Health Care

We hear lots of talk about tax reform and lots about health care reform, but rarely hear about the two together. While there are proposals to change the exclusion for employer-provided health care, such as President Bush's proposal to remove it and provide a standard deduction for health insurance, they typically don't consider either the entire health care or tax reform picture.

There are significant dollars in the tax code that should be on the table in reforming health care. All of the government dollars should be in the picture in looking at how to fund any change, such as universal coverage. The largest federal tax expenditure is the one where employees are not required to include in taxable income the value of the health insurance their employer provides to them. The estimated cost of this expenditure in 2007 was $134 billion.  There are other health care tax breaks as well such as the itemized deduction for medical care and health savings accounts.

ANTI-GAY MARRIAGE MEASURE HEADED FOR CALIFORNIA BALLOT: Or so its supporters say. This tracks though with information first reported here over the weekend that the initiative, at $2 per signature, had made the ballot. This is in spite of a well-organized blocking campaign by opponents. One wonders, however, why backers are spending their money. Some polls suggest that Californian is close to having a majority of citizens who support same-sex marriage, and the Republican governor has vowed to fight this.  

$10 PER HOUR IN EUREKA: Signature gathering is about to begin on a new minimum wage ballot initiative that would guarantee $10 per hour to anyone working in the city of Eureka on California's northern coast.

MOMENTUM FOR COLORADO RIGHT TO WORK: That's according to its supporters, who are lining up endorsements. Business groups are backing it, but they should be wary. A frontal attack on labor is likely to unite the state's unions and turn out to be a setback for business interests. Exhibit A: California, the year 2005.  

DEPARTMENT OF MOON HOWLING: The Las Vegas Review & Journal takes a long look at one of the country's more important signature firms, National Voter Outreach and its CEO Rick Arnold. I've interviewed Arnold in his Carson City home, and found him to be one of the more thoughtful people in the petition trade, critical of its problems and clear-eyed about its limitations. This story is built heavily around criticism from the liberal/progressive Ballot Initiative Strategy Center, which is quick to lable signature gathering as corrupt (at least in cases where it opposes the cause in question). There is a "shocked, shocked" quality to this criticism. The signature gathering business has plenty of problem workers, many of them poorly trained folks who, for lifestyle reasons, have taken a job that usually pays them in cash. But BISC and other critics invariably propopse to criminalize the process of gathering signatures, as in Oklahoma. In supporting these restrictions, liberals are hurting themselves, by establishing precedents restricting political speech that can be used by their political opponents. And such restrictions don't stop direct democracy. They merely slow it down, adding to the costs (and thus the influence of interest groups) that progressives love to denounce. The more you regulate, the more firms like National Voter Outreach will benefit.

Odds and ends from the past week...

TELL US WHAT YOU REALLY THINK: Steve Maviglio, Democratic political operative and aide to Speaker Fabian Nunez, unloads on the Foundations for Taxpayer and Consumer Rights, now called Consumer Watchdog. The group is putting together a ballot initiative on health care. 

EMINENT DOMAIN MEASURES: As the California press corps withers, Capitol Weekly gets stronger. This past week, the newspaper has an excellent account of the back-and-forth over two competing eminent domain measures on the June ballot, Propositions 98 and 99. In brief, backers of Prop 98 (supported by an anti-tax group) are accusing backers of Prop 99 (supported by California cities) of "astro-turfing," the practice of using deceptively-named organizations with no real members.

WOLVES!!! A new development in the wolf wars in Alaska. A judge says the government can continue to shoot wolves from the air, though he invalidated the practice in certain parts of the state. The question of such aerial hunting -- to reduce the wolf population and protect caribou and other species -- goes to voters in the Last Frontier in August.

DOING FOR CALIFORNIA HEALTH WHAT THEY DID FOR CALIFORNIA CARS: Advocate Harvey Rosenfeld, author of 1988's Prop. 103 initiative on car insurance, and his organization, the Foundation for Taxpayer and Consumers Rights, is putting together an initiative on health care that aimed for the 2010, Capitol Weekly reports. It's a complicated measure and not yet fully cooked. But the insurance commissioner -- a post that has been heavily politicized (and a source of scandal in California in recent decades) -- would get new powers to oversee HMOs and regulate insurance and co-pays. It also would be easier to sue, which shouldn't surprise anyone. Rosenfeld is close to the trial lawyers. 

TOO BIG A CONSTITUTION: One characteristic of states that have the initiative and use it often -- California, Oregon, Colorado -- is that they have very long constitutions. The people have the right to add to and change the constitution and so they do. (It goes with the territory; Switzerland, birthplace of direct democracy, has one of the longest constitutions in the world.) In Colorado, a special legislative committee is studying the state constitution to see if it can be cleaned up a bit. Face the State, a Colorado news and opinon web site, takes a look at the clean-up effort, and is skeptical.

At one point, it appeared that Californians might vote this fall on a plan to finance changes in the health care system. But the accompanying reform plan failed to pass the Senate.

Well, it turns out the Golden State is not the only place where health care taxes... er, fees are unpopular. This weekend, Hungarian voters overwhelmingly approved a referendum striking down a plan to charge $1.72 in fees for doctor and hospital visits. The Reuters story is here.