Barack Obama is a politician who likes to follow through on long-term strategies and avoid making course corrections. That’s how he believes he won in 2008, and since then he’s shown that he’s not much into details.
So he was happy to let congressional appropriators fill in the blanks in the 2009 stimulus package, and to let congressional leaders know he would be happy whether there was or wasn’t a public option in the 2010 health insurance legislation. Whatever. In the long run, the big things would work out his way.
Except right now they aren’t. And his partisan and petulant speech last Wednesday is unlikely to move things in the direction he wants.
Even as he was speaking, Congress was moving toward passing the fiscal year 2011 appropriations agreed to by congressional negotiators with only occasional input from the White House. The deal will substantially reduce spending below levels what he and leading Democrats used to call unacceptable.
Speaker John Boehner was criticized by some on the right for not pressing for deeper and more permanent cuts in spending than the $38 billion he claimed. But the deal nonetheless passed both houses by wide margins, and it contains some details that threaten to undermine the policies of the Obama Democrats in the future.
Most important, it requires the General Accounting Office to conduct an audit of the waivers from the Democrats’ health care bill that are being issued in large numbers by the secretary of health and human services.
This will raise an uncomfortable question. If Obamacare is so great, why are so many trying to get out from under it? And, more specifically, why are so many Democratic groups trying to get out from under it?
The fact is that HHS Secretary Kathleen Sebelius has granted more than 1,000 waivers from Obamacare. Many have been granted to labor unions. Some have been granted to giant corporations like McDonald’s. One was granted to the entire state of Maine.
By what criteria is this relief being granted? That’s unclear, and the GAO audit should produce some answers. But what it looks like to an outsider is that waivers are being granted to constituencies that have coughed up money (or, in the case of Maine, four electoral votes) to the Democrats.
If so, what we’re looking at is another example of gangster government in this administration. The law in its majesty applies to everyone except those who get special favors.
The GAO has also been ordered to produce audits on the effect of Obamacare on health insurance premiums. This is likely to reveal that the president did not keep his promise that you could keep your current health insurance if you want to.
And there will be an audit of the comparative effectiveness bureaucracy established in the 2009 stimulus package. Comparative effectiveness is supposedly an objective study of which medical techniques are most effective. But anyone who looks closely finds that the experts are constantly changing their minds, which suggests that this is more alchemy than science — and maybe political favoritism, as well.
All of which tends to undercut the thrust of Obama’s obviously-aimed-at-the-2012-campaign message: We can continue to fund Medicare and Medicaid indefinitely if we just tax rich people a little more.
Serious budget experts of all stripes know this is fantasy. Obama’s fiscal commission, which issued its report last December, recognized this clearly, and recommended a package of spending cuts, program changes and tax increases to address the long-term fiscal dilemma.
House Budget Committee Chairman Paul Ryan, in his budget resolution that passed the House Friday, put forward a package of changes that included giving the states block grants for Medicaid and replacing the current Medicare fee-for-service with the kind of premium support recommended by the bipartisan Medicare commission more than a decade ago — all without tax increases.
The voters, in current polls as well as in the elections last November, sent the policymakers down these paths. Obama on the one hand allows congressional Democrats to negotiate packages like the 2011 budget deal that go in that direction — and at the same time says, incoherently and without detail, that we don’t need to go there at all.
In all this he is acting on the assumptions that Americans will accept a permanently enlarged and more expensive government and that the details don’t much matter.
The 2010 elections refuted the first assumption. Now we’ll see about the second.
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