By Royal Calkins
To understand just how counterproductive California’s initiative process has become, consider Proposition 8 on next week’s ballot, the measure by which voters apparently could condemn thousands of kidney patients. At least that’s what the anti-Prop. 8 advertising tells us, over and over and over.
The ads, paid for by the for-profit dialysis clinics, are so long on emotion and so short on information that they have me almost ready to vote for the measure. Lots of money poorly spent. But when I take a look Prop. 8 itself I realize that it is indeed a mess of a measure, like so many this year, two years ago and, unless we do something, every other year until we have ballot measured ourselves into submission or chaos.
Prop. 8 is sponsored by the large, powerful and progressive Service Employees International Union. It aims to reduce the profit margin for the dialysis operators and somehow make the clinics more susceptible to becoming union shops. What’s wrong with the measure, like so many others, is that it is a simple-minded attempt to impose regulation on a highly complex situation, regulation that could not be fine-tuned later without another confusing and costly ballot measure.
In theory, initiatives present voters with the opportunity to do things the Legislature can’t get done. But there are few examples of grassroots efforts to use the ballot box to fix problems, many examples of monied interests using it to further enrich themselves and many examples of unintended consequences.
This form of direct democracy seemed to be such a grand idea a century ago. There have been some good outcomes. For a long while, Proposition 13 from 1978 in the last century eased the pain of increasingly onerous property taxes. But many on both sides of the political aisle now believe it has run its course.
Not-so-good ballot measures included Proposition 18 in 1958, which would have outlawed unions and a 1964 measure that would have banned cable TV. Guess who sponsored that. Movie theaters.
The same year voters approved Proposition 13, they defeated a measure that would have banned gays from working in public schools.
The corporate world has mastered the use of ballot measures, particularly in California, where size makes statewide campaigns exceptionally expensive and where the law makes the outcome, good or bad, especially difficult to amend.
Not all measures are bad ideas, of course, but even the best of ideas can be demolished by deceptive advertising. Consider the current Proposition 10.
Contrary to what the commercials have told you, Prop. 10 is not a mean-spirited attack on the elderly, minorities and veterans. It is not going to require landlords to raze their apartment buildings.
All it does is allow local jurisdictions – Seaside, for instance, or Salinas or Soledad – to adopt rent control ordinances. Some California cities already have rent control ordinances but a state law bought and paid for by the real estate industry in 1995 prevents cities from adopting new ordinances of their own controlling rents on units built after 1995.
The industry-financed ads tell us that Prop. 10 will reduce the amount of affordable housing. The ads also tell us that the measure contains “no protections” for the elderly and veterans. The first assertion could turn out to be true if the measure stops developers from investing in affordable housing but that ignores the fact that very, very few developers are investing in affordable housing at the moment. The second assertion is nonsense. The measure does not mandate the precise form of rent control the cities create. It allows tailoring to suit local conditions and it does nothing to stop Seaside, Salinas or any other city from including all sorts of protections for seniors, the elderly or anyone else deemed to be in need of protections.
In case you’re interested, here’s a little more on Prop. 8, the dialysis measure.
California is home to about 600 dialysis clinics, most of them owned by DaVita Kidney Care and Fresenius Medical Care. You can see their names at the end of those emotional ads. The two companies have proved difficult for the SEIU to organize despite an attempt at legislation that also would have capped their profits.
Here’s where it gets tricky. Proposition 8 would cap the clinics’ revenues at 115 percent of the cost of patient care. Income above that amount would be rebated to private insurers, theoretically reducing the cost of some insurance. Most dialysis patients, however, are covered by Medicare and Medi-Cal.
Ballot measures try to make everything sound simple, but health care finance isn’t simple. According to several analyses by independent parties, the revenue cap imposed on the clinics does not account for certain costs such as malpractice insurance. Public reports say the clinics now operate at a profit margin of about 17 percent, enough to allow them to hire accountants able to come up with various schemes to get around the caps.
If Proposition 8 passes, what is to prevent future measures from attempting to regulate the fees charged by lawyers, auto mechanics, hearing aid suppliers or, yes, even accountants?
My socialist side likes the idea of forcing the capitalists to get by on much less, but my practical side doesn’t have time to study the fine print on ballot measures aimed at reigning in all the various industries with their unique sets of circumstances.
By the way, in case you missed it, the Washington Post had a big scoop this week about the California law intended to reform the cash bail system so that poor criminal defendants aren’t forced to spend months or years behind bars while awaiting trial. The governor signed the reform bill earlier this year. But implementation is on hold because the state has certified a referendum petition that would overturn the law. Who’s behind the petition drive? The bail bond industry, of course. So be prepared for an onslaught of commercials intended to scare the reformist instincts right out of you.
It’s time for a ballot measure to end ballot measures.
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