Saturday, March 28, 2009

Obama, Doctors, and Health Reform, blogging general - Blog Delayed for Obama Book

I haven’t submitted a blog for a while for two reasons: one, my modem crashed, and I’ve been having difficulties finding a replacement; two, I’ve been putting the finishing touches on a new book Obama, Doctors, and Health Reform; The Health System, from Top-Down to Bottom-Up as Seen Through the Lens of Cultural Complexity, before sending it to the publisher.

The former is an annoying technological glitch, but it makes me realize how important the Internet is to my work. The latter has been a bitch to write because of the sprawling, comprehensive nature of the Obama initiatives.

It is tough to summarize the book. But basically I put the odds for sweeping reform, aka, universal coverage, or single-payer at 30:70, and for various incremental reforms as a slam dunk.

The White House proposal calls for an immediate expenditure of $150 billion, a ten-year savings of $253 billion, and a ten year “down payment” of $636 billion.
Frankly, I think Obama’s plans , if carried to their extreme, will cost several trillion more than estimated, but what the hell. To paraphrase the late Senator Everett Dirksen, “ A trillion here and a trillion there, and pretty soon we’re talking real money.” It is my view next year’ s federal deficit of $1.75 trillion will be too steep a hill to climb for radical reform.

As I say in my book’s foreword , “The Congressional Business Office placed an even steeper hill in front of Obama’s tax and spending plans by estimating the White House would create a budget deficit of $2.3 trillion more than Obama’s projections over the next decade. When President Obama says it may take ten years to achieve his goal of universal coverage, he’s hedging his bets.”

“In any event, in his first term, I don’t foresee how Obama can create 3.5 million jobs, redesign the health system, save the auto industry, reinvent the energy sector, revitalize the banks, and reform education with one swipe of his magic wand.”

President Obama may be good. He is certainly eloquent. But he’s not that good pr that eloquent. He is not a miracle man.

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