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Health Care: Good Deficits, Bad Deficits

“There are no solutions, Bernstein–only the rearrangement of problems.”
—David Mamet, ‘November’

Is the health-care debate a mess? It is. By which I mean it’s sure hard to keep up with the competing claims about what the pending legislation will do or won’t do. Yes, our leaders try to make things easy for us by declaring one set of ideas (theirs) good and another set (someone else’s) bad; the “someone else” in this equation returns fire in the same terms. It’s only certain at this point that nothing about the health-care system or the bills that may effect some changes in it is simply “good” or “bad.”

For me, “good” consists of two things: First, make health coverage universal. In a nation as wealthy as ours, no one should be without medical care. Second, ensure that health coverage is affordable for all. The devil, as they say, is in the details. The bill headed to the Senate floor is about 2,000 pages long. What all do you think is in there?

Rank speculation aside, one concern that lies outside my list of “good” or “bad” attributes of health-care legislation is the deficits they’d cause. This may be uncaring of me. I don’t want my kids and their kids to be paying for my colonoscopies, or for yours either. But I have to say that when I hear the opponents of the health-care bills screaming about deficits, it’s hard to take them seriously. Right down the line, these are the very same folks who thought nothing of committing the nation’s wealth to the Iraq war, deficits be damned. Some economists say that that little project will wind up costing us $1 trillion–the low estimate–before it’s all over. And although I think we can rest assured that the investment has been worthwhile for most Iraqis who survived our good intentions, I don’t think all that money has done a thing to make life better for the tens of millions of people here — a group double the population of Iraq, by the way — who make do without medical care.

So let’s see where the health-care legislation takes us. It may be far from perfect. but improvement, not perfection, is our goal. And if we mess it up on the first round, gee, it won’t be the first time. We’ll just have to go back and try to to better. That seems to be the only way this system of ours work.

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Pac 10 Football

We’ve expended exactly zero words in this space on this year’s football season, college or pro. There is a local team worthy of regular comment–or ridicule–and that’s the Oakland Raiders. But enough about them. The two teams most avidly followed under this Berkeley roof are California, of the NCAA’s Pacific 10 conference, and Chicago, a founding club of the National Football League. Both perform their gridiron labors under the sobriquet “Bears.”

We don’t lose a lot of sleep over either Bears squad. They’re just not good enough to cause that or to merit it. But emotional attachments are hard to sunder and occasionally the teams are entertaining. Cal is a more immediate experience, seeing they play a couple miles from our house, close enough that when the stadium cannon is fired to celebrate a touchdown it’s clearly audible here.

The conceit for any fan of a decent college football program is that the team they follow is on the threshold or at least capable of greatness (some people root for teams that actually are great–such as the quasi-pro squads at schools like Florida, Texas, and the University of Southern California. I don’t know have any idea what it would be like to root for such a team, though a certain infuriating smugness seems to come with that rarefied territory).

California, at any rate, is a school with a consistently decent football program, a program good enough and rich enough that its coach is a millionaire and fans enjoy a week or two every season thinking that, “Gee, this year these guys are for real.” But Cal, millionaire coach and all, is also a consistently inconsistent team, capable of spectacular performances, weird lapses and blind stupidity–sometimes on the same play. The team won its first three games this year, badly abusing a collection of overmatched squads. Then it began its conference schedule with a game against Oregon in Eugene. Cal looked helpless and scored a single field goal while the Ducks ran riot. Cal made an identical impression against USC in Berkeley: a lone field goal while the Trojans cruised up and down the field at will. Since then, freed of expectations, the Bears have had an OK season. They lost to a good Oregon State team. They beat UCLA, Washington State, Arizona State and Arizona. Today they played Stanford.

Step back a moment from the Cal particulars. The rest of the conference has been pretty interesting.

Oregon demolished Cal, then went on to smash USC, the perennial conference power. It was Oregon’s year, until they played Stanford a couple weeks ago. Stanford whipped them.

USC lost an early game to Washington–continuing a string of seasons during which it has lost a close game to a weaker conference opponent (other upsets in recent years came by way of Oregon State and Stanford). Then the Trojans seemed to get back on track by dominating California. But USC didn’t really flatten anyone else. In fact, they got steamrolled themselves by Oregon in Eugene. And last week, Stanford not only beat them but racked up more points against them than any team in history. It couldn’t have happened to a nicer bunch of guys (by which I really mean: a more entitled-seeming group of fans).

So Cal vs. Stanford. The Cardinal took down Oregon immediately after the Ducks’ big win against USC, and then it simply overpowered USC. Both Oregon and USC stomped Cal. What chance could the Bears possibly have? Naturally, the Bears beat them. Not just beat them, dominated them — the 34-28 score hid the fact Cal held the ball for nearly 40 minutes out of 60 and got 31 first downs to Stanford’s 16.

Elsewhere, Oregon came from behind to beat Arizona and keep the inside track for the conference championship and Rose Bowl berth. But to get there, they need to beat Oregon State on December 3. It’s a home game for the U of O. I’ll give the edge to the Ducks over the Beavers.

But this is the Pac 10, so don’t bet on anything.

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‘… Wednesday’s Worse and Thursday’s Oh So Sad…’

We’ve all thought about time travel and what we’d do with the gift to move backward or forward along the fourth dimension. I think the wish to be able to go back and undo a mistake came to me long before I ever encountered science fiction. I can’t tell you how many times I looked back on some rash action–usually from the perspective of a few seconds after the act–and wished I could have a do-over. Then at some point the notion of time travel came to me by way of Ray Bradbury, “The Twilight Zone,” elementary description of Einstein’s theories, and the Firesign Theatre. “Nancy! Nancy! I’ve just returned from ancient Greece! Look at this grape!”

I think time-shift fantasies fall into two obvious major categories: the visit to the future–either to check in on your future self or to visit the world we’re begetting with our blunders; or the visit to the past. The visit to the past hardly ever seems to be cast as a casual return to the olden days. It’s usually a trip back to an incident we see as crucial. A battle. An assassination. Any incident famous or infamous that we’d like to see firsthand or try to arrest with our knowledge of the consequences. What might happen if you could introduce Gavrilo Princip or persuade him to forego watching the archduke’s Sarajevo appearance for a nice raspberry gelato?

I was thinking about all this yesterday as I found myself listening, for maybe the 10.000th time, to the “Allman Brothers at Fillmore East” recording of “Stormy Monday.” I wore out a couple copies of the LP listening to that track and that side of the album. “While we’re doing that blues thing, we’re gonna play this old Bobby Bland song for you–actually, it’s a T-Bone Walker song”–is that Dwayne Allman introducing it?–and then the band rolls into the song’s first chords, followed by Greg Allman’s vocal: “They call it stormy Monday, but Tuesday’s just as bad. …“

I could fit everything I know about music on a postage stamp; and not one of the big rectangular kinds, either. But I do know what I like. There’s not a note in the 8-plus minutes of that track I don’t savor. The vocals. The dual percussion. The bass. And especially the guitars, the way the Dwayne Allman and Dickie Betts trade licks and leads and complement each other through the entire piece. They’re so good it hurts to think of how short a time they played together.

So: My time-machine wish list? I think I’d skip Sarajevo to attend that one show.

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East Bay Hipster Gulch: The Motel

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The Temescal district, the neighborhood surrounding Telegraph Avenue and 51st Street in North Oakland, has become a contender for the title of East Bay Hipster Gulch. By which I mean the area is characterized by lots of young folks hanging out, sporting the latest in fashion and barely rideable bicycles. In fact, the first Friday of the month is a phenomenon all the way up Telegraph from downtown to 51st. Galleries are open late, clubs are thronged, and except for the very wide well-paved street you might think you were in non-colonial Williamsburg–the one in Brooklyn.  

But traces of the avenue’s up-and-down history persist. Smack in the middle of a block that features an odd but cool gallery (it featured a live Halloween display with a young woman making like Norman Bates’s mother and spooking some visitors), a Burmese restaurant, and a good pizza-and-beer joint, you’ll find a rent-by-the-week motel. But like the rest of the area, it’s going through changes. I prefer to think of it as the Maya, but that’s because I formed my impression facing north. South-facing viewers see the Telegraph-Shattuck (those two streets meet, or diverge, a block away).

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Storefront

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There’s a Saturday morning routine that takes us by a restaurant for coffee and pastries followed by a pause at the King Middle School garden (so the dog can watch the chickens) and a stop at the schoolyard to sit and consume previously mentioned food items.

Then there’s a Sunday morning routine: different direction, different cafe, no pastries, and no stops. But we do walk along the old Santa Fe right-of-way, and our path takes us past an old storefront on Hearst Street that has been turned into a gallery.

The picture above: the gallery a couple Sundays ago. I’m a sucker for artfully arranged miscellany, I guess.

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California Water: ‘Crumbling Infrastructure’?

Sparse posts of late. The reasons are many. Let me toll off some of them: Facebook. Twitter. Another absorbing online project having to do with the future of California water. Work. Non-Internet recreations. Sleep. Dog-walking.

But about the water stuff: the current distraction was triggered by the Legislature’s recent passage of five bills, including an $11.14 billion bond measure, intended to refocus water policy and “rebuild California’s crumbling water infrastructure”–our governor’s preferred formulation and one widely parroted by politicos, pundits, and journalists alike.

Yes, I question the “crumbling infrastructure” line. Why? The system of levees in the Sacramento-San Joaquin Delta–an area drained and diked more than a century ago–is known to be in need of constant attention. Some of the levees may even be said to crumble. But the description doesn’t apply elsewhere. The state, federal government, and water districts have invested billions over the past couple of decades to keep their facilities from deteriorating.

“Crumbling water infrastructure” has become the early campaign slogan for the bond campaign. The phrase is standing in for a more complex reality, and one that has nothing to do with the condition of physical facilities. It’s true California’s water system seems broken. But the stress is the result of growing population, an ancient and unresolved battle for water between urban and agricultural interests, and the arrival over the past few decades of a new interest that demands water: environmentalists and fishery groups arguing on behalf of salmon and other species that have been extirpated or brought to the brink of extinction. And add one more factor: Schemes to divert Canadian rivers or the Great Lakes aside, there’s only so much water to go around in California.

One thing that’s struck me as I’ve pored paragraph by paragraph through the bond measure is that we’ve been here before. Just one for-instance. Back in the 1990s, there was a grand negotiation involving the state and federal government and all the interests, including environmentalists. Eventually, the process became known as CALFED–that’s pronounced “cal-fed” and has nothing to do with newborn beeves. In August 2000 CALFED produced a behemoth set of agreements, principles, legislation and environmental studies, all designed to do the same thing the governor and Legislature say they’re doing now. CALFED was to enhance the state’s water system by building more reservoirs, better managing groundwater, and figuring out better ways of moving water from north to south without killing the Delta.

But the consensus that built CALFED disintegrated. Neither the federal nor state governments delivered promised support. The parties to the deal backed out as prospects for progress on any of the basic issues dimmed. The new state legislation specifically supersedes CALFED. Except for that act–killing a moribund program–you wonder how much the new laws will accomplish. Important components are widely denounced, the state’s in no shape to take on the increased debt, and neither are the voters in a mood to write big checks to bureaucrats. And the political climate for the water bills seems simply poisonous: the bills were written virtually in secret, the bond has been faulted for being chock-full of earmarks, and only a small minority of voters express approval of the Legislature or the governor.

What’s next, then? It would be nice to believe some sort of open process could result in solutions that could win support from most of those affected, that would be feasible, and that would be investments in the state’s future. There’s talk of an alternative bond measure that would be much more precisely targeted than the one the Legislature approved. That could be a start, because I would guess that that’s the only way the voters approve a water bond in 2010. And if no money is approved, then California’s looking at another still-born attempt at tackling its water problems.

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November 11: The Notebook

Item 1: I’ve wondered to myself at what point I’ll consider deer roaming around central Berkeley as unremarkable as, say, crows. A picture of a deer in the front yard comes to mind, maybe eating some choice vegetation (though the plants in yards to either side of us are probably a lot more delectable). It seems we’re getting pretty close to that day. During our late evening walk, The Dog and I had two encounters with big hooved springing mammals. The first was a little startling as an adult-sized deer bolted from a front yard across the street and make a pretty good racket as it crossed a couple of hedges. Then it did that sproingy run that deer do all the way up the street into the dark. A few blocks away, The Dog got alert to something across the street, and two more deer went clattering up the pavement, paused at the next corner, then hung a right and vanished. I wonder who the next arrivals in the neighborhood will be. Mountain lions looking for a snack? No — coyotes are a lot more likely.

Item 2: Sometime in the last couple months, an old colleague of mine called attention via Facebook to a remarkable series of articles in the Ann Arbor Chronicle–what I’m guessing is an “alternative weekly.” The serial is running under the title “Washtenaw Jail Diary.” The Chronicle hasn’t announced a publication schedule, but a new installment seems to appear every couple of weeks. Elsewhere, I said I look forward to the new chapters the same way mid-19th century Londoners probably looked forward to the next piece of “A Tale of Two Cities.” But this jail diary isn’t fiction. It’s a story of an anonymous 40-something middle-class white guy who gets tossed into the county lockup. What makes the stories riveting is the writer’s skill in narrating his sudden passage from what he took to be “normal life”–telling the boss he’d be in late for work while he takes care of some business–to felony inmate. The Number One asked question about the series: What did the author do to wind up in jail? He hasn’t said yet.

Item 3: It’s November 11th. Veterans Day. Armistice Day. Remembrance Day. An occasion to reflect on a war so monstrously costly that a sequel was unimaginable. Today, we can imagine anything except, perhaps, an end to the killing.

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Spare-Time Work Project

As I was saying the other day, California’s new water bond measure sure is interesting. The voters will be asked next November to let the state borrow $11.14 billion for a whole slew of water projects: water conservation efforts, water reclamation, water recycling, groundwater monitoring, drought relief, and measures that will let local and regional agencies do semi-water-related things like build bike paths near rivers. A good piece of the $11 billion will simply be a pile of cash for the Legislature to sit on and hand out to worthy dam projects and other water-development initiatives. Governor Schwarzenegger signed the bill calling for the bond measure yesterday, and he’s talking as if it’s a done deal. At the same time, snipers have appeared. Legislators from both parties are saying the initiative is flawed and padded with unnecessary spending. Some reporters are getting in on the act, too. I decided to find the text of the bond bill myself and pore through it. Once I started to do that, I started thinking of ways to highlight the spending provisions. A spreadsheet? That’s good if you like raw data. A map? It seemed doable, so I went to work on Google Maps. The result–still a work in progress, and sing out if you have any suggestions–is here and also embedded below. We put it up on a KQED page, it’s gotten passed around some on Twitter and maybe elsewhere. And tonight I found out that one of the governor’s press aides was consulting it (well–the press aide is a former colleague of mine).


View California’s Water Bill: Where Would the Money Go? in a larger map

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California Water: A Taste of Pork

Tomorrow, our Action Governor is going to star at a media event at Friant Dam, near Fresno. He’s using the dam, which impounds the San Joaquin River, as a prop for a ceremony at which he’ll sign an $11.1 billion bond measure that will go onto next November’s ballot. The money’s supposed to go for building new dams and reservoirs and for environmental restoration of the Sacramento-San Joaquin Delta, which has been laid waste by earlier generations’ water schemes.

It’s a big bond. In ordinary times it might be a tough sell. But these are lean, lean times for the state, which is suffering through a staggering series of budget deficits and will have to pay interest of $700 million or $800 million out of its general fund every year once all the water bonds are sold. Schwarzenegger said last week he thinks voters will go for the measure because they’ve recently passed other big infrastructure bonds, such as last year’s $10 billion initiative to finance a California high-speed rail system.

Maybe so. But enter the Associated Press. One of its Sacramento reporters has been leafing through the bond bill. Here’s what she found:

“… Dozens of projects … were injected into the bond bill to secure enough votes to get it passed. The projects will add tens of millions of dollars to the interest taxpayers will have to pay on the bond if voters approve it next year.

“Many of the projects are only peripherally related to the purpose of the legislative package, which is intended to increase California’s water supply and restore the ecologically fragile Sacramento-San Joaquin Delta.

“For example, $30 million was earmarked to the state Department of Parks and Recreation for grants for watershed education facilities. Another $20 million is set aside for the Baldwin Hills Conservancy, which manages land for recreation and wildlife and is the Los Angeles district represented by Assembly Speaker Karen Bass.

“In the final days of negotiations, lawmakers in both chambers padded the bond bill with an additional $1.7 billion, despite previous statements by legislative leaders that the state could not afford such a large bond.”

The AP is following up here on what was widely rumored around the state Capitol when the bond was passed In fact, a reporter asked Schwarzenegger about the add-ins during his a self-congratulatory press conference the governor held after the Legislature acted. Here’s what the governor had to say last week to the suggestion that some of the projects in the bond measure might be “pork”:

QUESTION: Governor, how can voters support this package when you passed it in the middle of the night and the — so the pork, so-called pork, inserted in there including (Inaudible) pulled out?

GOVERNOR: Are you talking about — I don’t know what you’re talking about, because the end package does not have any pork whatsoever, so I don’t know what you’re talking about.

QUESTION: Late in the evening the bill, as it was being drafted, contained — was amended and contained — and these projects were added for various counties and for various projects. So the tab grew from 9 billion to 11 billion. So how can the voters take on something like this at a time when they’re still feeling the pinch and how can they be sure that all the money will be spent well?

GOVERNOR: Well, first of all, as you know, I’m not as interested in the process as in the end result. So throughout the process we went from 8 billion to 12 billion, to 9 billion, to 11 billion, back to 9 billion and back up to 11 billion. So I think this is maybe something interesting for the journalists but it definitely is not as interesting to me. To me always what’s interesting is the result and the result was a great, great package of approximately $11 billion.

One of the things you have to love here is the way Schwarzenegger, reputed to be a hard-headed businessman, so breezily dismisses the appearance of billions of dollars of extra stuff. That’s something that’s only interesting to journalists, he says. And, he may find out very soon, to the people who will have to pay the tab.

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Deck the Halls with Piles of Initiatives

If you could do anything to make California better–anything at all–I’m sure you’d do exactly what Merry Susan Hyatt is doing: promoting a ballot initiative that will require public schools to offer real, honest, genuine Christmas music (in effect, Christian Xmas carols) during the holiday season. Ms. Hyatt’s initiative is creating a little buzz now that state officials have given the OK for signature gathering. Mostly, the critics (we plead guilty) point to it as another example of how dumb the state’s initiative process can be.

The would-be doctors assessing the civic illness that seems to afflict California look at their clipboards and see a long list of other symptoms, too: broken budget process, hopelessly polarized Legislature, a disconnect between what people say they want and what they’re willing to pay for.

Then there’s the initiative process, nearly a century old and the chief reason the state’s Constitution has been amended more than 500 times. It’s become a system for the voters–or actually, a select group that’s whiter, richer, and older than the electorate at large– to dictate sweeping policy shifts and budget priorities without much regard for the long-term consequences. The most famous example, probably, is Proposition 13, the 1978 measure that overnight leveled and reduced property taxes and forever restricted local governments’ ability to raise them. But there are plenty of others, including the series of bond measures that fueled a prison-construction boom in the 1980s and ’90s and made possible the rise in the state inmate population from 25,000 in the late ’70s to 170,000 now. And just to make sure the new institutions were filled, the voters also approved tough anti-crime measure like the Three-Strikes Law.

Lots of people are talking about trying to rein in the initiative process. One modest proposal, which comes from UC-San Diego political scientist Thad Kousser among others, is to require initiatives that will cost the state money to say how it will be paid for. The thinking is that with the cost made clear, voters would be less willing to continue writing checks that the governor and Legislature have to find a way to cash even when the state is virtually bankrupt.

The talk about reform is coming on the eve of what may come to be known as the Year of the Initiative. Right now, the June 2010 primary ballot lists a modest total of three measures that have qualified to go before the voters. One is a constitutional amendment that would change the way seismic retrofits are assessed for property taxes. One would set up a system of public financing for state elections. One would create a sort of open-primary system for state offices.

But those three June 2010 initiatives? They’re just the tip of the iceberg. The calm before the storm. The overture to a grand electoral opera. The California Secretary of State’s office lists 68 initiatives–68!–that could wind up on the ballot next year. Of that number, 24 are out in the wild, with organizers and their (often paid) volunteers collecting signatures. Forty-four are under review at the state attorney general’s office to make sure legal i’s are dotted and t’s crossed.

Next year’s ballot booklet will be the size of a phone book.