This week’s OregonPEN is the last issue before the start of the 2016 legislative session, which promises to further highlight the extreme fragility and brittleness in in Oregon’s haphazard kludge of a tax and revenue-raising “system,” which includes the State Lottery, a special tax levied almost entirely on people with who suffer from any of a number of disabilities that are known to cause the impairment in judgment necessary to produce the participation that we choose to call “voluntary.”
The unceasing pressure to raise greater and greater revenue streams in a stagnant or contracting state economy creates exponentially greater tensions in the political arena. Senate President Peter Courtney predicts a disastrous session marked by such fierce warfare as to justify comparisons to the Battle of Antietam, the bloodiest day in America’s pugnacious history. The short, 35-day session is likely to be followed by competing initiative campaigns to raise Oregon’s minimum wage and to tax large corporations, among other hotly contested issues.
Both of those ideas are attempts to reverse just some of the dramatic losses that individuals have suffered, as workers and taxpayers, in the roughly 35 years since Ronald Reagan carried Oregon’s then-six electoral votes. Since then, Oregonians have waged increasingly bitter election campaigns and struggled mightily to find the magic lamp with a genie who can produce the fruits of economic expansion despite forces of contraction pressing on the state’s economic fortunes in all directions.
Thus, with the shooting about to resume, this is an opportune issue in which to highlight the important news that Oregon can, if it chooses, raise the revenue needed to operate a modern economy without the zero-sum politics that characterizes tax policy today and that regularly pits students and workers against retirees, the students and workers of prior years. But we first have to understand why our system is so poorly performing today.
Oregon: A Pogo Stick Instead of a Three-Legged Stool
Oregon’s methods of raising the funds needed to pay for public services combines the simplicity of a Rube Goldberg-designed cuckoo clock with the robust stability of a sand-castle built on the beach at low tide.
Although most state public finance systems rely on what is called a “three-legged stool” of taxes (income tax, property tax, and sales tax). In most states, the three main taxes differ enough to reduce the overall variability felt during recessions, as sales taxes help cushion falling income tax receipts. Property values do fluctuate, but because the property owning class and investing class is very different from the people who depend on wages, there are substantially different time periods involved in the cycles of wages versus the cycle of property values. (Even in recessions severe enough to force individuals to return to renting, the global pool of investors seeking investment property props up the values.)
The net effect is a much greater stability in state revenue pools fed by all three revenue streams.
Oregonians famously refuse any form of sales tax entirely, and we further allowed ourselves to be conned into approving strict property tax limitation measures. Thus, instead of a solid base with three supports, Oregon’s revenue is, functionally, a pogo stick with a shortened mainspring, where the truncated spring represents the effect of our property tax limitations.
Staying upright on any pogo stick is hard enough, much less making progress towards a desired destination; it requires constant exertion and attention just to stay in place. But Oregon’s specially hobbled pogo stick presents an even greater challenge. Our over-reliance on the income tax as our revenue mainspring means we get an amplified, painful jolt whenever incomes and income taxes fall, such as when national trends compress the state economy. There is no sales tax, and no matter how far incomes fall, the revenue boost available from property taxes is sharply limited. Without state revenue available to make Keynesian investments, the contractions in the business cycle are made more severe and last longer.
As if all that wasn’t bad enough, we have to add Oregon’s bizarre state tax “kicker” law to our understanding. If raising the funds needed to pay for services in Oregon requires keeping upright and balanced while jumping up and down on a hobbled pogo stick, the kicker moves the whole show into a concrete basement –with a very low ceiling.
Then there are the usual problems common to other states as well: balanced budget requirements coupled with laws that make no distinction between operating expenses and spending on capital improvements that pay for themselves over time.
It’s really no wonder that Oregon’s economy struggles. We exhaust ourselves just trying to stay in one place, even as our spending needs operate independently of any of the limits we place on ourselves in terms of raising revenues.
Worst of all, our over-reliance on income taxes means that we are heavily dependent on taxing – discouraging – income, which is the very thing we hope to encourage with much of our public spending. It’s as if we are driving with our foot on the brake and the gas at the same time, wondering why the engine overheats and breaks down so much.
Time to Get Off the Pogo Stick. It’s Time to Root our Tax System in Oregon Itself
There ARE solutions to our funding problems, ways that would let us get off the pogo stick that gives us a painful jolt every time the spring bottoms out and hurts our head whenever we smash against the ceiling kicker.
But implementing the solutions requires being willing to think about the problem of raising revenue in a new way, with the “how” first, rather than the “who” first. Oregonians never sat down and created our tax system from a clean slate, but ever since the days of the pioneers, the effort has been, as anywhere, to put the tax burden where it belongs, which is anywhere other than present company – and that applies for all values of present company, all across Oregon. When social scientists say that Oregon is one of the least religious states in America, that is only because tax avoidance and tax hatred is not a recognized faith.
This issue of OregonPEN focuses on the first, most fundamental change we need to stabilize our tax system and to improve how we pay for things, regardless of how much we pay.
Because our tax system is and always has been so dependent on income, we have an extraordinarily complex and inefficient system, since the income subject to an income tax is a defined quantity, and each definition is subject to countless exceptions, both intended and otherwise (exceptions to the definition of income are generally known as obvious or common sense when used by present company and loopholes when used by others).
A better tax basis than income, which is a purely defined quantity, is one where the tax basis is a real quality, and where that real quality is objective and apparent to all, rather than being something that can only be discovered by an accountant operating thousands of definitions in the aptly named “tax code” (where code means a system of sharing information with chosen allies while serving to confound all others).
As the articles in this issue will argue, the best basis for a tax system is with the basis for the state itself, the very land that makes up the state. And it is important to distinguish between land value taxation and property taxation, because property taxes – taxing both land and structures on the land -- work counterproductively, just like income taxes. That is because property taxes discourage the same things we want to encourage, improvements to land in places where people derive benefits from the improvements.
One metaphor to keep in mind throughout this issue of OregonPEN is that of the strong horse and the 200 pound weight. A healthy horse bears a 200 pound burden on its back with ease; but that same horse can be completely immobilized just by lashing the burden to the horse’s leg. Oregon is like a horse in that we have a burden we must bear, in this case the burden of raising the money we need to support the investments and services we want.
Sadly, while we expend thousands of hours fighting over the right size of the burden and millions of hours trying to shift the burden away from present company and onto “them,” we have given little or no thought to how we could go farther, faster, just by carrying that burden on our backs instead of having it tied to our legs. By taxing Oregon itself – the land value of our state, rather than the work of Oregonians or their improvements to the land – we can better carry the burden, and we would soon obtain the many additional benefits of a more efficient, transparent, honest revenue system.
Thoreau famously said that "There are a thousand hacking at the branches of evil to one who is striking at the root" and nowhere is that more true than in the area of tax policy, especially in Oregon, where a uniquely virulent refusal to think carefully about taxes has produced a distorted and dysfunctional tax system that has virtually no defenders, except for everyone who would rather live with the distorted and dysfunctional devil they know than one with any changes.
Consider the Oregon Center for Public Policy, a valuable and hard-working nonprofit that hacks away at the branches of Oregon's dysfunctional tax system by tirelessly studying and explaining how it works in plain English, year in and year out. OCPP does stalwart, intelligent work trying to get the word out about how the present tax system actually functions and contrasting that with the popular disinformation campaigns promoted about the tax system through interest groups seeking to bend the system further to their liking. Here's how OCPP describes itself:
The Oregon Center for Public Policy (OCPP) does in-depth research and analysis on budget, tax, and economic issues. Our goal is to improve decision-making and generate more opportunities for all Oregonians.
Another valuable nonprofit is Tax Fairness Oregon. Like OCPP, TFO works tirelessly to expose the distortions and giveaways proposed in Oregon tax policy. TFO strikes closer to the root of things by spotlighting the most egregious tax giveaways, which spring up every legislative session the way mushrooms spring up after a rain in an Oregon forest. TFO describes itself thus:
However, both groups operate entirely within the existing tax paradigm, never addressing whether we could ever find a way to raise revenue for public spending that was less vulnerable to finagling by pressure groups.
By accepting the existing tax framework as a given, groups like OCPP and TFO essentially condemn themselves to a never-ending battle against a hydra. Recall that, in Greek myth, one of Hercules’s labors was to destroy the Hydra, a monster with nine poisonous serpent heads, one of which was immortal. Even worse, every time Hercules would chop off one of the hydra’s heads, two would sprout from the wound. Battling the serpent by hacking at the heads only put Hercules in greater and greater peril.
According to the myth, Hercules survived thanks to what we might say today was the first instance of “working smarter, not harder:” Instead of redoubling his efforts, Hercules changed tactics, winning by telling his nephew to cauterize the wound left by Hercules’s sword after each cut, preventing the new serpent heads from sprouting.
That is very much what is needed in Oregon tax policy: fighting the giveaways is not enough, because for every one defeated, a handful more are proposed. Every special tax break that is proposed, even those denied, just creates increased pressure for additional tax breaks for others.
Worse, a system riddled with favors and exceptions lets the media portray groups like OCPP and TFO – the very people fighting on behalf of everyday taxpayers – as enemies of taxpayers, because they are smeared in the media as “pro-tax.” And Oregon’s unstable pogo-stick tax system creates abundant opportunities for lobbyists to argue for exemptions, and legislators are hypnotized by lobbyist promises of jobs, sweet nothings like a lover’s promise to be faithful always.
There is a group in Oregon that recognizes the true nature of our problems and realizes that we have to fundamentally change the basis of the tax system if we want to be able to stop struggling to hack at the thousand tax-break branches and to fix the root of fiscal problems: our dangerous over-dependence on income taxes.
That group is Common Ground of Oregon and Washington, a chapter of CommonGround-USA. The unique insight of these Common Ground networks is that many of our most vexing public policy problems derive from what and how we choose to levy taxes, rather than the levels of taxation. The CommonGround-USA.net website offers two succinct statements of principles that should be much more widely recognized and applied in Oregon:
The Revenue Source is Under Our Feet
And a letter to mayors suggests how many of the benefits of a new tax paradigm would be felt right where they are most needed, our urban centers. As this issue of OregonPEN arrives, Portland is the "hottest" real estate market in the United States, which means only that more and more of the socially created value in Portland land is being captured by those who can speculate in land, and income is flowing upward, even as people are being made homeless by the rising values:
An Open Letter to the Mayors of the Cities and Towns in the United States
This insightful analysis from November 2000 is about Seattle, but it could be easily updated and slightly modified to reflect the slight differences in Portland, Oregon, circa. 2012 to the present. That is because the author zeroes in on the DNA-level factors that express themselves as urban blight and fiscal weakness wherever we tax land and improvements at the same rate.
And we have only to look at what has transpired in Seattle since this article to see what is impending for Portland and the metro area: staggeringly expensive infrastructure projects that lead to tax revolts, levels of inequality within the city not seen since pre-Revolutionary Paris, huge amounts of gridlock, rising levels of homelessness, and equally huge profit taking by speculators.
This insightful analysis is by one of the key figures in Common Ground OR-WA, Tom Gihring:
The Growing Housing Affordability Gap
February 14th marks two birthdays, Oregon’s and OregonPEN’s: One of many for the state (157th), but the very first for OregonPEN.
In keeping with OregonPEN’s mission of “giving readers news and commentary that empowers and engages, providing the knowledge and insights needed for making Oregon better,” OregonPEN is developing a policy agenda or framework to guide its reporting and editorial work for the next decade, a period likely to be marked by substantial, fundamental changes in Oregon and the rest of the world.
Although the elements or themes of the OregonPEN policy agenda outlined in this and future issues are not intended to be static necessarily, the final list, culled from many candidates, were chosen with the idea that these are profound enough that, if adopted, they have the potential to make a great positive difference in ordinary life. As such, it is unlikely that these will be attained quickly or easily. As a wise Wisconsin graduate, computer scientist and pioneer Howard Aiken, once noted, “Don’t worry about people stealing your ideas. If your ideas are any good, you’ll have to ram them down people’s throats.”
And so the OregonPEN agenda will probably change slowly, more often by accretion of new policies than through deletion following successful attainment. Which is not to say at all that the policies are unattainable; indeed, to be worth pursuing, a policy has to be pragmatically possible, because the view here is that Idealistic policy prescriptions that presume a better class of people are better left to the religious institutions, not newspapers. So the trait common to all the ideas in the OregonPEN agenda is down-to-earth applicability with the people we actually have around now. That’s because, while the status quo we have today – which is a society in advanced decline, with an increasingly sclerotic politics that is unable to engage with basic, well-recognized threats, and that is dominated by rapacious but only short-term self-interest – is advantageous for a tiny few, it is not in the best interests of most Oregonians to allow this to continue. And self-interest is the most reliable source of motivation for change.
Indeed, the dismal and worsening status quo maintains itself in large part only thanks to the failure of our corporate media competitors to do their job. The job of the press is not just amusement and the delivery of advertising. Rather, it is not only making sure that the people of Oregon know what’s wrong today but why, and how it can be fixed. That’s where today’s media entities are blocked, because they are controlled by and answer to their shareholders: who are the same shareholders in the corporations that are plundering in Oregon and around the world and making the dismal future an impending calamity.
Therefore, those media channels cannot offer their readers a clear view of the situation, because the last thing the corporations who own the media channels want is for ordinary Oregonians to understand our dire situation and that there are some fairly straightforward principles that, if adopted and implemented throughout Oregon, can reverse our decline and equip us to face the next century with confidence.
So it is left to OregonPEN to deliver the good news: we are not fated to become an increasingly corrupted and stratified society where the real decisions of life affecting everyone are made by a tiny handful of wealthy people in Mitt Romney’s “quiet rooms.” By observing just a handful of key principles, we can create a more just, happier, healthier, and much more anti-fragile society without any supernatural miracles and without a fundamental change in human nature required.
Beginning in this issue are some of those key ideas. OregonPEN will develop and return to these themes again and again in the next decade, and will use them as measurement standards when assessing the news, ideas, policies, and programs of others, especially those of governments.
There are two main families of electoral systems in the world: proportional and winner-take-all. All single-winner systems are, by definition, winner-take-all. Multi-winner systems may be proportional or winner-take all.
What is ranked choice voting?
Three sayings capture the public attitude about our politics today: The first is H.L. Mencken’s line that
"Democracy is the theory that the common people know what they want, and deserve to get it good and hard."
And the next two are bits of bumper sticker wisdom:
“Don’t vote, it only encourages them.”
“If voting changed anything, they’d make it illegal.”
What would it require to persuade people in Oregon stop thinking that politics is just another name for a con game?
Perhaps the most important place to start is by recognizing that selecting public officials by using the same basic rules and setup as Mixed-Martial Arts Cage Fighting Championships might have more than a bit to do with why our politics have become so polarized and negative.
Oregonians should also be made aware that there is an a long list of democracies that are not only formally democratic on paper, but also practically so, unlike the United States. And these are countries like ours, only with happier, more literate people, people who are better educated, more secure, less depressed, less violent, and much less afraid of their neighbors than we are.
The big difference is that their political systems both help to produce and to reflect a much more robust form of “pluralism” than we see here in America. Here, our cage-fight-rules politics has produces such a rock-hard gridlock that, nationally, we see the GOP giving up on the idea of democracy entirely and essentially declaring that a Democratic centrist administration is illegitimate and that the GOP’s mission is to prevent from governing at all, while creating an enormous backlog of federal court judicial vacancies and spreading the poison into the judiciary.
It is difficult to recall that there was a time in America when the minority on any question were supposed to be able to feel like “Well, I may not have gotten my way, but at least my position was heard and I gave it my best even though we lost. Now my job is to make the best of things and help things work out best for everyone. I don’t like the outcome, but the process was fair.”
That doesn’t occur now. Why not? Is it because Americans are uniquely toxic and somehow have become a nation of people who think the worst of each other and that each person only takes positions to gain political advantage over opponents?
No, Americans are not uniquely toxic. But the winner-take-all rules of American politics are uniquely good at accentuating the worst in the American people. In other words, this is a case where we really can and should blame “the system” rather than the flaws of individuals. Because we are no worse as individuals than we have ever been; but our electoral rules are also no better than they were in 1793, when we faced a vastly different set of problems.
Modern neuroscience confirms what social scientists have long thought: as humans, our reasoning tends to follow our feelings, rather than the other way around as political idealists would suggest. But our election methods, virtually unchanged since 17th Century Britain, elicit certain kinds of feelings – the kinds seen at a cockfights and cage fighting championships – so it’s no surprise that our politics reflect the cockfight-to-the-death mentality.
The first mistake we make is that we use geographic districts to decide who can sit as a representative of others, as if the most important aspect of a person needing expression in the halls of power is that a zip code. Under our rules, we say that the only thing that matters is the place where a citizen lays their head at night, rather than whether they had anything to eat that day, work that year, or faced barriers because of the color of their skin.
And the usual practice with district-based are inherent in single winner elections. If you use an antiquated voting technology that was capable of handling the original paperless ballots – a handful of wealthy white men voting out loud in groups – you can only get from it what that technology is capable of producing. And that’s a simple yes-no result, one winner, who wins it all, leaving no representation for the others.
Thus, in Oregon, we start with the premise that we must divide up the state into geographic districts, and have each district elect one person. This is the metaphorical DNA of our toxic politics, and that DNA inevitably expresses itself in our national body politic just as DNA expresses itself in the shape of every living organism.
Luckily, there’s a better way. We can have a better result by using larger, multiple-winner districts, or even let everyone vote for all the representatives at once, and then awarding seats to winners in proportion to the share of the vote received. Hence the term, “proportional representation,” or PR.
PR lets people form fluid political coalitions that can be but need not only be based on geography. Indeed, the virtue of PR is that it allows citizens to band together because of shared views on traits other than a common zip code. As a state with very polarized politics, Oregonians can easily understand that just living near someone doesn’t necessarily mean you share many values with them.
The issue is this: Politicians don't go into office to become neutral advocates and to present both sides of a question. No one goes to Congress or their state legislature and says "Gee, many people in my district feel this way, and many feel that way and there are good arguments for both sides and here's what I think, but I’m going to vote against what I think because I’m in the minority in my district."
That has long been an issue at the heart or a question at the heart of democratic theory: are representatives supposed to vote the way that the district majority wants or should representatives feel free to reject the wisdom of the people who elected the representative?
Our method of holding many parallel winner-take-all elections, one per district, also explain why we have the most toxic and the most expensive elections: in each district, the winner takes all dynamic drives up the costs because there is no logical endpoint to spending by the two contending factions when control of the state’s entire legislative agenda can ride on one individual race in a balanced district (almost nothing gets spent in “safe” districts, where the gerrymandering has produced a comfortable majority for one party or the other).
This motivation to unlimited spending is fueled by the zero sum nature of winner-take-all. Because there is no second place in a single-winner district, anything that helps candidate A comes at the expense of candidate B and vice versa. Therefore, no matter how much has already been spent, there is no logical limit to future spending before election day, because only the winner gets any reward.
The solution is to realize that we’re asking the wrong thing of our politicians.
Basically, we should stop asking politicians to “represent” people whose views they staunchly oppose. That means the views of the voters in the district who did not vote for the winner. That is usually the minority of voters, but it can even be the majority: When more than two candidates vie for a seat in a single-member district, voters may divide enough among more than two candidates that the “winner” only obtains a plurality instead of a majority of voter support.
Instead of asking politicians to “represent” views they oppose, Oregon should instead ask them simply to do their best to represent the views they actually do hold, while electing multiple winners from enlarged districts, so that people who hold other views can also win representation too, even if they aren’t in the majority.
The contradiction caused by single-member districts is in large part why Oregon politics is so toxic: there is an irreconcilable conflict between choosing a single person to represent all the voters in a geographic area and the idea of representation for all.
Today, with technology, the tools are widely available to allow parties to carefully sculpt legislative bodies out of single member districts in such a way as to maximize the power of the group drawing the district lines and to minimize or even, in practical terms, to eliminate any chance that the voters could rebel and choose for themselves. It is possible today, with ordinary home computers to slice and dice the electorate into discrete packages, block by block, and to know exactly which positions are likely to gain support.
Thus, we now live in a state of unrepresented people who are supposedly living in a representative democracy. In the small “Blue” area of metropolitan Portland, where Democrats hold the overwhelming electoral advantage, anyone with a view outside the Democratic party is completely unrepresented and has zero chance of winning any representation in the Oregon Legislature or in Congress for their views. Similarly in the vast “Red” spaces that make up most of Oregon by acreage, Democrats and others have exactly zero chance of having any representation for their views. In both cases, the minority voters are only nominally participants in the system. The have essentially the same power to affect the outcome of an election as does an anti-Putin voter in today’s Russia.
As theory predicts, election systems built on districts with single winners are inevitably dominated by only two parties. The two factions in a two-party system pivot around the balance point, the number of votes where just one more vote decides the election for one side or the other. Since we elect from single-member districts, in each one only one party can win. Thus, Oregonians live almost entirely in one-party districts where they have no voting power. In eastern Oregon, anyone outside the GOP has zero chance of having a vote help elect anyone to represent them; likewise, a GOP voter in Portland has more of a gravitational pull on the orbit of the moon than on the views of their “representatives,” who are all uniformly Democratic Party members.
This systematic disenfranchisement is why no country making the transition to democracy since WWII has adopted any part of American election methods.
Consider South Africa: a tortured country with a vast black majority oppressed by a tiny white minority through terror and killing, but miraculously led to a peaceful revolution and a peaceful takeover by the majority black peoples. If South Africa had adopted a winner-take-all system like Oregon’s for elections, there would have been a bloodbath with a black takeover and slaughter or exile of the tiny white minority inheritors of the stolen wealth of the people. Although South African struggles continue, with crushing poverty widespread, it is generally a peaceful place and power is shared in a pluralistic society. South Africa wisely chose to avoid the single winner system and the single member district system. They recognized that, while majority rule is the essence of democracy, they also knew that peace meant making sure that minorities could be present and be heard in the Parliament, even without the power to win a majority of seats.
This idea can be called proportional representation, but it may be more correct to call it full representation, because it produces a much fuller kind of representation, with the majority winning the majority of seats, but allowing for significant minority groups to win some seats. The proportional representation name is troublesome, because it is a very abstract term that suggests it requires voters to do math or proportions or ratios. But full representation is not complicated in practice. It is simply based on an alternative ideal to the winner take all premise, one that avoids the contradiction at its heart (representation of opposing views by one individual). The idea of full representation election methods is that all voters matter and should be entitled to a voice, and that elections where the partisan winners are a foregone conclusion simply because of gerrymandering are shams.
In Oregon, instituting full representation elections would be quite simple for, say, the state house: with 60 members, instead of 60 separate, winner-take-all races, there would be 12 5-member districts. With that setup, any candidate with at least 17% of the vote would win one of the five seats in that district.
Almost every problem that vexes us as a state has, at its root, some degree of brokenness in the internal feedback mechanism that helps healthy well-adjusted organisms function successfully in a complex environment. A characteristic of stable, enduring societies is the close relationship between different groups of people within the society such that, even when there are different groups within the society, no one can escape knowledge about what is happening to the other members of the society.
But in the industrialized world, once-through processes and massive amounts of waste are enabled by distant owners who have a systematic blindness to the consequences being inflicted on people and the environment in the name of efficiency. The technology at the very heart of capitalism in industrial societies has, in its very DNA, this dangerous brokenness: the corporate form was created and has metastasized into its world-conquering form by breaking the link between actions and consequences. That is the whole purpose of limiting liability: to free certain people from the consequences of their actions when those actions turn out badly. This, as was intended, promotes risk-taking.
We labor today under a set of rules created for very different world, that of 15th and 16th century Europe, where the invention of the limited liability corporation was a force multiplier for the monarchs, who used crown corporations to further imperial ambitions. By creating incentives for adventurers – and protecting their fortunes from being erased by a stroke of bad luck or poor judgment – the corporate form caused a revolution in societies that is still playing out today, including in Oregon.
But just as the cancer cell is a particularly healthy, efficient cell whose success is at the expense of the host organism, the wild efficiency of the corporate form is going to be our undoing. Just as the cancer cell is blind and deaf to feedback signals from surrounding cells trying to tell the hyperactive cell to stop dividing and replicating, corporations are ignore any signal that would tend to impede the growth of the corporation. Coupled with distant ownership, what we are left with is like a collapsed ecosystem where the species diversity just tending towards zero for all but the so called ”weed species”– rats, the cockroaches, and the other omnivorous generalists.
Once, in a discussion of environmental concerns, a gentleman who had been to Sweden claimed that the Swedes had managed to deal with pollution in a particularly elegant way, without extensive bureaucracies or administrative overhead costs. According to this gentleman, the Swedish Clean Water Act amounted to one simple idea: factories had to draw their water downstream of their own discharge pipes.
True or not about Sweden’s, the story certainly contains an important truth, which is that self-regulation with honest, inescapable feedback is the best regulation. The converse is true as well, as America has proved repeatedly: without feedback, self-regulation is essentially no regulation at all. Unless there is feedback, it is very difficult to manage complexity except through over-sized bureaucratic measures.
To take just one example, consider confined animal feeding operations or CAFOs as they’re known. These are hellish Stygian wastelands of industrial agribusiness that dot the landscapes America, especially in the West, including Oregon. As presently “regulated,” CAFOs are a blight and a scourge that can only exist because those profiting from them stay as far away from them as possible. A system designed with feedback loops in mind would ensure that the owners of large numbers of livestock were not able to remove themselves while subjecting others to the consequences of gathering so many creatures in one tiny place.
Immunity for Officials is a Cancer in the Body Politic
An especially notorious case where the necessary feedback loops that preserve the health of the society and the social contract are broken is in the case of public officials, especially judges and prosecutors, who enjoy complete immunity from prosecution for violating the civil rights of ordinary citizens subject to their power.
The inchoate rage of the Black Lives Matter movement is due in very large part to this failed feedback loop, which reliably produces the spectacle of gross negligence and even intentional criminality by officials who cannot be made to account for their actions.
We know from exoneration after exoneration of innocent individuals that our fallible criminal justice system is found wanting day after day, in city after city and town after town all across America, with Oregon no exception. Unless prosecutors, judges, police, and investigators face the prospect of criminal liability for subverting and perverting the justice system, we will never restore faith in it.
True, it should not be easy to prosecute a public official in a fit of anger; however, it must also not be possible to pursue wrongful prosecutions and to obtain coerced plea-bargain convictions by carelessly or willfully using techniques and practices that are well-known to produce such miscarriages of justice. Those who would sit in judgment over others and insist on righteous conduct must be willing to be judged by that same system, not be immune from it.
For additional reforms in criminal justice, the reader can do no better than to read the introduction to a recent law review article Criminal Law 2.0 by Judge Alex Kozinski of the Ninth Circuit of the U. S. Court of Appeals.
With the outrageous fiasco in Flint, Michigan, forcing the corporate press to note the horror unleashed on the mostly poor, mostly non-white residents, lead is back in the news. The people of Flint learned that they and their children had been poisoned with lead (Pb) from their taps, thanks to the un-elected city manager appointed by the "businessman" governor. Many in Oregon might be inclined to be thankful that they are not living in a "rust belt" city beset by such a plague of ills.
Which is why this OregonPEN is devoted to the ongoing Pb poisoning occurring here in Oregon. Far too many people think lead is a hazard of poor children living in slums; they live unaware that lead is still with us, still being pumped into the atmosphere by the ton.
We begin with this recent release from OHSU (and Michigan State) about the first study to confirm a causal link between lead exposure and increased ADHD behavioral health problems, especially in males:
01/07/16 Portland, Ore.
Oregon Aviation Watch, a tiny, fierce nonprofit that monitors and reports on the costs of aviation, picks up the OHSU piece and provides valuable context, connecting the dots to the current biggest source of lead emissions: small, piston-powered planes that are collectively referred to as the “general aviation” sector.
OHSU Study Confirms Causal Link between Lead Exposure and ADHD
But, despite such clear warnings, and thanks to state and federal governments controlled by unlimited corporate bribes known as campaign contributions, Oregon is unwilling to displease or even inconvenience small plane builders and the wealthy pilots who own the older small planes that still require leaded aviation gasoline ("avgas,” also known as 100LL).
Oregonians like to recall the Beach Law and the Bottle Bill and the Growth Management Law, all of which let us feel superior to other, supposedly less-enlightened states. But we allow small plane owners to keep spraying us all with Pb exhaust from their engines. And these pilots pay about one-third of the taxes that you do per gallon – Oregon just increased the avgas tax from 9 to 11 cents a gallon, compared to the 30 cents per gallon you pay for your gasoline. And your gasoline for your car is, by law, unleaded, because we recognized in the 1970s what a terrible toll lead was imposing on society, and resolved to remove it. Except when it came to the well-heeled small plane pilots.
Here’s the position of the Federal Aviation Administration, which downplays concerns about toxic lead and clearly announces its real priority, making sure that “all aircraft can continue to fly” – without ever bothering to even consider explaining why Americans should care whether old planes that require emitting an extremely hazardous, permanent pollutant should be able to keep flying.
The Federal Aviation Administration (FAA) shares the Environmental Protection Agency's (EPA) concerns about lead emissions from small aircraft. Owners and operators of more than 200,000 piston-engine aircraft operating in the United States rely on aviation gasoline (avgas) to power their aircraft. Avgas is the only remaining lead-containing transportation fuel. Lead in avgas prevents damaging engine knock, or detonation, that can result in a sudden engine failure. Lead is a toxic substance that can be inhaled or absorbed in the bloodstream, and the FAA and EPA and industry are partnering to remove it from avgas. Avgas emissions have become the largest contributor to the relatively low levels of lead emissions produced in this country.’
Basically then, the position of the federal government is that avgas is a poison that they would like to eliminate, so long as doing so doesn’t interfere in any way with the profits of the small plane industry or the pocketbooks of the small plane owners. The economic power of the general aviation lobby are much more important to the FAA than the public health.
The FAA is so on the ball with the lead poisoning issue that the FAA’s website has no updates under aviation fuel since 2013, and no updated stories under the heading “Avgas in the News” since January 2014.
One might understand a captured “regulatory” agency putting the interests of its industry constituents first – after all, people who work for the FAA are quite likely to be pilots and have a windscreen view of the world. But then you might expect the Environmental Protection Agency to see protection of the environment as its primary concern.
Alas, not so. The EPA’s knees buckle every time it gets asked to think about leaded avgas – so much so that private advocacy groups have to push EPA to do its job:
WASHINGTON, D.C.– Three leading advocacy groups filed a petition today asking the U.S. Environmental Protection Agency to take action to address harms caused by lead emissions generated by the continued use of leaded aviation gasoline (avgas). Lead is a dangerous neurotoxin that destroys nerve tissue and causes a variety of health and neurological problems, particularly in children. Accordingly, EPA required a phase-out of lead in automobile fuel almost 20 years ago.
Despite the clarity of the science and the incontrovertible evidence that pumping lead into the biosphere is hazardous to human health, the EPA has again caved to industry, causing the same advocacy groups to sound the alarm again a year later:
WASHINGTON, D.C. – Today, the U.S. Environmental Protection Agency issued a response to a petition filed by environmental groups urging the agency to address lead emissions from aviation gasoline –– the largest source of airborne lead emissions in the country. Lead has been banned from paints and automobile gasoline, but the toxic chemical still remains in the gasoline used by small, propeller-driven airplanes and other general aviation aircraft. Children are particularly susceptible to the harmful effects of lead, and research shows that children who live near general aviation airports have elevated blood lead levels.
Explaining the EPA’s reticence is the power of the general aviation lobby, which includes only those people who can afford to be part of the small plane-owning set.
Indeed, the FAA website links to an editorial on a website aimed at plane owners about the FAA-run process intended to maybe produce a lead-free aviation fuel that will let “all aircraft . . . continue to fly.” The comments to the highly critical two-year old story, “Finding a New Avgas May be the Easy Part,” by Paul Bertorelli (AVWeb.com/blogs/insider, 5 January 2014) are quite informative and give a good sense of who the general aviation lobby serves and how dismissive pilots are of anyone else's concerns:
Bertorelli summarized the industry view in a comment of his own, in which he also reveals the key issue: the government allows general aviation builders and pilots to poison us with finely dispersed lead under a government-granted waiver to pollution laws that would otherwise have caused leaded avgas to be banned:
If you're going to have an informed opinion on avgas replacement, it's critical to understand one harsh fact: the legacy fleet drives the economics of the general aviation ecosystem and "legacy" now includes a lot of recent model Cirrus and Cessna airplanes.
As is so often the case with special privileges, the industry special pleaders can’t help but contradict themselves in their lobbying, claiming to provide jobs and economic benefits, but also claiming to be economically fragile and vulnerable to anything that increases their costs. The FAA's four-page white paper explaining the "initiative" that maybe will produce a replacement for 100LL is a revealing masterpiece of bureaucratic mumbo-jumbo, passive vocalization, and foggy generality and stubborn refusal to talk plainly about the reasons that lead in avgas must go and even more adamant refusal to set deadlines for this critical step.
Oregon’s own version of the FAA – the Oregon Department of Aviation – is equally dominated and controlled by industry and even more mute on the environmental and public health costs of fossil-fuel-powered flight and the toxic lead being sprayed across the state.
The state’s 2007 “Oregon Aviation Plan” never mentions climate change or lead pollution at all. Led by a board of seven gubernatorial appointees – all pilots or industry types, without a single public health or environmental expert, the Department of Aviation sees its mission as boosting the amount of flying, not even giving lip service to the idea that there are costs imposed on Oregonians by air travel and transport or that anything should be done to reduce those costs.
A summary of the lead issue, from a letter by Oregon Aviation Watch to the head of Portland Community College (which runs the flight training program in Hillsboro that causes that airport to impose extraordinarily high lead levels on nearby Washington County residents):
One of the most unappreciated virtues of the wired, communications-intensive existence that we so often disdain is that it permits people to remain engaged who, in eras past, would have had a hard time sharing their wisdom with an audience beyond their own immediate family, if they were lucky enough to remain in an extended household and have a surviving child to help care for them as they faced the vicissitudes of old age.
Oregon recently lost one of these elder giants, a fascinating 88 year-old poet and pol, who was lovingly eulogized by his son -- on the elder's own blog. A tour through five years of posts reveals a live, vital mind in a body beset by age. What a gift to be able to come to know such people "in real time," post by post. We are greatly enriched by the continuing presence and vitality of these elders, who are now able, with very little money and using only everyday computers, reach a diverse and far-flung audience of people anywhere, from nearly anywhere.
Even from Lake Oswego, Oregon, where Ronni Bennett, the fascinating, funny, and fearless proprietress of the terrific blog known as "Time Goes By" surveys the scene and tells readers all over the world about "What it's really like to get old."
Ronni kindly granted OregonPEN permission to reprint the essay below, which nicely complements the piece by Dr. Sam Metz of "Mad as Hell Doctors" and Physicians for a National Health Program because they both notice what many in medical world would rather not be noticed -- that the medical game is a business like any other, and that the corporations who play in that game are motivated solely by profit, not any altruistic desire to relieve suffering or improve health.
--by Ronni Bennett, "Time Goes By" blog Friday, 08 January 2016
-- by Katy Ottaway MD
Prior authorization is where, in the insane United States medical system, the doctor orders a test or medicine. The insurance requires “prior authorization,” that is, the doctor or their office have to call or go on line to fill out forms to get the prior authorization. Otherwise the test or therapy or medicine or even surgery will not be covered by the insurance and the patient eats the bill. Over 60% of bankruptcies in the US are now over medical bills.(1)
In most doctors’ offices, the prior authorization is done in the back rooms. Employees are on the computer or on the phone trying to obtain the permission, the code number, the magic words that will help the patient. This is a HUGE business and a scam as well. Physicians for a National Health Care Program estimated in 2011 that it costs at least $82,975 PER PHYSICIAN PER YEAR to have a person calling.(2)
Now, there is a person on the other end receiving that call or going over the forms. That person is paid with your insurance premium. Is that health care? It seems more like a barrier to health care. Let’s look at an example.
I do my prior authorizations in the room with the patient. I only have a front desk person, no back room people, and anyhow, if I do it face to face with the patient, I can charge the insurance company for the call. It is face to face counseling and coordination of care. I don’t get paid well for this, but it’s worth it for the patient education.
Yesterday I called for a patient. The insurance company first has a recording that tells me it is recording this conversation. I am too, in the chart note. Then it reminds me I could do all this on line. Well, that is sort of true. I could, but every insurance company has a different website, they all require logins and passwords and it would take me hours to learn them all. Nope, not doing that.
After the message it says: “Please enter the physicians NPI number.” I do. Then it leads me through choices: confirm the patient is insured, check the status of a prior authorization, appeal a prior authorization, initiate a prior authorization. That one.
At 3 minutes 50 seconds, I get a human. We are on speaker phone.
“This is Rex. You are calling for prior authorization?”
“Yes. This is Dr. Lizard. Mr. X is in the room.”
“Please spell the doctor’s name.” They are not used to doctors calling.
“Please give the NPI number.” (ok, we typed that in. But every time you are transferred, you have to give all of the information again. I am not kidding.)
“Please give your clinic address. Please give your clinic phone number. Please give your clinic tax ID number. Please give your clinic fax number.”
“Please give the patient id number. Please give the patient name. Please give the patient date of birth.”
My patient is looking amazed. This is how insurance companies treat the doctors who call them?
“What medicine are you authorizing?”
“A compounded testosterone.”
“Please list the ingredients.”
Crap. didn’t think of that. “Ok, we want to authorize an fda approved one.”
That is entered. “What are the instructions for the patient?”
“What is the dose or strength?”
“What is the diagnosis?”
“He has a condition from birth with no testosterone.”
I have to spell the condition for Rex.
“What is the ICD 10 code?”
I give that.
“Have you measured a testosterone level?”
“Yes. It’s zero. His body doesn’t make testosterone. Since birth.”
My patient is rolling his eyes.
“The form will be sent for review and you should get a fax within 24-72 hours regarding the authorization. Here is a number for tracking.”
“Thank you, we are recording this phone call as face to face counseling and coordination of care in the chart.”
Phone call is 13 minutes and 50 seconds. That is a fast one, actually. Most are 25-30 minutes and I
fought for an hour once when a patient’s prescription coverage was cancelled.
I wish that every doctor in the country would do one prior authorization on the phone once a week with the patient in the room. The doctors’ heads would blow off. They might finally see what the current system is doing and how the insurance companies throw more and more and more barriers up to refuse people care.
And how is it a scam? One way is that the patient calls the insurance. The insurance has people who only talk to patients. That person says, “Have your doctors office call for a prior authorization.” The patient calls the doctor’s office. The doctors office calls the insurance, but they are talking to a different branch of the insurance company. That branch tells the doctors office “We don’t cover that.” The doctors office calls the patient, who then thinks that the doctor’s office has screwed up the prior authorization.
How do I know that? With the person in the room, the insurance tells me “No.” I have had patients say, “Your company told me yesterday that all I needed was for the doctor to call!” The insurance person replied, “I only talk to doctors. It is another part of the company that talks to patients.” I have also had an insurance person say “Take me off speaker phone, I am only allowed to talk to physician’s offices, not to patients.” Riiiiiight. I took him off but put him right back on. My patients are outraged and furious: at the insurance, not me. The insurance companies are doing brilliant business plan triangulation and I hope whoever thought it up and whoever allows it as a business plan roasts in hell. No, instead I hope that they wake up and realize how many people they are hurting and I hope that they turn and work to heal a broken sick system.
Reprinted with kind permission of Katy Ottaway, MD, from her KO Rural Mad as Hell Blog
By Samuel Metz
There are convincing reasons why Oregon should embrace the Trans-Pacific Partnership (TPP), but a compelling reason for opposition is protection of our health care. The trade partnership treats prescription medications as commodities, selling at the highest price the market will bear. This promotes businesses that sell medications, but it's a poor way to get lifesaving drugs to Oregonians who need them.
Unaffordable medications are not a trivial problem. Based on national estimates, over 10 Oregonians die each week of treatable conditions because they cannot pay for treatment, a mode of death unknown in other developed countries. Last year, prices for specialty drugs rose by 19 percent. The most dramatic example was the 5,000 percent increase for an essential medication marketed by Turing Pharmaceuticals. The company pledged to reduce that increase. So far, the $750 price per pill to patients has not changed.
Turing is not alone in maximizing revenue on branded drugs. Bristol-Myers Squibb, Merck, and Eli Lilly raised drug prices by as much as 22 percent, 25 percent and 65 percent, respectively; Pfizer's highest increase was 115 percent. These price increases were not for new drugs with unrecovered development costs; these were older drugs enjoying high demand.
Can we justify these increases on free market principles? No. Simple economics do not apply to critical medications: When prices go up, need stays the same. Consequently, patients must choose to either pay the high market price, or to pay a still higher personal price: dying of their disease.
Americans already pay more for prescription drugs than citizens anywhere else in the world. One of the few constraints is the ability of our government to negotiate lower drugs prices on behalf of patients who need them — and on behalf of taxpayers who pay for them. The TPP allows private pharmaceutical companies whose profits are impeded by such negotiations to bring suit for restraint of trade. Such suits bypass American courts, being referred instead to an international court responsible to the economic interests of TPP signatories. This court possesses the power to overrule laws of participating TPP countries and to compel governments to compensate pharmaceutical companies for their lost profits.
Would such a court indeed place private profit over public health? Experience with NAFTA mediation indicates TPP mediation will favor business interests over consumer interests. Our government healthcare agencies, serving the sickest, poorest and oldest among us, must then either increase taxes to subsidize private profit or withhold essential drugs to patients who need them.
In its Oct. 6 endorsement of the TPP, The Oregonian/OregonLive editorial board challenged opponents of the TPP "to present a better alternative for boosting the region's economy." A more humane approach challenges TPP supporters to create an economic boost that does not further corrupt Oregon's deteriorating ability to provide lifesaving medications to the people who need them.
For the sake of Oregonians who depend upon prescription drugs to stay alive, Oregon's congressional delegation should vote against the TPP. Oregon needs an economic stimulus that saves lives, not destroys them.
Samuel Metz is a private practice anesthesiologist who lives and works in Portland. He is a member of Physicians for a National Health Program and a founding member of Mad As Hell Doctors, both of which advocate for universal health care.
This article is reprinted with kind permission of Samuel Metz, MD, after first appearance on the Oregonian/OregonLive website, 2 January 2016.
Last week, OregonPEN presented a Top Ten list of things better than any so-called "clean fuels" bill, starting with two proposals for making the way we pay for roads work better by incorporating market signals and feedback into the design of the gas tax and how it may be used.
For years now, the outstanding Seattle-based nonprofit known as Sightline (originally Northwest Environment Watch) has been doing strong work on policy problems that produce environmental problems and predicaments. The piece below, by Sightline's Kristin Eberhard, fits nicely with the OregonPEN proposals for how to better raise and use the gas tax, no matter how much revenue is required (that is, these proposals will still make things better whether the overall level of gas tax revenue rises or falls). Thanks to Sightline for permission to republish.
This article is part of the series Cashing In Our Carbon