South Dakota continues to cut a figure in national politics that one would not expect from our population or economy. Tom Daschle has accepted a position in the Obama Administration as Secretary of Health and Human Services. I quoted this passage in a previous post this afternoon, by Ezra Klein in The American Prospect:
CNN is reporting that Tom Daschle will not only be Health and Human Services Secretary, but also health reform czar under the Obama administration. This is huge news, and the clearest evidence yet that Obama means to pursue comprehensive health reform. You don't tap the former Senate Majority Leader to run your health care bureaucracy. That's not his skill set. You tap him to get your health care plan through Congress. You tap him because he understands the parliamentary tricks and has a deep knowledge of the ideologies and incentives of the relevant players. You tap him because you understand that health care reform runs through the Senate. And he accepts because he has been assured that you mean to attempt health care reform.
This certainly seems to me to be right. Daschle showed his shrewd judgment, or maybe his good luck, by joining the Obama tent rival early on. But I can't help but wonder whether that decision has more to do with the resentment he must feel for having done so much to rescue Bill Clinton during the latter's misadventures in office. Now he gets his place by the right hand of the savior.
Obama, conversely, is showing keen judgment in wanting to avoid the awful mistakes of Clinton's first term. He is tapping people who know how to get things done. Be afraid. Be very afraid. We are in for Canadian style healthcare, the sequel.
But Representative Stephanie Herseth-Sandlin (someday I will forgive her all the extra keystrokes her unnecessary name change is costing me) also ascended today. She has been elected co-chair for administration for the Democratic Blue Dog Coalition, according to the Argus Leader. The "Blue Dogs" are a group of Democrats committed to "fiscal conservatism," meaning balanced budgets and that sort of thing. With so many Democrats having been elected to represent relatively conservative constituencies, I am guessing that this group will get a little larger in the next Congress.
Here's the problem: current programs like Social Security and Medicare are already headed toward a budgetary precipice. Within a few decades, according to some estimates, these programs will consume the entire federal budget. Reforming them is almost certainly going to cost a lot of pain in reduced benefits and higher taxes and fees.
Now, what will be the fiscal consequences of a new program extending government paid health care to all Americans? Maybe a new system can remove a lot of the inefficiencies in the current system, something that large government programs are not known for. But it is not realistic to expect that such a system will not cost a lot more and require cuts in the benefits available under private healthcare. Can you really do that and make it palatable to the voters?
What is more, can you do it and satisfy the demand of the Blue Dogs for fiscal responsibility? If Obama can do all that, then maybe he is The One. The great social welfare systems of Europe were instituted in a time when populations were growing, and one could always count on waves of young to support the sick and elderly. I think those systems are in large part responsible for a half century of lethargy in the European economies. Can such a system be brought into being now? I have my doubts.
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