Healthcare Providers Aren’t Greedier than Uber

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

I just read An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Kaiser Health News Editor-in-Chief Elisabeth Rosenthal, a fact-filled* critique of the American health system. The author does a marvelous job of describing the Kafkaesque world in which Americans all-too-often find themselves — no fixed prices for procedures or tests, no […]

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Dissecting San Jose Unified

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

Normally, California school districts don’t face financial stress when state revenues are robust. Usually that stress arises only when state revenues shrink as a result of declining stock markets. But schools in California are experiencing stress right now despite record revenues from a long bull market and a tax increase. One illustration is the San Jose Unified […]

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Now California Must Take on the Healthcare-Industrial Complex

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

California dodged a budgetary bullet last week when Congress elected not to change Medicaid reimbursement rules. With 14 million people covered by Medi-Cal, which is California’s version of Medicaid, the consequences for the state budget of having to pick up more of that cost would’ve been enormous. But that’s just one battle. Medi-Cal is a […]

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San Francisco Officials Are Chasing Rabbits

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

San Francisco’s pension costs are expected to rise three times faster than revenues over the next five years (see “Even San Francisco, Flush With Tech Wealth, Has Pension Problems,” Bloomberg) but another disclosure in the city’s latest Five-Year Financial Plan is equally troublesome: Pension costs, which had already increased 5x in the ten years to FY2015, were […]

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LAUSD and Detroit Have This In Common: Pension costs will be higher than projected

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

Last month Detroit mayor Mike Duggan claimed he had been kept in the dark about calculations used during Detroit’s 2014 bankruptcy proceedings to predict future pension payments. Realizing now that payments will be much higher than projected, the mayor is considering a lawsuit because “we did not know that [the projections] were based on optimistic […]

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Big Changes In California’s Spending

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

Jerry Brown just proposed his sixth budget since taking office in January 2011. Boosted by a bull market and tax rate increase, General Fund revenues are budgeted to be 32% higher than the fiscal year in which Brown took office. But not all spending has kept the same pace: FY2010–11 Enacted Budget; FY2017–18 Governor’s Budget […]

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For Whom the California Budget Tolls

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

Journalists and elected officials occasionally make the mistake of viewing budget problems in terms of size rather than where the budget item falls. For example, the costs of unfunded pensions and retiree healthcare in the current fiscal year (FYE16–17) add up to 6% of the state’s General Fund, a much smaller share than retirement spending […]

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Fix Medi-Cal Or Lose UC and CSU

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

As a new Congress takes office, newspapers are filled with articles about the potential consequences for California of federal changes to Medicaid but not about how California’s existing version of Medicaid — known as “Medi-Cal” — is already in need of serious reform. Medi-Cal is a single-payer healthcare entitlement program covering 13.5 million low-income Californians. Funded jointly by the state and the […]

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Next Generation Is On CalPERS’s Menu

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

“If you’re not at the table, you’re probably on the menu.” — Dave Low, Executive Director, California School Employees Association “Pay now or pay more later.” — CalPERS board member Richard Gillihan, appointed by Governor Jerry Brown The CalPERS board is considering a recommendation to lower its investment return assumption to 6.1%. That would mean higher pension costs […]

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Public Pension Costs: Potential Good News for Californians

David Crane
Lecturer and Research Scholar at Stanford University and President of Govern for California

The California Supreme Court has decided to hear the MCERA case, which as explained here potentially is good news for citizens. Now citizens should turn their attention to CalPERS’s board, which in February will decide on its consultant’s recommendation to use a 6.1% investment return assumption when establishing pension contributions. That decision will have a big impact on citizens […]

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