Comeback America by David M. Walker

Author:David M. Walker
Language: eng
Format: mobi
Tags: U.S. Government, Debt, Fiscal policy
ISBN: 1400068606
Publisher: Random House
Published: 2010-01-12T07:00:00+00:00

OBAMA’S REFORMS

As I write this, the pressure is on the Obama administration to do something. Underinsured Americans and their underfinanced local and state governments are all looking to Washington for a way out of this national health care mess.

The political debate has become as frenzied as it was the last time a Democratic president proposed a major health care reform. President Clinton’s attempt in the early 1990s, led by First Lady Hillary Clinton, failed to make it far in Congress. That effort was brought down in part by the very effective “Harry and Louise” ads, sponsored by insurers, showing a middle-class couple despairing over the bureaucratic complexities of Clinton’s plan. Now we have Obama’s opponents charging that he will convene “death panels” to grant or withhold treatment for gravely ill Americans. This is a gross misrepresentation of the legislative proposals and amounts to nothing more than a scare tactic.

The truth is, Obama’s proposals at most would add a federal health insurance program only as an alternative to the private system we already have. We could all keep our family doctors and avoid bureaucrats, staying far from the reach of any “death panel.”

Ignore all that political noise. Obama’s commitment to comprehensive health care reform is a good sign. It puts him ahead of his predecessor in this regard. But will he make sure that his proposals are fiscally responsible and sustainable—and not just for ten years? A study commissioned by the Peterson Foundation has shown that while many of the health care reform proposals being considered by the Congress don’t pay for themselves even over ten years, the financing gap worsens beyond the ten-year time frame. In the final analysis, any effort to expand coverage without transformational reforms that significantly shrink the federal financial hole and seriously reduce the rate at which our total costs as a percentage of the economy are growing would be imprudent.

My greatest fear is that the Obama administration and Congress will enact universal health care coverage without making a significant down payment on the $38 trillion of unfunded Medicare benefits that we already have, and without ensuring that the plan will actually contain total health care costs. Yes, we need comprehensive health care reform. However, any such reform should help us get out of our fiscal mess while improving the equity and outcomes of today’s system. Those goals are not always so obvious in the wonderland of Washington.

We must avoid any temptation to add a new wing onto our existing health care house (system), which is already structurally unsound and headed for foreclosure. That is what some are proposing in Washington, and it’s not only imprudent, it’s irresponsible.

Our nation got into deep trouble by promising more health care than it could deliver. That approach has given Americans one of the most expensive systems in the world with among the least impressive results. My greatest hope is that we have begun to understand the predicament we are in and will come together to fix the system.

The outline of a reform program is clear.

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