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More Healthcare Fantasy Land


In his remarks announcing his new Surgeon General nominee this morning, President Obama said a few words about the Democrats’ health care reform effort:

Over the last several weeks, key committees in the House and the Senate have made important and unprecedented progress on a plan that will lower costs, provide better care for patients, and curb the worst practices of the insurance companies.  It’s a plan that will not add to our deficit over the next decade.  Let me repeat that:  It is a plan that will not add to our deficit over the next decade — and eventually will help lower our deficit by slowing the skyrocketing cost of Medicare and Medicaid.

To which any observer of the passing scene must say: What in the world is the president talking about? Where is the committee in the House or Senate that has offered up a bill that will not add to the deficit? What bill would that be? Even in their own terms, with all the gimmicks they’ve been able to come up with, the plans the Democrats have proposed so far are all enormously expensive, and no one has yet proposed a way to pay for them. So what is the “it” the president has in mind exactly?

Obama then launched another attack on incrementalism:

I know there are those who believe we should wait to solve this problem, or take a more incremental approach, or simply do nothing.  But this is the kind of criticism we heard when the country tried to pass Medicare, a program that is now providing quality care to generations of American seniors.  It’s the kind of criticism we heard when we tried to pass the Children’s Health Insurance Program, which has provided quality care and coverage to millions of kids.  It’s the same Washington thinking that has ignored big challenges and put off tough decisions for decades.  And it is precisely that kind of small thinking that has led us into the current predicament.

Well. The Children’s Health Insurance Program, for all its many problems, is of course precisely an example of an incremental approach, so it’s odd to see it used as a bludgeon against solving problems one by one rather than remaking the world. And as for Medicare, is that really the example we want to be using when calling for an effort to reduce costs and save our health care system? Because just two sentences later, in describing the nature of the problem to be solved, President Obama said this:

If we step back from this challenge right now, we will leave our children a legacy of debt — a future of crushing costs that bankrupt our families, our businesses, and because we will have done nothing to bring down the cost of Medicare and Medicaid, will crush our government.

So the model we should follow in solving our health care cost crisis is the program at the heart of the crisis, which threatens to “crush our government”? Will we correct past errors by repeating them? Remind me again which side in this debate is arguing for more of the same.

Never mind. “It” will take care of all that.