Critical Condition

Deficit Disconnect

Bob Samuelson has a pretty devastating takedown of the president’s proposed health overhaul in today’s Washington Post.  He makes two points, in particular, that bear repeating. First is the point I made on Friday that the president’s spending policies, on health care as well as in other areas, contradict what Samuelson calls his “cautionary message” on deficits. As Samuelson puts it, “The disconnect between what President Obama says and what he’s doing is so glaring that most people could not abide it.”

The second point is that while the current health proposals would reduce the number of the uninsured, they will not bring down costs and therefore do not constitute real health reform. Samuelson cites a number of studies finding “that various congressional plans would increase national health spending compared with the effect of no legislation.” I fear that if the Democratic effort passes, we will need to reopen this issue again in a very short time to address the cost issue in a serious way. And the second time will be harder, as the benefits we have to give in terms of expanded coverage will have already been doled out. In other words, there will be no spoonful of sugar to make the cost medicine go down.  

This benefits-first approach is in fact the opposite of reform. As Samuelson concludes: “If new spending commitments worsen some future budget or financial crisis, Obama’s proposal certainly won’t qualify as “reform,” as the president and The Post (also in its news columns) call it. It’s more like malpractice: a self-inflicted wound.”

Tevi Troy is a presidential historian and former White House aide. His latest book is Fight House: Rivalries in the White House from Truman to Trump.