The $3.55-trillion budget proposed Thursday by President Obama shows his potential to be a great, activist president in the mold of Franklin Delano Roosevelt.
Now all he has to do is get his ideas through a knotted Congress in the teeth of fierce lobbying by every powerful interest group you can think of, starting with health insurance companies, drug companies and private providers of student loans.
Obama is saying that government should run government programs itself, not buck them to high-markup private firms at a cost of billions to the federal treasury. If Congress approves, Pell grants and other student loans would be handled by the Education Department, not by private firms, saving $4 billion a year. To free money for providing health coverage for more Americans, Medicare payments now going to private insurers under the so-called Medicare Advantage plans would be reduced. It's a move to the advantage of original, "straight" Medicare.
Let me here talk up my own experience: Government gets a bad rap when it comes to the efficiency of Medicare. Medicare is not your local DMV office. Straight Medicare works well. You can go to any doctor that takes Medicare patients, and most do. Payments are made quickly to the doctors, and you get a report on what's been paid on your behalf so doctors can't readily bill the government for more services than they gave you. Co-pays are reasonable. The people you deal with on the phone at Medicare are really nice, as are the Social Security people.
Medicare Advantage plans are garbage. They don't give you much more than straight Medicare, in many cases premiums are higher, and the comapanies get too much money from the goverment; Democrats have derided the plan for years as a giveaway to the private sector, done by Republicans who love the private sector dearly (and their campaign contributions).
I signed up for a Medicare Advantage plan one year but later returned to straight Medicare. One problem: I couldn't find a Medicare Advantage plan that provided any coverage beyond California, my home state. When I spent summer weeks at a cottage my wife owns in Vermont, I had no medical coverage at all; I had to pay all bills out of my own pocket.
I'd like to see the Medicare Advantage plans eliminated, but short of that, trimming their cost to the government would be a plus.
And I'm shedding no tears for the student loan providers. Their profits have been enormous and their interest rates have been too high.
A start on more health coverage, a modest growth for the Defense Department, new investments in energy and education: All these are great goals. My taxes are likely to go up under Obama's plans, but I am ready to pay them if this helps bring universal health coverage to the United States at last.
It's up to the Obama administration to fill in details with line items, which will happen in a few months. Then it's up to Congress, especially its Democratic majorities, to follow the president's breathtakingly ambitious blueprint.