2nd Term Priorities

Obama's prioritization
In his 2nd-term administration
Should be making some dents
In the rising expense
Of medicine and education.

This priority shouldn't give pause
To government skeptics because
There's much to be gained
By undoing the pain
From ongoing federal laws.

President Barack Obama kicked off his second inauguration yesterday with a rousing speech of liberal policy prescriptions that he intends to pursue in his new term.  Underlying much of the rhetoric was the goal of using the social fabric and safety net to support and strengthen the American middle class.  Among the many factors that have led to the hollowing-out of the middle are the rapidly rising costs of education and healthcare.  It is education that is increasingly necessary to enter the world of steady, well-paid work, while affordable healthcare would prevent much of the undoing of employer-provided benefits that we have seen in the last generation, as well as the great number of personal bankruptcies.

To those who ask: what could the federal government possibly do to arrest these cost increases, I would say: what is it currently doing to contribute to them?  Two examples come to mind.  In education, the federal government contributes to the price spiral by providing a seemingly limitless supply of student loan funding for it.  A more discriminating, less misguidedly generous posture might be in order.  In medicine, the Medicare and Medicaid programs are the biggest contributors to the "fee for service" model that is one of the roots of healthcare inflation identified by the President.  These are just two thoughts off the top of my head; I'm sure that thoughtful policymakers could find more.

Supreme Court ACA Ruling

When the Chief Justice made a majority
To uphold the Prez' priority,
It wasn't because
Of the old commerce clause,
But the Congress' taxing authority.

In a landmark decision that delighted liberals, enraged conservatives and gave everybody something to ponder, the Supreme Court upheld President Obama's Affordable Care Act 5-4, with Chief Justice John Roberts siding with the majority - sort of. The rejectionists, led by usual swing voter Justice Kennedy, found the ACA "invalid in its entirety." The more liberal justices, led by Ruth Bader Ginsburg, sided with the President and his Solicitor General on the basis of Congress' ability to regulate interstate commerce. The Chief Justice, perhaps splitting hairs, would not validate the "commerce clause" argument, but did reason that the individual mandate in the ACA amounts to a tax, which the Congress has broad powers to impose. Part of the Court's ruling may be read as enabling the states to opt out of funding the expanded Medicaid coverage mandated by the ACA, which means that - even assuming the President is re-elected in the fall - we're not done fighting over Obamacare.

Cause of Death

Said the mayor of a municipality
Whose failure was filed with finality:
"The medical fees
Of our retirees
Were the cause of our fiscal mortality."

The city of Stockton, California is the latest US locality to conclude that the cure is worse than the disease. The city declared bankruptcy with $700 million in debt overwhelming the resources of its 300,000 residents. Among the insurmountable costs were Stockton's pension and healthcare outlays for its retired workers, along with falling property values and an expensive downtown-revitalization project. The Wall Street Journal reports that healthcare costs are expected to rise for all of the US states, regardless of the outcome of the Supreme Court decision on the Affordable Care Act, indicating much work to do to bring health care costs on a sustainable path.

GOP Deficit Reduction

House Budget Committee Chair Ryan
To balance the budget is tryin',
But without tax-rate hikes
He may cut as he likes
And fall short of the goal he's implyin'.  

The budget proposal unveiled by Rep. Paul Ryan (R., Wisconsin) serves up an unusual recipe of brutal realism and wishful thinking. On the one hand, Mr. Ryan correctly identifies healthcare spending as the element most in need of control, and makes potentially explosive changes and cutbacks to Medicare and Medicaid. On the other hand, by starting from the revenue base of the Bush tax cuts, he doesn't project a balanced budget until 2030. Even this achievement relies on such rosy assumptions as 4% unemployment and a reduction in federal spending from  24% to 14.75% of the US economy. A truly realistic plan to balance the budget will require more revenue as well as less spending.

Interest Not Yet Peaked

While growing his debt astronomic'ly,
Uncle Sam must prepare for ignominy;
As the bond int'rest cost,
Left unchecked, may exhaust
Ten percent of the US economy.  

Okay - not right away; however, the $200 billion annual interest cost on the federal debt, at current trends, could grow to 10% of US GDP by 2080, reports the Wall Street Journal.  That should be enough to focus everyone's attention on reducing the growth of Medicare, Medicaid, Social Security and defense spending.

Post Mortem in the West Wing

"With the number of seats that we lost,
The conclusion can't really be glossed:
We bungled our chance on
A cov'rage expansion
Instead of reducing the cost."

Taxes: Lost in Translation

Some studious counters of beans
Compared tax rates to national means;
They concluded that Yanks
Should certainly give thanks
To pay less than those poor Europeans.

But comparison solely on tax
Disguises some relevant facts,
Since to see an MD,
Which some countries get free,
Leaves Americans flat on our backs.  

America: It's Now or...

Said London, Pa-ree and Berlin again:  
"Those Democrats mustn't give in again.
It's better to tweak
Health reform where it's weak,  
Than to wait twenty years and begin again."

Legislative Analogy

"Say," Speaker Pelosi exuded,
When her colleagues to sausage alluded,
"If this casing we're filling
Is best after grilling,
Who cares how the wurst was extruded?"



(Special thanks to Wolfgang Babiel and his late brother Rolf, of Hallo Berlin sausage cart at 54th and 5th Ave, NYC)

Overheard in Quebec

"It's a comfort, whenever I'm sick,
Zat our système, while not magnifique, 
Is financially sound, 
Unlike zat to be found 
In l'États-Unis d'Amérique."

Will Insurance Solve the Problem?

Not to traffic with health reform cynics,
But the US needs more than just gimmicks;
We must also address
Why our health's in distress -
What we lack's not just access to clinics.

(Tip of the hat to Brett Hellerman of Norfolk Markets for his monthly commentary)