League of Women Voters of California Education Fund
Alameda County, CA November 6, 2012 Election
	Marilyn M. Singleton, MD Answers Questions Candidate for United States Representative; District 13

The questions were prepared by the League of Women Voters of California Education Fund and asked of all candidates for this office.
Read the answers from all candidates (who have responded).

Questions & Answers

1. In this time of high unemployment, what are the most important steps that should be taken to improve our nation’s economy?

Anti-business rhetoric does not get us jobs. Take away the businesses and what do you have? No products, no jobs, no benefits, no taxes, no money to spend in our community.

The role of the federal government should be to encourage growth. Washington does not create jobs. Oakland received $649,446,655.63 in Stimulus funds, yielding 913 jobs. That is more than $700,000 per job. Moreover, the Stimulus package emphasized federal, state, and local government jobs - not private sector jobs. It is laudable to save essential public services. However, always keep in mind that with government jobs, the taxpayers are paying the salary, benefits and pensions for these jobs.

A better value for the taxpayer is to focus on private-sector jobs. What Washington can do is create a business-friendly environment that will create jobs. Job creation happens when business owners are released from excessive taxation and red tape. Additionally, competition is increased when businesspersons know that Washington is not playing favorites.

First, regulations have gotten out of hand. Since 2009, federal agencies have issued 75 major regulations (those with an economic impact of $100 million or more). We don't want to put profit ahead of safety, but the ever-increasing number of rules cost businesses $1.7 trillion annually. Businesses with less than 20 employees carry the biggest burden: $10,500 per employee. Unnecessary regulations discourage new business and drive small businesses out of the market.

The solution here is to ensure that Congress, the legislative body, is the originator of laws. Regulations must be assessed for their effectiveness, cost/benefit ratio, and unintended consequences. If an agency passes greater than $100 million in new regulations, Congress should be accountable. It should have hearings, presentation of evidence that the regulation is effective, and vote on it.

Second, taxation must be addressed. All taxpayers are overburdened. Payroll taxes are a huge burden to low-income workers. We work almost half the year just for taxes. This gives more money to feed Washington's bureaucracy. The U.S. corporate tax is twice the world average and now is the highest in the world. It is no wonder that corporations keep their cash out of the country. Excessive corporate taxation destroys jobs, entrepreneurship, and innovation. Corporations pass their tax burden through higher prices to the consumer lower wages to workers, and/or lower returns to investors. If a high corporate tax rate reduces employment, the individual income tax receipts are reduced. Reducing the federal corporate tax rate by 10% of more would generate higher economic growth and ultimately more jobs and income.

Third, we must repatriate cash. New products require money to take the risk on new ideas. There is $1.4 trillion overseas. Of the $312 billion that was repatriated in 2004, $73 billion was used to create or retain jobs, $75 billion was used to finance new capital spending, and $39 billion was used to pay down domestic debt.

Finally, we need to get more teens into the workforce. Teen unemployment is 24 percent. I advocate exempting teens from the federal minimum wage law. No - I am not advocating slave labor! With the federal minimum wage, fewer young people get hired and get their all-important job experience. Young workers learn skills along with how to be punctual and other workplace manners. And importantly, early work experience gives pride and self-respect.

2. How should the federal budget deficit be addressed, now and into the future? How should budget priorities for defense and domestic programs be adjusted?

Washington is bloated with overhead, eating up our tax dollars and racking up $2 million of debt per minute. Children are born $50,000 in debt. We have to do something now!

We are willing to pay our taxes but want government to give us value for our tax dollars. Washington can't keep spending more money than it takes in. When anything fails in Washington, the answer is more government and more money. The 2011 budget deficit is $1.6 trillion. Congress has to make hard choices. The Debt Commission's recommendations have been largely ignored. Now people need accountability. We realize that there is no free lunch.

To address any budget changes, we have to note that federal spending is divided into three categories: discretionary spending, mandatory spending, and net interest. Social Security and Medicare make up the bulk of mandatory spending. Other mandatory spending programs where budget authority is provided by appropriation Acts include Safety Net Programs as Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and some veterans' benefits. These make up about 14% of the budget.

Discretionary spending is provided and controlled through appropriations acts. This includes executive branch, international, and defense (or security) spending. Only about 1/3 of the budget is discretionary spending.

It would be difficult to reduce the federal deficit significantly by cutting only discretionary spending. Social Security, Medicare, and Medicaid accounted for over 43% of total federal outlays in 2010. Thus, the task is to limit spending in these programs without prejudicing low-income individuals and vulnerable seniors.

Eliminate Waste

Washington should start by cleaning house. The GAO has determined that Washington wastes $200 billion per year on overlapping agencies and programs. For example, there are 15 agencies that oversee food safety laws. The Department of Education spent $59 billion last year. What do we have to show for it? Ten agencies track "teacher quality" with 82 programs. That should be the concern of the school district, not the federal government. Government auditors between 2004 and 2009 examined all federal programs and found that 22% of them, costing taxpayers a total of $123 billion annually, did not show any positive impact on the populations they serve.

We must consolidate, reorganize, and eliminate agencies, boards, and commissions. We have to design policies that have local decision-making and address local circumstances.

No Bail-outs or Subsidies

The business that makes terrible decisions will correct itself or it will fail. Replacing the business with government control does not do away with failure and mismanagement; it removes the possibility of self-correction. Moreover, bail-outs place the consequences of risky business on the shoulders of the public (through their tax dollars).

Many farm subsidies go to farms that are wealthier than the taxpayer. Ethanol subsidies have doubled corn prices. Many of the tax breaks for oil are no longer necessary. We should eliminate government research into fossil fuels, enhanced oil recovery tax credits as many of these techniques are no longer used, and marginal well production credits as this is a preferential credit.

Balanced Approach to Retirement Peace of Mind

Social Security takes up about 20 percent of Washington's budget. We all want the peace of mind of these programs to which we have contributed over the years. But they have to be reformed to stay solvent, keeping in mind that we live 20 years longer than the average American did when the Social Security program was started. We should do the following:

• Guarantee to current beneficiaries and those age 55 and older that there would be no changes to the system they anticipate receiving.
• Eliminate the income cap from the current $106,000.
• Raise the age by 2 years now and periodically evaluate.
• Means-test for benefits.
• Decouple Social Security from Medicare. As it is now, if you do not want Medicare as your health insurance, you lose your Social Security benefits.
• Give individuals options: Make changes to expand options, but not take anything away. This gives ownership, control and freedom.
• Option: Raise limits on contributions to IRAs. We need to encourage savings. People cannot live well on Social Security alone.
• Option: Personalize Social Security accounts. Instead of Washington making all the decisions, each person would personally determine how a portion (perhaps 5%) of his or her retirement savings would be invested. There could be limits on the type of account: money market, government bonds, AAA rated corporate bonds. This has been successful in Galveston, Texas, yielding more retirement income than Social Security at all income levels.

Patient-Centered Approach to Medicare

Medicare (14% of budget) has to be reformed as people are living longer. Life expectancy was 70 years when Medicare was started. Now it is 78 years.

• First and foremost, decrease payment error rate, waste, and inefficiencies.
• Decouple Social Security from Medicare. Then patients would be able to stay on private insurance programs without having to give up their Social Security benefits.
• Increase Part B premiums and part A deductible in a means-tested fashion. These premium payments are already considered offsets to the amount budgeted.
• Make medical costs transparent. Patients would be motivated to shop around for routine services. Physicians would be free to repackage and re-price their services -- thus profiting from innovations that lower costs and raise the quality of care.
• Give individuals options:
• Option: Workers (along with their employers) could save and invest about 4% of wages in tax free accounts - eventually reaching the point where the average person in each generation of retirees pays for his own post-retirement medical care.
• Option: Allow physicians to accept private payment for Medicare-covered services.

Medicaid

Medicaid (9% of budget) would be changed to block grants or capped allotments to the states instead of the current federal matching system. This would have minimal paperwork. The federal government would give a specified sum to the state per person who qualifies for Medicaid. It is then up to the state to allocate the funds. Some states' plans that give patients vouchers to purchase private insurance have worked well.

Defense

As a share of GDP, defense discretionary expenditures have trended downwards since the height of the Vietnam War in the late 1960s (10% of GDP). It was 20 percent of the budget (4.7% of GDP) in 2010. The CBO is projecting that the overseas spending will fall as the Middle East wars wind down. However, Defense and Security still need adequate funding for benefits for retired military with disabilities, and the projected increased health care costs for the wounded, and mental health and traumatic head injury service members. While the military must not invest in equipment that is no longer useful, it must have adequate funds to explore new technology that could save lives in other conflicts.

3. What are your priorities with respect to our nation’s energy policy? Should there be an emphasis on clean energy and reducing carbon emissions, and/or on reducing our dependence on foreign sources?

We need to start large-scale conversion from fossil fuel to non-polluting oil-free energy sources - on a level playing field. This goal must be balanced with the choice of giving up our computers, cell phones and other items that suck up energy and leave waste when they are disposed of.

First, we cannot jettison present technology while we are developing cleaner alternate fuel sources. Washington should remove barriers to responsible development of domestic resources. The ability to produce clean-burning natural gas from shale has transformed the economy of Pennsylvania and North Dakota. And replacing dirtier coal and gasoline with natural gas would reduce overall U.S. carbon dioxide emissions by about 25%. The EPA concluded in 2004 there were no significant environmental risks from hydraulic fracturing but launched a new study in 2010 to specifically study the connection between "fracking" and water contamination. That report is expected in 2014. In the meantime, approval of the Keystone pipeline should move forward.

Second, we cannot have the government picking winners and losers. Sometimes the favorite turns out to be a loser (as in Solyndra). More innovative solutions might be developed if they are given a fair chance to enter the market. Alternate sources are not without their own problems. These problems should be worked out before making a national policy regarding the use of one energy source. Just look at the problem with compact fluorescent bulbs and their hazardous waste disposal. Solar panels in the Mojave Desert are killing tortoises. Ethanol subsidies have raised the price of corn, thus raising the price of meat here.

Third, there should be periodic reviews of regulations with a cost/benefit analysis, assessment of the effectiveness and unintended consequences, using specific criteria. The regulations should have no loopholes or liability shields. The regulations must ensure the actual polluter is held responsible for harm done and not impose financial burdens on those who are good stewards.

4. What, if any, changes should be made to federal health care policies or programs?

The Patient Protection and Affordable Care Act (PPACA) is not affordable. In 1967, the House Ways and Means Committee said Medicare would only cost $12 billion in 1990. The actual cost was $110 billion. In 2010, total Medicare expenditures were over a half a trillion dollars.

Here, the PPACA has creative accounting. For example, the "Doc Fix", i.e., increase in physician Medicare payments, was achieved in a separate bill. Four years of taxes kick in before the benefits accrue. So the cost projections are really almost $1 trillion for 6 years, not 10 years. The withdrawal penalty on Health Savings Accounts (HSA), i.e., savings with pre-tax dollars, is raised from 10% to 20%. HSAs can no longer be used for nonprescription meds. The Flexible Spending Account (FSA) cap was lowered from $5,000 to $2,500. Itemized deduction floor for medical expenses was raised from 7.5% to 10%.

Patient-centered healthcare means giving patients quality, affordability, and control. We must add transparency of costs, and reinstate choice and common sense:

• Make sure insurers have appeal process for claim and coverage denials.
• Increase, rather than decrease amounts eligible for HSAs. This gives consumers "more skin in the game" and incentive to stay healthy.
• Studies show that when people have policies that have lower premiums and more out of pocket, expenditures are reduced by 4-15% in the first year. Annual costs are reduced by 3 to 5 thereafter. Expenses are 45% higher with free care than for plans with 95% coverage and $4,000 deductible.
• Give individuals more options: Allow catastrophic health insurance plans for all. The PPACA only allows this for people under 30.
• Rating smokers, overweight persons, motorcyclists makes economic sense. Why should those who have better health habits pay more to subsidize those who don't?
• Keep high-risk pools for those with pre-existing conditions.
• Allow insurance companies to sell policies across state lines--something that is now illegal and impedes competition. This will give consumers more options and drive prices down.
• Institute malpractice reform in federal programs. Half of healthcare is delivered by government programs. Defensive medicine has been estimated to cost between $100 - 210 billion a year. If evidence-based medicine is presumed the standard of practice by the government, then it should be a defense to malpractice in government programs.

Reform Medicare and Medicaid (23% of budget)

Medicare has to be reformed as people are living longer. Life expectancy was 70 years when Medicare was started. Now it is 78 years.

• First and foremost, decrease payment error rate,waste, and inefficiencies.
• Decouple Social Security from Medicare. Then patients would be able to stay on private insurance programs without having to give up their Social Security benefits.
• Increase Part B premiums and part A deductible in a means-tested fashion. These are already considered offsets.
• Make medical costs transparent. Patients would be motivated to shop around for routine services. Physicians would be free to repackage and re-price their services -- thus profiting from innovations that lower costs and raise the quality of care.
• Give individuals choice:
• Option: Workers (along with their employers) could save and invest about 4% of wages in tax free accounts -- eventually reaching the point where the average person in each generation of retirees pays for his own post-retirement medical care.
• Option: Allow physicians to accept private payment for Medicare-covered services.

Medicaid would be changed to block grants or capped allotments to the states instead of the current federal matching system. This would have minimal paperwork. The federal government would give a specified sum to the state per person who qualifies for Medicaid. It is then up to the state to allocate the funds. Some states' plans that give patients vouchers to purchase private insurance have worked well.

5. What, if any, changes should be made to federal rules on campaign financing?

Free speech is a core value of our country. Freedom of association and the right of people to join together to magnify their political voices is also at the core of the First Amendment. The Supreme Court, thirty-five years ago noted that a major purpose of the First Amendment was "to protect the free discussion of governmental affairs."

But the "pay to play" aspect of elections has gotten out of hand. Even when bashing corporations, historically politicians seek financing from unions, corporations, and non-profit organizations. So far this year, unions have spent $9.7 million, individuals, $6.4 million, and corporations, $3.4 million. It seems that more time is spent fundraising than solving problems. When solutions are advanced, we don't know if they are coming from the minds of our elected representative or directly from the pens of a special interest group.

Smaller donations presumably do not lend themselves to corruption as readily as large donations. But small donations depend on name recognition.

Political Action Committees (PACs) allow pooling of large sums. Arguably, the government has a compelling interest in eliminating PACs and giving the people their individual voices back. On the other hand, some PACs are made up of those ordinary folks who otherwise would have no voice. But we cannot make a rule that could pick winners and losers among PACs. If there are limits put on for-profit corporations, there must also be limits on other advocacy groups. Even as a "little guy" who is hurt by the big money system, I am wary of selective censorship. As the ACLU has noted, "The first target of censorship is rarely the last."

Possible Solution: Currently the disclaimer on union, corporate, and advocacy group ads is 4 seconds long and "readable." Why not make the disclaimer on advocacy ads longer, in larger print and specifically state that it is an ad by a self-interested group who wants to influence Congress?

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Responses to questions asked of each candidate are reproduced as submitted to the League.  Candidates' statements are presented as submitted. References to opponents are not permitted.

Read the answers from all candidates (who have responded).

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Created from information supplied by the candidate: October 24, 2012 16:59
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