Morrison Institute for Public Policy Publications Archives

St. Luke's Health Initiatives and the Flinn Foundation strive to make Arizona a better place to live for all of its residents. Despite our state's assets, Arizona has many issues to address, with health and poverty among the most important. Our organizations have been pleased to sponsor the state capacity research that provided the background and impetus for "More Promises to Keep: Sustaining Arizona's Capacity for Welfare and Health Reform." St. Luke's Health Initiatives and the Flinn Foundation view the information and analysis provided in this report as a good way to stimulate discussion of health and welfare policy options and community actions. Research and dialogue are essential steps in the process of constructive change, as is communication with the public. We urge readers to consider the ideas presented in this paper and to continue to work together to improve the health and welfare of all Arizonans.

Though the Great Recession may be officially over, all is not well in Arizona. Three years after the collapse of a massive real estate “bubble,” the deepest economic downturn in memory exposed and exacerbated one of the nation’s most profound state fiscal crises, with disturbing implications for Arizona citizens and the state’s long-term economic health.

This brief takes a careful look at the Grand Canyon State’s fiscal situation, examining both Arizona’s serious cyclical budget shortfall—the one resulting from a temporary collapse of revenue due to the recession—as well as the chronic, longer-term, and massive structural imbalances that have developed largely due to policy choices made in better times. This primer employs a unique methodology to estimate the size of the state’s structural deficit and then explores the mix of forces, including the large permanent tax reductions, that created them. It also highlights some of the dramatic impacts these fiscal challenges are having on service-delivery as well as on local governments. The brief suggests some of the steps state policymakers must take to close their budget gaps over the short and longer term. First, it urges better policymaking, and prods leaders to broaden, balance, and diversify the state’s revenue base while looking to assure a long-haul balance of taxing and spending. And second, it recommends that Arizona improve the information-sharing and budgeting processes through which fiscal problems are understood—so they may ultimately be averted.

High costs alone are enough to make anyone dizzy. How can health care and health insurance be understood now when tight budgets are presenting tougher and tougher choices to individuals and policy makers? One answer is to step back and take another look at what quality research says about the costs and benefits of health and health insurance and match those facts and figures with experiences among Arizonans. This report does just that. It also presents recommendations that could help Arizona fare better in the coming years. Money may make the world go round, but choices determine the future. In addition to reviews of state and national economic studies, focus groups and interviews were held with metro Phoenix and metro Tucson residents who did not have, or recently lost, health insurance. Participants’ own words are used throughout the report to illustrate a variety of research findings.

This report follows The Coming of Age report produced in 2002 by some of the principals involved in this project, and published by St. Luke’s Health Initiatives. That research showed that Arizona had much to do to get ready for the baby boomer age wave. The results of Unlocking Resilience from new survey data, interviews, and secondary research indicates Arizona still has much to do to prepare for aging and must make concrete policy decisions about aging.

A series of 51 individual “stakeholder” interviews and two focus groups conducted with members of the Pima County business community in fall, 2001, documented significantly divided opinion about the likely economic impacts of the county’s Sonoran Desert Conservation Plan (SDCP). The results of the stakeholder inquiries were striking. Only one major finding reflected consensus, while several others revealed sharp differences of opinion in the business community about the potential economic impacts of the SDCP and associated initiatives.

What do we mean by "shoes waiting to drop?" We mean the trends that are already well under way — but that we can't quite see yet. These trends could overwhelm us if we don't spot them now and aggressively use our knowledge to plot our course for the future. The five "shoes" highlighted in the report are: A Talent Shake Up; Latino Education Dilemma; A Fuzzy Economic Identity; Lost Stewardship; and The Revenue Sieve.

Does H20 = Growth in Arizona? That is how many people view the water-growth equation -- any introduction of "new" water supplies inevitably stimulates population growth and economic activity. However, the report by Morrison Institute for Public Policy, Growth on the Coconino Plateau, offers some surprisingly contrary conclusions. Completed on behalf of Arizona Department of Water Resources and the Coconino Plateau Watershed, this document is relevant for all regions of rural Arizona. Among the findings: - Some rural areas in the West have constructed major water supply projects only to see most of their towns languish, not prosper. - New water infrastructure in growing rural counties hasn't affected the size so much as the pattern of new development. - Leapfrog sprawl into unincorporated areas has been discouraged in regions where cities and towns hold control over the distribution of new water supplies. Bottom line, water won't automatically produce population growth. But planning for water - how it is supplied and governed - does offer a useful tool for managing future growth. Moreover, it can provide some measure of protection for the environment. We believe this report has important application well beyond northern Arizona. By providing original research and analysis on the water-growth equation, this report helps resolve one of Arizona's most critical issues. As a result, public policy discussions in the future will be able to focus on the state's most important growth drivers and how they can be managed.

Fast Growth in Metropolitan Phoenix is the first product of a comprehensive effort to describe and analyze the region’s growth. The Brookings Institution Center on Urban and Metropolitan Policy in Washington, D.C. presented the opportunity for this project to Morrison Institute for Public Policy. The story of growth in metropolitan Phoenix is a complicated, often surprising, tale. There is much to be proud of in the region. Yet there is also much to worry about, and much that needs to be done. Hits and Misses will have been successful if it becomes a catalyst for getting started.

Aging affects all dimensions of our society, but none so much as health care. Thus, St. Luke’s Health Initiatives (SLHI) decided to dedicate part of its Arizona Health Futures program to exploring Arizona’s capacity to meet the health care demands of an aging population. SLHI asked the Arizona State University School of Public Affairs and Morrison Institute for Public Policy to collaborate on The Coming of Age to inform Arizona’s policy leaders and residents about these critical issues. The Coming of Age engaged demographers, economists, public policy analysts, human service and medical professionals and citizens. Through its research, the team developed a realistic picture of Arizona’s "capacity to care" for an elder population. The results of the research are presented in The Coming of Age: Aging, Health and Arizona’s Capacity to Care.

In February of 1998, the Pima County Board of Supervisors launched what has evolved into the Sonoran Desert Conservation Plan (SDCP) -- a comprehensive effort to protect the Sonoran Desert, guide growth and rationalize land development in the metropolitan Tucson region. Proponents of this planning process maintained that the project would reconcile conflicts between human activities and conservation, providing benefits for both wildlife and economic development. Critics, however, have increasingly alleged that implementing such an initiative will adversely affect land and housing markets, increase taxes and create problems of housing affordability. Over time a pressing need has consequently grown for objective information about the possible fiscal and economic impacts of the conservation programs being assembled by Pima County. This report addresses that need. It is a tool in the form of an impartial framework for assessment that government officials, environmentalists, business people and the general public can use for debate and decision-making.