Although the national election pretty much preserved the status quo, California politics took an unexpected violent lurch to the left on Tuesday. Even veteran political junkies were surprised by the gains made by the Democrats in the legislature. The Golden State is now completely in their control. Unlike some of my right-leaning friends, I see this as a good thing.
For one, the Donkeys can’t use the lame excuse that the state’s sluggish economy is all the fault of the obstructionist Repubbys anymore. From January forward, the fortunes of California rest in the quivering hands of the blue/green party, and I have no doubt that they are already salivating at the prospect. Assembly Boss John Perez, speaking on KCRA Wednesday, tried to reassure residents that there would be no massive tax increases under his rule, but Democrats are insatiable when it comes to implementing their expensive progressive agenda. (Does anyone believe the Prop 30 taxes will be allowed to expire in seven years? I thought not.) How long can they restrain themselves from leaping on the Calicarcass like the ravenous beasts they are?
Prop 13 will be the first on the chopping block. Oh, they’ll say that it will only affect commercial properties, but secretly they despise the entire concept of allowing people to live in their homes for decades without paying the piper while new homeowners are forced to pay the current market value. It’s a “fair share” issue. To keep longtime homeowners pacified, they’ll come up with a convoluted formula that takes money from residents, launders it through several bureaucracies who will skim the cream off the top, and then redistribute the remainder back to the taxpayer if he or she qualifies. (Reams of imported paper will be required for the forms. Will probably require professional help to fill out. Hey! More jobs!)
Even if they hold the line on taxes, they will do everything they can to complicate our lives. Look for more stringent regulations on virtually everything. Their pet project has been setting us up as the poster child for sustainable energy, but they have run into roadblocks from enviros and their lawyers when it comes to building enough big solar facilities to power gadget-hungry Californians. Look for a requirement mandating solar panels on all new construction in the state, which will drive up the cost of a new house another $20K and change. (Add that to the sprinkler mandate and other energy-saving measures.) Fossil fuel extraction (especially fracking) will be discouraged by the Nimby Coalition, who fear cheap energy that isn’t politically correct. Mining will be next, as they have already shut down dredging, and logging is a no-no. Anything that requires raw materials will have to be imported from some less-enlightened locale. Soda pop will be more expensive than whiskey, and plastic bags will be banned from your genetically-pure grocery stores.
I also expect that Mark Leno and friends will revive the single payer health bill at some point. People will be ready for it after they get a taste of Obamacare and try to navigate the complicated and confusing policies offered by the insurance companies. Figure another five grand a year on your tax bill. (And in truth, it will be cheaper although the quality of care will diminish.)
Of course, all the new fees on businesses will be passed along to the consumer, making us the Number One Most Expensive State in the country to live in or visit. And this is what guys like Jeff Pelline want. Force out the hillbillies and those who aren’t in the college-educated elite. Only then can California become the Utopia of the future, pure and unsullied by ignorant savages and other free thinkers. There will still be plenty of poor people, but they’ll be herded into public housing in walkable communities so they don’t sully our roads with their ugly gas guzzlers.
So yeah, I’m all for the Democrats running the show. Once they shove their grubby hands into our pockets to get the last of our change, people might finally get pissed off enough to send them packing. Don’t expect the Republicans to save us, it’s time for something new.
Here’s some info from Jeff Kane to back up my assertions on healthcare…
Good words on the Kane site, he has it exactly right. Single payer is the way to go.
But there was no way our political system could choke it down, so PPACA is the truncheon we are using to create some blue sky between those Democratic and Republican tonsils.
We’ll get to single payer soon enough, but w/o PPACA is never would have happened.
The plan all along has been for a Single Payer system. Not sure California is going to afford this. I would be receptive to any ideas on how we do this given our current shortfalls and the shrinking tax base and an electorate unwilling to raise tax rates.
Speaking of hikes, Prop 30 was a very interesting , and frankly deceptive ploy, if one actually read the text of the proposition. Governor Brown basically said this:
“If you don’t give money to the cops I’ll shoot the teachers.”
Maybe that’s what we need to do? Lie to the voters? Does my ass look big with this tax hike? No dear, they only look big on wealthy people who are leaving the State and poor folk.
I love big ideas. But I also like to see the numbers. I’m weird like that.
In the USA we pay 16% of GDP for healthcare and get shitty results: too many costly procedures because doctors get paid by the unit, too many workers required in the billing process, millions of our citizens uncovered who must resort to the emergency room, and uneven levels of care across the land.
In countries with single payer the percentages of GDP are 8% – 12%: streamlined billing, everyone covered, doctors get paid for results instead the number of procedures they perform, and consistent service levels.
In single payer countries, the rich are still free to compliment single payer with additional coverage, so as to avoid the “death panel” bogeyman.
Those are the numbers. Why does no other country on the planet have a health care system like ours? Because they are not insane, that’s why.
I was referring to a CA Single Payer System, which RL was referring to. Not a National system.
Regarding the savings/increased efficiency, I’m not going to argue that. Who would? The question has always been level and quality of service, which has never been answered with numbers, just anecdotes about someone’s aunt in Canada getting a timely hip replacement or whatever.
If the California State, which is my question, goes off on it’s own it will have to be funded by State coffers. Unless we’re imaging the Feds coming in with funds, which they might to promote the experiment. And we can’t print our own currency [yet]. I guess we could issue bonds.
So my question is still unanswered with regards to a State-funded single payer, which for the record I’m NOT against providing we don’t slip deeper into deficits and debt: how are we going to fund it? It seems to be an honest and straight-forward question.
But since you brought it up, one of the aims, and not an unintended consequence of the PPACA was frankly to crush expensive private practices, pushing doctors into more managed institutions, like Hospitals. The assumption is that this kind of economy of scale will lower costs. It probably will. This is being done by lowering government payments to private practices, but more onerously via the student loan process which was a less talked about provision of the PPACA: now if you take student loans for medical school, you have to take government funded patients. I’m a little torn by that if it wasn’t for the fact that the government forced this policy on the private lenders; private lenders who are underwritten by the Federal Government. It’s quite a pickle.
Why would anyone become a doctor anymore? Probably out of the goodness of their hearts and because they’ll enjoy having $300K worth of debts they’ll never pay off and because they want to be beholden to some faceless administrator at a Hospital. Doesn’t sound very rewarding if you ask me.
Sorry, I missed the state angle you were getting at…reading too fast, trying to get kids out the door. I’m not supposed to blog in the morning (-;
Yes, the funding will be tricky. I wouldn’t favor bonds, and I doubt the feds will cough up anything (except phlegm and blood), so that leaves us with state taxes and/or redirected insurance premiums. I haven’t read up at all on the CA single payer proposal, so your question is valid, poignant, important, and will of course need to be answered to a majority of the state’s citizen’s satisfaction, presuming that single payer is enacted through the initiative process.
Single payer systems in other countries do not go wanting for doctors. Why is that? I think the answer can be found with lots of research and honest analysis. America’s Achilles Heel after WWII has always been hubris; we are unwilling to leverage good ideas invented in other places because we are stubborn and way too full of ourselves.
We’re like the guy in the F350 driving to a desk job every day–big truck, tiny penis.
I have a couple of doctor friends (yes, I do have friends) in private practice who pretty sure they’re not going to be able to afford to keep up with their private practices. I know, “a couple” is hardly a meaningful sample, but they tell me they hear the same from other Doctors as well.
They were the ones that provided me with the data student loans and the migration to Hospitals, FYI.
However I’m not so convinced they weren’t already on a path to insolvency anyway. The PPACA is just hastening that. It’s a bad time to be a Doctor, IMHO.
Regarding the State? a Single Payer is not going to work with sizable tax increases across the board. Massachusetts isn’t single payer, well sorta, and >50% of their budget is getting digested by Health and Human Services, from my understand from family members who work in hospital admin. Probably should double check that.
Yeah, I’ve heard the same thing from other doctors. I just have to believe that it’s fear of the unknown. Again, let’s see how others are doing it (non-Americans).
Median salary for doctors is about $200k, but varies by specialty. Starting salaries are all above six figures. http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey
You can also look at the salaries that the University of California, the state prisons, and other state institutions pay their doctors–it is consistent with the study cited above. The best paid doctor at the UC is paid $1.9 million, and is the third best paid employee working for the State of California (the two best paid are the football coaches at UCLA and UCB respectively).
To the doctors who assert that they will go out of business if salaries fall, I can only wish them the best of luck in finding another line of work that pays as well!
Admittedly doctors salaries are only one part of the big costly mess that is US medicine. But I suspect that it is a big part.
The actual gross income of internal medicine physicians is $205,441. The *net* income is about $140, 939 if they are married. The average hourly wage for a doctor is ~$34.46.
The above requires some reading, but the conclusions are rather daunting. You’ll note that after wading through the calculations, the author concludes, that they’re making about $4 more an hour than a teacher. Please note the equations and the footnotes.
It’s not as simple as saying a doctor’s median income is $200K and that we wish them the “best of luck in finding another line of work that pays as well.” How much should Doctors make? What is a reasonable wage for all of that overhead and time in school? Not to mention their expertise and liability.
If you take the onerous costs of medical school out of the mix, a doctor’s salary pencils out better. In America, we choose wasteful (not efficient) entitlement programs and killing brown people with our military industrial complex over things like education, health care, infrastructure. It’s just who we are, it’s in our bones.
But this folly can be unlearned.
Professions besides doctors have such “onerous” training requirements–I could go through all the costs of getting my PhD, too, but i don’t quite see the point–and I certainly don’t make $200k.
But whenever I hear a doctor assert that declining Medicare/Medicare reimbursements will “push them out of medicine” my reaction is t ask, Why not let the market decide ? If they can sell their skills in another profession for more money–they should go for it.
So we should subsidizing or pay for Medical School (we already do to some extent). Right? Let’s assume yes, because I’m not sure if you’d agree with that. That’s a lot of dough. What strings are attached to that? Is it like how the State of California will pay for a Social Work degree in turn for the candidate coming to work for Health and Human Services? I’d be OK with that for Doctors. Clinic work, etc. And what about other important degrees? Dentists too? Nurses? What about civil engineers? Do they get a free education too? Maybe a sliding scale in terms of “value” to our society? Who decides all of this?
It is indeed probably the most burdensome thing to complete medical school. I sense rhetorical attempts to level the Doctoral field, however as a point of contention, I know not of many English Professors who can write a script or remove a tumor. I’m not being snarky, I’m being deadly serious.
And with regards to Government Funded care, Medicare for example, the point is they are going to be forced to take Medicare patients if they except government loans as I mentioned above. Also, the plan is to squeeze private practices into larger institutions.
I think you’ll find that most doctors would support your “let the market decide” thang, Except that’s simply not the case with government. The US Government is ostensibly the biggest company on planet Earth, who gets to make the laws and regulations, implement them and then enforce them. There’s no “market” there for Doctors to compete in. Well there’s always a market, just one that will be whacked out, tilted in favor of what the government whimsically thinks is valuable.
Ryan, you asked “who decides all of this?”
It’s a great question. I would hope that our political process decides all of this. I know that is not a specific answer to your question, but it’s the best I can do. This we know: someone will decide–whether it’s a gov’t agency, a private company, or a social movement, a decision-making process will push itself forward. Most importantly, I will need to see the revenue source for subsidized tuition before I can support it. But I also believe that subsidized tuition is valuable. Patronage has a long history, and modern iterations will have to be new inventions.
You are the one who raised the issue of how hard it is to complete med school, and using it as a justification for high medical salaries. I just pointed out that lots of people get doctorates which are difficult, and don’t make as much money as MDs–I’m just pointing out that years/cost/difficulty of training is a poor criteria for setting salaries, which is the case that Ben Brown MD and you seem to be making.
One part you left out, medical school is not the end of the poverty cycle for doctors. Residency only pays around $50K/year, and with the 7 years required to become a neurosurgeon, that allows the interest on the student loans to really pile up. Not sure if there are any residencies of less than three years.
Tony, unfortunately having a PhD does not allow one to save lives, or at least try to, or at least improve them, and those skills command higher salaries, for obvious reasons. I could argue that city planners make decisions that likewise save, improve lives, but Joe Blow will not make the connection. On the other hand, someone who patents a drug on their own would out earn any MD many times over.
This is an old thread and perhaps no one is still reading–but an article about doctor’s salaries just came out. It seems the US doctors are the best paid, but least satisfied: http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/15/six-out-of-every-seven-doctors-agree-our-health-care-system-doesnt-work/
My wife and I, like Big Bird, are glad to be off the Republican shooting gallery for at least another 7 years. Looks like plans for house expansion will be refocused on a bunch of aging RV’s, circled like old time wagons, to stave off Prop 13 issues. I predict a big market for tents, jumbo sized. Already have one semi-trailer for 320 sq feet of storage of stuff inherited, that the rest of family thought only we had room for. There it sits, out sight. out of mind, I renew the moth balls every couple of months, and throw in some Irish Spring too, keeping out rats and mice. It’s an elevated basement, or attic on wheels. with skylights and John Henry for a sound and solar lighted (during the day) roof. Total cost placed and modified, under $3000. Forest fire proof? Naaaah. At least not without a lot of brush clearing, yet to be done. You can’t beat $10/sq ft and no taxes. It’s good to own acreage with hidden back canyons..
Is a Yurt exempt from property taxes in terms of lot improvements? I always preferred Yurts to tents.
The democrats will blame George Bush for California’s woes and they will get away with it for at least eight years. The press will dutifully report their assertions. Hey it works for Obama.
Bob, don’ t hold back. Tell us how you really feel.
I’ll be in trouble no matter which ox gets gored. I fail to see how a state run by union bosses and trial lawyers will fare any better than the Koch Gang. Has everyone forgotten what a swell job these folks did with energy deregulation?
I do not comment here normally. But you have forced me to respond to by putting words in my mouth. I never said nor do I believe what you wrote about me. Down Fido!
Nonsense. Even today, you are encouraging those who don’t share your enthusiasm for the Democrats to get out of Dodge. It’s been a consistant theme on your blog for the past two years. You’ve belittled Aaron Klein for not having a degree and being a Republican. You’ve hounded The Union and KVMR for allowing Rebane to have a voice in the community. You linked to some guy in LA that commented on Maddow’s site calling Northern California a backwater of regressive nuts. If I had time, I could probably dig out a few dozen more instances of your disdain for any conservative point of view.
And all the while you ignore the extreme left wing policies and politicians that infest Sacramento. I could give you more respect if you stood up to them occasionally. California has been a Democratic stronghold for decades, whether they held all the marbles or just three-quarters of them. They have worked hard to earn my disrespect and apprehension. What’s your excuse for ignoring them?
Crabbman: Please do not forget about Jeff wildly singing the praises of wildly liberal Jim Firth – someone who is nowhere remotely close to “middle of the road.” This blog is the only local blog with a true sense of humor regularly skewering both sides with humor which is the reason I like reading your posts and cartoons. Always funny…
I think The Prophet is still annoyed because that scoundrel Pruett tried to pull fast with his list of dead voters while the purple one was at the horsey races and unable to defend his favorite elected or give The Union some backbone.
Instead of pulling the theatrical stunt of making an FOI request and doing his own reporting, he could have just read The Union’s story. Then he might have come to same conclusions I did:
–This was much ado over very little.
–It’s amazing that the state of California, home to some of the most successful database software companies in the country, doesn’t have a database of registered voters.
–The Prophet’s favorite elected is always front and center when he has the chance to play the role of competent public servant, but is MIA when anything touchy comes up.
Does this reflect his San Francisco values, where election officials are notorious for screw ups when the polls are open, and then taking forever to count the votes?
Eternal vigilance is the price of political correctness!
You still muddy the waters when it comes to moderate conservatives and hard-right conservatives. There is a difference in philosophy between Doug Ose and Tom McClintock, or between Nate Beason and Sue McGuire, even though they are all Republicans.
You paint with too broad a brush, oversimplifying the discussion into “R vs. D.”
In case you didn’t notice, the GOP is losing its base in California. A lot of people blame that on the hard right, not the moderates.
RL, you are actually on the money with your perceptions about the purple man and his misinterpretation of the R party. Certainly there are shades of red in the R and there are shades of blue in the D’s but the purple fellow only discusses the red. He is a blue, a dark blue, in denial.
The reason the R registrations are diminishing and why the state has turned dark blue is the R’s are usually the business folks and many are out of business and/or leaving. They are going to states where they are wanted. The D’s own California and have a super majority’s and will be unable to blame the folks on the right they won’t even let into the room. So be it. California will remain a D stronghold and and no business/jobs over time. The R’s have voted with their feet and are sacrificing great weather for jobs. Simple as that.
There’s a difference between “simple as that” and just plain “simple.”
Talk about simple, in every other part of the country we are seeing the same dynamic, the reason the R’s are diminishing in California is that they are too conservative for the people who live here–young people, Latinos, women and tolerant people…..anyone who does not see that is just simple.
Sorry boys, I have it right. As regards the rest of the country. We have the House, the office closest to the folks. Try harder with your illogical. Purple man is a simpleton.
Can’t see where I’ve cut the right wing of the right wing any slack over the past fourteen years of doing the Village Idiot or the past two years of bloggery. Where we differ is that I don’t kowtow to the New Hegemony. I really don’t care if they are popular or not. One party rule will be a breeding ground for corruption and general mischief. Apparently, you welcome it.
Yeah, right….I am crazy and Todd is Mr. Accurate…
By the way, I agree with you Bob, you have been an equal opportunity skewered…….but rest assured many of us who have a natural affinity for the Democrats are widely counseling caution and hyper financial responsibility on their part….
Hey how come you haven’t drawn Frisch and Pelline as the devil? I guess it is just my honor to be drawn as Mr. Red. LOL!
Call me naive (I’ve been called worse), but I don’t think the situation is as bad as you paint it.
My reading of American history suggests there’s a corrective mechanism built into our system, causing us to move to the middle when we swing too far left or right. If the Dems try to accomplish half of what you’re expecting, they’ll be punished at the ballot box two years from now. While your conservative readers won’t believe this (maybe you won’t either), I’m willing to bet the governor will be a moderating influence on the more radical impulses of the legislature.
If California is truly the harbinger of trends in this country, then the Republicans are in big trouble. We’re in this situation because California Dems have reached out to blacks, Asians and Hispanics while the Repubs have drawn the wagons into a tighter circle. The GOP is fast becoming the WOP, White Old Party.
MOR Republicans will win the battle. The Tea Party Patriots will be a rump party and become increasingly irrelevant. Good-bye Forty Year Plan!
Like Ryan, the docs I have talked to plan on getting out of the biz before the shit hits the fan. If we are talking to different doctors in the same little town, I’d say there will be an impact. What we’ll end up with is a new wave of third world physicans, anxious to cash in on govt. payments. When my mother was still with us, she went to one of the very few local doctors who accepted new Medicare patients. (I name no names, but you can probably figure it out.) He wasn’t a bad doctor, although his bedside manner was abrupt and all business. It’s hard to get personal when you have hundreds of cranky elderly patients. Mom didn’t like his advice and refused to go see him for about a year until her dementia reached a point where I had to step in and get her back in his office. I went in to ask him if he would take her back and found him going through one of the mounds of files in his office, so I asked, jokingly, “Staying busy?” He looked up and said in his best Apu accent, “Not busy enough if I’m talking to you.”
My guess is future patients on the lower rung of the financial ladder will be standing in line at clinics for care.
> My guess is future patients on the lower rung of the financial ladder will be standing in line at clinics for care.
That’s exactly what’s going to happen. But at least, as supporters maintain, they’ll now have a line to stand it. Whereas before, they just ran to the ER or died.
Ryan, good point!
Does the new Dem regime mean It’ll be easier for me to get on welfare or more difficult?
Another look at the ruling party’s prospects for the future…
I told you we were Number One…
Been out of town for a while. I bet you will be surprised how much of the Democratic Party rhetoric is just that, rhetoric. Not much difference between the two party leaderships where all the decisions are made. Some moves to the left will happen but nothing like the “cons” will lead us to believe.