Recently in Healthcare Category

Sunday's San Jose Mercury News contains an anti-government op-ed by George Will, "Democrats want nation dependent on government". (The online headline is different.)

This sounds scary, sinister, even somehow slightly evil.  But if you look into the meaning of the words, the effect changes.

Here is what I mean.  In America government is us.  Our Constitution is the defining document of our government and it couldn't be clearer, declaring that We, the People formed this country "to promote the general Welfare, and secure the Blessings of Liberty to ourselves"... In other words, watch out for and take care of each other; "We, the People" have banded together to watch out for each other, take care of each other and build institutions to protect and empower each other.

So with them real meaning of the words in mind Will's headline becomes "Democrats want nation to take care of each other."  Will is exactly right, and good for them.

Will's column is about the national healthcare reform battle and proposals for a "public option," which offers a Medicare-like health insurance plan to all of our citizens.  Will opposes this, because,

"Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers."

In other words, he is complaining that a public option health insurance plan will provide more benefits to more citizens at a lower cost.  Will casts this as a bad thing, because it threatens the ability of a few wealthy business owners to profit from people's need for health care. 

Profits for a few instead of benefits to the public appears to be his idea of the purpose of government.  But to the rest of us the point of health care reform is to take better care of each other while lowering the costs.  This is why the "public option" is necessary -- private, profit-driven companies are not designed to accomplish delivery of essential services to everyone.  Profit-driven companies are designed to deliver only to those who are willing to pay the most, which when applied to essential human needs violates fundamental tenets of democracy.  We are supposed to be a one-person-one-vote country, not a one-dollar-one-vote country.

Again, Will and other conservatives use lots of scary words.  But if you look at the meanings of the words, their complaint is with Americans who want to enjoy the fruits of democracy and equality, and take care of each other. 

And this is supposed to be a bad thing?
  

Over at Calitics there is an interesting diary from 'zeroh8' asking "Why Are We Spending So Much More?"  zeroh8 looked at the changes over the last ten years in how the state spends money.  The result, according to the diary, is a per-capita increase of $1088 as follows:

California Government Department
2007-08 less 1997-98 Per Capita Spending

Criminal Justice $185
General Government $14
Health $265
Higher Education $109
K-12 Education $399
Resources & Environmental Protection $27
Social Services $59
Transportation $30
Total $1,088 

Robert Cruikshank commented that the appearance of an education spending increase is an illusion, (sadly California still ranks 47th in education spending-per-pupil)

Much of the "increase" in K-12 funds is illusory. When Arnold cut the VLF in 2003 that money had to be backfilled by the state. That backfilling is listed on the books as "spending" and so it appears as a huge "spending increase" when in fact it is no such thing. Schools didn't actually get more money. It's an accounting trick.

Robert is pointing out that this appearance of a large increase in education spending is actually just replacing spending that was already there, but that was cut from local budgets when Governor Schwarzenegger cut the Vehicle License Fee, so the state had to make up (backfill) the loss.  The state is spending more because local governments are spending less, but the total hasn't increased.  Lesson: you have to look at the whole picture including local budgets to see the whole story because the state has to step in when local governments lose their funding sources.

Health care spending increases are certainly not isolated to California state government.  This is the health care crisis that is eating up government, business and family budgets around the country.  So far We, the People, in our wisdom, had avoided the kind of "socialized medicine" that the rest of the world has, which means we spend vastly more for health care with vastly worse results.  There is little California can do about it, except to further deny health care to people.  Is that the kind of people we will decide to be? 

Then there is that huge increase in criminal justice (prison) spending.  Was that necessary?  Well, we decided to pass laws that put people in prison for life for stealing a pizza or for years for smoking a joint.  And in the last few decades we have cut education spending, which to some extent has necessitated the increases in prison spending, because we know where that inevitably leads,

"18-to-24-year-old male high school dropouts have an incarceration rate 31 times that of males who graduated from a four-year college"      

We're seeing the health care crisis eating the state budget, and the problem of the prison costs.  Part of our problems today are because yesterday we were "penny wise and pound foolish," saving some money by cutting education only to spend it on prisons (and who knows how many other ways) later.  Along with foolish tax cuts like cutting the VLF, and cutting property taxes for big corporations, and instead borrowing which has led to huge interest payments, those are the spending problems that brought about the budget crisis and that keep our government from being able to spend more on things We, the People need.

About those choices:  zeroh8 did a ton of research because no California citizen would know any of this from sources available to most of us.  The corporate media is not explaining the state budget and the functions of government to the public.  The example of the state making up local revenue losses in order to save our schools is a great example -- instead it is just presented to people that the state is "spending even more".

So what is the point of this exercise? To give the people the facts, not the phony sound-bites designed to further anger people against government and rail even further about having to pay taxes to fund the programs and services. The goal of the conservatives is to simply unfund government, thus making "We the People" powerless against the big moneyed interests -- the people who brought you the sub-prime fiasco, the Wall Street boondogles, the Haliburton no-bid contracts and the Blackwater mercenaries.  As long as the bucks are flowing, what do they care if government can't do its job.... what do they care about long lines at the DMV, wildfires that burn down communities, gangs that take over our streets and oh, yes......swine flu epidemics that kill millions?  They can just fly away in their private jets or sail away on their yachts -- that california won't tax.

Over at SEIUVoice.org there is a petition to Governor Schwarzenegger asking him not to balance the budget using cuts that hurt homecare workers.  The Governor is proposing to cut state funding for In-Home Supportive Services, which helps provide crucial assistance to thousands of elderly and disabled people in California.  The proposal would reduce state funding for homecare workers to minimum wage and eliminate care.  This would cause thousands of workers to lose their health benefits.

here's the thing: it would also force many current homecare patients into nursing homes.  So in future years this would be a far greater cost to the state.

Here is the wording from the petition page:

Dear Governor Schwarzenegger-

Balancing the budget shouldn't be done on the backs of homecare workers whose hard work allows hundreds of thousands of Californians to live safely and with dignity in their own homes.  Cutting California's homecare workers to the minimum wage with drastic cuts in benefits is unacceptable.

I stand in solidarity with the homecare workers who are gathering on Saturday, January 24th in Sacramento, San Francisco and Fresno to stop the cuts.

Go to the page and sign the petition.

Society is only as strong as its weakest link, and it is the responsibility of the people and our government to protect those who are genuinely unable to care for themselves.  We are morally and duty bound to do whatever we can to assure every human being a level of basic dignity. That is what these workers provide for those whom they serve.  We are talking here about cutting this kind of care rather than, for example, asking oil companies to pay something when they take our oil out of the ground to sell back to us.  How have we gotten to this point?

The following was submitted by Speaker of the U.S. House of Representatives Nancy Pelosi:

When I was sworn in as the first woman Speaker of the House in January, my 8-year-old granddaughter Madeleine said she hoped because of my step forward, more women would also be able to have jobs like mine. With those words, Madeleine spoke a simple but powerful truth: Without the pioneering women who have blazed the trail before us, we would not have come nearly as far as we have today.

When I proudly assumed the role of Speaker, it was with a nod to both the past and to the future. It was in honor of those pioneering suffragettes and women whose tenacity and sacrifice allowed me to become the first woman Speaker. And it was in honor of our children, who represent our hope for the future and for change. At the time, I said that we have made history, and now we must make progress.

The religious right is at it again, with another ballot measure intended to divide Californians and prevent women from making their own choices about their own bodies and lives. This time it is Proposition 4 -- "Sarah's Law" -- the old "parental notification" initiative that bans the termination of a pregnancy in a minor unless their parents are notified 48 hours ahead of time.

The same initiative has been rejected by California voters twice for good reason. Yes, this is the third time in three years. So the state -- We, the People, the taxpayers -- runs the expense of another ballot initiative.

So this time they have named the parental notification initiative "Sarah's Law" after Sarah of the Bible -- a fictitious name being used for a real woman who died in Texas in 1994 from an infection caused by a torn cervix. Prop 4 proponents claim that "Sarah" would have been saved if Prop 4 had been in effect there. Now it turns out that Prop 4 would not have applied. So this new rationale for the previously-rejected law -- that Prop 4 would save the lives of minors, entirely based on one 1994 case -- is false. Obviously helping young women is not the point of this law. Below I will talk about how this will actually endanger their health and lives.

First, though, an Aug. 2 LA Times story explains: 'Sarah's Law' would not have applied to 'Sarah,' acknowledge backers of the abortion-notification measure,

Backers of a ballot measure that would require parents to be notified before an abortion is performed on a minor acknowledged Friday that the 15-year-old on which "Sarah's Law" is based had a child and was in a common-law marriage before she died of complications from an abortion in 1994.

[. . .] Proposition 4 would amend the California constitution to prohibit abortion for unemancipated minors until 48 hours after a physician notifies the minor's parent or legal guardian. State voters have twice rejected similar measures.

At first glance it might seem like a good idea to require minors to notify parents before they can terminate a pregnancy. Unfortunately the reality of people's lives does not always match up with the ideal families of 1960s TV shows. There are very serious reasons that a young woman might not want to tell parents about a pregnancy. These can involve abuse, incest and fear. In these cases requiring parental notification can bring about serious consequences. It can also cause the young woman to turn to unsafe alternatives.

There can even be very bad reasons where the young woman really should tell the parents. But a law like this also endangers a foolish, unwise young woman's health because it can cause her to to to an illegal, unlicensed, unsafe practitioner, or even try something herself. People do not always do the best and wisest thing. Foolish and unwise young people even more so.

History and experience have taught society that having a safe and legal place to turn for help is the best way to protect our young women. When a young woman is pregnant and does not want to be and there are no safe procedures available she might out of desperation turn to unsafe alternatives. When pregnancy termination was illegal it didn't mean women did not terminate pregnancies, it meant they did so at very high risk to their health. Terrible consequences were not uncommon. This is why the right's justification for Sarah's Law, and the false story behind it, is such an abomination. They are trying to take away these safe procedures with false stories that this will protect young women. It is safe and legal procedures that protect women who decide to choose to terminate a pregnancy.

The California Chamber of Commerce has released its annual list of what it calls "job-killer bills."

Why is it that the Chamber's job-killer bills hit-list seems to only target Democrats? Not a single targeted bill belongs to a Republican. "Bad bills", like those designed to protect public health, climate concerns or consumer rights legislation, are all authored by Democrats. The chamber has always been a lobbying organization, but it has gotten so bad that the Chamber seems to have devolved into little more than just one more fear-mongering Republican Party front group.

The "job killers" on this list are any laws that protect consumers, reduce energy use, require worker protections or anything else that might hinder a very few corporate executives from reeling in another several-hundred-million dollars a year. The jobs that are "killed" are those of lobbyists for the energy industry.

The first group on the "job killer" list is bills that ask for any kind of energy or water conservation or environmental standards for new housing construction. For example, AB 1085. The bill describes itself as undating,

"building design and construction standards and energy conservation standards for new residential and nonresidential buildings to reduce wasteful, uneconomic, inefficient, or unnecessary consumption of energy."

But the Chamber's job-killer list says this

Substantially increases the cost of housing and development in California by implementing significant energy efficiency measures

Now, think about this -- if it costs less to heat and cool your house, this saves you money. If you want to add energy-saving technology like solar electric or water-heating on your house this creates good jobs. Maybe Exxon won't benefit as much from this as the new, upcoming solar industry, but heck, the solar companies aren't coughing up the big bucks and providing the good jobs to the Chamber of Commerce's lobbyists!

The next group of "job killers" is "workplace mandates" like paid sick leave for employees, disability pay for on-the-job injuries or providing California’s citizens with health insurance.

Ah yes, the money businesses pay out to provide sick leave and disability pay for those pesky employees "kills jobs." They could hire so many more people if they didn't have to actually pay them and keep them from getting injured! This is one of the oldest arguments in the books. Slaves are always cheaper. But why do we have an economy if not to provide US with good jobs and other benefits? Do we have an economy so a very few corporate CEOs get all the money and benefits, or do we have an economy so the people can also get good pay and benefits and safe working conditions? The evidence (this, for example) is clear that good wages and benefits do not hurt jobs or the economy.

Then there are “economic development barriers” like asking online retailers to collect the same sales taxes that you local business owner collects, asking the wealthy to help pay for our schools, raising fire standards in high-risk fire areas and protecting our environment. I guess the online retailers must be paying the Chamber more this year than the retailers who have to actually rent storefronts and pay wages in your town. I can't think of any other reason why SOME retailers should collect sales taxes and others should be exempt. Doesn't this change the playing field waaayyy in favor of online retailers and harm the prospects of businesses that actually set up in our local communities? God forbid we ask them to help pay for our schools and police and fire protection!

This "job killer: list is nothing more than the use of fear to scare us into allowing a few rich corporations to have their way. By saying that protecting workers or the environment might "cost jobs" they are trying to make us afraid to ask these big corporations to live up to their responsibilities to our communities. How long will we let these lobbyists make us afraid?

While those of us deeply immersed in the healthcare debate have strong opinions about which way to go, we could probably benefit from hearing the ideas of others who are students of government, while not necessarily engaged in its actual nitty-gritty where we sometimes don't see the forest for the trees.

While teaching at UC Santa Barbara, I had the opportunity to work with Stuart Kasdan, who served as the Teaching Assistant in a class I taught on California Politics and Public Policy.

Stuart Kasdan is a graduate student and PhD candidate in Political Science at UC Santa Barbara.
His previous employment includes work as a senior program examiner at the federal Office of Management and Budget (OMB). Stuart has a masters degree in Agricultural and Resource Economics from UC Davis and served as a peace corps volunteer.

Although I'm a firm believer in the importance of removing the insurance industry from the healthcare debate, Stuart proposed a system that acknowledges the political reality that the insurance business carries alot of weight in the halls of Congress. They certainly control our own governor's thinking on the subject and continue to be part of the dialogue among our presidential candidates. So, in the spirit of offering another perspective, I asked Stuart to give his take on the situation and this is what he came up with:

Senator Alan Lowenthal has served in the California Legislature since 1998. He served six years in the State Assembly and was elected in 2004 as the senator from the 27th Senatorial District, representing the communities surrounding the Ports of Los Angeles and Long Beach.

He is a committed and strong voice for reasonable yet firm environmental protections, especially when dealing with issues of public health and air quality specifically. His SB 974 has engendered a full-scale push-back from big businesses both state-wide and nationally. In typical hyperbolic and hysterical fashion, these companies (which read like a Fortune 500 company who's who) claim that the measure will destroy business in California. As Senator Lowenthal explains below, this is typical business balony.....

What they don't, and can't do is deny the health problems they create or encourage when they deny any responsibility for the mess their current transportation practices engender. This measure will split a mere $30 per container use fee equally between air quality mitigation measures, such as the replacement of dirty diesel trucks and infrastructure improvements such as rail grade separations.

It all boils down to these big Fortune 500 companies, and their cronies, wanting to maintain the status quo which allows emitting filthy and noxious diesel fumes into the air and sustaining gridlock. Rather than addressing and trying to solve the very real issues of LA's deadly air quality, they prefer forcing California's residents to continue suffering so the rest of the country can have cheap goods. Who ultimately pays the price? In SB 974,Senator Lowenthal says it shouldn't be the health and well-being of Californians. This measure is moving its way toward the Governor's desk. He vetoed a similar measure last year. This time, we're hoping a groundswell of public support will force Schwarzenegger to do the right thing for the people of our state. Here are Senator Lowenthal's thoughts on the issue:

By Patty Berg

Here's an alarming little tidbit that should make you spill your latte all over the New York Times on the front seat of your Volvo:

The Religious Right is poised for a victory in Sacramento.

That's right. With the help of conservative doctors and nervous politicians, the muscle and money behind the right-to-life movement is orchestrating an anti-choice victory on Death With Dignity in Sacramento.

Amazing as it may seem, the Right is just a few votes away from stopping a bill that has support of 70 percent of the state's voters. We're talking about the California Compassionate Choices Act, AB 374, which would give terminally ill patients the right to use medication to control their dying, just like the Death With Dignity Act allows Oregonians to make that choice.

If you think California should be immune to the anti-choice message, you'd be right. But that's what makes this play so unnerving. Anti-choice organizers are keeping the zealots in the closet, and cloaking themselves as protectors of the underclass. In short, they're using our progressive ideology against progressives.

They've managed to convince some Democrats who should know better that giving people a choice could end up hurting the poor. They're trying to get good solid Demcrats to ignore the strong support of the ACLU, MALDEF, NOW, AFSCME, every major state Senior Citizen group and CAPG, the California Association of Physician Groups,one of the state's largest physician organizations. Heck, the Speaker of the Assembly is one of the authors of the bill -- when was the last time he did anything to hurt the poor?

They're also using Astroturf politics, making something look like it's a grass-roots movement when, in fact ,it's being orchestrated by long-time campaign operatives. The Catholic Church hierarchy, in conjunction with a well-greased Republican machine, has unleashed a flood of e-mails, letters and phone calls, all designed to convince fence-sitting Democrats that there's a price to pay at the polls for anyone who supports choice at the end of life.

Never mind that statewide polling consistently shows that 70 percent of California voters support choice at the end of life. Never mind that support among Democrats is closer to 80 percent. Never mind that the Democratic Caucus' most trusted private pollster says there is no way anyone could be hurt politically by this vote - the anti-choice campaign is nonetheless gaining traction. We must stop this misleading campaign now!

We should know this week whether California is run by progressive thinkers, or whether a well-run conservative campaign can actually send progressives running. AB 374 should be heading toward a vote of the full Assembly in the next few days. We need your help right now!

Let's insist that our end of life decisions belong to each of us, and not to strangers.

If you want to support AB 374 sign our action alert!.

Assemblywoman Patty Berg represents the 1st District, which includes a third of the California coast, from Bodega Bay to the Oregon Border. She is a joint author of AB 374.

As we see a woman's reproductive rights being chiseled away on the national level, thanks to the currently Bush-stacked US Supreme Court, we have to rely more and more heavily on setting the standards for Reproductive Choice right here in California. But the anti-choice movement knows there are more ways than just stacking the court to reduce access to safe and early abortion and reproductive health care services......just squeeze providers financially and watch the number of facilities shrink so rapidly that these services become unavailable or at the very least, so stretched that the ability to obtain healthcare becomes dangerously delayed for patients from all walks-of-life.

Such is the story right here in California. And that is why Wednesday, May 2nd, when Planned Parenthood conducts its annual Lobby Day in Sacramento, it is critically important to support their efforts to obtain a committment to increase the Medi-Cal reimbursement rate for reproductive health services. Not just a promise from the Legislature, but the Governor as well. For all his bluster about being a moderate, "post-partisan" governor, there is nothing that will show that he has at least a modicum of moderation more than his supporting the increase in rates that haven't been adjusted in almost 20 years!