of state government structures, but the budgetary smoke and mirrors as well.
·        The Dems in the Leg are in some seriously difficult political times.  Not only is there is no agreement between the Senate and Assembly Dem leadership about how to get a budget deal done, but inside the Dem caucuses, especially in the Assembly, semi-chaos breaks out at times on how much to cut, tax, and yell.
·        Reps in the Leg are mysteriously toned-down at present about the entire mess.  They may have done the political calculus and figured that the political winds are finally blowing in their favor after the May special election when it comes to a “NO NEW TAXES” mantra, and decided to let well enough alone.  Their possible strategy?  Let the Dems twist in the wind and have to go to the people alone if they want to deliver some seriously bad budget news…i.e. were coming at you with tax increases…like it or not.
·        Absolutely nobody knows at present what state agencies, departments, boards, commissions and programs are safe, done for, or somewhere in between.  Anyone who tells you they do isn’t paying close enough attention to the near frenzied, changing daily, climate under the dome at the state Capitol.  Don’t be fooled…this thing is a long way from over.

Gov. Schwarzenegger and the CA State Budget Crisis

Governor Arnold Schwarzenegger is up to his classic black Terminator shades in the worst budget mess in modern CA history. His address to a rare joint session of the Legislature this week made clear one important point…he has not a single thing on his mind right now except how to cut roughly $25B dollars and do it quick. He indicated absolutely no interest in tax increases, and appeared to attempt to provide political cover for both the left and right for this position based on the outcome of the May 19 Special Election. In his view, voters essentially said “get your act together in the Capitol, get it done, and don’t bother asking us for any more money.” While Arnold had in the past talked down tax and fee increases, this time he seems a lot closer to really meaning it. This point is important, because state budget negotiations over the past couple of deficit-ridden years have taken on almost surreal, never-to-be-trusted quality that goes something like this…”we’ve got a really big problem, but we can’t burden the people further, oh wow it’s a bigger problem than we thought, OK we’ll have to go ahead and upset the folks after all.” Forces inside and outside The Building (as insiders refer to the place with the big white dome in Sac) therefore simply tried to wait out the storm…and often were successful in avoiding a fiscal tidal wave by doing so. Deals were cut, most of them involving lots of accounting and fund shuffling that put the real tsunami off for another day. Well the Cat 5 storm has now hit, and those running up and down the halls of California’s statehouse, regardless of party or interest, seem to know it intuitively. The gig is up. And it ain’t going to be pretty. Most Californians are only beginning to get what those inside The Building already know all too well – what happens in the next 12-18 months is going to make past budget problems look like kindergarten. And Arnold looks reprise his K Cop role in a wholly different fashion…this time riding herd on a process that is going to make millions angry…many of them intensely so. Look for political forces to begin rising up soon talking about ballot measures for 2010 that have only been whispered about up to now…including a possible measure to return CA to a part-time legislature…the ultimate political sword hanging over the electeds tasked with cleaning up a fiscal mess unparalleled even in the minds of those who’ve been around Sac since before cell phones…heck…before fax machines and computers for that matter.

Driving through the Central Valley of the Golden State

Remember that California’s Special Election on May 19th is next week, so check out CitizenVoice.org to get informed!

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