Startling revelations sometimes turn up in unexpected places. For instance, one of the nation's most thoughtful, influential liberals recently conceded in a New York Times book review that Democratic plans for health care reform could well wreck the U.S. economy but he insisted that the achievement would be worth the cost.
Robert Reich, who served as Bill Clinton's Labor Secretary and now teaches public policy at Berkeley, praised the new book The Heart of Power: Health and Politics in the Oval Office which described 60 years of efforts to expand the government role in medical care. Concerning authors David Blumental and James A. Morone, Reich baldly declared that their most provocative finding is that presidents who have been most successful in moving the country toward universal health coverage have disregarded or overruled their economic advisers. Plans to expand coverage have consistently drawn cautions or condemnations from economic teams in every administration, from Harry Truman's down to George W. Bush's.
Neither Reich, nor the authors he cites, chose to challenge this bipartisan consensus from both Democratic and Republican economists over some six decades. Instead, The Heart of Power highlights the shameless effort by Lyndon Johnson to conceal the true costs of Medicare in order to secure its passage in 1965. In a taped conversation with Senator Ted Kennedy, the president attacked his own economic advisors because the fools had to go to projecting those costs down the road five or six years. LBJ deliberately misled the public by lowballing the amount of money that taxpayers would need to spend to secure health coverage for senior citizens, contradicting the official economic estimates and intentionally distorting the truth. Ill spend the goddamned money, he indignantly (though privately) declared. As Secretary Reich admiringly insisted: An honest economic forecast would most likely have sunk Medicare.
He continued with the hugely damning admission that economists have always had a point when they cautioned against expansion of government spending for health care. Its not so much that presidential economic advisers have been wrong in fact, Medicare is well on its way to bankrupting the nation but that they are typically in the business of thinking small and trying to minimize risk, while the herculean task of expanding health coverage entails great vision and large risk. Economic advice is important, but its only one source of wisdom.
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