CMA Capitol Insight: An Insider's Report on California Politics

CMA Capitol Insight is a biweekly column by veteran journalist Greg Lucas, reporting on the inner workings of the state Legislature.

'Tis the Season

In college basketball, it’s March Madness. In the state Capitol, it’s September Scariness. All kinds of groups with all kinds of agendas worry how the governor, Edmund G. Brown, Jr., will act on the 700 bills that lawmakers dump-trucked onto his desk in the waning days of the legislative session that concluded August 31. In the last Insight, the lead item was tagged “Phew,” but that elation may have come a “phew” weeks too early — while lawmakers can’t pass more bills this year, the Democratic governor still can sign plenty. Those who have long observed the Capitol will accurately note that these bills can be substantive, simple or silly, but rarely a combination of all three. The scariness is that Californians must bank on the state’s chief executive to determine which is which and act accordingly.

On the Plus Side...

The governor signed a CMA-backed bill that offers scholarships of up to $105,000 to medical school students who commit to serve three years in one of California’s “medically underserved” areas, of which the federal government says there are roughly 200 — most rural, most low-income. The bill — AB 589 by Assemblyman Henry Perea, a Fresno Democrat — is actually a three-fer. While it increases the availability of medical care in the state’s underserved areas, it also reduces the mountain of debt nearly 90 percent of medical students shoulder after graduation. And, perhaps more importantly, increased financial incentives may help the state take a bite out of its growing physician shortage. That’s a smart move — assuming President Obama’s re-election — with the Affordable Care Act taking effect in 2014. The scholarships come from the non-profit Health Professions Education Foundation, which is supported in part by licensing surcharges paid by doctors and nurses. Wondering if there’s a need for that kind of assistance? The average medical school graduate starts his or her career $158,000 in the red.

Says Willie Nelson...

”My doctor tells me I should start slowing it down — but there are more old drunks than there are old doctors, so let's all have another round.” Divergent views abound.

Don't Sugarcoat It, Tell Us What You Really Think

Love him or loathe him, part of Gov. Brown’s uniqueness is the individuality he brings to signing and veto messages on legislation during September. There’s no doubt he personally pens — or very strenuously edits — these missives. They routinely bear his acerbic wit and his seemingly boundless quirkiness, and are accented with a dash or two of his ancient Greek and Latin education. Here’s one without Greek or Latin but a classic nonetheless: “This bill establishes a ‘Children’s Coordinating Council,’ consisting of members of government to advise itself on how it can improve collaboration amongst itself when it comes to delivering services to the children of this state. For almost two years now, this administration has worked to eliminate unnecessary boards, commissions, advisory bodies and reports so that government is not so overloaded with the work of form over the work of function. I commend the author’s heartfelt desire to improve the lot of all children in the state but the creation of another council is not the solution. If anything, it lulls us into the fallacy that forms can solve our problems. Instead, let’s try to be honest and thoughtful about the good we can do and then do the good — without the statutory decree, not because of it.” Not sure if the author of the bill appreciated the thought.

Curmudgeonly...

Is an adjective sometimes leveled at the septuagenarian governor. His veto of a bill by GOP Assemblywoman Linda Halderman, M.D., a Fresno physician leaving the Legislature after one term, might be a reason why. Dr. Halderman’s bill would have required the Department of Consumer Affairs to post information on its website regarding construction defects. "This has already been done," Brown said in vetoing Dr. Halderman’s measure. "So in keeping with the author's oft-stated mantra that government should not be wasteful or do unnecessary things, I am returning (your bill) without my signature." Kinda like on those old game shows where the contestants who wouldn’t be coming back were told: “Please enjoy these lovely parting gifts” — except not so swell a parting gift.

The Free Marketplace for Scrub Techs

Another veto by the Democratic governor of a bill mentioned here back in May means it’s still OK to be a scrub tech in California without completing a nationally accredited program for “surgical technologists” or passing a training program in the Armed Forces and receiving certification from the National Board of Surgical Technology and Surgical Assisting. “I respect the time and effort that surgical technologists have put into developing their skills and obtaining voluntary certification. I don’t agree, however, we need to establish ‘title protection’ for certified surgical technologists in law. For those who have taken the time to become certified, let the marketplace reward their higher skills and education.” California is home to some 5,000 of the nation’s 90,000 scrub techs, who carry out orders from registered nurses in preparing an operating theater and assisting during a surgery. As of one year ago, 1,400 of the state’s scrub techs had received certification from the national board, according to the Association of Surgical Technologists, which sponsored the bill. The American Nurses Association of California was opposed, saying it “minimizes the leadership role of the RN.”

Space, the Final Frontier

For limited civil liability, anyway. Among the bills the Democratic governor signed and chose to issue a press release touting the action was a measure giving the nascent commercial space industry protection from lawsuits if they warn passengers that space flight is inherently dangerous. (As though the issue was in dispute.) Supporters say that reasonable liability protections will help grow their industry. Gov. Brown agreed: “California aerospace pioneers like Virgin Galactic, SpaceX and the Spaceship Company are blazing a path to the stars with commercial space travel (and) this bill allows commercial space-travel companies to innovate and explore without the worry of excessive liability.” A little like MICRA, spaceflight companies would still be liable for injuries caused by gross negligence or ignoring a dangerous condition. What’s interesting is that the “warning” passengers rocketing into infinity and beyond must read and sign is not unlike those for inside-the-stratosphere activities like rock climbing, scuba diving, zip-lining, parasailing, hang-gliding and horseback riding. The first paragraph reads: “I understand and acknowledge that, under California law, there is no civil liability for bodily injury, including death, emotional injury, or property damage, sustained by a participant as a result of the risks associated with space flight activities provided by a space flight entity.” More than 30 years ago during his first go-around in the Capitol’s office, Gov. Brown was saddled with the sobriquet “Governor Moonbeam.” Maybe he’ll be on one of the first flights.

For What It's Worth

New York Mayor Michael Bloomberg says, “Canada sets aside 36 percent of their visas for people with skills they think their country needs. We set aside 6 percent. We educate the doctors and then don't give 'em a green card.”

CMA Capitol Insight is a biweekly publication for members of the California Medical Association.