President Obama has learnt the lesson of his bailout plan: don’t leave it to Congress to write the details. Or even the outline. Let alone the dollars.
He is also right in his calculation — call it a warning to Congress — that if he doesn’t get a Bill passed by the autumn, it’s probably dead. His political capital is at an astonishing high, given the recession and the worsening job figures. His thoughtful, deliberate stand on the Middle East has helped; so has his success in persuading Congress to back the $700 billion bank bailout and $800 billion stimulus package.
But his wish list of health reforms is more formidable yet. The aim has confounded attempts by presidents as successfully as has Afghanistan foreign armies, and now has a reputation as a lethal political goal. Although the uninsured, a sixth of the population, would benefit, all taxpayers would feel the pain. Next year there will be elections for all the House of Representatives and a third of the Senate.
Obama is now scrambling back from Plan A, which was to bring all interested parties together and see what came out of it. Not enough of them are backing the part of his plan that he wants most: a government-funded insurance scheme that would compete with private ones. He wants to extend cover to the 45 million (out of 300 million) who don’t have health coverage at all. But Republicans and employers don’t like this. Nor do unions and many Democrats in Congress like another notion of taxing the healthcare benefits of those who already receive them.
Obama is so concerned about regaining the upper hand on the crafting of the plans that he has begun a tour of “town hall meetings” — resorting to his campaign technique of appealing to voters over the heads of Congress. Even though he was in Europe at the weekend, he deployed his weekly radio address to the nation to the healthcare challenge.
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Estimates put the bill for his health plans at about $1 trillion over ten years (his own figure is about two thirds of that). He suggests that he will fund this by making healthcare more efficient (good luck), squeezing growth out of the Medicare scheme for the elderly (unpopular) and ditching tax breaks for high earners. Scepticism is justified, indeed entirely proper. His best card is that by the standards of the bank bailout and stimulus, he is offering a torrent of detail. The question is whether it is one huge demand too many.