Friday, February 20, 2009

Measuring caps on the Mohs scale.

There are several notorious topics to pick up after my sabbatical from this blog. My favorite format on this blog has been the debate format, so let's start with a discussion of the hard cap on spending which I believe will be on the ballot in May. (Part of the compromise made with Republicans for a fifth of their votes.)  If voters approve the proposition (I'm guessing,) the spending side of the state budget will be limited to current spending plus a growth factor, likely to equal population growth plus inflation.

There's no question a hard cap causes realistic concerns for the future of this system and, more importantly, the people the system serves. But the notion not only attacks the principle of a community digging in to support the needs of their neighbors, it also defends the principle of good government. As with previous debate posts (here and here,) I'll post five arguments for and against a proposition and invite commenters to give their own opinions.

The proposition:  A hard cap on state spending may benefit people supported by California's developmental disability system.

Pro:
1. With the size of government set in the constitution, the focus may move from polarizing and tiresome demagoguery to governance.  The debate I listened to from the Senate Gallery on Wednesday and read in the press was a competition between a philosophy that taxes are the root of all evil and one that government spending is the sole source of earthly virtue.  If the voters set the proper size of government, legislators can turn to subtler and more constructive discussions of priorities and process.  Of course, we'll probably need a whole different set of legislators to grasp the concept.
2.  Under a spending cap regime, voters will have to better interrogate their own values.  As dismal as our legislators have been, their most meritorious action has been to claim to represent their constituents.  In proposition after proposition and election after election, spending whether for water, punishment or people with problems seems to get our rubber stamp.  If the hard cap requires that long imprisonments and prosperous prison guards must be weighed against help for people born challenged, it is entirely possible that we discover ourselves to be a little more Tamino with our neighbors and a little less Night Queen.  A society that chose help for a struggling neighbor over vengeance upon an erring one might be easier for the disabled to integrate into.
3.  A leaner system might produce better outcomes.  Another way our State has failed to choose is between the well-intentioned control-freak and the good-hearted failure.  Regulations build up in our system for good reasons but without any cost-benefit analysis.  Meanwhile, the system does not discriminate between (or identify) functionaries and agencies that are highly productive and those that kindly serve badly.  There are often many people who have to say yes before an individual can be served, or their services can change.  Heaven alone knows how many people are struggling needlessly due to ineffective support.  Hell has the accounting on needless regulatory costs. If this system has to struggle with choices, some of the energy and resources we lose might well be doing mild harm or weak good while stronger support is available
4.  A trade-off between growth and predictability has value.  The cycle has quickened from annual to pretty near monthly in which promises are made, budget crises confessed,promises revoked, outrage erupts and the promises get restated but only partially and decreasingly kept.  It's hard to imagine who benefits from such chaos.  A system in which per-person funding declined slowly and predictably might be better than such a volatile one, even setting aside that the funding outcome might not be worse.  A learning system could probably improve efficiency and keep pace with the declines in capacity if those declines were predictable.  Morever, it is unrealistic to think government can continue to grow sustainably  as a share of society.  
5.  We have more important battles to fight.  This is almost corollary to the point above, but I remember a conversation with the mother of a 40-year-old with autism when her son was about 32. My friend said, at a protest of budget cuts, that we haven't even started the right war yet.  The important struggle has always been making the system work better for those it serves.  At least since I got here in 2000, the urgent one has been funding.  Steven Covey says that what is important but not urgent makes the best use of time.

Con:
1.  Changes in the frequency and severity of developmental disabilities do not track the population and or correlate with inflation.  Duh.  The increasing frequency of autism, for example, had nothing to do with the factors which will ultimately determine the total size of the state budget.  Once a hard cap is enshrined in the constitution, the state will lose flexibility to address important changes.
2.  See #2 of the pro arguments.  We might also discover that as a people we really prefer to persecute our neighbors than to meet them.  In fact, I kinda do.
3.  Competition for state funds favors the many and the well-funded.  Even after clients, families, support staff and people of conscience are totaled up, those who fear crime, want wider roads and/or use marijuana outnumber us.  Teachers, prison guards and ne'er-do-wells are more organized and wealthier.  In an uncapped budget, there are two ways we can grow: by winning an argument with other beneficiaries or one with tax protestors.  Under a hard cap, we can only grow at the expense of another beneficiary.  What's more, other beneficiaries will see us the same way.
4.  There is no reason to think our system will get smarter as it gets leaner.  The record so far: We cut less costly and more integrated service modalities more aggressively than more expensive and segregated ones.  We cut low-cost providers proportionally with more expensive providers of the same service.  Most new regulations are written for the purpose of containing cost and avoiding risk, not to make services more efficient or integrative.  The best and smartest advocates our system has had in the legislature haven't succeeded in making positive reforms.  Nothing has been accomplished in my time here to make the market mechanisms in the system work to allow useful accountability, transparency or information to clients or family members.  A cheap dumb system is unlikely to function as well as a prosperous dumb system.
5.  Are self-directed services rolled out yet?  Right.  SDS in many ways represents a miniature of  the best we could hope for from a capped state government and three gubernatorial terms have not brought it to statewide reality.  Unpromising.

OK, y'all's turn.