Penny Pinching Is Fine. But Virginia Needs to Think Big.

It’s no fun being governor when all you do is cut, cut, cut.

James A. Bacon

Gov. Bob McDonnell has the right instincts: When it comes to preparing the next two-year budget, Virginia needs to brace for the worst. The governor has asked state agencies to submit proposals for achieving budget reductions of 2, 4 and 6 percent of their General Fund appropriations. And they have responded, flooding the governor’s office with ideas from the profound to the quirky — from closing 1,000 prison beds to scrapping funding for the dangerous dog registry — giving him many options to choose from. (See the Times-Dispatch story here.)

State revenues are forecast to grow 3.7% through the current budget year and 3.3% through 2013, but that’s not enough to cover the rising cost of state services and loss of aid from the federal government. And that’s the good news. The bad news? The failure of the congressional supercommittee to devise a federal deficit-reduction plan could trigger $1.2 trillion in automatic budget cuts, which will be divided equally between domestic and defense spending. With its economy so heavily tied to defense, Virginia could be especially hard hit. Meanwhile, there’s no predicting the impact on the U.S. economy of the European sovereign debt crisis or, a wild card, a possible melt-down of the super-heated Chinese economy. Never in my adult lifetime has there been so much uncertainty about where the economy is heading.

So, I’m in favor of penny pinching. Even if that means saving $45,000 by delaying the replacement of equipment at veterans cemeteries or selling Department of Forestry buildings, to list two ideas noted in the Times-Dispatch article. Two-percent cuts in affected agencies would yield $77 million in savings in the fiscal 2013-2014 biennium, while 4% cuts would save $147 million, and 6% would lop off $220 million.

The problem is that the economic uncertainties are so great that we could be talking about budget gaps measured in the 10 digits — $1 billion or more. Trimming and pruning line-item spending is necessary and good. But it’s not enough. If Virginia wants to close the long-term budget gap, it needs to fundamentally re-think how it delivers core services. At the risk of repeating previous posts, I would argue that legislators need to go for big, dramatic savings such as (in rough order of importance)…

Reform transportation and land use. The scattered, disconnected, low-density pattern of human settlement patterns prevalent in Virginia drive up the cost of utilities and public services for local governments and create inexorable demand for more state transportation spending. We need to re-think the zoning policies and funding mechanisms that promote sprawl. There is no need to resort to leftist social engineering — just insist that Virginians pay the full costs relating to where they live, shop and work, and give developers more freedom to pursue infill and re-development.

Build a market-based health care system. Now that Medicaid and employee health insurance are the fastest-rising component of state spending, Virginia should aspire to creating the most productive, efficient and innovative health care system among the 50 states. Primarily, that means creating new models for delivering health care, which requires more freedom for entrepreneurs to innovate and more flexibility in how Medicaid and private insurers pay for medical services.

Reinvent K-12 education. Bust up the monopoly of the public schools, increase parental choice and foster experimentation and innovation. Promote  virtual learning. Encourage that incubator of testing and experimentation, “home” schooling, which is fast evolving into a sophisticated form of parental-led educational cooperatives. Allow parents to contract with teacher cooperatives. Government’s job should not be to educate every Virginian but to ensure that every Virginian gets an education.

In the new age of austerity we find ourselves, we must aspire to achieving mind-bending gains in productivity through audacious change. Tinkering on the margins of existing programs will lead to nothing but an endless and unsatisfying cycle of cuts, cuts and more cuts.

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42 responses to “Penny Pinching Is Fine. But Virginia Needs to Think Big.”

  1. Before we outlaw sprawl, why don’t we first determine what are the material costs for infrastructure in urban, suburban, exurban and rural areas? Tysons Corner is one of the best planned projects in the history of the United States. Indeed, Fairfax County won the prestigious Daniel Burnham Award for its efforts. The evidence from Tysons strongly suggests that major urban growth is extremely expensive. I have seen absolutely no evidence that suggests the information developed and collected by Fairfax County is incorrect.
    Another key factor is that sprawl pushes many costs from urban-suburban areas to other localities. For example, the costs of schools. New development outside Fairfax County means we don’t need to add as much school capacity here. The costs are borne by others. I know quite a few people, Democrats, Republicans and Independents, who think this is a good idea.
    I agree with EMR that matching jobs and homes can be more efficient. But it may be much less expensive to do that matching outside the clear edge. Perhaps the cheapest thing is to allow Ray and his neighbors to develop their land, rather than attempt to pour more people and jobs inside the Beltway or even east of Dulles Airport. The evidence I have seen suggests this is true.

  2. TMT, Urban redevelopment in locations such as Tysons Corner may indeed be more expensive than continued sprawl. I suspect that Tysons is such a hideous mess that it cannot be fixed (without massive subsidies). But Tysons Corner does not constitute the entire universe of re-development options in Northern Virginia. There are many other locations where re-development would be supported by market demand.

    Further, please note that I never insinuated that we should “outlaw sprawl.” I said we should stop mandating it through zoning policies and subsidizing it through our transportation and utility-pricing policies. If we level the playing field and curtail restrictions on infill and re-development and we still end up with “sprawl” (scattered, disconnected, low-density development), that’s OK with me. I may not *personally* be happy with the result, but if others were willing to pay the cost of building it, I would have no objection. As a practical matter, I don’t think the market would support more “sprawl.” But I could be wrong, and I’m willing to let the marketplace rule.

  3. My experience is that living inside the clear edge of the National Capital NUR while owning a home in the countryside as well is that taxes inside the clear edge are always higher. This experience has been bolstered as I have traveled across the US and around the world.

    There are better employment opportunities in densely populated areas but the taxes are higher there as well.

    Jim’s suggestion that Virginia should fix its problems through central planning is, once again, off target.

    The needs, aspirations and willingness to pay high taxes for high services is very different inside the clear edge than in the countryside.

    Why would ANYBODY believe that a single state Politburo could possibly establish a governance approach which would effectively meet the needs and aspirations of at least two vastly dissimilar constituencies?

    The simple answer is that a single state Politburo cannot and will never meet the needs of both constituencies.

    Power needs to be de-evolved on a regional basis.

    The Virginia state constitution needs to be rewritten. Certain rights, such as the right to bear arms, need to be expressly granted to all residents of the state regardless of locality. However, other rights, such as the right to tax and spend for all local services, needs to be expressly given to local government.

    Some localities will accept high taxes for good schools, good roads and other public services. Other localities will force down the costs of taxes along with the level of service.

    This “competition among localities” will provide the same impetus to progress that competition among companies provides. The localities need to be big enough to allow self-determination but small enough to let citizens “vote with their feet”.

    The simple fact is that the value of state government has been largely erased by modern society. While there is a definite need for a check on the federal government the belief that this check must be a nanny-state government is absurd.

    Our General Assembly needs to lose its egomaniacal view that it can properly allocate resources fairly and efficiently among Virginia’s seven regions.

    Of course, schools and prisons are location variable costs just like roads and hospitals. If certain regions in Virginia want to keep the tax on cigarettes near the lowest in the country, they should bear the economic consequences of that strategy. If certain localities refuse to raise property taxes to a level where they can pay teachers an attractive wage, they should bear the economic consequences of that strategy – including the costs of incarcerating the citizens who turn to crime from no other option.

    If certain regions want to allow widespread use of charter schools or provide education vouchers, they should be allowed to make those choices. If other regions want to pay tribute to the teachers’ union by stifling educational innovation, they should be free to do that as well.

    The problem with Jim’s philosophies is that they cannot be implemented in a place as big and diverse as Virginia. I think they could be implemented on a regional basis but I am sure they will not be implemented state-wide. Therefore, his cries for accountability fall on the deaf ears of a failed and unfixable nanny state governance structure.

  4. I thought Jim covered the issues well but Groveton’s “hit” on central-planning is a direct challenge as to what role State govt should play (or not) in transportation, education and health care.

    Of course if you think people are going to stay in the counties they were born in… Groveton’s regional-centric strategy is more viable but you still have issues like state police, interstate highways… DMV, social services, etc.

    One of the issues McDonnell and the GA needs to confront in the next session of the GA is how to fund Virtual Virginia. Right now, it basically encourages private providers to locate in the poorest counties in Va because there they get the highest per student state subsidy – not the mention – the issues of standards and academic performance…

    transportation is going to end up a regional/county responsibility with either property taxes or tolls ….. the state is going to concentrate on “corridors of State/National significance.

    One of the problems with TMT’s advocacy is that moving residential to the exurbs but keeping the jobs in NoVa leads us to a transportation conundrum of who should pay for the commuting transportation facilities.

    Jim thinks (correctly) that the folks who commute should. The State and the Feds think all taxpayers should pay… apparently as they actually provide subsidies to commuters… even Fairfax County is willing to 1. charge 2.1% extra for fuel to fund VRE and 2. toll the bejesus out of Loudoun drivers to pay for Metro.

    I think Jim and EMR call this external costs – not born by those who incur them. What is the role of govt on this?

  5. A parking tax at Tysons and other job centers served by Metro or express bus would go a long way to help capture money from long distance commuters. It could also help fund some of the transit that would hopefully replace some of the SOV traffic.
    Question to, and comment for, Groveton. It’s my understanding Maryland is also a fairly strong Dillon Rule state. Only Baltimore City, Baltimore County and Montgomery County have home rule status with respect to taxes. How is that different from Virginia for the rest of Maryland?
    Comment. I don’t think the Virginia business community would accept home rule status on taxes for local government, at least according to some state legislators. The only true impetus for higher taxes from the business community has been those that would build transportation facilities for land speculators. See T. P. Carney, “The Big Ripoff: How Big Business and Big Government Steal Your Money.” The Author and many people believe that the goal has never been to improve traffic flow, but rather, to build more roads where the land speculators owned property. As the Richmond T-D correctly noted, traffic congestion is reduced only when road capacity is increased and the volume of traffic remains constant. Such a result begs not just for more tax revenues, but also development controls. From what I’ve seen I don’t think most Virginia businesses are seeking higher taxes that a local government would levy. Home rule tax powers would likely see a shift in tax burden from residences to businesses. My two cents.

  6. TMT:

    Maryland has its quirks. However, the localities seem to have considerably more power in Maryland than Virginia – even outside of Baltimore, BC and Montgomery. My home is in Talbot and they like to complain about the Bu***** coming from Annapolis and/or Baltimore.

    My main point in the prior comment about Maryland was more of an observation of rural life vs. city life. Even in high tax Maryland, the local taxes, fees, etc seem pretty low out where I live (at the end of a 120 acre corn/soybean field). Everything from real estate taxes to the cost of joining the local YMCA seems lower than in Fairfax. However, you better have a four wheel drive vehicle because it could be a while after the snow before the plow comes. And a gun at home along with some ammo is probably better than having 911 on speed dial. The public schools are pretty weak but smart / motivated kids find a way into good colleges despite it.

    All in all, a pretty square deal.

    As for the business interests in Northern Virginia not agreeing to tax hikes – no business interests in any jurisdiction will agree with tax hikes. It comes down to whether the voters can be convinced to raise taxes. And there are plenty of good places to live where the voters have decided that being in a good place to live is worth a bit more money out of their pockets. San Francisco, for example. Or, Austin.

    If there were a regional plan with any level of vision for Northern Virginia I think Northern Virginians would vote to fund it. However, that vote would rely on two pre-requisites:

    1. Competent politicians.
    2. A constitutional guarantee that the money not go through Richmond for the typical skim.

    Absent that, most people around here will want low taxes and will put up with transportation chaos waiting for:

    1. Becoming old enough to retire and leaving.
    2. Having government funding slow down, seeing the economic opportunity falter and moving.

    Either way, the cash cow of the Commonwealth goes on life support without more confidence in our local leaders’ ability to fend off the skimmers in the General Assembly.

  7. Peter Galuszka Avatar
    Peter Galuszka

    “Market-driven, innovative health care?” Give me a break. I just went through a lot of turmoil finally getting a plan that is very expensive because I am (a) self-employed, (b) have pre-existing conditions, all under control and (c) am pushing 59.
    Medicare would be so much easier and having managed an elder parent through the system for seven years, I must say it worked pretty well.
    Virginia and the U.S. need to stop blaming the government for our outrageously high cost of med care and its modest results when vital stats are considered. Government is the solution — the only one, in fact.
    Managed care sucks. I know. I paid thousands and thousands of dollars into it over the years either through the companies where I worked or by myself. And now I am a pariah because of my age and because I take drugs for blood pressure and cholesterol. JAB always comes up with this “market” nonsense and it means basically that rich people can get doctors to do a “boutique” deal.
    My one shattering question is this: Jim Bacon, when was the last time you actually had to go out and shop for health care for yourself or a loved one?

  8. Peter , take a look at Lasik eye surgery. The costs for this procedure are rarely covered by insurance, if at all. Docs are advertising all of the time and offer specials, etc. This lone instance suggests to me that medicine is no immune to market forces and that Docs have no choice than to become competitive when consumers are responsible for payment.
    The big challenge is, of course, how to harness market forces and also provide for some risk sharing, which I think is critical for health care in the U.S.

  9. Peter, to answer your shattering question, I haven’t had to search for health care for myself and/or loved ones. I’m lucky — my wife has a good plan. But, then, that’s not really germane. I totally agree that our health care system is dysfunctional. That’s not a matter of dispute. The question is how to fix it. To fix it requires understanding what’s wrong with it.

    One reason the insurance market is FUBAR is that most working Americans get their health insurance through their employer because of the tax breaks. As a consequence, private sector insurers design their policies for the convenience of employers, not employees. Another reason is state mandates that prohibit you from buying a plan tailored to your unique situation. A third is the under-funding of Medicare and Medicaid, which forces providers into jacking up charges and fees to privately insured patients, which get passed on as a higher cost for insurance.

    In all your ranting and raving about the injustices of the health care system, I don’t ever recall you acknowledging these basic facts. You’ve made up your mind on the issue and have no intention of being dissuaded by mere technicalities!

    TMT raises a great point about Lasik eye surgery. The same points can be made for cosmetic surgery. It’s just remarkable that the two segments of health care NOT heavily regulated by government have seen the least cost inflation over the years.

  10. My only question is this – to those who say “free market”. Name the top 3 countries in the world who don’t have govt-involved health care.. and instead have free-market health care – and are at least competitive with the govt-directed health care countries in terms of costs and outcomes.

    this is the part that cracks me up. We say “free market” but the only countries in the world who have it – are 3rd world.

    Every industrialized country in the world has govt-directed health care – and the best in the world according to some is Singapore which is heavily govt-regulated and has an individual mandate and a 30% payroll tax but it’s per capita costs are among the lowest in the world and it’s life expectancy among the highest.

    so.. how about taking up the challenge here and name the top 3 private-sector, market-based health care countries in the world?

  11. re: home rule….. the REASON for Dillon Rule (which is implemented in virtually all states) is the belief by state govt that local govt without restrictions would run amok…. on taxes…

    I’m not sure I buy it totally but in Fairfax Case, they already get away with a lot and it seems to have no consequences at elections and yet… at the same time, they do have GA permission to levy additional taxes – if voters approve….and yet Fairfax demurs….

    Groveton’s challenge to the poorer counties about increasing taxes or suffering the consequences …. is …. um….. well… untoward… coming from a region that sucks heavily on the Fed Govt TEAT….and STILL taxes the heck out of it’s citizens – to the point where it drives many to the exurbs…

    for myself – we need a state govt. and I do not think the Va GA is any worse than the Maryland or NC or many others and, in fact, is better by a long shot than the ones in New Jersey and locales.

  12. Larry, Free-market health care has never been tried. But until 1776, democracy had never been tried. I imagine that quite a few Tories used an the very same argument as you.

  13. yeah Jim… but how about examples of countries that do SOME OF IT.

    or how about just the BEST EXAMPLES?

    are you advocating something that does not exist …?

    no.. not really.. we KNOW that pure free market health care DOES EXIST.

    in most every 3rd world country in the world.

    please educate me on why it is about 3rd world free market that we need in this country for healthcare?

    I could be “sold” on free-market health care … but I’m not at all convinced that an unfettered free market “delivers” the goods…

    you ought to do a separate blog on the best examples in the world of “free market” health care…

    I realize it would be 3 sentences… but it would still be illuminating!


  14. Poor LarryG. He just can’t understand the difference between having a job and getting a handout.

    My Dad still has his old Navy uniform. My kids ask him what the various ribbons signify. Maybe someday he’ll say, “Well back when I was a government employee sucking on the government teat … this ribbon meant I was in direct combat and that ribbon mean I was fighting in China, etc.”. Then, maybe Dad will say, “LarryG is the source on this one. Getting shot at in several Asian wars is just like getting a welfare check or having the government pay for things I need without my having to work at all.”.

    And, of course, LarryG wants a state government. How else would he steal from the places that carry their own weight?

    As for the Virginia GA … dear Lord, do you even read the papers? North Carolina is miles ahead of Virginia. They created Research Triangle Park out of tobacco fields and political grit. They took the banking industry right away from Richmond and bolted it into Charlotte. As for Maryland, again … spare me. The highest median family income in the US. Start there. People making enough money to afford health care. What a concept! Maryland actually takes their role as a bay state seriously while Virginia plays “frat boy games” with regulations, BigAg and everything else. While William & Mary is graduating poets and UVa is minting lawyers, College Park is stamping out engineers and computer scientists.

    If Northern Virginia makes it through the inevitable federal downturn, it will be because we live close enough to Maryland and far enough from Richmond.

  15. re: this ribbon – it’s a govt job… and worse than that – there are usually 3-4 civilian jobs to support that military job – and many of them are contractors.

    we now spend twice as much for DOD as we did in 2000 … and we spend more for National Defense than we take in – in income taxes.

    wrapping oneself with the flag is how the tax&spenders for DOD defend their wanton waste of taxpayer dollars – that NoVa then becomes the economic “powerhouse” of Va.

    re: Md – the highest median income? ha ha ha.. yes.. from DOD…same Church different PEW!


    Va is reputed to be more well run than NC or MD… by more than one authority.

    I don’t defend Va per se – only to point out that we’re probably no worse than many other states that ALSO have Dillon Rule …INCLUDING Maryland.

    How in the world does Md … ALSO have Dillion Rule and not suffer near as bad as Va does?

    explain that please.

    College Park?

    Okay.. I’ve got you on this.

    Is it Md or is it the locality that makes College Park “better”?

    careful how you answer…


  16. LarryG – you just don’t pay attention, now do you. As TMT said, Maryland has de-evolved taxing authority to its three biggest localities … Baltimore, Baltimore County and Fairfax County’s twin sister – Montgomery County.

    How many localities in Virginia have that authority?

    And that’s just taxing authority. There are other authorities which are also more de-evolved in Maryland.

    Every state “has” Dillon’s Rule to some extent. It’s the extent that matters.

    Maryland is better run. Trust me, I own property and live part of the year in both states.

    One example of being better un is Maryland’s ability to have a higher median family income than Virginia. You claim both get their money from the DoD. Fine. Then why is Maryland able to better provide for its citizens than Virginia?

    Because they are better run? Really, this isn’t all that hard.

    I know state legislators from both states. While Virginia has some smart lawmakers, Maryland has the better average of the people I’ve met. By quite a margin.

    As for the locality of College Park – that’s irrelevant. College Park is on a better trajectory for STEM majors because Maryland is better run at the state level. They put their emphasis and focus on the right majors and the right universities located near economic centers. Kind of like North Carolina.

    Virginia is lost in the ozone. The state barely manages the universities. There is no viable plan to leverage higher education for economic gain.

    Just saw the latest Forbes rankings for the best cities in America for technology jobs. Guess who was number 2? Baltimore. You know why? Cause Maryland has Johns Hopkins anchoring Baltimore while UMD anchors their DC suburbs.

    Wow! The two areas of greatest economic activity have the two best universities. What kind of mad geniuses do they have in Annapolis? How do they think up these stunning and brilliant ideas?

    Virginia and MAryland have been swimming for years in a sea of federal money. When the water level falls it will be clear that Maryland is wearing a bathing suit while Virginia is swimming naked.

    And it will be all the Clown Show’s fault.

  17. Peter Galuszka Avatar
    Peter Galuszka

    With all due respect, if you haven’t had to shop for health insurance and endure the rejections and then squeak by under a deadline that will cost you, you really don’t know what you are talking about on this topic.

  18. Peter, with all due respect, if you persist in describing the current health care system as a market-based system, *you* don’t know what you’re talking about on this topic.

  19. For what it’s worth …

    I have been to Denmark many times. I know many Danes. Wealthy or not, Danes rave about their state run health care system. Even the wealthy Danes I know prefer the state run system to the very small private system.

    My current company has a software contract with the Danish National Health Care system. They are remarkably efficient and far more facile with information management than health agencies in the United States.

    I normally don’t support more government or larger government. However, the American system is broken. I see no examples of successful free market systems. I see a number of examples of successful government run systems.

    The following article is brief but accurate based on my experiences in Denmark:

    Of course, the government in Denmark is ranked among the least corrupt in the world:

    Which brings me to my main point … a point LarryG just cannot understand … American government debate should not be about conservative or liberal, Republican or Democrat. It should be about competence vs. incompetence, corrupt vs. honest.

    I have no problem paying higher taxes to a competent, honest government. However, that is not what we presently have at the federal or state level. Therefore, I see no point in feeding more of my income into what has essentially become a criminal enterprise.

  20. And to Peter and Jim ….

    Speaking of corrupt, incompetent and dishonest government ….

    Nice job of the Mayor of Richmond in obviously having two sets of rules – one of the Tea Party and another for Occupy Richmond. Then, using his office to harass the Tea Party with a tax audit. Disgraceful. Jim, I assume this is a location variable cost? If so, its decision not to charge the Occupy Richmond crowd the same costs it assessed against the Tea Party represents yet another example of soaking all of us not living in the City of Descendants for the political beliefs of those living in River City.

    If you try hard enough you can see subsidies in the cream swirls in your coffee each morning.

  21. re: Md and taxing authority.

    I’ll make Groveton a deal that if he will provide the specific advantages that Montgomery county has in taxing authority, I’ll give more credence to that claim.

    In terms of “better run” – here’s one assessment:

    Rank – 7th. Virginia

    Debt per Capita: $6,939 (22nd)
    Unemployment Rate: 7% (10th)
    Home Price Change (’06 – ’09): 3.4% (31st)
    Median Household Income: $59,330 (8th)
    Virginia is in the top ten in median household income, percentage of population below the poverty line, violent crime rate, and unemployment. Like many of the other states on the top of our list, it also maintains an AAA rating from S&P. Virginia’s savvy marketing has resulted in a 16% increase in state tourism in a year, the highest of any state in the U.S. Department of Commerce’s 2009 Overseas Visitation to U.S. States, Cities and Traveler Characteristics Data report.

    9th. Maryland

    Debt per Capita: $6,661 (20th)
    Unemployment Rate: 7.3% (13th)
    Home Price Change (’06 – ’09): -4.8% (42nd)
    Median Household Income: $69,272 (1st)
    One of only two Northeastern states in the top ten, Maryland benefits from having the highest median household income in the country, as well as the third-lowest poverty rate, with 9.1% below the poverty line. However, the Old Line State ranks eighth-worst in both violent crime rate and property devaluation, with a 4.8% drop from 2006 to 2009.

    Now – these are facts and I realize actual facts are troublesome concept for Groveton at times…


  22. re: partisan divide over health care

    I’m ALL FOR FACTS and this is why I say for any/all countries look at the per capita cost and look at outcome metrics such as life expectancy.

    and the facts tell you that the best health care systems in the world are run by govts… the same govts that Groveton say are corrupt and incompetent.

    What Jim Bacon and his ilk advocate is a system that does not exist – a grand “experiment” that is not seeking cost-effectiveness as the explicit goal but rather ideology.

    one of the best market-based health care systems in the world that works quite well is Singapore – which is, ironically, offered up by conservative groups like Heritage as an example of a private sector market-based system – when in fact – it’s a wholly-constructed govt enterprise that basically does what ObamaCare seeks to do but is relentlessly demagogued.

    Singapore mandates a hefty payroll tax, individual mandates, HSAs held by individuals, subsidized catastrophic insurance, requires providers to post their prices, etc, etc.

    Notice I say nothing about left or right… only the specifics including cost effectiveness.

    When I hear conservatives say that they are after the most cost effective system regardless of govt involvement.. then I’ll give them a second listen.

    Right now they offer no solutions and prospect of a solution – only a intransigent philosophy that advocates a system of which there are no real world analogs other than 3rd world country health care.

  23. Groveton, Regarding well-run government health care systems: I have no doubt that Denmark has a great government-run health care system. Denmark also is a homogenous society with commonly shared values, and among those values are honesty, lack of corruption and a sense of personal responsibility. A government-run health system will be far more effective if people don’t lie, cheat or game the system, and if they take responsibility for their personal health. Take the same system and transplant it into the United States, and do you really, honestly think you’d get the same result?

    Regarding the city of Richmond… Yeah, there’s a double standard there regarding Occupy Richmond and the Tea Party. What else do you expect from a Democrat-run city? Compare and contrast the efficiency and competence of the city administration with that of neighboring counties, Henrico and Chesterfield, both of which are very well run. (I draw a distinction between administrative efficiency and competence and land use policy, which in Henrico has been intermittently disastrous and in Chesterfield almost uniformly disastrous.) Inefficiency and incompetence seem to be the hallmarks of inner-city governments. You see the same differences see in Northern Virginia vs. Washington, D.C.

    Another headline in the Times-Dispatch today: The Richmond central post office is the worst in the country, ranked by relevant quality metrics. Don’t lose a chance to use that factoid to indict the entire Richmond metropolitan area and everyone in it!

  24. Larry, your antipathy to market-based health care strikes me as purely ideological. Your argument to date consists of the fact that no other wealthy country in the world has a market-based health care system. So? All that means is every wealthy country in the world has fallen sway to the same liberal-left philosophy. You don’t account for the differing homogeneity/heterogeneity and health status of different countries. You don’t account for differing methodologies for measuring health and life expectancy. You don’t account for the fact that Euro health care systems also experiencing skyrocketing costs (though from a lower base) and, as well documented in England, have increasing quality problems (people dying, neglected, in gurneys in the hallway, that sort of thing). You don’t account for the fact that other health care systems are free riding upon the innovations introduced in and paid for by Americans. You totally ignore my market-based critique of how government is the source of the many of the problems in American health care. And you refuse to engage on the issue of how best to inject innovation, productivity and quality into the American health system.

  25. Jim – we currently pay twice as much per capita as any other industrialized country in the world, do not cover everyone and rank way down the list in life expectancy and infant deaths.

    what is partisan or ideological about the facts?

    wow… you have a long list for me to deal with – but I will:

    “All that means is every wealthy country in the world has fallen sway to the same liberal-left philosophy.”

    do you classify EVERY EXISTING universal health care country as “liberal”?

    does that include Japan, Australia, and Singapore?

    “You don’t account for the differing homogeneity/heterogeneity and health status of different countries.”

    what, pray tell does that have to do with the price of tea in China? ALL of the very diverse industrialized cultures do better than us – using an approach that we reject while at the same time we have no real proposal..just a bunch of ideas from different people – and none of those ideas have coalesced into a specific alternative legislative initiative – rather they are used as proxy arguments against existing methods including ObamaCare.

    ” You don’t account for differing methodologies for measuring health and life expectancy.”

    of course I do. If you have a better ranking system then provide it. you don’t.. you just reject the current …. in other words.. you have no approach just opposition to the current.

    You don’t account for the fact that Euro health care systems also experiencing skyrocketing costs (though from a lower base) and, as well documented in England, have increasing quality problems (people dying, neglected, in gurneys in the hallway, that sort of thing).”

    ALL countries are experiencing these cost pressures. ALL countries DO RATION health care… don’t fool yourself. We DENY health care to people in this country – that’s a worse kind of rationing system that waiting on a gurney but you get that from the right wing anyhow … treating cherry-picked anecdotal data as if it means something more than that. that’s not a legitimate way to actually do a comprehensive measure that actually deals with the issue in a legitimate way.

    “You don’t account for the fact that other health care systems are free riding upon the innovations introduced in and paid for by Americans.”

    and vice-versa guy. A LOT of innovation comes from other countries…also but what the heck does that have to do with your guys coming up with a viable competitive alternative instead of whacking on the current existing systems?

    “You totally ignore my market-based critique of how government is the source of the many of the problems in American health care.

    that’s the party line but what do you say about the govt-run Singapore system? How come we have a bad govt-run system and they have a good govt-run system and your solution is to take govt out of the equation?

    how do you logically get to this?

    “And you refuse to engage on the issue of how best to inject innovation, productivity and quality into the American health system.”

    I’m all for it but I don’t rule out a govt role like you do.

    I ask you to show me systems that don’t have a govt role – they do exist… but you run away from this… why?

    name a country that does not have the govt involved in health care that you would cite as “promising” or “on the right track”.

    you cannot or will not… so my view is that your argument has a lot of hypocrisy in it.

    if you really believe what you say – then you show how instead of attacking the systems you don’t like.

    show some countries that are, in your view, …. on the right track with health care.

  26. here is a timely article from the NYT on MedicAid – and the relationship between the Feds and the States:

    so I issue this challenge:

    tell me how you would handle health care in Va for the folks who currently rely on “govt” healthcare.

    be innovative!

    Suggest how Virginia could promote private sector healthcare for those currently dependent on the “govt”.

    Wouldn’t that be a more positive approach than using arguments against govt healthcare?

    It’s not like other states themselves have not taken the bull by the horns on health care… Mass and Utah to name two.

    So how about a plan for Virginia since this is a Va blog first and foremost!

  27. Gee, Larry, nice challenge. Write my plan for re-ordering the delivery of health care in Virginia? Next time I have to research and write that book, I’ll post it on this blog first.

  28. Jim…. that’s a reasonable request … tackling Virginia is prerequisite to taking on ObamaCare!


    seriously.. if you don’t have clue how to make it work in Va why would you think you’d know how to make it work for 50 states?


  29. One of the reasons Fairfax County has such high taxes is that the County tries to be all things to all people. It has taken advantage of the fact that the county is so close to Uncle Sam’s trough and, as a result, produces lots of tax dollars. Even in the most recent downturn, the County has not made any major cuts. Tony Griffin, who is a pretty good administrator, took the position that, if consolidation was beneficial, agency heads would propose it. What happens when the Feds finally stop spending like sailors landing after a two-year cruise? What would Fairfax County look like with 20% less revenue. Much of the rest of Virginia is also clueless. If our trough is empty, so is their’s. I agree with Groveton in that the Commonwealth does not have any plan to prosper except for the state’s access to Uncle Sam.
    I disagree that devolving more authority to the localities would make a difference. Let’s take transportation. Stripped to the basic facts, there is no plan or intention on the part of local government in NoVA to improve transportation. Keep in mind that transportation improves only when there is more road and transit capacity and the demand stays the same or decreases. At best, we will lay more track five minutes before the train arrives. At worst, we will use the citizenry as railroad ties.
    People know this and will not buy into these hollow plans to fix transportation. Mark Warner learned the hard way in 2002. Bob Chase’s latest effort will likely have similar results because people know the goal is just to raise taxes to enable more development that will make traffic even worse. If we are serious about improving transportation, we would enact a very strong adequate public facilities law, require cost-based traffic impact fees, reform the CTB, devolve control over local roads to counties and then provide more tax revenues to VDOT and DRPT.

  30. ” Bob Chase’s latest effort will likely have similar results because people know the goal is just to raise taxes to enable more development that will make traffic even worse.”

    devil’s advocate question – should we assume that new development is necessary to provide homes for new workers moving into the area?

    I think Chase and Til Hazel would say that population increases mean that more housing (development) is needed.

    what’s the argument against new development that provides housing for growth?

  31. I’ll say it again. I have no desire to develop my property. I just don’t think I should be prohibited from using it for anything other than agriculture. Particularly if this makes it more possible to sell expensive urban properties. My restriction amounts to an urban subsidy.

    I’m quite certain I can put up a nicer space and rent it for substantiAlly less than in Tyson’s. But, even if I do nothing, I would be money ahead without the phony agricultural designation.

    The damage is done in any case. Years ago I might have done something and profited by now. But that opportunity was killed by my former supervisor. He was able to retire in comfort, and I might have too, without his ” help”. Such people are devoid of imagination as to how much damage they do to people in favor of the land.

    Maybe what is being done is necessary, but Bacon has it completely wrong on the costs of what we are doing now and who is footing the bill.

  32. Housing for the next two million? Smart growth thinks we can accommodate it all around the metro stations. No new cars, no new traffic.


  33. Nice story on innovative health care on NPR. Condense an eye clinic in India. They figured that with 45 million blind people, 80 of which could be helped with surgery they needed to get more efficient.

    They roll two patients in at once and the doctor does both operations. They do as many as 40 a day, 2000 per year. American surgeons do 125 per year.

    That much practice makes their surgeons very good, and the suffer very low rates of complications – only a quarter of that in the UK.

    Such success means the attract people willing to pay market rates. They use the profits from fuse surgeries to provide many more for free – the clinic is nonprofit.

    They did so many surgeries they could not get enough lenses, so they started a lens factory, which is another profit center.

    The clinic points out that their profit for altruism model is superior to depending on charity, which is undependable.

    But the underlying feature is still the same – some people pay and others benefit.

    With health care there seems no way around that, and propositions for true market based care or medical savings accounts are nothing but libertarian cocaine.

  34. you know….. the states can opt-out of ObamaCare if they meet the same standard for covering people – like Massachusetts does.

    so… the complain that Jim Bacon and others who agree with his position is that ObamaCare is a bad way to do health care.

    so..Virginia can opt-out of ObamaCare if it has it’s own plan.

    yet… not a word from any of those who oppose ObamaCare as to how to do it “right” in Virginia.


    my take? It’s not really about ObamaCare… it’s about opposing anything that Obama proposes….

    if it were REALLY about ObamaCare – Bacon and others and the state of Virginia would simple say: ” Obamacare is wrong.. and Virginia is going to show how to do it right”.

    the silence is deafening…..

  35. TMT:

    You seem to be arguing with yourself.

    First you write, “I disagree that devolving more authority to the localities would make a difference. Let’s take transportation. Stripped to the basic facts, there is no plan or intention on the part of local government in NoVA to improve transportation…”.

    Then you write, “If we are serious about improving transportation, we would enact a very strong adequate public facilities law, require cost-based traffic impact fees, reform the CTB, devolve control over local roads to counties and then provide more tax revenues to VDOT and DRPT.”

    First, devolving authority over transportation would not help. Then, control over local roads should be devolved to the counties.

    I agree with most of your plan. My only material objection would be the exclusion of devolving taxing authority for local roads along with control of the roads. Despite their braggadocio, Henrico County seems to be getting screwed by Richmond in the funding allocation used to pay them for their management of local roads. They get less than the state-wide average per lane mile (a half-assed measure to start with) and they annually complain that they are being short-changed (which they are).

    The real truth in Virginia is that it’s not Republican vs Democrat. It’s not conservative vs liberal. It’s not even NoVa vs RoVa. It’s urban/suburban vs. rural/small town.

  36. Jim:

    Thank you for the point about the central post office in Richmond. I will add it to my anti-Richmond file. I would update my enemies list to include the postal service but all ten slots on my enemies list are filled:

    1. Richmond
    2. Richmond
    3. Richmond
    4. Richmond
    5. Richmond
    6. Richmond
    7. Richmond
    8. Richmond
    9. Richmond
    10. Richmond

  37. re: transportation in Va and ….

    Groveton’s apparent conflict

    first he says that Richmond screws NoVa on transportation funding….

    then he says the state gas tax needs to be raised ( to send more money to Richmond so it can screw NoVa?)


    so which is it?

    or how about this question: What is the BEST – way for NoVa to fund transportation needs?

    1. – depend on the Feds
    2. – depend on the State
    3. – fill in your own answer

  38. Ray, Thanks for pointing out the story about the Indian eye clinic. In this post from two years ago, I blogged about heart surgery at India’s Narayana Hrudayalaya Hospital. Those are real-world examples of what I’m talking about when I say we need to overhaul the delivery of health care in Virginia. I don’t know about the eye clinic, but the heart surgery hospital is very market driven, although it also has a philanthropic component to help poor Indians.

    Unless we can figure out how to drive down the cost of health care while also improving patient outcomes, there will never be enough money to pay for all the health care Americans want. Redistribution schemes just spread the pain. Rationing simply picks different victims. The only win-win approach to solving America’s health care crisis is to radically improve productivity and quality.

    Larry G. continues to try to make this a partisan issue. There are many scholars and commentators who have outlined plans for how to boost productivity and quality around a market-driven health care system. (I quote some in “Boomergeddon.”) I don’t care who adopts their ideas, Rs or Ds. Although Obamacare does have some minor elements that would be helpful, for the most part it takes us in the wrong direction toward more government command and control.

  39. partisan? Heck no!

    I’m open… welcome any/all innovations and reforms.

    I pointed out that Va could opt out of ObamaCare if it implemented it’s own system and I challenge Jim to show how Va could adopt a market-driven system to demonstrate that there are better approaches than ObamaCare.

    The problem I have is that the opponents of ObamaCare are more committed to opposition than to real live alternative paths.

    they keep suggesting that a “grand experiment” – not currently seen anywhere in the world – is “better” than all the countries that provide UHC.

    All I ask is for you to provide something more than “ideas” to back up your claim.

    Again… I do not care if it is D or R… but I do hold accountable those that say Obama Care is the wrong approach – to provide a real alternative.

    I suggested, in fact, that we take a closer look at how Singapore’s Health care system works – one that is apparently admired by folks form the Heritage Foundation and other right wing think tanks.

    So, I’ll put it to you. Should Va use the Singapore model ?

    yes or not.. no weasel words…

    my guess is that ANY health care that involves the govt will be vociferously opposed.


    Give me an alternative.

    Again.. No D’s or R’s… just produce the goods…

    The opponents these days are paper tigers… all show and no go.. they talk the talk then run away….

    the challenge still stands.

    show me a Virginia approach…. since Va is opposing ObamaCare.

    How about instead of Va just opposing ObamaCare, we actually put together something that renders the lawsuit moot – for Virginia?

  40. I think the thing to take away from fbe Indian examples is the Philanthropic component.

    Fundamentally, it is a non- capitalist model. I doubt we can ever have a truly capitalist health care system That works.

    Whether we have ” free” health care at the er, mandates, bonds for those without health insurance, of what have you, there will be some kind of socialism involved, or it wont work.

  41. The gas tax is still the fairest and least expensive way to collect transportation money.

    How it is dispersed is a different problem.

  42. I do not think India is a good model for health care myself. It’s just again an example of SOME isolated innovations that SEEM to be market-driven but there is a basic conflict in any system where we say we want it to be capitalistic AND philanthropic.

    Most 3rd world countries have that system right now and in in India ..there is “universal” coverage but in reality – it’s market-driven and many who are destitute get virtually no care at all. It’s not a good model IMHO.

    the basic …fundamental problem with health insurance is how to provide it universally when there are some who have very expensive or chronic conditions.

    We’ve opted in this country for a capitalistic type of system that allows people with pre-existing conditions to be denied insurance – and in the process the govt (taxpayers) are currently killing themselves to “save” certain segments of the population like kids …. and Moms, etc (MedicAid – the 500 billion gorilla in the closet that will be a trillion dollar gorilla in less than a decade if we don’t reform).

    but we also continue to pretend that we don’t “ration” health care in this country which is nothing short of self-delusional.

    we give examples of wait times and inability to get timely treatment while in our own country we pretend we do not have “rationing” …. even as we have millions who are not covered and millions more who ultimately do get care for “free” when their conditions have advanced to end stage diseases… and only then do we pay for them ..when their conditions require heroic financial efforts.

    The whole narrative is bizarre to me.

    it’s not about D’s and R’s. At one time, Republicans INCLUDED health care in their core philosophy of personal responsibility – now abandoned to “let the market provide health care”.

    Finally – in any country with universal health care, it is never mandated as the ONLY health care you can receive. It’s the MINIMUM. Anyone is free to buy more/better… anywhere they wish to go to get it.

    so .. basically .. the real debate is what the proper goal of health care SHOULD BE and my take on it is that the folks who oppose ObamaCare believe two things:

    1. – the govt should not be involved in it – let the private sector do it

    2. – if the private sector does not want to provide universal access – so be it.

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