Author Archive: Bill Orr

About Bill Orr

University of Virginia Masters in English. Have lived in Argentina, Panama, Delaware, Virginia, California, NYC, and New Jersey for the last 25 years. Former editor and manager at McGraw-Hill, former President of Gay Activist Alliance of NJ, founder of NJ ActUp, and North Jersey Community Research Initiative (NJCRI) in Newark.

NJ Economics: “Eyes Wide Open” not “blinders”

The two recent Christie vetoes of Family Planning and “Homebuyer tax credits for newly built homes, beyond reflecting disdain for women and middle class home purchasers, are signs of a financial lack of vision and a reckless disregard for the need to stimulate a floundering NJ economy.  In the case of Family Planning for every dollar NJ invests the feds will contribute nine dollars – money that will help hold on to jobs and circulate throughout our state. In the case of home sales, NJ continues in a slump, drastically impacting construction and related industries, with no hope for recovery until there is an improvement in the housing market.  

The outlook for our state economy remains dire. The Department of Labor reported jobless claims in NJ rose this week the most in any state. At a Federal Reserve regional press conference Fed economists said, “Recently, economic activity in New York State, New York City and Puerto Rico appeared to be recovering, while activity in New Jersey remained essentially flat.” The Star Ledger reported Friday, “Bank economists said a slow jobs recovery and a shrinking manufacturing sector mean the Garden State, which entered the recession six months before the rest of the nation in June 2007, could also be one of the last to emerge.”

The conservative philosophy of “cut, cut, and cut” does not work in a depressed economy as we learned during the Great Depression.  A more progressive vision is needed, one which seeks to keep people employed, strengthen an anemic housing market, reduce fees, taxes, and expenses on those least able to afford them, provide loans and incentives to small business, and as suggested in a Federal Reserve article, temporarily raise income taxes on high-income households. Without this broader vision not only do more people suffer unnecessarily, but state revenue continues to decline and undesirable unemployment-related expenses increase, resulting in an ongoing vicious cycle and a stagnating economy.  

The legislature in the Family Planning and Homebuyer Tax Credit bills has addressed needs which are both socially/medically relevant and economically necessary. In confronting a governor with blinders, the legislature with eyes wide open should continue to promote progressive solutions.

HIV Advances Stalled: From Vienna to USA to NJ

With the 18th International HIV/AIDS Conference going on now in Vienna, the news has remained depressingly similar over the last 10 years. Yes, treatments have improved significantly and there have been other important developments, but over this period there has been each year about 55,000 Americans newly infected and an even larger number who lack proper access to care. The White House just released its National HIV/AIDS Strategy, which calls for steps to reduce the annual number of new H.I.V. infections and increase the proportion of newly diagnosed patients linked to clinical care.

Data from our Department of Health indicates that since the beginning of the epidemic in NJ there have been 73,800 documented individuals with HIV/AIDS, of which 38,788 have passed away and 35,102 remain alive. The HIV-related health disparities are particularly pronounced in NJ where one in 62 Blacks and one in 184 Hispanics are living with HIV/AIDS vs. one in 701 Whites. The number of people who were exposed through injection drug use has shown a downward trend between 2005 and 2009, while those exposed through male-to-male or heterosexual contact has continued to increase. 31% of our cases, higher than in other states, are women.

The problem is that internationally wealthy donor nations are reducing their funding, nationally the White House’s plan does not propose an increase in funding, and in NJ our governor and legislature are cutting funding. In our NJ budget there is a reduction in the number of individuals who qualify for the state drug distribution program, a $5 million cut in the HIV rapid testing program, and increases in medical co-pays. As the NY Times has editorialized, “Slowing the spread of H.I.V. will require multiple approaches. The challenge will be to find enough money at a time of limited resources when AIDS financing has flattened out.”

Discrimination, stigma, and public apathy remain as significant barriers. However, they existed initially with cancer as well, but Americans, regardless of whether they thought they were at risk for cancer, united to demand solutions. Every nine-and-a-half minutes, another person in the United States becomes infected with HIV, and many of them will struggle for access to care. We must continue demanding more and better research, prevention, testing, treatment, and access for all Americans. Imagine how much better off we would be if 25% of our current war budget were transferred to improving our health.

Summer Reading: Privatization Report Lite

Promoted by Jason Springer: We’ve had some posts about the privatization proposals and here’s Bill Orr’s take.

The NJ PrivatizationTask Force Final Report is superficial, sloppy and biased. As a Business Plan it is an abject failure because it provides no support for its many claims. A venture capitalist, university professor, or CEO would grade it as “C” as in crap, “I” as  in  incomplete, and “U” as in useless. A governor reading such a report should provide similar grades, unless it happens that he agrees with the conclusions and is willing to ignore the lack of quantifiable substantiation.

In the introductory section the report pays lip service to such goals as  quality, timeliness, risk management, expertise, and innovation. However, in discussing potential targets for privatization it generally fails to mention such goals. For many targets it states a specific cost saving but provides little or no basis to justify the claim.

For example, the report recommends four activities of the Department of Corrections for privatization and lists the anticipated cost savings:        

  

Inmate Medical Services ($6.9 million) The recommendation vaguely states, “Through a combination of privatization and changes in the delivery and management of inmate medical services the state should realize a 15% saving.” The basis provided for such savings is the plan to introduce a wellness program (vaccines, health tests, etc.) which experts agree improves healthcare but does not necessarily reduce costs. Biases are introduced into the report with two statements: 1) the fact that there is an opportunity now to privatize because the provisions of an inmate healthcare law suit have just expired, and 2) “NJ is generally considered to provide quite generous medical services in its correctional facilities.” This significant change is presented in a few paragraphs with unsupported generalizations and no evidence any homework was done.

   

Prison Food Services ($6.8 million) With a current cost of 3 meals per day at $8.18 per inmate the report concludes that costs can be reduced to $6.00 per day because Kansas recently privatized its food service and realized a 25% savings. Such a statement is fatuous with no further explanation or footnotes. Also do we really think $6.00 per day is sufficient for acceptable food?

Food Distribution Network (TBD) The only explanation for this change is that the state’s system is outdated and that all but three states have privatized the delivery. There is no explanation as to why the system is outdated, what system would supplant it, or what the cost savings might be.

Inmate High School Education & GED Program ($2.7 million) The recommendation is: “It is difficult to ascertain what the savings would be. That said, based on a 10 to 25 percent range of expected savings, the state should expect to save anywhere from $2.75 million to $7.13 million annually.” There appears to be no due diligence or homework done on the matter, so we are provided a “guesstimate,” with no other benefit stated.

The report is an embarrassment and no basis on which to make important decisions.

HIV Meds: “That’s Your Governor.”

Promoted by Rosi

A provision in the recently approved state budget will mean that about 1,000 HIV/AIDS patients can no longer receive free medication from the AIDS Drug Distribution Program. These meds are the difference between life and death, but they are expensive – anywhere from $12,000 to $30,000 per year. The maximum annual income allowed to qualify for the program effective August 1, has been lowered from $54,150 to $32,490. People earning $33,000, for example, would now have to spend between 36% and 91% of their income just on medicine.    

As someone in the Health Department succinctly explained when a patient faced with this crisis asked what he should do, “We offer nothing else here. That’s your governor. We didn’t do it.”  So welcome to the brave new world of less government, less spending, and less compassion.

It took many years (too many years) of research to develop the drugs that are now successful enough so that patients can not only live with HIV but also work and be productive individuals. Starting August 1 some of these patients may quit their meds and die soon or stop working and seek Medicare or Medicaid. There are some limited alternatives including NJ Workability Program, but they are complicated. Individuals faced with this dire situation should contact HIV/AIDS service organizations such as NJCRI (973.483.3444) and Hyacinth (732.246.0204.)

The State only contributes about 22% of the cost of these drugs as the remainder is paid by the federal government and pharmaceutical firms. For those who quit their jobs the state will have to assume higher costs. For a productive  individual having to become a “ward of the state” is a crushing blow.

But as was explained, “That’s your Governor.” And because of the breadth of the cuts through so many different programs, in how many other cases will people seeking help from their government be told, “We offer nothing else here?”  

King James and King Christie

Passed downcourt by Rosi

Basketball is a team sport. To win the finals a team generally needs three superb players. When a team lacks multiple strong members and someone like LeBron James takes over the game, he scores a lot of points, but  because other members stand around submissively watching their leader, their team does not do as well. The Lakers and Celtics, each with multiple superstars, fared better in the playoffs. In the unlikely event that LeBron were to decide to join the Nets, he could score lots of points, but he would not have key high enough caliber team members to ensure play-off success.

In NJ government where a team of Executive, Legislative, and Supreme Court leaders should be striving together for excellent governance, we have King Christie taking over the game while others often stand by and watch. Not a formula for victory.  Even on a basketball team different players have different personal agendas, but like our NJ leaders they are paid by the same source and should have a single objective of succeeding in their task. NJ governance would benefit from at least three key players, but is currently operating with only one superstar.

NJ Nets would not benefit from King James, and NJ is not benefitting from King Christie. Neither the Nets nor NJ need one superstar. They each need a roster with several seasoned, high-performing leaders.

Now Is the Time to Hasten Our Withdrawal

Here’s a link to analysis from Princeton prof Julian E. Zelizer to go along with this diary. Paragraphs 10 & 11 particularly cogent. Promoted by Rosi.

Our War of Independence which we are proud to celebrate today was hard fought and successfully won. Most, not all, of our other many military engagements have been ill-advised, cost too many lives, wasted money, and proven to be non- productive, and some have ended in embarrassment. Once begun presidents and legislators have a hard time stopping wars, as some form, and often a changing form, of “Victory” is foremost in their minds. Such is our sad history in Afghanistan and Iraq, where no pre-established exit plan was created and the goal posts to justify continuation keep changing.

Five months after elections, Iraq has still not formed a government, adding another impediment to our withdrawal. Mutterings within the military imply the possible need for extending our stay. In reality shortly after we reduce troops to a “holding” number, whenever that occurs, Iraqis will do as they wish, not as our leaders proclaim. So now is the time to to hasten our withdrawal.  

In Afghanistan what started as a counter-terrorism action (kill al-Qaeda and its leaders) has morphed into a counter-insurgency activity (strengthen the government and people) which requires a timeframe of another ten years not the one year which the President advocated. Indeed, interpretation of the July 2011 deadline seems constantly in flux. Most of al-Qaeda has left to greener pastures, so much of our effort is in fighting different anti-government elements, which upon our departure, whenever that is, will do as they wish anyway. While a limited counter-terrorism action in the border area has some merit for us, Afghanistan, and Pakistan, our government’s notion of creating a stable government and nation in such a short time frame is a pipe dream. So now is the time to hasten our withdrawal.

So today while we enjoy this weekend and celebrate the independence one war brought us, let’s have no illusions: now is the time to hasten our withdrawal from Iraq and Afghanistan.

A Pretty Band-Aid vs. Real Gain

A final deal has not yet been struck. However, for much of the public which feels anger and frustration over NJ’s high property taxes, a cap of 2% (or something similar) sounds great. I can hear the sigh of relief, combined with praise for our governor and disgust for prior governors. But in fact the cap is not very hard and not a solution – just a pretty band-aid. Individual localities by a vote of 50% +1 person can overturn the cap and raise the rate. Also there are various exceptions locales can use to increase the rate. By following one of these two steps they maintain the status quo of high taxes with no real reform.  

The Office of Legislative Services (OLS) will only say that the cap may (not will) lower property tax levies. OLS points out the levies are affected by labor contracts, cost of goods & services, debt service requirements, non-property tax revenues, number of pupils to be educated, etc. Since many of these items can be the basis for an exception the final rate could be considerably above 2%. In many or most localities anticipated cost increases in one or more of the above items can eat up so much of the budget that either draconian cuts elsewhere become necessary or the use of exceptions or voting to overturn the cap become essential.      

Our Governor’s solution is his “tool kit,” which among other things aims to impose reductions in the number of local employees in Civil Service and renegotiate existing labor contracts. What its fate will be is still unknown and what its impact will be on property taxes is anyone’s guess.  To me it looks like huge sledge hammers being tossed from the sky upon us by an angry god (or angry governor.)

The advantage of the government-imposed cap is that it will make people realize that change is needed but that the cap is just a band aid.  If towns seek exceptions or overturn the cap they are accepting the status quo of ever higher operating costs and property taxes – not the promised land they sought.  Their other options are: 1) The tool kit imposed by government and seemingly draconian, 2) A substantial erosion in local services or 3) Creating their own local/regional sharing and consolidation programs with help from the government.

The band aid will not solve the problem, only make people realize they need a more lasting solution, one which is already in their own hands: co-joining of school districts (ideally one per county) and municipalities (by county or with a larger anchor city, or in some other combination of 10 or more towns.)  Doing away with substantial management overhead, duplication of equipment and facilities, and centralizing departments are key ways to reduce costs, improve quality of services and halt the escalation of property taxes. Some pain – much gain.

 

Medical Marijuana Mess

ATCs are Alternative Treatment Centers. Promoted by Rosi Efthim

In her recent weekend NJN interview Commissioner Dr. Alaigh shed little light or enthusiasm on the Medical Marijuana program: she expressed her belief that the Governor was a strong proponent of health matters (yet to be demonstrated,) and her realization as a doctor that the program may be beneficial (damning with faint praise.)  She also showed concern that ATC’s not be widely available and that because the law was complex it would take considerable more time to establish policies and procedures. They were words of a cautious administrator with no sense of urgency or advocacy for this issue.

What might have been a highly beneficial, straightforward law has devolved into a mess. Christie-led Republican legislators tinkered with it during the lameduck session, and six months later the program remains mired in uncertainties and delays. The amendment passed this week does only one thing: it delays the effective date of enactment by 90 days until October 1. The original law still provides 90 additional days, in effect until Jan 1, 2011, for finalizing regulations. Significant uncertainties remain to be resolved: who will produce the cannabis and who will sell it.

There have been reports that the State would like Rutgers to produce the cannabis and hospitals to sell it. That is not what the law says. The law requires alternative treatment centers (ATC’s) to be the ones both selling and producing the marijuana.  It is unlikely that Rutgers would want to become a seller and it is unclear whether it even wants to produce it. Also by law the first six ATC’s have to be non-profits, but some hospitals are for-profit and even-nonprofit ones are unlikely to be enthusiastic about selling cannabis. The ideal non-profit ATC’s would initially be community-based agencies located mostly in urban areas, but security and high costs make marijuana cultivation there impractical.

The solution is for an amendment to the law which allows the Health Department to select several producers who are not required to become ATC’s, and Rutgers could certainly be one of them. With several producers, as opposed to a monopoly, there is more likelihood of a steady, dependable source of high quality cannabis at a reasonable price. By law the first six approved ACT’s would still have to be non-profits, but they would not be required to cultivate it.

There needs to be the amendment proposed above, some serious butt-kicking, and possibly a lawsuit for this critical service to see the light of day.  

NJ’s Grim Future

Some of what we see in the Governor’s budget is similar to what is happening in other states. It is a response to years of over borrowing, over spending, a terrible recession, “entitled” labor and government employees, and “coddled” less-advantaged people. Reducing some spending and borrowing became essential, and began under Corzine’s administration, in order to maintain a mandated balanced budget. However, our new budget is not a wise response and will  lead to a grim future of either a double-dip recession in NJ, or a lengthy period of little or no growth, with desperate prospects for the unemployed and low income residents. Right now we see a lowered stock market, continued high unemployment, and a seriously depressed housing market.

Last year, with the American economy in deep distress, the Federal government correctly responded with a stimulus program which provided temporary relief to NJ and other states. With that relief coming to an end the states are now more on their own. Our new budget shows disdain toward those less privileged, panders to the wealthiest, enhances class warfare, damages our infrastructure, and insists on belt-tightening when the real problem is not enough growth-enhancing spending. “Less government, less spending, and less taxes,” – a simplistic mantra – did not get us out of the great depression, and it won’t get us out of our current crisis. Our governor speaks in cliches, with stubbornness and mean spirit – not with the wisdom and good judgment we need now.  

Medical Marijuana: The Clock Keeps Ticking

What should be medical policies for the Health Department to resolve has become a political matter with interference from the governor’s office. Our governor should relax his heavy-handed micromanaging ways and let the experts make the decisions. According to today’s Star Ledger, “Gov. Chris Christie’s administration said Rutgers University’s agricultural center should grow the pot and hospitals should dispense it.” In addition, lead sponsor Senator Scutari seems poised to seek a 90 day extension.

Because of the cost and security problems of dispensaries in urban areas trying to cultivate the cannabis, it makes sense to seek other growers. Such requires a change in the Medical Marijuana Law, which the legislature should enact. Rutgers University would be an excellent choice, but it should not be the only provider. Poor weather or glitches in the indoor cultivating process can result in supply disruption. The goal is to produce consistently high quality and quantity at a reasonable price, best achieved through multiple cultivators.

The institutional, antiseptic, and bureaucratic, atmosphere of hospitals is not the best setting for dispensing the cannabis.  Non-profit organizations which already provide multiple services to the potential clients can better serve these patients in helping them with required paperwork, counseling, and support sessions. Purchasing cannabis is not like buying a loaf of bread. The complexity and restrictions of the law call for the involvement of social service agencies which have the patience, expertise and experience to assist patients, liaison with physicians and provide the extra services which are not “cost effective” for a hospital.

The original law stipulated that the program should be implemented by July 1 with an additional 90 days to October 1 to review and finalize the regulations. The Health Department has been asking for more time to draw up the policies and procedures.  If the legislature agrees to grant an additional 90 day extension until January 1,such should be the last extension. Governor Christie must end his meddling, and the Department of Health must move forward rapidly to provide this critical medical service without delay. Medical marijuana: the clock keeps ticking.