Price of Bigotry is Big Government

The national debate over Immigration reform is, in the words of CNN’s Wolf Blitzer – a man not prone to understatement – “widening a crack within the Republican Party.” He’s only slightly exaggerating. Because unless Republicans come to their senses and stop tearing each other – and Immigration Reform itself – apart the Grand Old Party may learn that the wages of bigotry is, in fact, big government.

Before sending me off to college on the East Coast, my father told me to know what I believe in and apply those principles religiously. Well, what I’ve come to realize is that I kneel at the church of limited government.

Generally, I have applied this philosophy in approaching the immigration debate. That’s led me to support proposals which would allow for people already here to gain the right to work and perhaps, over time, to earn citizenship. But what gets me sounding like a right-wing member of Congress is when it comes to the provision of government services to illegal immigrants. It almost makes me want to type the words in all-caps…ILLEGAL IMMIGRANTS!!!…just to get it out of my system.

Take for example the case of Antonio Villaraigosa, the Democratic Mayor of Los Angeles. He wants to put a $1 billion bond on the November 2006 ballot to build affordable housing. If you’ve tried finding a place to live in Los Angeles, you know that we need to do something for working people who make less than six digits, and the plan to subsidize private development of affordable housing makes sense.

Well, an Affordable Housing bond makes sense until you realize that Fair Housing Laws prevent discrimination on the basis of someone’s legal status—which means that the City of Los Angeles is asking voters to raise their own taxes in order to give cheap housing to ILLEGAL IMMIGRANTS!!! It’s not that I have anything against immigrants – it’s that I object to our country opening up my wallet to redistribute wealth to just about anyone who comes across the border.

I think most Republicans – and if the 1994 vote on Proposition 187 was any indication, most Americans – find something offensive about the idea cross-border carpet-bagging freeloaders. Come here and work, and we’re fine with immigrants. But come to suckle off the government dole and there’s a problem.

Republicans have gone astray in attacking the wrong head of this two-headed monster. Instead of trying to go after big government, Republicans in Congress are attacking the immigrants…and in the process, making Government even bigger.

Just this week, on the floor of the United States Senate, two Republicans proposed raising taxes by eliminating the Earned Income Tax Credit for immigrant workers. That’s just the latest. Proposals to secure the border only create more government bureaucracy, and the crackdown on employers who hire ILLEGAL IMMIGRANTS will only burden an economy that is shaking of the post 9-11 recession.

Higher taxes, bloated bureaucracy and economic stagnation are the cost some Republicans seem willing to pay for their attacks on immigrants – but I have to wonder if people wouldn’t mind welcoming migrant workers into our country so much if, instead, we started slaying the beast that is Big Government.

Italian superstitions? You bet

Got my number

I managed to change a train ticket in Venice at the last minute. It was a major triumph.

First Jabba the Hut behind the counter puffed at me, saying he wasn’t sure he could change my Internet ticket. So I Spaniel-eyed him.

He reconsidered. Then punched in a few things with monstrously fat fingers and waited for the computer’s verdict.

“You shouldn’t have fought with your boyfriend,” he commented, smiling through a row of green-gray teeth. Because, of course, the only reason a woman would need to get the hell out of Dodge in a hurry would be a love spat.

Anyway, he managed to get me on a Cisalpino — great but rare Swiss trains — leaving in 10 minutes. I said “grazie” and ran.

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Italy’s Strike Predictor

In most countries, people check the weather forecast before leaving the house.
They may also check traffic. Or, with skyrocketing gas costs, prices at the pump.
In Italy, people check the strike-o-meter, or scioperometro, a strike forecast published on the Internet.

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Italians, with strong union representation, are some of the most active strikers in all of Europe. They are fourth with an average of 113 days lost per 1,000 workers in protests.
As a freelancer who usually works from home, they don’t affect me that much. But the law of travel in the Bel Paese states that if you have to go anywhere, especially from one city to another, more than once in a month you’ll get nailed by some sort of transport strike.

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Public Rejects False Choices on Immigration

For the first time since the national debate on immigration began, pollsters went to the people to ask Americans what they really want. Faced with to seemingly irreconcilable choices on Capitol Hill, the public came back and said, “we want both!”
In a nationwide survey conducted by the Los Angeles Times, a majority of Americans said they’d support the Democratic plan to allow undocumented workers to get a path to citizenship. In the same survey, more Americans were for fencing off the border than were against it. A majority also supported creating a guest-worker program.
Cheers can be heard coming from all corners of Capitol Hill as everyone can now say they’re trying to implement the will of the people.
But the people pulled a fast one on Congress, rejecting the false dichotomy of the partisan choices. Forced to choose between one solution or both, those polled said by a 2-to-1 margin that they’d take both stronger enforcement and a guest worker program. Heh.
Similar results came out of California this week in the Field Poll’s bilingual survey of Californians.
Californians favor: a path to citizenship, a guest-worker program, penalties on employers of illegal immigrants, and requiring immigrants who have been here less than two years to leave the country. Practically the only things we’re against are giving illegals drivers’ licenses and arresting illegal aliens and charging them with a felony.
So while politicians in Washington bicker about who’s at fault for stalling the Senate compromise on Immigration reform, the public is seriously engaging in the issue and forming their own opinions.
Mostly, they favor an approach which embraces both the Democrats’ and the Republicans’ proposals to grant rights to immigrants already here and toughen enforcement at the border. In other words, most Americans probably support George Bush’s proposals—just don’t ask the question that way on a poll!

Boys R Us

I remember a time back when my sons were little when, up to my eyeballs in loud, hyperactive Cub Scouts, I mused to the mom helping me out that it might be nice if they were all calm, quiet little girls.
She rolled her eyes and said, “You don’t have any girls, do you?”
No. I don’t. There were never girls. I grew up with all boys. I gave birth to all boys. All my life it’s been boys, boys, boys.
As a child this wasn’t so bad except for the fact that all the hand-me-downs had a definite masculine slant, causing my mother to overdo it in the other direction when “dressing me up.” So I either looked like Scout from To Kill a Mockingbird or Little Bo Peep. And, while you would think this would be wonderful for a teenaged girl, all the guys surrounding me were relatives who hung out with each other rather than bring an eligible male around for their sister/cousin.
When it came time for me to have children, I thought surely I’d put in enough man-hours to deserve to give birth to at least one daughter. With confidence I made a deal with my husband that he could name the boys if I could name the girls.
But it was not to be. (I picked out the name Eliza, which I think is still a great name for a girl, if anyone wants to use it.)
Ironically, all our friends are in the opposite boat. Everyone we know has a plethora of girls. So, thankfully, just when I begin to feel sorry for myself, life reminds me that I probably wasn’t cut out to raise girls.
For instance: You know when you go into a Toys R Us and you see a pink glow in the distance? That is called “The Barbie Aisle.” I never have to go there and see what a cheap tart the once fashion-elegant icon has become.
And then there is the girl-noise, which is vastly different from boy-noise. Boys yell, stomp around and sweep through a room like a tornado. Not pleasant, but it’s better than, say, dental surgery. But I’ll open wide and say “ah” before subjecting myself to that screeching and screaming emitted by a group of little girls.

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Italian Politics for Beginners

Primary ballot

I finally got an ‘admit one’ ticket to the circus of Italian politics. Well, sort of.
I voted. In a way.
Milan is holding primary elections for center-left mayoral candidates and immigrants can join the fun, too.

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Busboys On The Street

Everybody’s a critic but some critics – particularly those with real-world experience – shouldn’t be ignored. My last pair of columns discussing the uninsured and San Francisco Supervisor Tom Ammiano’s proposal to get city employers to cover their employees health care costs caused a moderate amount of fuss. One San Francisco restaurateur told me in a series of emails that the new law would put essentially him out of business. I think he’s actually wrong, but he does point out why, politically, pay-or-play is so tough, and also why it’s bad public policy. So let’s talk about the Incanto problem, and then we’ll hint at some solutions.

What’s the Incanto problem? Incanto is a fine restaurant in San Francisco’s Noe valley neighborhood. By San Francisco standards it’s not particularly expensive, but it’s not cheap eats. Furthermore, restaurants like this are one of the main reasons why San Francisco is such a great place to live, and we don’t all sell up and move to (insert name of podunk town here) instead. Incanto’s owner Mark Pastore took issue with my remark that pay-or-play wouldn’t be that disastrous because many of the businesses that would be forced to pay for their employees health insurance couldn’t move, and would stick their prices up instead. Here’s Mark’s experience:

There are limits (in economics the concept is known as price elasticity) to increasing revenues by raising prices. In my own restaurant, which is considered one of the better restaurants in the Bay Area, our prices increased slightly in 2005 (3-4%), however our total revenues declined slightly versus the prior year.

In other words the consumer wouldn’t deal with the price increase, costs went up and profits went down. Now the marginal dollar that was no longer being spent at Incanto got spent somewhere, presumably not on dining out, or, if so, at a cheaper restaurant. Now, that may not matter to economists or health care consultants too much, it matters like heck to Mark and his fellow owners. So even though I can cite evidence that these forced wage increases on a city or national level don’t impact unemployment overall, they may cause an adjustment in employment. This will necessarily be exacerbated in the San Francisco proposal where employers with fewer than 20 employees won’t have to pay into the insurance fund, and therefore will have a big cost advantage over those that do. So you can expect an enormous amount of opposition to this from people directly affected, who will make their feelings very well known, whereas it’s hard to identify businesses that will gain (even if some do).

The ordinance may avoid his Gavness’ veto — don’t forget that Newsom ran a group of restaurants but is also responsible for the city budget — much of which goes on the spending on the uninsured at SF General hospital. If it does, you can expect that lots of restaurants that were 40 tables and 25 employees suddenly lose 20% of both. Lots of other small businesses will get smaller and split into two, delivering a mini-boom for creative lawyers and accountants.

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Pain All Around

For our next adventure in the American health care system we are going to look at a heated debate in San Francisco, one that nicely sums up the problems with the health care systems but fails to answer – really – the tough questions.
City Supervisor Tom Ammiano is demanding that that city businesses with 20 or more employees begin providing insurance for anyone who works more than 18.5 hours a week. It’s a political stake in the ground that Ammiano – who led the fight to have employers give spousal benefits to same-sex domestic partners – seems to intend as his political legacy.
But there are some practical politics at work here, too. To be sure there’s lots in the mix (Ammiano has enjoyed lots of support from the city’s unions, for instance), but it won’t have escaped the attention of the city’s more moderate politicians that one of San Francisco’s major liabilities is its general hospital. Like many cities, San Francisco is a health care provider. And SF General is located close to the poorer end of town. As we’ll see, that means – like urban hospitals across the country – it doesn’t enjoy the same clientele as say Sutter’s Cal Pacific hospital over in tony Pacific Heights. So getting employers to insure their employee isn’t just a feel-good idea that plays well politically; it’s a bottom-line issue as well. As we’ll see, If more low-wage earners showed up at SF General with health insurance their care would cost the city (and its taxpayers) much less.
But Ammiano’s proposal is a band-aid, not a solution. And while it’s political appeal – saving the city money – may well get his proposal adopted by even by business-minded moderates on the Board of Supervisiors, it’s not getting at some of the real problems with the health care system.

It’s not just uninsurance that’s the problem. Large numbers of Americans are significantly under-insured too. The under-insured tend to have either limited coverage for the first several thousand dollars of care, or have certain conditions excluded from their insurance, or in a small number of cases they have a policy but it doesn’t cover real catastrophes. Many university policies that cover students are like this–they often top out at less than a few hundred thousand dollars, which may not be enough if something goes badly wrong.

To remedy the number or uninsured and to make sure that they’re not just replaced by the highly under-insured, Ammiano’s proposal requires employers to spend as much as the city does – $345 monthly each – on insurance for employees. Not surprising, that element of the program is what has employers really up in arms and is the least likely to be written into law.

I explained last column why the presence of the uninsured allows the health care system to go on raising its prices willy-nilly, and how that hurts the rest of us. But today I’ll touch more on who gets directly hurt by uninsurance and how that relates to what’s being discussed here in San Francisco.

How many uninsured people are there? The number has actually been remarkably stable in the US over recent years. Employers have been dropping benefits coverage rapidly, Medicaid – that’s you the taxpayer – has made a valiant effort to pick up the slack by expanding coverage, especially for children. Don’t forget that we have a universal single payer system for the elderly called Medicare, so there are no uninsured older than 65. (That’s one reason we don’t have a universal insurance care system for the rest of us, but that’s a subject for another day).

What’s important is that the uninsured are not a stable bunch. Roughly 8% of Americans are hard-core uninsured, and have been that way for 2 years or more. The 45 million (or 16% number you hear often) is a snapshot. That’s the number of uninsured right now. But there are a hell of a lot more people cycling through that number; the best estimates are that over a two year period, some 80-90 million people will be without insurance for a brief – a few months – period. So effectively some 30% of American adults have experienced being uninsured.

Who are they? We have seen them and they’re us.

Kaiser Family Foundation has done a fantastic job quantifying the uninsured for years. 81% of them are working or are in a family that has at least someone working part-time. They are more likely to be poor and/or ethnic minorities, but there’s a sizable contingent from households who earn significantly more than poverty level incomes. Seven percent of those in households earning three times the Federal poverty level or more are uninsured — even if those of you paying mortgages in San Francisco may not realize that $60,000 a year is not a poverty level income!

More importantly, what’s the impact of uninsurance? Not surprisingly the uninsured get less access to care and have less money spent on their care than the rest of us (about 50% of the average).  And they are far more likely to skip recommended or necessary care, not be able to pay their medical bills, or not fill a needed prescription. And as you can imagine, given that prevention is better and cheaper than cure in virtually every sphere of life, this does come back to haunt them. The Institute of Medicine estimated that 18,000 deaths a year can be attributed to uninsurance. So skipping your medical insurance because you don’t remember being unhealthy is not such a great idea.

But there’s is another, less obvious, group that suffers from uninsurance. It’s health care providers. And as with everything else, in health care the distribution of hurt is not even. Providers who are geographically located in areas where there are more likely to be more poor and minorities – say, the Southern reaches of San Francisco near the Latino-heavy Mission and Excelsior neighborhood – are more likely to have the uninsured showing up on their doorsteps seeking help. So much so that there’s actually a Federal designation for hospitals like SF General which enjoy what the industry euphemistically terms a “poor payer-mix”. The designation is called “disproportionate share hospital” (known as DiSH) and like most Federal designations it comes with dollars attached, in this case via the Medicaid program. And most of these dollars go to the big inner-city hospitals and rural hospitals that you’d expect they’d end up at.

But of course there are not enough dollars to make up the difference. If you look at the profit margins of hospitals that receive DiSH money compared to those that cleverly chose to locate in affluent suburbs near patients with good insurance, you’d see that the safety-net hospitals barely scrape by while the rest make 3% margins in a bad year and 6-10% in a good one. (Don’t worry, those numbers get buried deep enough in the non-profit hospital accounting world so that no one notices). And hospitals in the suburbs – or nice neighborhoods like Pacific Heights – are on the mother of all building booms right now, so that they are ready for the time when the baby boomers hit Medicare in 2010.  Yes, unless you don’t intend paying taxes in the future, you’ll be paying for that too. 

There’s way more to this. But in summary Ammiano’s proposal is a doomed local attempt to fix something that just escaped reform at the state level last year and the national one in 1994. But that story will have to wait till next week. For now realize that uninsurance does actually matter in more ways than you’d might think. And ponder the realization that the type of person likely to be uninsured (young, poor, a minority) is also the type of person not likely to vote.

Editor’s note:This entry was written by Matthew Holt but, for technical reasons, posted by Spot-on editor Chris Nolan.

Au Revoir Mon Minivan

Dear reader, please forgive my reddened eyes, my tear tracks, my sighs. it’s just that we’ve decided to sell the minivan.
A suburban mom without a minivan is like a knight without his steed, a snail without its shell, a mail carrier without her bag, a fast food joint without its garbage cans; she is lost, vulnerable, defenseless, reduced to only what she can carry in her hands and stuff in the basket under the stroller, she is without a base, without a trusty friend, she is, in short – an SUV driver.
No, no, not that, I assure you, my friends. Although many suburban families do believe they somehow increase their coolness factor by driving an overpriced, ill-famed hunk of monster metal so they can pretend they off-road through ecologically sensitive desert terrain, instead of driving the ever-useful and often-humble minivan, we’re not going that route.
No, we’re giving up my mother’s little helper because we’re moving to Spain. While it’s relatively inexpensive to ship a car there, there are apparently quite a few hassles getting it through customs and adapted to EU car standards. But mostly, we’re not sure if it will be useful. If we live in its natural habitat, a suburb, of course it will fit right in; but if we live in the city or even a village, with street construction a carryover from foot and horsie days, then, well, the poor thing might have to be shot when it gets stuck trying to turn a corner somewhere. Or abandoned when it knocks down a few pillars in a city parking garage designed for Matchbox-sized cars. And that’s possible even though it’s on the smaller end of minivans. So we’re leaving it behind.
I’ve never cared about cars, or even liked them much, but, ah, my minivan. The thing is, it’s not a car, it’s more like a really big tote bag on wheels. With room for the kids, of course. And it helps uphold the U.S. competitive advantage in number of cup holders per vehicle. With the kids’ car seats we have nine individual places for drinks. Take that, you scooter-riding Euros. Sure, you look great in your miniskirts and your leather jackets whizzing around on your Vespas, but where do you keep your Big Gulps? Huh? Ha! You don’t, do you? You stop at cafes when you need something to drink. And where’s the efficiency in that? Ha! Over here, we even have cup holders in our ride-on mowers. Now that can make you think of some fun ways to spend a Saturday. Top that!
But of course, now we’re off to Vespa-land, or the dinky little sedan equivalent. Europeans drive cars that a Hummer wouldn’t even consider a worthy snack. Yes, you know, there’s that much more expensive gas thing and there’s the shorter distances thing and there’s the everything is more smooshed together over there thing, and there’s also that decent public transportation thing, so Euros seem quite happy with their cute little cars, and subways and trains and buses and trams.
Like many people I had to overcome the initial recoil from buying a minivan. No one wants to think of herself as a boring, clichéd suburban mother carpooling around in her minivan. But then I got in, and I found I had more parity with the big beasts on the highway, I saw the nets and the hooks and the drawers and the cubbies, and the extra room to sit even with the car seats in, and I decided I still don’t need to be defined by what I drive. And it’s not like all Minivan Moms sweetly tool around in them with a sedate, earth mother generosity. Plus, I figure if a red sports car is the ultimate cop magnet, a white (safety color!) minivan is just the opposite. So you do not want to get in my way when I’m late for a kindergarten pickup.
Disagree with me? Come say that standing right here in front of my bumper, buddy. Oh, forgive me, I’m just a little upset these days – we’ve decided to sell the minivan.