mississippi and tennessee valleys. during a great depression, congress created the tva-- a federal project to control the ravages of the great tennessee river. why would anyone object? medical advances have added years to americans' lives. but not everyone can afford medical care's high cost. why shouldn't the government guarantee a minimum level of health care? in 1978, californians voted for propositio13 even though it was likely to result in cutbacks of government services. had the gornment gone too far? not everyone agrees on government's proper role. some feel government has gotten out of hand. others feel we're not doing enough. public goods and responsibility-- how far should we go? we'll examine that question with the
they are, usually in the form of taxes. why must the government provide these services? why can't we rely instead on the free market? it's aontroversial question, as we see in the case of private utilities versus the tva. the great mississippi flood of 1927 left 800,000 homeless. swelling waters overran levees throughout the tennessee river and into the mississippi turning northern louisiana into an inland sea. secretary of commerce herbert hoover called the flood the greatest peacetime calamity in the history of the country.
the disaster was predictable. the mississippi had flooded before. local authorities attempted to pvide flood control but with uneven efforts. the levee systemis only as strong as its weakest link. the building of dams could have prevented the flood. some legislators wanted to use federal funds. but they faced tough opposition on capitol hill. dams not only control floods but they can be used to generate hydroelectric power. that presented a threat of competition to the private utilities. to justify the expenditure required to build these dams electricity had to be sold. that would be produced by these hydroelectric units which were to be installed in the dams. that feature disturbed people who opposed tva.
they thought that was a function the government ought not to engage in. the private utilities were successful in their opposition until 1933 when a newdministration with an activistiew of government's role came into power. franklin delano roosevelt created e tennesseevalleyuthority, e tva. william jennings randolph was a member of congress during the roosevelt administration. the tennessee valley authority was a product of the new deal. it was not doling out money here and there. it was the planning of an area in the united states where there would be a development. hydroelectric power was a part of it. the plan to provide economic development to the appalachian region began with the construction of the norris dam on the clinch river. the tva plan
was ambitious. the regional economies could be improved if the waters were made navigible. the tva constructed housing, began a malaria control projec worked on agricultural development, and provided electrical power to this depressed region. some thought the government was going too far. along with the utilities others who feared economic loss joined in the opposition. coal miners feared hydroelectric power would reduce the demand for coal. the coal operato of wesvirginia came to washington, d.c. they were very angry at me because i was an open supporter of the legislation to create the tennessee valley authority. they said this will rob us of hundreds and thousands of jobs if these rivers are turned into productive areas
for the power systems that will not stop in the tennessee valley authority but will go into other regions of the united states. they saw it as something to oppose and they did so vigorously. the tva argued that flood control was its primary goal. the opposition argued that the government had no right being in the power business. within 5ears some 57 suits we bugagainsthe a. in 1937, the legal issues were resolved. e u.s.isiccourt upheld the tva ruling that the projects were, primarily, for the improvements of navigation and flood control. but the political issues lingered. tva had harnessethe valley's great flood waters. on the other hand, utility companies continued to claim
that the tva was an element of creeping socialism. we asked economic analyst richard gill how economists determine the extent of government involvement in a free-market society. as far back as am smith in the 18th century, even economists mostevoted the pnciple of a private market economy have recognized that certain areas virtually require government interventio the tva project of the 1930s had many different aspects. it provided what economists call "a public good"-- a good that has to be provided collectively or not at all. i'm speaking of the flood control and navigation improvements made possible by the tva dams. these improvements were in the interests of society but they would not have been in the interests
of private businesses. the benefit of flood and navigaon control was spread over the entire region and not limited to a few paying customers. flood controprotects thousands of people in the region and thousands more who may move in afr the dams are built. whether thousands or millions of people enjoy this benefit the cost of providing it is unchanged. the problem with a public good like this is that it's extremely difficult to charge private consumers for benefits they receive. my neighbor decides to pay for flood control but i do not. there is no way in which i can be excluded from the benefit of his flood control just as i can't be excluded from the benefits of a nationwide polio vaccine program, or national defense.
invasions of flood waters or foreign armies can be handled only in one way-- collectively. public goods provide one clear reason for government intervention in the economy-- a point on which virtually all economists agree. our country has accepted the need for the government provi public goods ke dams,raffic lights,poce, nationalefense that doesn't cover all questions of governmeninvolvementin ourives. what areovernment's responsibilities to people who can't afford necessities like housing, food or the subject of this instigation, healthare? health care costs ha risen astronomically over the past few decades. most of usope withhese costhrough insurance. but those withou medical insurance face being turned awayfrom emergency rooms or being dumped to public hospitals many miles away.
low-income people go without adequate mecal services and have a shorter life expectancy as a result. heal care usedo be within one'seans. but in the 1940s health care costs became more expensive as medical technology advanced and grew more specialized. the cost of medical care went beyond the means of most milies. the marketplace offered one solution-- private insurae coverage under the blue cross/ blue shield programs. by the end of world war ii only half the populaon was protecd by hospital insurance. many, particularly the aged, the poor, and the jobless had no coverage at all. in 1946, president harry s. truman called for national health insurance to cover all americans. his program didn't make it through congress. the american medical association blocked its ssage.
ama president dr. james sammons. the ama's opposition was in greatart responsible for helping defeat the truman plan. if this country's doctors had agreed with those plans, they would now be in place. on any proposed national health insurance program the ama will have the same objections we've had all along. it interferes in the doctor-patient relationship. it does not guarantee quality of care. it would be incredibly expensive on a national basis. there is no need for it in this country. that question has been debated long and hard. i think the argumes onehalf of a government role are overwhelming. they range fm the fact tfoa variety of reasons we have decide in a developed societies that at the time peopleecome il
weill t require them to payorhe full cost of the services they recei athat ryime. as medicalare costs grew more and more favored government action. wilbur cohen former undersecretary, hew. in 1950, when i was the director of research and statistics for social security, the federal security administrator asked me for ideas on how to get out of the inactivity we were in. i said instead of covering everybody, why not cover just the aged who were receiving social security? he thought that was a good idea. he asked me to draft the bill. in 1950, 1951, i drafted that bill for him. it was introduced in congress in 1951, 1953, 1955, 1957, 1959, 1960.
but in 1959, i persuaded senator john f. kennedy to be for the idea. that's what changed the whole situation. kennedy and johnson in the campaign of 1960 came out for medicare. kennedy appointed me the assistant secretary of hew to get the bill through congress. i spent five years doing that. finally, in 1965 medicare, an insurance program for those 65 and older and medicaid a feral/statehealth program for the poor, were passed. president lyndon johnson ew to independence, missouri and in the presence of harry s. truman signed the bills into law. medicaid covered the health care costs of millions of low-income people. we asked henry aaron if that met our sponsibilities to tseho couldn't afford medicacare
is wouldn't be a problem if all stes provided benefits as generous ashose in say the upper third or upper half of the distribution. sometates provide meager medicaid benefits-- fewer than 10 days a year ofospitalization severe limits on the number of doctor's visits one can receive-- so that evenoderate illnesses may not be fully protected under the medicaid program. in addition, the population that may be served by the medicaid program in many states is quite narrowly defined. so notwithstandi e fact thamedicaid is the fedel health program for the poor millions of poor americans are not covered by any benefits at all they don't have government protection or private insurance because they're unemployed
or because they work in jobs that don't provide such coverage. about 15% to 20% of the american population at the present time has little or no health insurance protection either through priva insurance or government programs. in the 1970s, medicare and medicaid costs mounted. as the burdens on state governments increasedthe progms rainto criticism from state governors like ronald reagan. medical, our medicaid program in california, is increasing by 50% aear. in i first 16 months it was budgete fo$7 million. t $876 million were spent. this program went $130illion in debt in that limited time. that debt must be paid out of ts year's budget. we're in trouble in this phase of welfare.
in california alone, hastily drawn legislation in this field can bankrupt our ste unless we ha revisions. the costs of medicare and medicai coinued toise atn alarmingate. asesul gislators havehiedwayfromrodi t nationalalth iuranceysm caedor by esidentruman evenug rge numbers ofmeca hanadequate accesstoeah care weskedconomistichardill abouthe economicationa fogornmentubsidizeal care. the fundamental argument for government subsidized health care r the elderly and the poor is that a market economy doesn't distribute income in the way most people consider desirable. a market economy does have its own principle of income distribution. a market economy pays people more e mo economically productive they are.
this principle probably keeps the productive process running rather smoothly, and this ultimately provides more abundance for all of us. however, many people can get left out in this process-- for instance, people who att both poor and ill. when a poor person gets seriously ill his already low productivity suffers a severe blow while his need for support mounts sharply-- often catastrophically-- given today's monumental medical costs. the medicaid program saysin effect, that this burden is too great r any individual bear by himself. the market may have a just appreciation of abilities but it doesn't have a just appreciation of needs. society has to step in. there is always some cost to this. when you start redistributing income,
you're increasing tax burdens on the economically more productive groups in the economy. medicare and medicaid programs have a tendency to up medical costs generally. as in many economic issues the question isn't whether but how much-- a question not infrequently raised during the past decade. [david schoumacher] california-- a land of plenty-- plenty of parks, vish public schools, and a tradition of providing public services. carnia enjoy these ts but there's a cost for these services. public officials at all levels of government decide what publicervices are required but when expenditus and tas continued to rise in the late '70s california'sitizens asked, how we determine when enough is enoug i'm mad as hel the people are mad as hell.
i'm getting madder than hell every day. howard jarvis led a taxpayer's revolt inalifornia. inflation and housing shortages led to a rapid increase in land values. this resulted in a steadily increasing property tax. many homeowners felt the burden of local taxes was too much. the revolt began by collecting over a million signatures-- enough to place proposition 13 on the statewide ballot. proposition 13 would limit property taxes to 1%-- a 60% roback which would wipe out $7 billion of local government funds. journalist ron sobel covered the tax revolt for the l.a. times. the inflation of the 197os translated into the unescapable fact that many california homeowners were paying more in property taxes or faced paying more in property taxes than the actual mortgages on their
homes. many of these people were older individuals on fixed incomes who, had this not carried, certainly would have lost their homes. they couldn't meet their tax payments. at the polls propositio13 easily passed with 65%f the te. and the tax revolt was in the national limeght. the victory for proposition 13 is the openg bate in a new american revolution. we have a new revolution against the arrogant politicians and inseitive buaucrats whose philosophy of tax, tax, tax spend, spend, spend, elec elect, and elect isankrupting we the american people and the me has come to put a sto
how did proposition 13 affect local governmenterces? los angeles city council esident, pat russe. we cut our property tax by 2/3-- thatas $200 million out of our budget-- just about 20%. we lost about 4,000 employees over the period of the next year. we cut back on nearly all of our services. the priorities of the city were to maintain police and fire services. that meant that as you got down the line libraries and parks were severely cut back. tree trimming went out the window, except on emergency street repair... the things that make a difference in your daily life. dire predictions that permeated the campaign by the opponents of prop 13--
they didn't come true. there were not massive employee layoffs. there was enough flexibility in government to handle the direct impact of 13. there was not an immediate crisis in government. the changes were more subtle. the government did not grind to a halt. despite the feeling that the taxpayers had come out ahead other consequences surprised some voters. the biggest winners from prop 13-- i think this is very important-- was california business and california agriculture. as i recall, if one was creating a pie chart, you'd say in this chart that about 1/3 of the benefits from 13 went to homeowners. 2/3 went to business and agriculture. one group that did lose, in my opinion,
was the renter. jarvis had literally promised renters that savings would be passed on from apartment owners to the renter. and really that never occurred. but for the average taxpayer proposition 13 seemed remarkable-- getting a break on taxes with little sacrifice on services. jarvis was back in 1980 with a new initiative-- proposition 9, which would cut state income taxes by 50%. the opposition led by the california public employees union focused its tv campaign on fairness. is it fair that if 9 passes you get a huge tax break and the average person gets nothing? i didn't write proposition 9. why not reduce the sales tax so everyone benefits equally?
as i said, i didn't write proposition 9. you could have fooled me. the campaign against proposition 9 was successful. the tax revolt was put down. what level of public goods is desirable? that depends on your viewpoint. some believe the government's role should be only minimal filling in gaps left by private enterprise. others believe the government should play an activist role. but as the citizens of california demonstrated the public will decide. economist richard gill offers a commentary on how the government's role in the economy is determined. the sharp controversies over propositions 13 and 9 in california suggest that people differ intensely about how deeply the government should involve itself in the economy. this is understandable since there is usually a difficult tradeoff involved.
the more public goods we have, the fewer private goods. the more we redistribute income to the needy, the greater the disincentives for the productive. but the tax revolt across the nation in thely 1980s raised the question of whether federal state, and local governments accurately represented tthe people's will in this matter. the government was pictured by the tax cutters as an independent organism with strong drives of its own-- drives in one direction only-- expansion. the feeling that government spending was inefficient and getting out of hand was as much a political as an economic statement. it said to bureaucrats and politicians, "you're out of touch "with the people you're representing. we don't want you to expand."
so we have a difficult economic question-- what are the costs and benefits of government expenditures-- and also the political question-- will the government we're dealing with carry out our wishes in this matter? one needs no crystal ball to predict that the debate will continue on. [david schoumacher] despite the advantages of the free enterprise system, there are certain goods and services that the market will not provide. it has generally been accepted that the government will provide those services. the government's responsibilities have evolved, however, pushing beyond economic reasons for government involvement into broader social responsibility. how far we should go in this direction depends on the public's perception of needs, of government's effectiveness in serving them,
august 9, 1999. on december 8, 1997. november 30, 2002. i was hit by a drunk driver. i lost both of my legs. a stranger tried to kill me with a hammer. our 7-year-old son evan was murdered after signing up for basketball. i was severely beaten in a hate crime. i was raped. when your child is murdered, it's devastating. you have to re-think life again. it just keeps on running over and over in my head all the time. while i was in the hospital, a friend told me about victims' services. they helped me with my medical expenses. they helped me with counseling. a victims' advocate stood by us