Yesterday, just days after holding a “summit” on “fiscal responsibility,” President Obama hosted another hours-long confab with a cast of thousands (ok, one-hundred and fifty), this time to talk about health-care reform.
What’s all this summitry really about?
After all, it’s obvious that nothing of any real substance was discussed at yesterday’s sessions. Indeed, the entire day seems to have been devoted to talking in generalities (“we need more prevention, better quality care, and lower costs”) about a subject that depends entirely on its details.
Nonetheless, the meeting was clearly a success for the administration because they got what they wanted from a compliant media. Bipartisanship and openness on health-care? Check. Learned lessons from the Clinton debacle? Check. Key Republicans signaling a willingness to negotiate? Check. Business support instead of opposition? Check.
But here’s an interesting question: What is the Obama health-care plan, exactly?
The Obama budget specified the “offsets” to pay for health-care reform legislation, but, with regard to the actual plan, the budget said only “TBD.”
This is, of course, the favorite White House legislative strategy of every member of Congress: The president hands off a pot of money for the Congress to spend as they see fit. Remember the “stimulus”?
This approach gives the president maximum flexibility. Whatever Congress produces, he will sign and declare victory.
The most difficult problem in health-care is what to do about rapidly escalating costs. The president and his team keep talking tough on the subject. But when is the president going to come forward with his vision for how to address it? Don’t hold your breath.
With the summit behind them, the administration is signaling that all of the action will now take place in Congress. We probably will not see anything more on the Obama “plan” before the committees start marking up a bill this summer.
Medicare and Medicaid have been run by Congress for more than four decades. The favored approach to cost control has been heavy government regulation and price setting, which has only made the programs more inefficient. Nonetheless, many Democrats in Congress believe this is the way to go for the rest of the health-care system. And the Obama administration has given them an open invitation to write a bill doing just that.
– James C. Capretta is a fellow at the Ethics and Public Policy Center. He served as an associate director at the Office of Management and Budget from 2001 to 2004.