Monday, April 20, 2009

Let's fast-track universal healthcare

By Robert Reich | Salon

Symbolism counts in Washington, and Obama's request that his Cabinet officers come up with $100 million in spending cuts will be played up by the White House as the beginning of a major effort to trim unnecessary government spending. It's part of the president's effort to reach out to Republicans (and calm the nerves of "blue-dog" Democrats) worried about all the money the administration has spent and still wants to spend -- $787 billion on the stimulus, $700 billion committed to the bank and auto bailouts, and, most important, $3.5 trillion for the next 10 years, including universal healthcare. Throw in the cost of a cap-and-trade system to control climate change and you're talking big money.

Over the longer term, Obama must be careful not to put entitlement programs on the chopping block as part of a "grand bargain" to elicit Republican support for healthcare and cap-and-trade. Social Security is not in dire straits; it can be made flush for the next 75 years by ever-so-slightly lifting the ceiling on the portion of income subject to Social Security payroll taxes (and if Democrats are reluctant to do that on incomes over $100,000, then they could do so on incomes over $250,000).

Medicaid and Medicare are in trouble because healthcare costs are rising so fast, which argues for healthcare reform rather than cuts in these important programs. Yet if healthcare reform has any prayer of controlling the rising tide of healthcare costs, the plan must allow beneficiaries to opt into a public insurance plan -- something Republicans and the healthcare establishment are determined to fight. So it's critically important that the Senate wrap healthcare into a reconciliation bill that can be enacted by a majority vote in the Senate.

Obama should fast-track healthcare and stop trying to court Republicans. Every House Republican and all but three Senate Republicans voted against the stimulus; all Republicans in both houses voted against the budget. During the recess they hosted "tea parties" claiming that Americans are overtaxed. Over the weekend, House Minority Leader John Boehner called the idea of carbon-induced climate change "almost comical."

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