2016 Davis City Council Candidates Forum

Candidates Forum on Saturday/ Photo by Eunah Cho of Davis Media Access
Candidates Forum on Saturday/ Photo by Eunah Cho of Davis Media Access

On Saturday, March 12, the Davis Vanguard and Civenergy hosted the campaign’s first Davis City Council Candidates Forum.  As we now know, this forum marks the only campaign appearance of Paul Boylan, who dropped out the following day citing the health of his mother.

The forum was held at the Davis Community Church.  Also participating were Lucas Frerichs and Brett Lee, incumbents seeking reelection along with Will Arnold and Matt Williams, two challengers.  There are now four candidates for three seats as the filing period is now concluded.

The candidates asked each other one question each.  The Vanguard added two questions at the end.  And each candidate gave an introduction and conclusion.

Here is the full video recording by Davis Media Access:

About The Author

Disclaimer: the views expressed by guest writers are strictly those of the author and may not reflect the views of the Vanguard, its editor, or its editorial board.

Related posts

56 Comments

  1. The Pugilist

    Watching this video – I come away impressed with the overall focus of the candidates.  Less platitudes, more substance.  I remain sorry that Paul will not be continuing.

  2. Matt Williams

    Here’s a question to all Vanguard readers . . .

    In the last 120 days (since 12/1/2015) City Staff has presented to Council a combined projection of greater than $655 million in  unfunded liabilities for the City over the next 20 years, including $200 million for roads, $354 million for buildings and parks, and $114 million for retiree pension and health benefits.

    — Are you alarmed to find Davis has that level of unfunded liability? 

    — Given that we have a $50 million annual General Fund budget, what are the important steps/decisions that Council and Staff need to make in order to address this $30 million per year funding shortfall?

     

    1. Barack Palin

      For starters:

       

      Cut all unneeded programs

       

      Cut all unneeded jobs

       

      Get upper management and firefighters to take a pay cut

       

      Freeze all other public employee pay

       

      Get employees to share more of their pension and medical costs / maybe go to 401K retirement programs

       

      Freeze all new hiring except to replace necessary positions

       

       

      1. David Greenwald

        I hate to tell you this, but most of those things have already been done or are impossible to do. And the reality is that our unmet needs exceed our general fund budget by a large magnitude. Cuts aren’t going to solve this problem. I’m all for holding the line on spending, but we need revenue to fix this.

        1. Barack Palin

          Did you miss I stated “for starters”?

          Every savings helps, cuts aren’t the whole answer just a piece of the puzzle.

          Which of my suggestions are impossible to do?

           

          1. David Greenwald

            I didn’t miss that you stated for starters, but I don’t consider it for starters.

            We pretty much cut the programs that we felt we could cut. We reduced 100 jobs already and I don’t think we can cut any more. The firefighters are not going to take a pay cut especially since the police got a pay raise. I agree with the free other employee pay but that is hard to do when you just gave a raise. I think we now have the employees taking on the max in terms of pensions, could be wrong on that.

        2. Barack Palin

          There’s always more programs and jobs that can be cut and switching pensions to a 401k would also be a good money savings move.  I can go down the list of programs and employees and find many that aren’t essential.  It just takes someone with the cahones to make the cuts.

          1. David Greenwald

            There may be but when you have a $50 million general fund and $655 million in unmet needs/ unfunded liabilities, cuts are only going to trim around the edges

          2. Don Shor

            I can go down the list of programs and employees and find many that aren’t essential.

            And it’s almost a certainty that there are others in town who would disagree with your definition of essential.

        3. Barack Palin

          And it’s almost a certainty that there are others in town who would disagree with your definition of essential.

          And it’s also a certainty that when residents are looking at drastic tax hikes their definition of essential will evolve.

      2. Mark West

        It isn’t necessary to cut programs or services as we could outsource them instead.  We may not save much on a current year basis, but we would save considerably by getting rid of the pension and retiree healthcare costs.  We have started this on a small scale by outsourcing all the tree maintenance and the care of the smaller parks in town.  No reason why these programs could not be expanded.  I have never understood, for instance, why we need to handle fleet maintenance in-house since all of those needs are readily met by private companies in the region.

        1. hpierce

          There may be merit in specific services being “out-sourced”… yet there are others, due to ‘institutional knowledge’, being detached (yes, you can have conflicts of interest in the ‘private sector’), proximity to interaction with related function, etc., where it would be grossly inappropriate.

          “Out-sourcing” in certain cases should be up for discussion as a “tool”, but I do not see it as a “panacea”… remember the private sector also pays salaries, benefits, has administrative overhead, and profit (and taxes, to get to actual profit).  Selection of an outside firm also requires periodic RFP’s, so all firms providing the services sought have an opportunity to fairly compete to provide them.  At the end of the day, the City needs to look at effectiveness and TOTAL cost in providing services.  Not as simple as some might think.

        2. Mark West

          “At the end of the day, the City needs to look at effectiveness and TOTAL cost in providing services.”

          This is absolutely true, and something that the City needs to do even without considering outsourcing.  One of the major problems with the City’s fiscal situation now is the opaque and archaic accounting system that is currently being used, and the significant expenses that are being held off-budget.  We need a new accounting system, one where it is possible to ask the question ‘how much does it cost to provide service X,’ including the costs of pensions and retiree benefits.

          The only way to significant reduce total compensation will be to reduce the pension and retiree benefits that are currently being offered.  I doubt there is the political will to make those decisions, so the only way we will see reductions is through outsourcing.  Not a panacea by any means, but probably the only way forward at the present time.

        3. hpierce

          Mark… remember that new (and some existing) hires of the City have lower medical coverage, pension, post-retirement benefits [and increased costs for the ’employer’s share’](I’ll pass on arguing if they are now low enough), and the private sector will have them increasing due to mandatory medical coverage (and I’ll also pass on arguing the pros/cons of that).

          Full analysis, wherever that might lead…

  3. Tia Will

    City Staff has presented to Council a combined projection of greater than $655 million in  unfunded liabilities for the City over the next 20 years,”

    I agree that $ 655 million is a very large and sobering number and not to be taken lightly. However, presenting the problem in this way draws on an emotional, not a logical response to the issue. We do not have to come up with this $ 655 million dollars now. What we are charged with is finding a path towards fulfilling the payments on this amount over the next 20 years.

    Very few of us would own our homes if we had asked the question where am I going to come up with the entire price of this home now ?  Almost all of us have had to make assumptions prior to purchasing a home. And those assumptions were based on our own, not someone else’s ability to raise the money. Likewise, very few of us choose to foist our costs off onto our children When we buy, upgrade, and/or decorate our homes, we do that based on our own ability to pay for what we want. We do not assume that some future neighbor, regardless of her ability to generate more money than we do, will assume our costs for us. If we do not have the money for what we want, we either take the money from other goals or desires by choosing less expensive alternatives, or we do without. So why, do we city citizens believe that plans to have someone else pay our bills are sound strategies for our city ?

    I have stated frequently that I believe that we have the obligation to pay as we go for what we want. So in good faith, I am going to put forward my initial proposals for how I would “pay as we go”. I will however need your help. My math skills are abysmal. I am going to make my initial bid for how to generate the  $ 33 million/year needed according to this report to meet the unfunded liabilities. Someone who gets the math can help me out by telling me how much money  I have come with each proposal. Not to single anyone out….but how about you, Matt ? I will keep adding suggestions until I either meet my goal, or run out of ideas. Anyone who wants to play feel free to join in.

    1. Extend the current sales tax which will expire unless renewed. I would recommend an increase, but let’s just extend it for now and see what we get. I would not pose this as an “emergency” stop gap measure but as something that will be needed across the 20 year time span and inform people up front that depending on economic circumstances, more may be needed in the future.

    2. Charge for downtown parking during the hours of 8 am to 6 pm

    3. Increase taxes on tobacco and alcohol products and allow a vote on a soda tax. While we are at it on taxes, let the voters decide on which taxes they are willing to pay. When a fully formed idea for a tax comes forward ( such as using the Berkley model for a soda tax) we do not need the additional filter of the City Council who may or may not have ulterior motives for putting it on or keeping it off the ballot. Just let the voters decide. The voters are capable of “having a conversation” between the time of proposal and the election.

    4. A modest parcel tax. You get to decide what “modest” is and I’ll play along.

    5. We hear repeatedly that we tax for one purpose and then spend the funds on something else. How about a fresh approach ?

    Consider “go fund me” type means of raising funds for desired goals. For example, I care very much about the maintenance of our greenbelts, side walks, parks and recreational facilities….and much less so about our roads. I recognize that others feel differently. So why not post how much it would cost to restore and maintain a given piece of infrastructure,  and let people pitch in directly to meet that specific need. Then we could follow those costs directly on line. Talk about transparency !

    This could be either voluntary or a specified percentage of the parcel tax distributed to the infrastructure item of your choice, or both.

    These are just the off the top of my head musings.So if someone tells me what my short fall is, I will keep chipping away at it.  I would be interested to hear other people’s thoughts on how we might pay our own way rather than hoping that someone else will bail us out.

     

    1. Barack Palin

      However, presenting the problem in this way draws on an emotional, not a logical response to the issue. We do not have to come up with this $ 655 million dollars now. What we are charged with is finding a path towards fulfilling the payments on this amount over the next 20 years.

      I agree with this, even though I do know we have unfunded liabilities my first thought when I saw the figure of $655 million then saw it was based on a 20 year projection is it came across like fear mongering to me.

      1. Matt Williams

        BP, was Staff practicing “fear mongering” when they reported to Council that it would take $10 million per year for 20 years to keep the roads at the current level, which is 5% below the statewide average?

        Was Staff practicing “fear mongering” when they reported to Council that it would take a minimum of $37.7 million over 30 years (not including any electrical repairs) for buildings?

        Was Staff practicing “fear mongering” when they reported to Council that it would take a minimum of $3i7 million over 20 years (not including anything for pools) for parks and recreation?

        Was Staff practicing “fear mongering” when they reported in the Comprehensive Annual Report that our unfunded CALPERS pension liability is $53 million (out of a total pension liability of $182 million)?

        Was Staff practicing “fear mongering” when they reported in the Comprehensive Annual Report that our unfunded OPEB retiree healthcare liability is $61 million (out of a total OPEB liability of $70 million)?

        None of those were “fear mongering.”  They are a reality check.  Staff should be congratulated for bringing those numbers out of the shadows and into the light.  Why are you castigating them for doing so?

    2. Matt Williams

      Thank you for the thoughtful engagement Tia.  You are right, there is going to be an emotional response to “$655 million over a 20-year period.”  But is “$33 million each year for 20 years” really any different?

      Setting aside the semantics of how we describe the challenge before us, let’s look at the possibilities you have put forward.

      Extending the full 1% of the Sales Tax is almost a certainty, but as Internet sales gain a larger and larger share of consumer spending, unless the sales tax laws are modified, the revenue from Sales Tax will decline.  Page 14 of the 2015 Comprehensive Annual Financial Report (CAFR) says, “Sales tax increased $3.0 million, primarily due to the passage of Measure P, to collect an additional 1/2 cent in sales tax.”  That would mean your suggestion of extending the full 1.0% of the Sales Tax would generate approximately $6 million per year . . . all of which was included in the 2015 CAFR revenues.

      Your paid parking proposal will produce a howl of protest from many in the Davis business community whose argument will be that changing from free parking will drive their customers away.  I believe an efficiently installed and managed paid parking system can actually provide better “free” parking for the customers of Downtown businesses than the current system.  In today’s computerized cash register world, providing a rebate to a customer at the time they make a purchase to compensate them for the cost of their parking will make the parking “free.”  Once a month the business’ sales software would tally the total of the rebates provided, and submit that to the City for reimbursement from the paid parking revenues.  That means window shoppers will pay for their parking, as will entertainment seekers.  The net amount left over after the expenses are paid will go to the City coffers.  It will in all likelihood be a modest amount.

      I’m willing to get on board with your suggestion 3, but at least at present, only if the tax is handled as a Special Tax, with a clearly spelled out plan for how/where the monies are going to be spent and with a 2/3 majority vote requirement.  No general taxes.

      Given your suggestions 1, 2 and 3 above won’t generate any appreciable incremental revenue over what we have in the Budget now, a “modest” parcel tax would have to generate the full $33 million per year, which works out to approximately $2,000 per parcel per year for the approximately 16,500 parcels currently in the City.   That $2,000 per parcel per year could come down somewhat if we identify other sources of revenue and/or methods for decreasing our current level of annual expenditures.

       

       

      1. hpierce

        Matt… you forgot that paid parking increases direct costs for the systems/personnel to implement, maintain, and administer it… not likely to generate any income of significance.  Oh, and to accept it, DT businesses are on record to capture either the gross or net receipts from paid parking for DT improvement projects not currently funded.  So, either $0 net income, or an additional GF expenditure.

        Now, if we expanded it to Old East Davis, Old North Davis, the City might achieve a small positive cash flow…

        1. Tia Will

          hpierce

          Now, if we expanded it to Old East Davis, Old North Davis, the City might achieve a small positive cash flow”

          As an affected individual, I would be up for that. J and the surrounding streets are now used by many as an overflow parking for the train station. I have no problem with asking people to pay for what is at this time free car storage.

        2. hpierce

          Key words were “small” & “might”… you conveniently ignored, “that paid parking increases direct costs for the systems/personnel to implement, maintain, and administer it… not likely to generate any income of significance.”

          You picked up on my thought about ‘expanding’, and you focused on that… the most trivial (and yeah, somewhat sardonic) of my thoughts.

      2. Tia Will

        Matt

        But is “$33 million each year for 20 years” really any different?”

        I believe that it is very different. Take again the consideration of buying a house. Saying this house costs  $ 600,000 will cause some people to shy away as it being just too expensive without considering that perhaps they could  raise the downpayment of, for example $ 150,00 dollars and then be able to afford the monthly payments, perhaps by cutting back on trips, entertainment and other luxuries. If human beings only used logic in making their decisions of course they would realize that the two are factually the same, but humans frequently make their decisions based on emotion with fear being one of our primary drivers. That is why I believe that it is critically important to be clear of the time interval over which the cost is to be distributed each and every time the topic arises. Mixed statements such as discussing our yearly budget and then juxtaposing that within the same sentence with the 20 year total shortfall creates unnecessary confusion and anxiety.

         

        1. Matt Williams

          Tia, how is “$655 million over the next 20 years” any more onerous than “$33 million each year for 20 years”  It is the same amount of money and the same time period.  The only difference between the two is that 655 has been divided by 20.

          Using your analogy, we haven’t said “This house costs $600,000.”  We have said “This house costs $600,000 over the next 20 years.”

    3. Mark West

      “What we are charged with is finding a path towards fulfilling the payments on this amount over the next 20 years.”

      We know that for the roads, the $200 million over 20 years is not to repair the roads to their condition of 10 years ago, but instead to keep them from getting much worse than they are today.  The same is likely true with the rest of the infrastructure, where the estimates don’t cover the cost of solving the problems, but rather keeping things from getting much worse.  In the end, we should be considering the problem not as $33 million per year over 20 years, but that amount or more in perpetuity.

  4. Tia Will

    Frankly

    When the facts are fearful….”

    Fair enough. I understand that you believe this number to be “fearful”, but levels of fear are subjective, not fact based.   I think we need to be more specific. $ 30 million / year for approximately 70,000 people to tackle is in my eyes serious, but not “fearful”. What number of unfunded liability would be less than “fearful” for you ?

     

    1. Barack Palin

      $ 30 million / year for approximately 70,000 people to tackle

      Let’s be real here.  There’s not 70,000 people to tackle a yearly debt of that size.  35,000 are students and how much do you really think you’re going to extract out of them to fund Davis shortfalls?  The other 35,000 represents how many households?  I would guess say approx 17,000?

      So let’s do the math.

      655,000,000/20=32,750,000

      32,750,000/17000=$1926 per household per year for 20 years

      I know many if not most households can’t afford a yearly tax bill like that on top of all of the city taxes we’re already paying.

       

      1. hpierce

        Why not?  It’s only about 2.5 times what many of us are paying for the DJUSD assessments… if we eliminate those, and amortize over 30 years instead of 20, it just might be doable…

        1. Matt Williams

          pierce, the answer to BP’s and your questions can be answered by the DJUSD School Board.  If the City levies a $2,000 per parcel, 20-year Parcel Tax, what does that do to the chances of passage of the next Parcel Tax put forward by DJUSD?

        2. hpierce

          What will the effect be to the chances of any City parcel tax/assessment be if DJUSD continues or rachets up their taxes or assessments?  BP cited the increase in CITY assessments, with no acknowledgement of the DJUSD assessments.  You are doing the same.

          DJUSD has, on at least two occasions, convinced the City to do nothing, and or defer, any City assessments so they could get theirs passed.  Perhaps an “inconvenient fact”.  They have also, in the past 15 years or so, gotten the City to absorb costs for their facilities, most notably the HS parking lot.

          Had you and/or BP acknowledged the joint effect of BOTH City and DJUSD assessments on the community, I would have not posted twice in this thread.  Actually would not have posted at all.

          Both entities serve the community… both have had their challenges due to funding take-aways/diversions by the State, and the implications of Prop 13, and subsequent measures.  City roadway revenues were also diverted by the Feds and SACOG.  Yet, you and others seem to support whatever it takes “for the kids” (and teachers, Administrators, etc.).

          DJUSD, City of Davis, and Yolo County have had “rugs pulled out from them” for many years now, financially… to lay it all on the City is more than somewhat disingenuous.

        3. hpierce

          Fair enough, BP…

          Would not have posted on this matter had you said that, but not inherently your responsibility… I just am inclined to look at the entirety of the problems/challenges, and (like my dog) my hackles go up when a given entity is singled out, unless patently justified… ex.  FF salary/benefits  grossly outstripped both other City and DJUSD ones.  That would be fair… but the fact is CalSTRS and CalPERS have very similar challenges as to ‘unfunded liabilities’… City and DJUSD are “fishing in the same pond” for revenue from Davis residents… [and the State and Feds are no longer ‘stocking’ that pond…]

        4. Barack Palin

          Maybe an even more realistic choice would be per adult. 

          If you’re talking a parcel tax then per household is the only barometer to gauge.  So two wage earners means nothing.  I don’t know how you would plan to tax individuals any other way.  A soda tax or alcohol tax would never approach the amount of money needed to fund such a he shortfall.

      2. Tia Will

        BP

        OK, I agree that 70,00 was not a realistic number but I only put it out there to start the discussion. I do not think that your choice to use “household” is necessarily optimal either. Maybe an even more realistic choice would be per adult. This would allow for the fact that many households have two ( or in some cases more) wage earners. So I was running a high estimate and you are low balling. How about we meet somewhere in between, say 25000 ?

        Now we have 32,750,00/25000 = 1,310 per adult individual per year. And that is without any of the suggestions for cost savings that you made, and without any of the ideas for generation of income that I made. So maybe someone again more math savvy than I would like to factor those in. I honestly don’t believe that this is so impossible. I just believe that we are so wedded to our typical tax vs putting the cost on someone else dichotomy that we are unable to look past our typical biases let alone outside the box.

        1. Matt Williams

          Tia, for discussion purposes, consider that in your scenario, each UCD student who lives in the City is responsible for $1,310, but each UCD student who lives on campus is responsible for $0.  That seems to be a serious challenge.

    2. Matt Williams

      Tia, you answered your own question in one of your earlier comments.  You favor a “pay as you go” approach.  In that system the target value for the unfunded liabilities is zero dollars.

       

    3. Biddlin

      “Fair enough. I understand that you believe this number to be “fearful”, but levels of fear are subjective, not fact based”

      http://www.alternet.org/news-amp-politics/how-conservative-brains-are-wired-differently-and-what-means-our-politics

      http://2012election.procon.org/view.resource.php?resourceID=004818

       Psychologists have found that conservatives are fundamentally more anxious than liberals, which may be why they typically desire stability, structure and clear answers even to complicated questions. “Conservatism, apparently, helps to protect people against some of the natural difficulties of living,” says social psychologist Paul Nail of the University of Central Arkansas. “The fact is we don’t live in a completely safe world. Things can and do go wrong. But if I can impose this order on it by my worldview, I can keep my anxiety to a manageable level.”

      http://www.scientificamerican.com/article/calling-truce-political-wars/

        1. Tia Will

          BP

          Poppycock.”

          Interesting response to a post in which there are over 12 articles, some of which offer possible physiologic rather than psychological differences between self identified conservatives and liberals. Did you actually read all of the abstracts ?  If you did, do you see some of them as “poppycock” while others have merit ?  If so, could you be more specific ?  If you did not read them all, how can you pass judgement on their validity or lack thereof ?

          Please note that I am not treating you and Bidden differentially. I am making the assumption that he was merely taking a poke at your response, not making an independent judgement of content as you were.

  5. Tia Will

    BP

    There’s always more programs and jobs that can be cut and switching pensions to a 401k would also be a good money savings move.  I can go down the list of programs and employees and find many that aren’t essential.”

    You could well be right. But we wouldn’t know unless you were willing to be specific about which programs and employees you would eliminate. Since you are posting anonymously you have a safe venue in which to state your specific suggestions and those of us to whom this issue is important could then make our replies. It would make for a good conversation.

    1. hpierce

      (specifically… which) employees you would eliminate…

      Are you freaking serious?  By name?  Title?  Class?  General work group?  Nice… not…

      Particularly under the cloak of anonymity…

       

  6. Tia Will

    hipierce

    If one is willing to state that this is part of the answer to our problems, then why not be specific if one has a particular position in mind ?  If it is just a general statement, fair enough, just say so and and we can take as a philosophic preference rather than as an actual suggestion.

    1. Barack Palin

      I actually have two positions I could name right off the top of my head but that would be kind of crappy if those two people happen to read this blog, so I digress.

      1. hpierce

        Thank you for your restraint about getting “personal”, too specific, BP… I do believe “program areas” are fair game… whether that be HR, Finance, PW, “special programs” (open space, innovation center recruitment, etc), Planning, Building, Parks, CMO, Public Safety, etc.

        What I sensed from what was written before was more like trying to identify deletions by “name, rank, serial number”… that to me, is offensive and inappropriate.  At least in a ‘public forum’ such as the VG…

    2. hpierce

      Simply, Tia, is that I believe employees should be protected from random animus from the general public… at least by name and position… ex.:  someone doesn’t like the way a staff member wrote a staff report for ‘project X’… because the recommendation ran counter to the public member’s opinion/preference?… is it appropriate to use the VG to suggest/demand that individual staff member being fired/laid-off?  If you believe it’s appropriate, I’d suggest a certain editorial board member of the VG voluntarily resign from that position.

      BP has shown what I believe to be appropriate restraint.

      Public employees (and retired employees) already have their full names, positions, salaries/pensions, benefits easily available on the “net”… which may well have led to “mining” of this data by solicitors/scam artists… all in the name of “transparency”… how would you feel if your data were similarly on the “net”, for all to see (Kaiser is a major provider to PERS, and its member agencies, who are compensated by taxpayers, so I don’t think this is a real “stretch”)… if you have a disgruntled patient, would you want a call for your ‘termination’ to be out on the “net”?

  7. Tia Will

    Matt

    That seems to be a serious challenge.”

    I agree. And there are serious challenges with all options. There are no guarantees any way that one looks at this issue. MRIC was proposed at least in part as an expansion space for Schilling Robotics which is now apparently ( I heard this but have not independent confirmed it) laying off some workers rather than expanding. The once thriving Carrier, a major manufacturer of air conditioning and subsidiary of United Technologies is laying off 1,400 manufacturing blue collar workers in order to move their plant to Mexico. That’s quite a challenge for the people losing their jobs and their families and the community. The existence of manufacturing space is not a guarantee of prosperity for Davis or any other community. It might be successful, it might not. But to only point out the “serious challenges” of options one does not favor while painting in rosy tones the options one does like is, in my opinion, an error.

     

  8. Tia Will

    Matt

    Using your analogy, we haven’t said “This house costs $600,000.”  We have said “This house costs $600,000 over the next 20 years.”

    I think that your proficiency with numbers and analytic nature may be deceiving you about how many of those of us who do not share these abilities view the world. While I agree with your statement, I think that many people view the cost of a home in terms of the entire $600,000, but view their salary as how much they make in one year ( say $100,00 0) rather than the equally true statement that if that remains constant over time, they will make two million dollars over the 20 year period. Clearly enough to pay off the mortgage as long as your interest rate is reasonable. 

    Easy enough to think through ( or have a realtor and/or loan agent walk you through) when purchasing a house. Much, much more complicated and yes, potentially fear inducing when we are talking about all of the variables involved in the finances of a city. My point is not that any one is “fear mongering” but rather a call for consistency in the discussion. Either we are talking about annual costs, or we are talking about costs over 20 years. But for purposes of clarity and logical processing of information rather than creating drama and emotional responses, we should not be mixing the two time frames in the same sentence as David has done on occasion.

    1. Matt Williams

      Tia said . . . “Either we are talking about annual costs, or we are talking about costs over 20 years.”

      Tia, when you talk to a patient of yours who has developed adult onset diabetes, do you talk to her about the the life style changes they are going to have to adopt and the  insulin that they are going to have to take for a month?  Or for a year?  Or for the rest of her life?

      The duration of the course of treatment is just as important as the individual periodic treatment dose.

      1. Tia Will

        Matt

        when you talk to a patient of yours who has developed adult onset diabetes, do you talk to her about the the life style changes they are going to have to adopt and the  insulin that they are going to have to take for a month?  Or for a year?  Or for the rest of her life?”

        I talk to her about all of them. But I do not mix them all up in the same sentence and then expect her to figure out which are applicable to what time frame. Nor do I mix cost to her immediately with the toll which may be accrued across her entire lifetime.

        1. Matt Williams

          We are going to have to agree to disagree. I will rest my case with two examples from your profession.

          First, when you write a prescription you include both dosage and duration.  If you fail to include both, the patient will not be able to get the prescription filled when they take it to their pharmacy.

          Second, when you prescribe birth control pills to one of your patients you discuss (a) dosage, (b) duration, and (c) consistency/regularity/diligence.  If you don’t discuss all three of those parameters, then there is real risk that the treatment regimen will have periods of time where the realities of Mother Nature will rule the day.

  9. Biddlin

    “. I am making the assumption that he was merely taking a poke at your response”

    Indeed, I was torn between balderdash and my late Pater’s favourite, hooey, settling on the former because it seemed more temporally akin to the the transgender/trans-racial avatar’s profound retort.

    Gudawnya for reading the links, too.  More and more studies confirm the earlier physiological findings.

  10. Tia Will

    Biddlin

    The scientific connection between brain structure, neurotransmitter variation and the behavioral expressions of these differences is in its infancy. I consider this one of the most exciting ares of current behavioral research. What I anticipate is that there will be many theories that will be developed which will not bear up under future scrutiny. There will also be those who will interpret research findings to strengthen their current biases. However, that is an argument for rigorous study design, reproducibility of findings and vigorous peer review. It is not an argument for being dismissive of studies because they do not align with your personal viewpoint.

    1. Biddlin

      “The scientific connection between brain structure, neurotransmitter variation and the behavioral expressions of these differences is in its infancy.”

      Yes, but with time and research, we may be able to help those overburdened by complex reasoning and addicted to fear. (LOL)
      By the way, evolution seems to be favouring those who prefer reason over reaction.

Leave a Reply

X Close

Newsletter Sign-Up

X Close

Monthly Subscriber Sign-Up

Enter the maximum amount you want to pay each month
$ USD
Sign up for