Stupid or Playing Dumb?

President Obama's new budget creates a very rough outline of how he plans to make a substantial “down payment” on universal health care. The only details given are that the plan would set aside $634 billion over 10 years for health care reform, and some of that money would come from a change to tax deduction rates for families making over $250,000 a year. Obama's administration is using the estimate that universal health care reform would cost $1 trillion over ten years. (I strongly dispute this often cited figure, but that is a separate article.)

His plan for health care reform in his budget outline appears a first glance, frankly, stupid. Why make a huge “down payment” and just not go for universal reform? Why cover only 36 of the 45 million uninsured? Why link a popular plan to this specific tax increase? The Democrats have the numbers and the momentum to finally achieve a goal they have sought for decades. If they pass the first step now, there is no guarantee they will have the political power to finish the job later. Technically, there is a big difference between $635 billion and $1 trillion, but to the American people, they are both just really big numbers. Not making the health care plan universal will in the long run only make it more expensive.

It is possible that the White House is stupid, but its more likely they are a dozen steps ahead. Obama's budget for health care is probably an elaborate rouse. By giving basically no details about what a plan should look like, he can act like he is blameless while Congress is forced to make the tough choices.

The health care reform bill is probably already written by Senator Baucus and/or Senator Kennedy. While it will be changed around the edges, it is likely Obama already knows its basic shape. The bill will be more expensive than planned and probably contains a mandate even though, during the campaign, Obama laid out a health care plan without a mandate. It is even possible the deduction change to pay for it will drop. He will be able to act like he is being forced to compromise instead of breaking campaign promises he doesn't care to keep.