November 18, 2005

Lyon County Growth has impact all over

A quick perusal the Mason Valley News and Leader-Courier will confirm what you all are seeing on a daily basis: Lyon County is growing by leaps and bounds.

There is no stopping the growth. With real estate prices going through the roof in Reno and Carson City, it's only natural that families will be looking to find an affordable place to live. The question is, will we make sure that this growth is a win-win for all concerned?

Privatization and Medicare - No Choice for You

Paul Krugman's column this morning tackles the new Medicare prescription plan.

[. . . ]

Here's some background: the elderly have long been offered a choice between standard Medicare, in which the government pays medical bills directly, and plans in which the government pays a middleman, like an H.M.O., to deliver health care. The theory was that the private sector would find innovative ways to lower costs while providing better care.

The theory was wrong. A number of studies have found that managed-care plans, which have much higher administrative costs than government-managed Medicare, end up costing the system money, not saving it.

But privatization, once promoted as a way to save money, has become a goal in itself. The 2003 bill that established the prescription drug benefit also locked in large subsidies for managed care.

And on drug coverage, the 2003 bill went even further: rather than merely subsidizing private plans, it made them mandatory. To receive the drug benefit, one must sign up with a plan offered by a private company. As people are discovering, the result is a deeply confusing system because the competing private plans differ in ways that are very hard to assess.

[. . . ]

But confusion isn't the only, or even the main, reason why the privatization of drug benefits is bad for America. The real problem is that we'll end up spending too much and getting too little.

Everything we know about health economics indicates that private drug plans will have much higher administrative costs than would have been incurred if Medicare had administered the benefit directly.

It's also clear that the private plans will spend large sums on marketing rather than on medicine. I have nothing against Don Shula, the former head coach of the Miami Dolphins, who is promoting a drug plan offered by Humana. But do we really want people choosing drug plans based on which one hires the most persuasive celebrity?

Last but not least, competing private drug plans will have less clout in negotiating lower drug prices than Medicare as a whole would have. And the law explicitly forbids Medicare from intervening to help the private plans negotiate better deals.

Last week I explained that the Medicare drug bill was devised by people who don't believe in a positive role for government. An insistence on gratuitous privatization is a byproduct of the same ideology. And the result of that ideology is a piece of legislation so bad it's almost surreal.

November 6, 2005

Colorado rejects TABOR and Nevada should reject TASC

So, when Bob Beers starts making noise about TASC (TABOR under a new name) and Sharron Angle pushes for a Nevada version of Proposition 13, remember Colorado. Do you really want underfunded schools? No libraries? No rural health programs? Police and fire departments operating on a shoestring? Roads that cannot handle the traffic of expanding communities?

TASC turns our budgets into mathematical formulas and does not allow our elected officials any flexibility in moving funds around so that growing areas of the budget (education, for instance) get adequate funding while areas that slip down the priority ladder don't get more than they need.

Can you imagine running your household budget that way? When you are done paying off your car, do you continue to make payments on it? As your children get older, doesn't the cost of their clothing, food, and school and after-school activities go up? Sure would be nice to take that money no longer needed for a car payment to help offset the cost of your children's expenses, wouldn't it? If your budget was restricted the way TASC seeks to restrict government funding, you wouldn't be allowed to.

From the November 3rd Editorial in the NY Times:

How Colorado Got Its Government Back

In 1992, to the unmitigated glee of antitax types everywhere, Colorado voters amended the State Constitution to impose the nation's strictest tax and spending limits. On Tuesday, they decided that government was worth paying for after all. By 52 percent to 48 percent, they voted to suspend the fiscal limits for the next five years and told the state to keep $3.7 billion that would have otherwise been refunded to taxpayers.

The vote clearly has to do with the pain of a permanently underfinanced government. Middle-class and low-income residents were getting burned by ever deepening spending cuts in education, health care and transportation.

Colorado has the ninth-highest per capita personal income in the nation, and only Washington, D.C., and Massachusetts have larger proportions of college graduates. Yet over the past decade or so, Colorado has dropped to near the bottom among the states in funds for basic public services. Last November, Republicans lost control of both chambers of the Legislature for the first time since 1960, and Gov. Bill Owens, a Republican, then shocked his base by supporting the suspension of the budget restrictions.

Voters and legislators in nearly half the states are currently considering tax and spending limits, some of them quite severe, like Proposition 76 in California. Coloradans, who have the most experience with extreme budget constraints, have said "time out" and telegraphed their displeasure to elected officials. Taxpayers and politicians, including those in Washington, should take heed. This vote was a thumbs down on "starving the beast" - the Republican strategy of excessive tax cuts to force government to shrink.