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And Then the Trillion Dollar Healthcare Plan’s Going to Pay for Everthing Else!

David Brooks suggests the entire Obama domestic agenda is built on a giant falsehood, or a big “whoops” to say the least. He explains:

The government now borrows $1 for every $2 it spends. A Treasury bond auction earlier this month went poorly, suggesting the world’s hunger for U.S. debt is not limitless. President Obama has been thrown back on his original theory. If he is going to sustain his agenda, if he is going to prevent national insolvency, he has to control health care costs. Health care costs are now the crucial issue of his whole presidency.

So to make the whole thing work, healthcare reform has to be a big cost-saver, you see. What?! It’s going to cost a fortune (a trillion maybe), you say. Well yes, and that’s the problem — the huge problem. As Brooks explains, all the cost-savings notions are of questionable value and in any event, cost a lot up front. So the upshot:

The likely outcome of this year’s health care push is that we will get a medium-size bill that expands coverage to some groups but does relatively little to control costs. In normal conditions, that would be a legislative achievement.

But Obama needs those cuts for his whole strategy to work. Right now, his spending plans are concrete and certain. But his health care savings, which make those spending plans affordable, are distant, amorphous and uncertain. Without serious health cost cuts, this burst of activism will hasten fiscal suicide.

Well, shouldn’t we be doing something about that? Perhaps ending the silly dog-and-pony photo-ops and having some heart-to-heart talks with the American people. Maybe we should explain that the money has already been spent — on junk (e.g. a stimulus bill that won’t stimulate and a jumbo budget without a single meaningful cut).

It might be smart to look at alternative plans that don’t involve expanding coverage by government fiat. We could for example open up interstate health insurance sales, allow small business to create insurance-purchasing pools and begin to transition from an employer-provided to individual-purchased healthcare system. All of those would be prudent moves.

But we’re not doing any of that. So what does that say about the president — who was going to dispense with ideology and govern on the basis of “pragmatism”? I’m not exactly sure what pragmatism means as a governing philosophy, but it’s not promising everyone healthcare with money we have already spent. And if this president was supposed to usher in a “new era of responsibility,” I don’t see how we wound up with a fiscal policy that is the equivalent of going to Vegas with the grocery money.

Maybe, just maybe, this is not the pragmatic or responsible administration we were promised. If we had that sort of administration we wouldn’t be digging our fiscal graves.



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