Transcript read Eric Schnurer`s PowerPoint

Rightsize:
Government Budgets in the 21st
Century
Council of State Governments
January 20, 2012
The Government People Want
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Functional
Streamlined
Constantly improved
Lower- and-lower priced
Personalizeable
Not just left or right
Outline of Presentation
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Waste is a Terrible Thing to Mind
A New Twist
An Ounce of Prevention
Talkin’ ’bout de-Regulation
Providing Some Backbone
The Life Raft
Waste is a Terrible Thing to
Mind
Comprehensive Efficiency
Reviews
• Texas – first in the nation
– $4 Billion the 1st year
• National Performance Review
Clinton/Gore)
– $108 billion 1st year
• Our experience:
Consistently 5%
The Basic Approach
The Basic Approach
Savings Examples
• Employ technology to
fight Medicaid fraud
• Implement Reverse
Auctions
• Calibrate salt
spreaders to reduce
road costs
• Eliminate most free
postage for prisoners
• Consolidate agency
mail service
• Combine duplicative
commissions
• Consolidate highway
pipe types
• Require doubled-sided
printing
• Eliminate blank
report pages
A New Twist on Human
Services
• 19th Century Model
• “Discovery of the Asylum”
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Insane Asylums
Poor Houses
Orphanages
Penitentiary
• Year in the State Pen
vs.
Year at Penn State
Corrections
• Divert non-violent offenders
– Pretrial detention
– Misdemeanor reform
– Habitual-offender laws (“3 strikes”)
• Alternatives to incarceration
• Re-entry services
• Drug treatment
Similar Issues: MHMR, Juvenile
Services, Long-Term Care…
More Effective
Less Expensive
• Prevention
• Smaller facilities
• Promote home- and
community-based care
• Individually-targeted
• Aftercare
• Evidence-based
Less Effective
More Expensive
• Intervention arises
due to crisis
• Overemphasis on
incarceration
• Especially: Large
facility
• One-size-fits-all
• Inattention to
community/family
connections
Up Next: Education
• Distance Learning Technologies
– Improve outcomes
– Especially for current lower-performers
– Will transform role of schools, need for and
use of facilities, nature of debate (e.g.,
vouchers, home-schooling)
– Lower cost
An Ounce of Prevention
• Government intervention usually posthoc
– Ideology
– False economy
• We know better
– Policing
– Health care
Proactive = Cheaper
• Fall prevention
• Dental checks for expecting mothers
• Investment in chronic disease research
We Need More Research
• Early Childhood Ed reduces downstream
costs
• What would reduce the costs of Early
Childhood Ed?
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Parenting Instruction?
Book Rx?
Get Parents a GED?
What’s the chicken/What’s the egg?
Talkin’ ’bout de-Regulation
• False dichotomy:
– More regulation
– Less regulation
• Best example
(as usual):
Policing
One Regulatory Taxonomy
15%
Hostile compliers
30%
Hesitant compliers
30%
Clueless (‘inhabitants of the
parallel universe’)
15%
Spontaneous compliers
10%
Industry leaders
Cheaper Regulatory Strategies
• Performance Tier
• Netherlands
• Compliance
(instead of
enforcement)
• British
Commonwealth
• WA State
• Target bad
actors
• IRS
• Wisconsin
Providing Some Backbone
Providing Some Backbone
“A few of the things we use
the most are the ones we love
the least, like Facebok, which
according to ForeSee Results
holds an approval rating close
to that of the IRS.” BusinessWeek
8/16/10
Government as Backbone
• Post Office
– Public Apps: Package services
– Private Apps: Ad/coupon packages
• Public Employee Health Care Plans
– Private apps on public background:
• FEHBP
• Connecticut municipal pool
• Health exchanges?
• A Counter-Intuitive: Public Pensions?
The Life Raft
• Cut services or
raise taxes?
• Grandparents or
grandchildren?
• Public vs. Private?
• ROI
Questions?
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