Swinging for the fences: Obama’s trillion-dollar healthcare gamble

Sure, George W. Bush might have doubled the national debt while he was president, but — I think you will agree — there were extenuating circumstances of the first order.

Even so, what started out as a highly principled “all-in-this-together” fight against worldwide terror somehow morphed into a cartoonish Mexican standoff with his own Republican Congress at the other end of Pennsylvania Avenue.
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Bush would not veto any of those porked-up, GOP-crafted spending bills in exchange for keeping his stateside Capitol Hill troops fat, happy, on board and silent about their disillusionment with the war and an occupation that they, too, like most of the country, had increasingly come to see as ill-conceived and ineptly implemented.

Having a seat at the grown-ups’ table for a nice little game of White House extortion must have seemed empowering to the former GOP revolutionaries who had long ago run out of gas, but it came with an expensive price tag for the nation. Red-inked spending bills as far as the eye could see and a trillion-dollar war of questionable worth. Ka-ching! Ka-ching!

To be sure, President Obama, with his trillion-dollar plan to reform American healthcare, could very easily be on his own course of doubling the debt once again. But let’s be fair here.

After all, like it or not, the nation hired Obama fully aware of his big, bold, new — and potentially expensive — ideas. Then, together, and in real time, we all got a James Cameron-like view of the iceberg of an economic crisis that had ripped a huge chunk of hull out of the American ship of state.

After scrounging around for more TARP money, a 2009 catch-all omnibus spending bill, a $787 billion stimulus bill, and then some coin to keep the car companies afloat (for a few months, anyway), President Obama had a decision to make — go forward with his plan for reforming healthcare, or continue kicking the can down the road. Given the severe economic realities, a little more can-kicking would have been an acceptable, safe path of political least resistance.

On Monday, Obama decided he was going to swing away, touting his plans for a big, bold, trillion-dollar healthcare reform plan during a very-well received speech before the American Medical Association (AMA) in Chicago.  

Saying “we cannot let this moment pass us by,” Obama gave a congressional shout-out to Rep. Earl BlumenauerEarl BlumenauerHere are the 95 Democrats who voted to support impeachment Overnight Defense: House approves 3 billion defense bill | Liberal sweeteners draw progressive votes | Bill includes measure blocking Trump from military action on Iran House approves defense bill after adding liberal sweeteners MORE (D-Ore.), who apparently gave Obama a magazine piece titled “The Crisis in American Medicine.”

“One article notes ‘soaring charges.’ Another warns about the ‘volume of utilization of services.’ And another asks if we can find a ‘better way [than fee-for-service] for paying for medical care.’ It speaks to many of the challenges we face today. The thing is, this special issue was published by Harper’s magazine in October of 1960,” Obama said.

“I am here today because I do not want our children and their children to still be speaking of a crisis in American medicine 50 years from now,” Obama said.





Spendthrift-in-chief?



Speaking of the hefty cost of his plan, during his weekly Saturday radio address, President Obama stressed that the trillion-dollar price tag would be mostly offset by savings he could find elsewhere and therefore would not add to the deficit over the next decade.

Obama said his green-eyeshade guys had already identified how to pay for “the historic $635 billion down payment” for his plan, including over $300 billion in savings that could be had by reducing Medicare overpayments to private insurers and rooting out waste in both Medicare and Medicaid.

Not to be too snarky about it, but “waste, fraud and abuse” have always been fair game — and immediate money on the balance sheet for politicians of all stripes when the numbers for their highfalutin plans don’t quite add up. And that could certainly be the case this time around as well.

But during his Saturday radio address, Obama said he would find another $313 billion in savings from “common-sense changes,” like being able to cut government spending on prescription drugs by getting drug makers to pay “their fair share” and providing a system free of “unnecessary hospital stays, treatments and tests that drive up costs.” All points he also underscored during the AMA speech in Chicago.

Republican critics, of course, are hoping this Obama 2009 effort on healthcare goes the way Hillarycare did in 1993, with equal fallout at the polls in the off-year elections of 1994, when Republicans recaptured the House and Senate, repeating in 2010.

A little too speculative and premature for any of that kind of 2010 talk just yet, but what is not speculative is the fact that Chicago White Sox fan Obama has made a clear decision that his will not be a “small ball” presidency, but one that will be all about swinging for the fences.



You can reach Jim Mills at
jmills@thehill.com.