One can’t help but think there is considerable danger in Barack Obama’s unswerving determination to alter the nation’s health care landscape at what may be a cost most Americans can’t even fathom.
The president’s zeal is impressive. It is the passion of a true believer who sees a country in which no one is without medical insurance as key to restoring the economy even as the national debt approaches unimaginable dimensions and some of his most ardent supporters are beginning to wonder how to pay for such an ambitious goal.
Should employer-provided health benefits be taxed as regular income to those receiving them? Should Medicare and Medicaid payments to hospitals and doctors be curtailed? Should there be an overall income tax increase, not just one aimed at those who are in the top one percent bracket? Should there be a national value added tax on goods with revenues earmarked for health care? Or is it possible that all of the above will be needed to support what easily could amount to a multi-trillion dollar expenditure over the next decade and apparently still not reach everyone now uninsured?
As the Congress wrestles with competing plans and ideas, one thing seems certain — the impact of a final solution without the utmost care easily could be catastrophic, leaving us struggling for generations to find the wherewithal to meet the rest of the country’s needs from the schoolhouse to the battlefield. As Federal Reserve Chairman Ben Bernanke warned recently, the resulting impact of spending on the debt could dramatically interrupt economic recovery. And the Congressional Budget Office has reported that the White House proposals are likely to dig us further into debt without some very painful spending controls.
Obama has been running around the country plugging his initiative and using his personal charisma to assure Americans that while it won’t be easy to manage, in the long run overhauling the hugely complex system that supplies this most basic of needs — viable health care — is absolutely necessary. His is a "Dr. Feel Good" lecture, which includes large doses of "everything will be just fine" medicine. No one is arguing about the nobility of his proposals just their viability in the face of high cost bailouts, two overseas battlefronts and the possibility there quickly could be a third if North Korea’s nuclear saber rattling becomes more than that.
But the White House believes — despite all the growing signs of doubt — there may never be a better time to accomplish what several past administrations could not, that this president’s approval ratings and overwhelming majorities in the Congress will make it so. They may be right but from a political standpoint, the fact that this and other domestic spending plans are expected to cause us to borrow $9 trillion over the next 10 years has begun to raise alarms among Democrats at both ends of Pennsylvania Avenue — Capitol Hill and the White House.
The president’s continued hold on long term approval ratings will undoubtedly depend on how he deals with the spending questions and whether his party in Congress can add to a succession of election victories in next year’s midterm balloting. A recent vote in the House on funding for Iraq and Afghanistan was much closer than expected with 32 Democrats voting against it even after House Speaker Nancy Pelosi strongly pleaded the president’s cause.
There is, of course, another problem when it comes to raising money for the health care plans. Republicans are likely not to support major tax increases, although some, including Sen. John McCain, have been among those suggesting taxing insurance benefits. Democrats don’t want to go it alone when it comes to paying the bills for all this new spending. Then there are the older folks who might see some decline in their Medicare benefits if doctors and hospitals get their payments cut. Their lobby is still politically potent.
The president wants to have this all wrapped up and on his desk and signed by mid-fall. Well, he may have the votes to do it, but the ultimate cost to his political fortunes could give him a headache. But why should he be any different than the rest of us?
(E-mail Dan K. Thomasson, former editor of the Scripps Howard News Service, at thomassondan(at)aol.com.)