CMA Capitol Insight
January 17, 2011

Welcome to the debut issue of CMA Capitol Insight. For those of you who have walked the halls of the California State Capitol, you know it is akin to visiting a foreign land, with an equally foreign language. To provide CMA members with some insight from the inside, we have asked Greg Lucas, a reporter who covered the state Capitol for the San Francisco Chronicle for 19 years, to write a regular column for us.

We will publish a new column from Greg every two weeks, and we invite you to visit his blog at www.californiascapitol.com. Greg promises to deliver an inside report from under the Capitol dome that begins with some musings on our newly inaugurated governor. We hope you garner a new perspective and that you have a laugh or two in the process.

Enjoy,
Dustin Corcoran
Dustin Corcoran
CEO, California Medical Association


Same Old, Same Old... Edmund G. Brown Jr.'s first state budget proposal in 28 years contains more of what was proposed all too frequently under his GOP predecessor – a reduction in rates paid to doctors, pharmacists, clinics, some hospitals and other providers of services under Medi-Cal, the state's health care system for the poor. The Democratic governor's proposal, on its surface, doesn't seem any different than the previous 10-percent rate reductions proposed by Gov. Arnold Schwarzenegger in February and September 2008. The federal Ninth Circuit Court of Appeals swatted down both attempts. Brown notes in his budget summary that the state has appealed the Ninth Circuit's ruling to the U.S. Supreme Court, which is expected to decide this month whether to hear the case. If the court agrees to review the case and if the state wins, there's a savings of $709 million. If not, there's a $709 million hole to fill.

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Unrepentant Quipster... Jerry Brown can't help himself. There may not be a song in his heart but, more often than not, there's a quip on his lips. Famously, during the oath of office at his inauguration, he turned to the audience of Sacramento's Memorial Auditorium and said, "Really, no mental reservations." After introducing his budget proposal on Jan. 10, Brown was asked how he would convince California to continue paying $8.3 billion in "temporary" taxes. He said he would pitch the proposal to Republicans and the business community. "So I will sometimes go into the lion's den and see if I can satisfy them with less red meat than they're accustomed to." Asked where money to finance the campaign to convince Californians to keep paying higher taxes would come from, Brown said: "There are a number of people that spend a lot of money on campaigns. I think I'll check in with them." Then, in a seeming reference to his GOP opponent Meg Whitman, "It's amazing how much money people are willing to spend in political campaigns." If voters in a June special election don't approve keeping the taxes, additional budget cuts will be "extremely difficult. Even draconian, if I can use that word," Brown said. "And Dracon was not a very kindly chief executive."

(Dracon, also Draco, was a lawgiver from ancient Greece whose code was particularly harsh imposing the death penalty for what today would be considered parking violations. Plutarch, the Roman biographer, said Dracon thought such crimes deserve death and he couldn't think of anything harsher for the more serious ones.)

Speaking of death...

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Few Are Called, Even Fewer Can Answer... Hopefully an apocryphal yarn but reportedly not, the once-and-current governor is said to have given a list of potential appointees to a staffer to do some digging into their backgrounds. For several of the septuagenarian Brown's choices, no digging was necessary – the potential appointees were already at six feet.

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Josiah Who?... In what passes for political discourse in the 21st century, there's a fairly finite number of people who get quoted by politicians. Like so many things at the Capitol, it tends to be partisan. Democrats quote Martin Luther King, Jr., RFK, and César Chávez. Republicans go for Ronald Reagan and Abraham Lincoln who, like Richard Nixon – the 90th anniversary of his birthday was Jan. 10 – probably couldn't get elected as Republicans today. Both sides quote John Kennedy. And whenever a politician of either stripe wants to be droll, it's something pithy allegedly said by Mark Twain or Winston Churchill. (Much of what's attributed to them they never uttered but no doubt wished they had!) But that's not how California's iconoclastic 39th governor operates. The key to transcending partisan gridlock, according to Brown in his inaugural speech, is to embrace Josiah Royce's "philosophy of loyalty." Not exactly hitting Joe, Joan, Joaquin and Juanita Bag O' Donuts where they live, but classic Brown, nonetheless. Royce, 1855 – 1916, was born in Grass Valley, Calif., and from 1900 until his death was one of the most influential philosophers around. He created an ethical system based on loyalty, which has to be expressed socially through commitment to something greater than oneself: a cause, a vocation, some community of like-minded persons. Physicians, for example, share common ideals to which they are loyal – healing the sick, doing no harm and so on. The highest good for Royce is to give "loyalty to loyalty" – commit to a cause that helps create more opportunities for others to express their loyalty. And for Royce, the best thing to be loyal to is a "lost" cause, one that won't be realized in the individual's – or the community's – lifetime. Like world peace. Or, as Brown said, bettering California for those who follow. It's easy to see how this service to a higher calling might appeal to someone who entered a seminary and spent time with Mother Teresa after his first two terms as governor. But getting enough politicians – and, more importantly, Californians – to embrace a cause as amorphous as "California" is a tall order.

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Viva la Difference...Brown is a far different person than his GOP predecessor, Arnold Schwarzenegger. Most noticeably, Brown has no hair – burnt sienna, mahogany or otherwise. Brown will live in a midtown Sacramento loft from which he can walk to work. Schwarzenegger had a penthouse atop the downtown Hyatt, flying back and forth from Los Angeles on a private jet. Brown walks through the Capitol hallways without security sealing them off and enters the governor's office by the front doors, not through the private elevator from the Capitol's basement parking lot. Brown is into jogging and treadmills, not free weights. Nor does Brown countenance a phalanx of security personnel shadowing him. SUVs and Hummers are out. Think Crown Victoria. And, under Brown, experience is a plus, not a pejorative. That's just how it is: Older folks tend to listen more to old hands.

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The Times They Are a 'Changin'... During his campaign for the not-so-Golden State's most dead-end job, Brown often told audiences he hasn't been in Sacramento for 28 years. A lot has changed in the City of Trees since 1982. (The nickname stems – pun intended – from a claim that only Paris has more trees per capita than Sac-a-tomatoes. Bean counters, sure. But tree counters?) Things outside of the state Capitol are kind of different too. Consider: In 1983, one year after Brown unsuccessfully ran for U.S. Senate, HIV was identified. The following year, a vaccine was created for leprosy. In 1986, the first human coronary heart stent implant. The following year, disposable contact lenses were introduced and DNA was first used to convict criminals. Eight years after Brown left office came the Internet, revolutionizing pretty much everything. Simvastin. Lipitor. Rogaine. Mevacor. Celebrex. Crestor. Nexium. All within the last 15 years. Protease inhibitors. In 1998, Sildenafil. Retinal implants. fMRI. Wellbutrin. Gleevec. Stem cell research. Human genome mapping. The first "draft" was in 2000, Brown's second year as mayor of Oakland. Still haven't found a way to take a blood sample without needles – ouch – a sad state of affairs over which only phlebotomists rejoice.

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CMA Capitol insight is a biweekly publication for members of the California Medical Association.