Governance Reform

There's a lot of talk in Sacramento and around the state these days about budget and governance reform. That's good - with an unemployment rate about 12 percent, a Legislature who's approval ratings in today’s Field Poll hover at 16 percent and a Capital filled primarily with well-meaning people who lack the tools they need for success, it is time for substantive, specific and comprehensive reforms.

So where to start? Here are some ideas:

First, change the state budget process.

* Move to performance-based budgeting, where what the state spends of our tax dollars is actually measured against whether it efficiently and effectively produces the outcomes we were promised.

* Emphasize strong oversight of existing expenditures. Some states, like Texas, legislate one year and focus on over-sight of existing programs the next year. California should consider a similar system.

* Create a Sunset Review process to determine whether there is a continuing need for existing commissions, agencies and programs.

* Require the state auditor to participate in oversight hearings and report on whether past recommendations were enacted.

Second, reform the initiative process.

* Require initiatives that propose new spending to specifically propose how to pay for that spending.

* Require that one-time revenues only be used for one-time, rather than on-going, purposes.

Third, unshackle well-meaning legislators from the power of political party caucuses and the special interests that fund them.

* Pass the Open Primary Initiative on this year's June election ballot. Specifically, let’s change the state primary election nomination process for Congressional, Statewide and Legislative Elections to allow all voters to choose any candidate, and the top two candidates become the nominees for the November general election run-off, regardless of their political party.

There is a lot of talk about reforming the way our state government functions today, or more accurately, does not function. When people talk to you of reform, demand specifics rather than generalities.

These are a few of the specifics I would like to see in any comprehensive reform proposals seeking my support. Equally important, what are your priorities? Tell your Legislators and the Governor the reforms you want to see. This isn't a time to take pitch forks to Sacramento. Rather, it is a time we all pitched in to save and strengthen our state. Never forget, our Democracy was not created for us to sit on the sidelines. Get engaged and move things forward.

Health Care Reform

Here is some "Food for Thought" that aired Tuesday on 1590 AM KLIV during "The CEO Show," which I host:

Currently, Congress and President Obama are putting their final touches on what they hope will be comprehensive health care reform. Since health care accounts for one-sixth of the American economy, the decisions they make will impact the lives and livelihoods of almost every American.

From my perspective and the perspective of the Silicon Valley Leadership Group, there are core elements that we hope will be in any final health care plan: Universal coverage for all Americans; cost containment for individuals and employers; improved quality and coordination of care; an emphasis on wellness, diet and exercise; health IT; and tort reform.

The current House and Senate bills stack up against our priorities as follows:

• Universal coverage for all Americans: It looks like 96 percent would be covered; not 100 percent, but much better than today's 85 percent. 
• Cost Containment: In terms of reducing the cost of health care for individuals and employers, serious concerns remain that the current plans will not reduce costs in the short-term or even the mid-term. 
• Improved quality: We spend more per capita than any nation in the world but have poor health outcomes. We need quality, not quantity. The bill will create medical homes for patients and providers will be in charge of managing your health, not just treating you and sending you home. 
• Wellness: Forty percent of American adults are obese or overweight, and nearly 30 percent of children obese or overweight creating an epidemic that triggers largely avoidable serious illnesses like diabetes, heart disease, high blood pressure and cholesterol. Both bills could and should do more about this. 
• Health IT: Electronic medical records, electronic prescribing and disease management, telemedicine and other emerging technologies will bring us improved efficiencies, reduction in errors, and better outcomes, all positive byproducts of positive gains in incorporating health IT. This has the potential of being a strong aspect of a final bill. 
• Tort Reform: Avoiding frivolous lawsuits against doctors has proven to lower costs in states that have adopted thoughtful tort reform. Currently, such sensible steps are not in either plan. 

Comprehensive Health Care Reform: The chances look increasingly certain that something will pass, and be signed by the President, in the days or weeks ahead. I have shared the priority provisions of the Silicon Valley Leadership Group. They may or may not be yours. Whatever your priorities might be, pick up your phone or click on your keyboard and contact your Member of Congress.

There is too much at stake to sit on the sidelines of this important national debate.
I welcome your feedback. Never forget, our Democracy was not created for us to sit on the sidelines. Get engaged and move the ball forward.