Radical Surgery for Health Care

Republicans who went ballistic over the stimulus bill had better check their blood pressures for the Big One--the taxing and spending the Administration wants in order to revolutionize American health care.

"President Obama," the Washington Post reports, "intends to release a budget tomorrow that creates a 10-year, $634 billion 'reserve fund' to partially pay for a vast expansion of the U.S. health care system, an overhaul that many experts project will cost as much as $1 trillion over the next decade."

The New York Times adds: "President Obama will propose further tax increases on the affluent to help pay for his promise to make health care more accessible and affordable...That plan, coming after recent years in which more wealth became concentrated at the top of the income scale, introduces a politically volatile new edge to the emerging Congressional debate over the new president’s top domestic priorities."

The surprise here is that, with his reputation for pragmatism and prudence, the President seems to have decided to go for broke on health care reform now instead of, as Congressional Democrats have suggested, moving "incrementally" during the economic crisis.

The mother of all legislative battles will have Republicans screaming "socialized medicine" over a proposed cap on itemized tax deductions for couples earning more than $250,000 a year to raise a $634 billion “reserve fund” for broadening health care coverage, along with ending billions of dollars in Bush-era subsidies to insurance companies under the Medicare Advantage program.

Drug company lobbyists will go berserk over a proposal to increase the rebate for medications sold to Medicaid patients from 15 percent to 21 percent, and hospitals will hate a new flat-fee plan to keep them from profiting on readmission of Medicare patients within 30 days of discharge, as they now do.

In any case, the "Harry and Louise" commercials that killed the Clintons' reform efforts in 1993 won't work in a time when Americans are worried about much more than having the government involved in doctor-patient relationships.

This time, if the health care industry wants to hold onto its bloodsucking profits, they and their Republican allies will have to offer substantive arguments to an all-out Obama offensive for some of the reforms that are long overdue.