Funding Delayed Is Funding Denied

The reaction from pundits and editorial pages to President Obama’s healthcare reform plan is beginning to trickle in. The New York Times likes it:

Mr. Obama’s proposals provide a firm basis for both the Senate and House to move forward with comprehensive reforms. If the Republicans resort to filibusters to block passage, the Democrats should use a budget reconciliation procedure that requires only a majority vote for passage in the Senate.

wishing for more of the items from the House’s more progressive bill:

The president’s proposals are far from perfect. We wish he had included a public plan. And we regret that he accepted the Senate’s decision not to require employers to provide insurance. He would boost the payments required of employers whose workers end up needing public subsidies to help them buy their own coverage.

and carefully eliding over the proposal’s manifest shortcomings.

The Washington Post considers those shortcomings head on:

But just because both flanks are unhappy doesn’t mean Mr. Obama has found the right mix. The changes the administration suggests to the Senate-passed measure heap more dessert on an already calorie-laden plate; the 10-year cost would be $950 billion, the White House says, about $70 billion more than the Senate’s approach. Meanwhile, the time for eating spinach would be pushed off even further.

As David Brooks correctly notes, the decision to delay funding the White House’s more generous bill may well be a decision not to fund it at all:

On Monday, the White House made another compromise. On the surface, it seems mundane. The imposition of the excise tax will be delayed until 2018, and the threshold at which the tax kicks in will be raised. In reality, the delay turns the tax into another Washington gimmick. Lord, give me virtue, but not yet.

The odds are high that the excise tax will never actually happen. There is no reason to think that the Congress of 2018 will be any braver than the Congress of today. It will probably get around the pay-go rules or whatever else might apply and it’ll postpone the tax again. The excise tax will turn into another “doc fix.” This is a mythical provision in which doctors are always about to get their reimbursements cut. But somehow they never do because the cuts are always pushed back, year after year.

So we’ve sunk another level in our tawdry tale. The White House, to its enormous credit, has tried to think about the long term. But it has been dragged ever lower into the mire by Congressional special interests that are parochial in the extreme.

This bill may be deficit-neutral on paper. But it has just become a fiscal time bomb. The revenue will never come. Compromises have to be made to keep it (barely) alive. But responsibility ebbs. Politics wins.

The correct balance and the only one that will deal forthrightly with the most pressing of the problems with our healthcare system is one that, while poisonous to Congress, is well known to every parent: “Eat your vegetables or no dessert!”

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