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Healthcare Reform - Too Big to Fail?

The opinions expressed by columnists are their own and do not necessarily represent the views of

The Washington press corps was busy last week stocking up on Red Bulls and Diet Cokes in anticipation of a late night following President Oba ma’s second prime time news conference in his short tenure. White House aides said privately they wanted to convey the image of a “calm, relaxed, and confident” commander-in-chief, whose baptism by fire with the financial crisis has only steeled his resolve and reaffirmed that his is the correct path.

Let’s suspend disbelief for the time being and assume last week’s 500 point market rally was a sign of better times for our embattled economy. What happens next with respect to Obama’s agenda? He has certainly bitten off more than he can chew, even if his Cabinet and aides feel they’re primed for bolder agenda items. One issue that will suck all of the political oxygen out of the room in the coming weeks and months is the president’s health care plan.

When he submitted his budget at the beginning of the month, Hill veterans were forced to ask where the health care specifics were located in such a large tome. No one could find any details. The proposal even listed an exact amount of $634 billion to be placed into a reserve fund. Again, with such a precise dollar amount, one would assume this amount was reached by having a clear plan of where and how the money would be spent. Apparently, details only complicate the otherwise smooth and rapid approval of boundless sacks of taxpayer money heaped on our national woes.

It’s not like health care wasn’t on Candidate Obama’s radar. He gave countless speeches on the matter with specific, concrete ideas. So why were none of them included in his budget submission? If I handed a potential buyer/customer/investor/taxpayer a plan with that enormous a price tag, it better include a detailed blueprint. Otherwise, it’s nothing more than a glorified wish list that hasn’t significantly moved this debate any further than Hillary Care in 1994.

When asked a similar question before a congressional hearing earlier this month, OMB Director Peter Orszag essentially said, “trust me, it’s all up here…E2 and then pointed to his head. Senate Finance Ranking Member Charles Grassley expressed his concern with the lack of details included in the budget and hoped that Mr. Orszag could explain more on how these “bold proposals” were going to be implemented and how the money would be spent. Unfortunately, Orszag’s response to the Senator’s concerns was that “right now, everything is on the table.”

With everything on the table, there is great potential for reform. There is also great potential for little-to-no action. A cardinal rule for understanding Congress is first grasping the concept that the institution always chooses the path of least resistance. If it can spend more to avoid controversy, it will. ;If tough decisions are required, then the body eagerly punts until after the next legislative cycle.

Certainly, Rahm Emmanuel appreciates this tenet. So why, then, did he allow his team to craft as its signature item an otherwise vague element known as the “public plan” option? Purportedly, the provision would force private health-care providers to compete with a more efficiently run delivery system not beholden to price fluctuations and available to all, regardless of their current health status. Gives you a warm, fuzzy feeling all over, doesn’t it? The error rate alone on Medicare payments hovers close to three percent. In real dollar terms, that’s over $10 billion every year. And somehow the White House now exp ects Americans to trust that they can competently keep health care affordable?

Sen. Grassley and his allies will have none of this new hybrid of voodoo economics, which brings us full circle in this new yet familiar vignette – Obama administration floats amorphous, costly proposal; the press fawns over its visionary approach; private market pans it; Republicans pile on. The only scene left to re-create is HHS Secretary Sebelius getting skewered by the Hill, which began last week with OMB’s Orzag.

Not to fear, President Obama has another sil ver bullet in the chamber and it’s called Health IT. Yes, even the local bicycle shop now keeps electronic files, and finally the government is about to come around to the notion. But arguing computerized medical records will slow costs is akin to saying automated kiosks at AMTRAK turned that industry around. It didn’t happen, because it doesn’t work that easily.

Just as it was a central theme last week during President Obama’s press conference, health care reform will continue to rise as the next major issue Americans want dealt with. It simply impacts too many facets of life - the budget, the economy, seniors, productivity, etc... I just hope the president’s team doesn’t take the same too-big-to-fail approach with the nation’s health system that it did with our banking system.

Truly the time has come where everyday Americans must begin to keep score of the many agenda items that this President is trying to initiate in this struggling economy that is headed fast towards a depression. We understand that our President inherited an economy that’s on the brink of financial collapse. We should be most concerned that this administration’s policies don’t make matters worse and extend this economic crisis for another 10 years. One needs to look no further than Japan to find a pattern between the policies and initiatives that this administration is pushing and what the Japanese initiated 10 years ago that still has their country trying desperately to move beyond their recession economy.

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