Speaking of conservative approaches to "health care reform" we figure most of our readers know about Rick Scott, the man behind the "Conservatives for Patients Rights" (CPR—get it?) ad campaign. But the New York Times lays out the whole story of the prophet of for-profit medicine; How he built Columbia/HCA into the world's  largest health care company in the world and how he was ousted after the biggest U.S. health fraud scandal in which the company paid  $1.7 billion to settle charges. How he is now putting up millions of his own money to try to stop the comprehensive health reform for all Americans being developed in Congress in favor of more ... market competition and state deregulation.

     As the Times said:

"He hopes people don't Google his name," said John E. Hartwig, a former deputy inspector general at the Department of Health and Human Services, one of various state and federal agencies that investigated Columbia/HCA when Mr. Scott was its chief executive.

Want more proof that the initiative process is too powerful in California? All the recent talk about lawmakers reaching a budget deal is bunk. The deal, even if it passes, requires the voters to sign off on multiple ballot measures later this year. That's right -- California simply can't handle a budget emergency without a vote of the people.

Details have not been released, but I count at least five separate ballot measures that would be needed to complete this deal: 1. a measure authorizing the modernizing of the lottery and borrowing against future funds. 2. the approval of some sort of new spending limit that Republicans insisted upon in negotiations. 3. Changes to the state's education funding formula. 4. A measure permitting the state to raid money that voters approved for early childhood programs and 5. A measure permitting the state to raid money that voters approved for mental health programs.

Given the extreme costs of delays by the legislature, and their inability to do much without the voters OK, the real question is: why bother having a legislature at all?

Last fall's initiative campaigns in Colorado saw an extraordinary change in the ballot at the last minute. Labor unions agreed to withdraw from the ballot a package of initiatives that targeted businesses in exchange for a promise by business groups to contribute to a labor effort to defeat three business-backed initiatives. The four labor-backed measures technically remained on the ballot, but under Colorado law, without the support of their labor sponsors, the initiatives were a dead letter. The votes cast on those initiatives didn't count.

To some, it looked like business groups were bribing the labor unions to pull the measures off the ballot. So two Republican lawmakers introduced a bill that would make it a misdemeanor to withdraw a ballot initiative in exchange for money or any promise of value. The bill was defeated in committee last week on a party line vote, the Rocky Mountain News reports.

It has become obvious that Gov. Schwarzenegger and legislative leaders of both parties simply won't be able to reach a compromise that comes anywhere close to closing California's rapidly growing budget deficit, now estimated at some $40 billion over two years. The state government is running low on cash. Within weeks, it may have to start paying people in IOUs.

Democrats simply won't agree to enough cuts. Republicans won't agree to tax increases, and they can block that because of the state's requirement for a two-thirds vote. The Democrats' convoluted (if politically smart) attempt to do an end run around two thirds and raise taxes by majority vote isn't going anywhere; even if it's revived and signed into law, it's all but certain to get struck down in the courts or overturned by referendum. The governor you ask? Schwarzenegger has little credibility with lawmakers of either party. When it comes to big deals, he simply can't close.

The new Democratic leader in the state senate, Darrell Steinberg, appears to have concluded -- correctly, it says here -- that California's legislative Republicans will never back any tax hike, no matter the current budget crisis. Republicans had thought they could block a budget solution because of the state's requirement of a two-thirds vote to pass a budget or raise taxes. But now Steinberg and Assembly Speaker Karen Bass have constructed a proposal that mixes revenue cuts and tax hikes and is designed to avoid the two-thirds rule. The result is highly technical and convoluted. One piece involves moving around tax revenues between state and local pots, another involves reducing some taxes while establishing or raising others. (Details are here, via the Sacramento Bee).  but it should pass his chamber on a party-line vote. Here's hoping the Assembly then takes it up and sends it to the governor's desk.

I recently mused on Facebook about which might arrive first: Christmas or a new budget agreement for California, which is already more than two months late. A conservative friend quickly responded with his hope that Christmas would come first.

You might call the Republican legislative strategy in California the Doomsday Approach. And it's not a threat. Republicans seem more than happy to usher in the closing of state government. California will run out of cash within a month. It's not at all clear that the governor could keep the state open if that happened. But for Republicans, there might be very little to lose. The party is already terribly unpopular in the state. There's little hope of any change in that. Nearly all of the Republican legislators are insulated from being kicked out of office in November by a gerrymander. And Republicans have little hope of gaining any new seats from Democrats because of the same gerrymander. Republicans already have thrown their best-known, best-liked politician, Arnold Schwarzenegger, under the bus, all but dismissing him as a Democrat. The California GOP is stuck at the bottom of the pit. So why not blow up the state? There's nowhere to go but up.