California’s “Health in All Policies” Could Revolutionize Health Care

Editor’s note: We’re happy to welcome Dan Weintraub to the Fox&Hounds Team!

Even as Republicans and Democrats fight over the future of health care reform in Washington, California is quietly laying the groundwork for what could be a revolutionary change in the way government policy keeps people from needing health care in the first place.

The effort, known as “Health in all Policies,” is roughly comparable to California’s response to the 1970s energy crisis. While others focused on drilling for more oil, mining more coal or securing alliances with foreign energy producers, California embarked on an aggressive initiative to reduce the state’s use of energy, especially electricity.

The energy efficiency focus sometimes makes California the subject of ridicule, as when it recently adopted new standards for big-screen televisions. But overall, the changes have paid off: Since 1975, electricity consumption per person in the rest of the nation has increased by 50 percent while it has remained nearly flat in California.

Voters know little about budget details

Cross-posted at HealthyCal.

Gov. Jerry Brown wants California voters to weigh in by June on his plan to balance the budget. But the voters, polls show, know next to nothing about the state’s finances, and much of what they think they know is wrong.

That widespread ignorance, understandable in a state as complex as most countries, might play a role in shaping the debate over Brown’s plan, and ultimately the outcome.

Brown is asking state legislators to approve about $12 billion in spending cuts by early April. Then he wants to ask the voters to pass another $11 billion in taxes, mostly by extending temporary taxes adopted in 2009 and due to expire this year.

Brown believes the voters will be more likely to approve the taxes if the cuts are done first. But his approach carries high risk. If the voters say no, the new governor will have used up much of his political capital and he will then be forced to try to get the Legislature to make extremely difficult decisions to cut spending even further.

Senate Plan to Shift Services to Counties Doesn’t Help Balance State Budget

Cross posted at HealthyCal.org

A plan unveiled this week by Senate Democrats to shift billions of
dollars in services from the state to the counties might make
government more efficient. But it won’t help balance the budget.

The Democrats are proposing to shift several health, social service and
criminal justice programs to California’s 58 counties, but they are
also proposing to transfer the money to pay for the programs. Some of
that money would come from tax increases.

The proposal would shift juvenile parole services to counties, along
with the responsibility for jailing and supervising certain low-level
offenders convicted of drug and property crimes.

Truck rule based on flawed data, ARB staff admits

A computer model that the Air Resources Board used to justify historic restrictions on diesel emissions from off-road construction equipment may have attributed twice as much pollution to those heavy trucks as they actually produce, according to interviews with ARB staff.

That error, coupled with the effects of the recession on the construction industry, means that the excavators, backhoes and graders that operate in California are producing only a fraction of the pollutants that the board believed was the case when it adopted the regulations in 2007.

The industry has been pushing the air board to repeal or at least suspend implementation of the rule, which requires contractors to get rid of old, heavily polluting engines and retrofit others with filters to capture the diesel particulate matter before it reaches the ambient air.

From the beginning, construction contractors have contended that the rule was misguided, would force some contractors out of business and had costs that exceeded its benefits.

Modest soda taxes don’t affect consumption or weight gain

Modest additional taxes on sweetened soft drinks don’t do much to curb consumption or child obesity, according to a study released today. But more significant levies targeting soda might have more impact.

The study, published in the journal Health Affairs, could find no significant connection between soda consumption or weight gain among children and special taxes on soda. The taxes in the study averaged 3.5 percent, and none were larger than 7 percent.

“If the goal is to noticeably reduce soda consumption among children, then it would have to be a very substantial tax” said Roland Sturm, the study’s lead author and a senior economist at RAND, a nonprofit research organization. “A small sales tax on soda does not appear to lead to a noticeable drop in consumption, led alone reduction in obesity.”

New soda taxes have been proposed in California and elsewhere. Democrats in Congress considered the idea as a way to finance an expansion of health insurance for the poor but dropped the proposal in the face of opposition from the beverage industry.