The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Posts Tagged ‘George Skelton’

Health Care Reform in a Dilapidated House

Posted by Alan on November 8, 2007

Sometimes it’s so easy to get caught up in an issue, especially one as big and complicated as health care reform, that one misses the big picture. That’s why it’s a good thing George Skelton is around.

In his Los Angeles Times column today, Mr. Skelton reminds us that health care reform is just one of the issues facing the state. First among them, he asserts, is the structure of the state’s financing. “[T]his would be an opportune time for Capitol politicians to reform many things: a volatile tax structure that’s too dependent on affluent-income taxpayers, autopilot budgeting that is straitjacketed by past ballot initiatives, an education system that is the biggest gobbler of tax money but clearly needs reforms, and a healthcare system that leaves 6.7 million uninsured during any given year. It all fits together: the money, the policy, the politics.”

Of these challenges, Mr. Skelton considers fixing the state’s budget structure and addressing California’s water storage and delivery system as the most urgent issues lawmakers need to address. Concerning the budget he believes the Governor and Legislative Leaders are in denial. In the same week Governor Arnold Schwarzenegger’s demands state agency heads prepare for 10 percent spending cuts — including on existing health care programs — they continue to develop plans for a $14 billion health care reform package. And the Governor is already calling 2008 the Year of Education suggesting new taxes may be needed to reform that system. (The 10 percent spending cuts are necessary in light of a state deficit likely to reach $10 billion this year. When I wrote the about the deficit less than a month ago, it was projected to reach $8.5 billion). 

Concerning water, Mr. Skelton notes negotiations on that issue have gotten deeply bogged. Yet, he notes, water is “truly a disaster in the making.” (Like health care reform, water is the subject of a current legislative special session).

Mr. Skelton has seen a lot of silliness in his many years covering Sacramento. But in this column he seems truly dismayed. Adding costly new programs while cutting existing ones seems to exceed the normal unreality that is state government (and this doesn’t even acknowledge the $66 million previously cut from the budget which had been targeted for bringing into Healthy Families children eligible for, but not enrolled in, the program). “The Capitol is like a family that’s losing income, but going ahead with plans to build new rooms on a house deteriorating from dry rot,” writes Mr. Skelton.

Mr. Skelton recognizes, and has written eloquently, on the importance of universal health care. He is not calling for the state to forget about these reforms altogether. But, he notes, “[T]he state’s budget structure — the dilapidated house — should be shored up along with adding on a costly new program.”

Agree or not, it’s a perspective worth keeping in mind.

Posted in California Health Care Reform, Health Care Reform, Healthcare Reform | Tagged: | 1 Comment »

Tea Leaf Time for Health Care Reform

Posted by Alan on September 24, 2007

The health care reform debate in California appears to be in a bit of a lull — at least in public. Appears is the operative word. There’s a lot of negotiating and maneuvering happening behind the scenes, but not much happening in public view. (It’s like watching synchronized swimming on television — things look organized and relatively calm above the water, but below the surface they’re kicking like mad).

So with little real news emerging, those who care about the issue are left reading tea leaves. Every utterance by the key negotiators are parsed like it’s a pronouncement from the Federal Reserve Chair. This can drive folks who care passionately about the issue crazy. Based on the emails I’m copied on, that’s exactly what’s happening.

My advice: take a deep breath. Stay calm. Stay tuned. Stay active, but stay calm. Remember, it’s only tea leaf reading.  Like with Professor Trelawny in Harry Potter’s world, there’s a lot of predicting going on, but very few actual prophecies.

Consider the tea leaves offered in the Los Angeles Time today. George Skelton has an interesting interview with Speaker Fabian Nunez.  On health care reform, Mr. Skelton quotes Speaker Nunez as saying he and the Governor are about two weeks away from agreeing on a compromise bill. He says what they come up with will require only a majority vote. The Governor and Democrats would then sponsor a 2008 ballot initiative to fund their reform package. Speaker Nunez states his belief that passing the ballot measure, which will probably face voters in November 2008, will be a challenge. While leaving open the possibility of settling for more modest reforms (presumably expanding children health programs) if more comprehensive changes aren’t possible, the Speaker says it’s too early to consider settling for less right now. All in all, Speaker Nunez recognizes that enacting meaningful health care reform won’t be easy, but he remains optimistic it can be done.

So tea leave readers, what does this all mean? Nothing new. Negotiations continue. Progress has been made. Substantial differences remain. Differences will be resolved in two weeks. Unless it takes longer. Or unless no compromise is ever reached. If there’s no compromise, the Legislature will consider less comprehensive action.

Of course, when the only thing on TV is synchronized swimming, you’ve got to do something to stay awake. The reality is, we’ll know something substantive soon enough. Reading tea dregs can be fun from time to time, but all-in-all, I’d rather read a good book. 

Posted in California Health Care Reform, Health Care Reform, Healthcare Reform, Politics | Tagged: , | Comments Off on Tea Leaf Time for Health Care Reform

A Health Care Reform Initiative May Be Unprecedented, But Its A Sound Idea

Posted by Alan on September 15, 2007

I have a great deal of respect and admiration for George Skelton, the veteran Los Angeles Times journalist. Yet I have to take issue with his September 13th column in which he takes Governor Arnold Schwarzenegger and the Democratic Legislative Leadership to task for contemplating an initiative to fund the health care reforms expected to come out of the upcoming legislative special session.

Mr. Skelton claims the initiative would “confirm many people’s view that the Legislature is indecisive and irrelevant.” He also warns that by backing an initiative, Governor Schwarzenegger “would further alienate Republican legislators. He would be shunting them aside again, signaling that they’re not needed.” He goes on to question the timing of an initiative. It would likely be on the November 2008 ballot — more than a year after the special session adjourns and shortly after a bruising budget battle which is likely to be worse than what we endured this year.

Much of what Mr. Skelton says is true. People do hold the Legislature in low regard. Republican lawmakers are increasingly marginalized (and will likely continue to be until the way we draw legislative districts in the state is changed so as to make more of them competitive). The timing of the initiative is unfortunate.

Yet, it also is the right thing to do. What makes the initiative route worth traveling is that it holds out the promise of making comprehensive health care reform a reality. The Legislature is impotent any time a two-thirds majority vote is required. The Governor, Speaker Fabian Nunez and Senate President Pro Tem Don Perata could ram there heads against that wall, lose and slink away. Instead, they’re taking the only path the current political reality in California leaves them.

Is the need for an initiative an example of a healthy state government? No, in fact it’s evidence of just how dysfunctional state government has become. Will it bring the state meaningful health care reform? It certainly holds out that promise. The key, of course, is whether the framework of reform, including the elements that don’t require passage by a two-thirds vote, will actually make California’s health care system better. Based on the version of Assembly Bill 8 passed by the Legislature, the answer is no. Hopefully the special session will produce more responsible legislation, something worthy of being financed by the very necessary initiative.

Posted in Arnold Schwarzenegger, California Health Care Reform, Health Care Reform, Healthcare Reform, Politics | Tagged: , , | Comments Off on A Health Care Reform Initiative May Be Unprecedented, But Its A Sound Idea